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Kim J, Chu D, Jeon H. Reliability and validity of the L test in participants with chronic stroke. Physiotherapy 2015; 101:161-5. [DOI: 10.1016/j.physio.2014.09.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2013] [Accepted: 09/23/2014] [Indexed: 10/24/2022]
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Functional Electrical Stimulation–Assisted Active Cycling—Therapeutic Effects in Patients With Hemiparesis From 7 Days to 6 Months After Stroke: A Randomized Controlled Pilot Study. Arch Phys Med Rehabil 2015; 96:188-96. [DOI: 10.1016/j.apmr.2014.09.033] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Revised: 09/24/2014] [Accepted: 09/25/2014] [Indexed: 11/21/2022]
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53
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Bower KJ, McGinley JL, Miller KJ, Clark RA. Instrumented static and dynamic balance assessment after stroke using Wii Balance Boards: reliability and association with clinical tests. PLoS One 2014; 9:e115282. [PMID: 25541939 PMCID: PMC4277284 DOI: 10.1371/journal.pone.0115282] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 11/21/2014] [Indexed: 12/02/2022] Open
Abstract
Background and Objectives The Wii Balance Board (WBB) is a globally accessible device that shows promise as a clinically useful balance assessment tool. Although the WBB has been found to be comparable to a laboratory-grade force platform for obtaining centre of pressure data, it has not been comprehensively studied in clinical populations. The aim of this study was to investigate the measurement properties of tests utilising the WBB in people after stroke. Methods Thirty individuals who were more than three months post-stroke and able to stand unsupported were recruited from a single outpatient rehabilitation facility. Participants performed standardised assessments incorporating the WBB and customised software (static stance with eyes open and closed, static weight-bearing asymmetry, dynamic mediolateral weight shifting and dynamic sit-to-stand) in addition to commonly employed clinical tests (10 Metre Walk Test, Timed Up and Go, Step Test and Functional Reach) on two testing occasions one week apart. Test-retest reliability and construct validity of the WBB tests were investigated. Results All WBB-based outcomes were found to be highly reliable between testing occasions (ICC = 0.82 to 0.98). Correlations were poor to moderate between WBB variables and clinical tests, with the strongest associations observed between task-related activities, such as WBB mediolateral weight shifting and the Step Test. Conclusions The WBB, used with customised software, is a reliable and potentially useful tool for the assessment of balance and weight-bearing asymmetry following stroke. Future research is recommended to further investigate validity and responsiveness.
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Affiliation(s)
- Kelly J. Bower
- University of Melbourne, Department of Physiotherapy, Melbourne, VIC, Australia
- Royal Melbourne Hospital – Royal Park Campus, Department of Physiotherapy, Melbourne, VIC, Australia
- Australian Catholic University, School of Exercise Science, Melbourne, VIC, Australia
- * E-mail:
| | | | - Kimberly J. Miller
- University of British Columbia, Department of Physical Therapy, Vancouver, BC, Canada
| | - Ross A. Clark
- Australian Catholic University, School of Exercise Science, Melbourne, VIC, Australia
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Benito García M, Atín Arratibel MÁ, Terradillos Azpiroz ME. The Bobath Concept in Walking Activity in Chronic Stroke Measured Through the International Classification of Functioning, Disability and Health. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2014; 20:242-50. [DOI: 10.1002/pri.1614] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Revised: 05/21/2014] [Accepted: 08/21/2014] [Indexed: 11/06/2022]
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Reynolds AM, Peters DM, Vendemia JMC, Smith LP, Sweet RC, Baylis GC, Krotish D, Fritz SL. Neuronal injury in the motor cortex after chronic stroke and lower limb motor impairment: a voxel-based lesion symptom mapping study. Neural Regen Res 2014; 9:766-72. [PMID: 25206888 PMCID: PMC4146271 DOI: 10.4103/1673-5374.131589] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2014] [Indexed: 01/08/2023] Open
Abstract
Many studies have examined motor impairments using voxel-based lesion symptom mapping, but few are reported regarding the corresponding relationship between cerebral cortex injury and lower limb motor impairment analyzed using this technique. This study correlated neuronal injury in the cerebral cortex of 16 patients with chronic stroke based on a voxel-based lesion symptom mapping analysis. Neuronal injury in the corona radiata, caudate nucleus and putamen of patients with chronic stroke could predict walking speed. The behavioral measure scores were consistent with motor deficits expected after damage to the cortical motor system due to stroke. These findings suggest that voxel-based lesion symptom mapping may provide a more accurate prognosis of motor recovery from chronic stroke according to neuronal injury in cerebral motor cortex.
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Affiliation(s)
- Alexandria M Reynolds
- Department of Psychology, Barnwell College, University of South Carolina, Columbia, SC, USA
| | - Denise M Peters
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA
| | | | - Lenwood P Smith
- Neurosurgery Center, University of South Carolina School of Medicine, Columbia, SC, USA
| | - Raymond C Sweet
- Neurosurgery Center, University of South Carolina School of Medicine, Columbia, SC, USA
| | | | - Debra Krotish
- University of South Carolina School of Medicine, Columbia, SC, USA
| | - Stacy L Fritz
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA
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Pin TW. Psychometric properties of 2-minute walk test: a systematic review. Arch Phys Med Rehabil 2014; 95:1759-75. [PMID: 24814460 DOI: 10.1016/j.apmr.2014.03.034] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Revised: 02/24/2014] [Accepted: 03/12/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To systematically review the psychometric evidence on the 2-minute walk test (2MWT). DATA SOURCES Electronic searches of databases including MEDLINE, CINAHL, Academic Search Premier, SPORTDiscus, PsycINFO, EMBASE, the Cochrane Library, and DARE were done until February 2014 using a combination of subject headings and free texts. STUDY SELECTION Studies were included if psychometric properties of the 2MWT were (1) evaluated; (2) written as full reports; and (3) published in English language peer-reviewed journals. DATA EXTRACTION A modified consensus-based standard for the selection of health measurement instruments checklist was used to rate the methodological quality of the included studies. A quality assessment for statistical outcomes was used to assess the measurement properties of the 2MWT. DATA SYNTHESIS Best-evidence synthesis was collated from 25 studies of 14 patient groups. Only 1 study was found that examined the 2MWT in the pediatric population. The testing procedures of the 2MWT varied across the included studies. Reliability, validity (construct and criterion), and responsiveness of the 2MWT also varied across different patient groups. Moderate to strong evidence was found for reliability, convergent validity, discriminative validity, and responsiveness of the 2MWT in frail elderly patients. Moderate to strong evidence for reliability, convergent validity, and responsiveness was found in adults with lower limb amputations. Moderate to strong evidence for validity (convergent and discriminative) was found in adults who received rehabilitation after hip fractures or cardiac surgery. Limited evidence for the psychometric properties of the 2MWT was found in other population groups because of methodological flaws. CONCLUSIONS There is inadequate breadth and depth of psychometric evidence of the 2MWT for clinical and research purposes-specifically, minimal clinically important changes and responsiveness. More good-quality studies are needed, especially in the pediatric population. Consensus on standardized testing procedures of the 2MWT is also required.
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Affiliation(s)
- Tamis W Pin
- Department of Rehabilitation Science, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong.
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Oczkowski W. Pharmacological therapies to enhance motor recovery and walking after stroke: emerging strategies. Expert Rev Neurother 2014; 13:903-9. [PMID: 23965164 DOI: 10.1586/14737175.2013.814940] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Stroke is the most common serious neurological disorder. To date, the focus for research and trials has been on prevention and acute care. Many patients are left with serious neurological impairments and limitations in activity and participation after stroke. Recent preliminary research and trials suggest that the brain is 'plastic' and that the natural history of stroke recovery can be improved by physical therapy and pharmacotherapy. Motor weakness and the ability to walk have been the primary targets for testing interventions that may improve recovery after stroke. Physical therapeutic interventions enhance recovery after stroke; however, the timing, duration and type of intervention require clarification and further trials. Pharmacotherapy, in particular with dopaminergic and selective serotonin-reuptake inhibitors, shows promise in enhancing motor recovery after stroke; however, further large-scale trials are required.
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Affiliation(s)
- Wieslaw Oczkowski
- Department of Medicine, McMaster University, Population Health Research Institute, Hamilton General Hospital, ON, Canada.
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Silva PFS, Quintino LF, Franco J, Faria CDCM. Measurement properties and feasibility of clinical tests to assess sit-to-stand/stand-to-sit tasks in subjects with neurological disease: a systematic review. Braz J Phys Ther 2014; 18:99-110. [PMID: 24839043 PMCID: PMC4183244 DOI: 10.1590/s1413-35552012005000155] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Revised: 08/19/2013] [Accepted: 11/11/2013] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Subjects with neurological disease (ND) usually show impaired performance during sit-to-stand and stand-to-sit tasks, with a consequent reduction in their mobility levels. OBJECTIVE To determine the measurement properties and feasibility previously investigated for clinical tests that evaluate sit-to-stand and stand-to-sit in subjects with ND. METHOD A systematic literature review following the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) protocol was performed. Systematic literature searches of databases (MEDLINE/SCIELO/LILACS/PEDro) were performed to identify relevant studies. In all studies, the following inclusion criteria were assessed: investigation of any measurement property or the feasibility of clinical tests that evaluate sit-to-stand and stand-to-sit tasks in subjects with ND published in any language through December 2012. The COSMIN checklist was used to evaluate the methodological quality of the included studies. RESULTS Eleven studies were included. The measurement properties/feasibility were most commonly investigated for the five-repetition sit-to-stand test, which showed good test-retest reliability (Intraclass Correlation Coefficient:ICC=0.94-0.99) for subjects with stroke, cerebral palsy and dementia. The ICC values were higher for this test than for the number of repetitions in the 30-s test. The five-repetition sit-to-stand test also showed good inter/intra-rater reliabilities (ICC=0.97-0.99) for stroke and inter-rater reliability (ICC=0.99) for subjects with Parkinson disease and incomplete spinal cord injury. For this test, the criterion-related validity for subjects with stroke, cerebral palsy and incomplete spinal cord injury was, in general, moderate (correlation=0.40-0.77), and the feasibility and safety were good for subjects with Alzheimer's disease. CONCLUSIONS The five-repetition sit-to-stand test was used more often in subjects with ND, and most of the measurement properties were investigated and showed adequate results.
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Affiliation(s)
- Paula F. S. Silva
- Rehabilitation Sciences Graduate Program, Universidade Federal de
Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | | | - Juliane Franco
- Physical Therapy Department, UFMG, Belo Horizonte, MG, Brazil
| | - Christina D. C. M. Faria
- Rehabilitation Sciences Graduate Program, Universidade Federal de
Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
- Physical Therapy Department, UFMG, Belo Horizonte, MG, Brazil
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Silva PFS, Quintino LF, Franco J, Faria CDCM. Measurement properties and feasibility of clinical tests to assess sit-to-stand/stand-to-sit tasks in subjects with neurological disease: a systematic review. Braz J Phys Ther 2014; 18:99-110. [PMID: 24839043 PMCID: PMC4183244 DOI: 10.1590/s1413-35552012005000155%20%20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Revised: 08/19/2013] [Accepted: 11/11/2013] [Indexed: 10/16/2023] Open
Abstract
BACKGROUND Subjects with neurological disease (ND) usually show impaired performance during sit-to-stand and stand-to-sit tasks, with a consequent reduction in their mobility levels. OBJECTIVE To determine the measurement properties and feasibility previously investigated for clinical tests that evaluate sit-to-stand and stand-to-sit in subjects with ND. METHOD A systematic literature review following the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) protocol was performed. Systematic literature searches of databases (MEDLINE/SCIELO/LILACS/PEDro) were performed to identify relevant studies. In all studies, the following inclusion criteria were assessed: investigation of any measurement property or the feasibility of clinical tests that evaluate sit-to-stand and stand-to-sit tasks in subjects with ND published in any language through December 2012. The COSMIN checklist was used to evaluate the methodological quality of the included studies. RESULTS Eleven studies were included. The measurement properties/feasibility were most commonly investigated for the five-repetition sit-to-stand test, which showed good test-retest reliability (Intraclass Correlation Coefficient:ICC=0.94-0.99) for subjects with stroke, cerebral palsy and dementia. The ICC values were higher for this test than for the number of repetitions in the 30-s test. The five-repetition sit-to-stand test also showed good inter/intra-rater reliabilities (ICC=0.97-0.99) for stroke and inter-rater reliability (ICC=0.99) for subjects with Parkinson disease and incomplete spinal cord injury. For this test, the criterion-related validity for subjects with stroke, cerebral palsy and incomplete spinal cord injury was, in general, moderate (correlation=0.40-0.77), and the feasibility and safety were good for subjects with Alzheimer's disease. CONCLUSIONS The five-repetition sit-to-stand test was used more often in subjects with ND, and most of the measurement properties were investigated and showed adequate results.
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Affiliation(s)
- Paula F. S. Silva
- Rehabilitation Sciences Graduate Program, Universidade Federal de
Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | | | - Juliane Franco
- Physical Therapy Department, UFMG, Belo Horizonte, MG, Brazil
| | - Christina D. C. M. Faria
- Rehabilitation Sciences Graduate Program, Universidade Federal de
Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
- Physical Therapy Department, UFMG, Belo Horizonte, MG, Brazil
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Carvalho C, Sunnerhagen KS, Willén C. Walking performance and muscle strength in the later stage poststroke: a nonlinear relationship. Arch Phys Med Rehabil 2012; 94:845-50. [PMID: 23219614 DOI: 10.1016/j.apmr.2012.11.034] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Revised: 11/02/2012] [Accepted: 11/16/2012] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To evaluate the relation between muscle strength in the lower extremities and walking performance (speed and distance) in subjects in the later stage poststroke and to compare this with normative data. DESIGN A cross-sectional observational study. SETTING University hospital department. PARTICIPANTS Subjects poststroke (n=41; 31 men, 10 women) with a mean age of 59±5.8 years and a time from stroke onset of 52±36 months were evaluated. An urban sample (n=144) of 40- to 79-year-olds (69 men, 75 women) formed the healthy reference group. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Muscle strength in the lower extremities was measured with an isokinetic dynamometer and combined into a strength index. Values for the 30-meter walk test for self-selected and maximum speed and the 6-minute walk test were measured. A nonlinear regression model was used. RESULTS The average strength index was 730±309 in the subjects after stroke compared with 1112±362 in the healthy group. A nonlinear relation between walking performance and muscle strength was evident. The model explained 37% of the variance in self-selected speed in the stroke group and 20% in the healthy group, and 63% and 38%, respectively, in the maximum walking speed. For the 6-minute walk test, the model explained 44% of the variance in the stroke group. CONCLUSIONS Subjects in the later stage poststroke were weaker than the healthy reference group, and their weakness was associated with walking performance. At the same strength index, subjects walked at lower speeds and shorter distances after stroke, indicating that there are multiple impairments that affect walking ability. Treatments focused on increasing muscle strength thus continue to hold promise.
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Affiliation(s)
- Cristiane Carvalho
- Section of Clinical Neuroscience and Rehabilitation Medicine, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
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