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Son CH, Sim GW, Kim K. A Study on the Effects of a Self-Administered Eye Exercise Program on the Balance and Gait Ability of Chronic Stroke Patients: A Randomized Controlled Trial. J Pers Med 2024; 14:595. [PMID: 38929816 PMCID: PMC11204622 DOI: 10.3390/jpm14060595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Revised: 05/14/2024] [Accepted: 05/31/2024] [Indexed: 06/28/2024] Open
Abstract
This study investigates the effects of a self-administered eye exercise (SEE) program on the balance and gait ability of chronic stroke patients hospitalized due to hemiplegia. This study includes 42 patients diagnosed with stroke-related hemiplegia and hospitalized at D Rehabilitation Hospital. The researcher randomly allocated 42 patients into two groups: the experimental group (EG, n = 21, mean age = 58.14 ± 7.69 years, mean BMI = 22.83 ± 2.19 kg/m2) and the control group (CG, n = 21, mean age = 58.57 ± 6.53 years, mean BMI = 22.81 ± 2.36 kg/m2). The SEE program was applied to the EG and the general self-administered exercise (SE) program was applied to the CG. After 4 weeks of intervention, weight distribution of the affected side, the Timed Up and Go test (TUG), step length of the affected side, step length of the unaffected side, gait speed, and cadence were analyzed and compared. In the within-group comparison, both groups showed significant differences in weight distribution (p < 0.05), TUG (p < 0.05), step length of the affected side (p < 0.05), step length of the unaffected side (p < 0.05), gait speed (p < 0.05), and cadence (p < 0.05). In the between-group comparison, a significant difference in the TUG (p < 0.05) was observed. The SEE program had an overall similar effect to the SE program in improving the balance and gait ability of chronic stroke patients, and had a greater effect on dynamic balance ability. Therefore, the SEE program can be proposed as a self-administered exercise program to improve balance and gait ability in stroke patients who are too weak to perform the SE program in a clinical environment or have a high risk of falling.
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Affiliation(s)
| | | | - Kyoung Kim
- Department of Physical Therapy, College of Rehabilitation Science, Daegu University, Gyeongsan 38453, Republic of Korea; (C.-H.S.); (G.-W.S.)
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Egger M, Finsterhölzl M, Buetikofer A, Wippenbeck F, Müller F, Jahn K, Bergmann J. Balance function in critical illness survivors and evaluation of psychometric properties of the Mini-BESTest. Sci Rep 2024; 14:12089. [PMID: 38802388 PMCID: PMC11130260 DOI: 10.1038/s41598-024-61745-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 05/09/2024] [Indexed: 05/29/2024] Open
Abstract
Critical illness survivors commonly face impairments, such as intensive care unit-acquired weakness (ICUAW) which is characterized by muscle weakness and sensory deficits. Despite these symptoms indicating potential balance deficits, systematic investigations and validated assessments are lacking. Therefore, we aimed to assess balance function using the Mini-BESTest, evaluate its psychometric properties, and identify associated variables. Balance was assessed post-ICU discharge (V1) and at discharge from inpatient neurorehabilitation (V2) in patients with ≥ 5 days of invasive ventilation. Mini-BESTest measurement characteristics were evaluated in an ambulatory subgroup. A multiple linear regression was conducted. The prospective cohort study comprised 250 patients (34% female, 62 ± 14 years, median ICU stay 55 days). Median Mini-BESTest scores improved significantly from V1 (5 (IQR 0-15)) to V2 (18.5 (10-23)) with a large effect size. Excellent inter-rater and test-retest reliabilities of the Mini-BESTest were observed (ICC = 0.981/0.950). Validity was demonstrated by a very high correlation with the Berg Balance Scale (ρ = 0.90). No floor or ceiling effects were detected. Muscle strength, cognitive function, cerebral disease, critical illness polyneuropathy/myopathy, and depression were significantly associated with balance. Despite significant improvements during the rehabilitation period, balance disorders were prevalent in critical illness survivors. Ongoing therapy is recommended. Due to its excellent psychometric properties, the Mini-BESTest is suitable for use in critical illness survivors.Registration: The study was registered at the German Clinical Trials Register (DRKS00021753, date of registration: 2020-09-03).
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Affiliation(s)
- Marion Egger
- Research Group, Department of Neurology, Schoen Clinic Bad Aibling, Kolbermoorer Str. 72, 83043, Bad Aibling, Germany.
- Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Faculty of Medicine, LMU Munich, Pettenkofer School of Public Health, Munich, Germany.
| | - Melanie Finsterhölzl
- Research Group, Department of Neurology, Schoen Clinic Bad Aibling, Kolbermoorer Str. 72, 83043, Bad Aibling, Germany
| | - Alisa Buetikofer
- Research Group, Department of Neurology, Schoen Clinic Bad Aibling, Kolbermoorer Str. 72, 83043, Bad Aibling, Germany
| | - Franziska Wippenbeck
- Research Group, Department of Neurology, Schoen Clinic Bad Aibling, Kolbermoorer Str. 72, 83043, Bad Aibling, Germany
| | - Friedemann Müller
- Research Group, Department of Neurology, Schoen Clinic Bad Aibling, Kolbermoorer Str. 72, 83043, Bad Aibling, Germany
| | - Klaus Jahn
- Research Group, Department of Neurology, Schoen Clinic Bad Aibling, Kolbermoorer Str. 72, 83043, Bad Aibling, Germany
- German Center for Vertigo and Balance Disorders, University Hospital Grosshadern, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Jeannine Bergmann
- Research Group, Department of Neurology, Schoen Clinic Bad Aibling, Kolbermoorer Str. 72, 83043, Bad Aibling, Germany
- German Center for Vertigo and Balance Disorders, University Hospital Grosshadern, Ludwig-Maximilians-Universität München, Munich, Germany
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Ikeda N, Sakurai M, Yamada E, Gotoh S, Tanabe N, Hayashi Y, Matsushita I. Factors associated with independent ambulation at 3 months after putaminal hemorrhage: an observational study. J Phys Ther Sci 2024; 36:167-174. [PMID: 38562533 PMCID: PMC10981957 DOI: 10.1589/jpts.36.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 12/30/2023] [Indexed: 08/30/2024] Open
Abstract
[Purpose] This study was aimed at evaluating the clinical indicators for predicting ambulation at 3 months after putaminal hemorrhage. [Participants and Methods] The participants were 84 inpatients with putaminal hemorrhage. The patients' background characteristics and computed tomography findings at the time of the onset of putaminal hemorrhage were obtained from their medical records. Impaired consciousness, severity of hemiplegia, higher brain dysfunction, sensory impairment, activities of daily living, and ambulatory ability were evaluated. Logistic regression analysis was performed to identify factors associated with ambulation at 3 months, and receiver operating characteristic curve analysis was conducted to determine the predictive value of the identified factors and the optimal cut-off values. [Results] Ventricular rupture, severity of hemiplegia (determined using the 12-grade hemiplegia function test), and Functional Independence Measure cognitive score were found to be independent predictors of prognosis. Severity of hemiplegia was the strongest predictor of ambulation, with a sensitivity of 80.4% and specificity of 100% when the cut-off was set at grade 6 (the ability for coordinated movement of the extensor and flexor muscles of the hip joint). [Conclusion] The severity of hemiplegia, Functional Independence Measure cognitive score, and ventricular rupture were independently associated with ambulation in patients with putaminal hemorrhage. The ability of the hip joint movement is one of the most important factors in ambulation prognosis.
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Affiliation(s)
- Noriko Ikeda
- Department of Rehabilitation, Kanazawa Medical University
Hospital: 1-1 Daigaku, Uchinada, Ishikawa 920-0293, Japan
| | - Masaru Sakurai
- Department of Social and Environmental Medicine, Kanazawa
Medical University, Japan
| | - Emika Yamada
- Department of Social and Environmental Medicine, Kanazawa
Medical University, Japan
| | - Soichiro Gotoh
- Department of Social and Environmental Medicine, Kanazawa
Medical University, Japan
| | - Nozomu Tanabe
- Department of Physical and Rehabilitation Medicine,
Kanazawa Medical University, Japan
| | | | - Isao Matsushita
- Department of Physical and Rehabilitation Medicine,
Kanazawa Medical University, Japan
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Bartloff JN, Ochs WL, Nichols KM, Gruben KG. Frequency-dependent behavior of paretic and non-paretic leg force during standing post stroke. J Biomech 2024; 164:111953. [PMID: 38309133 DOI: 10.1016/j.jbiomech.2024.111953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 01/10/2024] [Accepted: 01/15/2024] [Indexed: 02/05/2024]
Abstract
Maintaining upright posture in quiet standing is an important skill that is often disrupted by stroke. Despite extensive study of human standing, current understanding is incomplete regarding the muscle coordination strategies that produce the ground-on-foot force (F) that regulates translational and rotational accelerations of the body. Even less is understood about how stroke disrupts that coordination. Humans produce sagittal plane variations in the location (center of pressure, xCP) and orientation (Fx/Fz) of F that, along with the force of gravity, produce sagittal plane body motions. As F changes during quiet standing there is a strong correlation between the xCP and Fx/Fz time-varying signals within narrow frequency bands. The slope of the correlation varies systematically with frequency in non-disabled populations, is sensitive to changes in both environmental and neuromuscular control factors, and emerges from the interaction of body mechanics and neural control. This study characterized the xCP versus Fx/Fz relationship as frequency-dependent Intersection Point (IP) heights for the paretic and non-paretic legs of individuals with history of a stroke (n = 12) as well as in both legs of non-disabled controls (n = 22) to reveal distinguishing motor coordination patterns. No inter-leg difference of IP height was present in the control group. The paretic leg IP height was lower than the non-paretic, and differences from control legs were in opposite directions. These results quantify disrupted coordination that may characterize the paretic leg balance deficit and non-paretic leg compensatory behavior, providing a means of monitoring balance impairment and a target for therapeutic interventions.
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Affiliation(s)
- Jennifer N Bartloff
- Department of Mechanical Engineering, University of Wisconsin - Madison, Madison, WI 53706, USA.
| | - Wendy L Ochs
- Trek Bicycle Corporation, Waterloo, WI 53594, USA
| | - Kieran M Nichols
- Department of Mechanical Engineering, University of Wisconsin - Madison, Madison, WI 53706, USA
| | - Kreg G Gruben
- Department of Mechanical Engineering, University of Wisconsin - Madison, Madison, WI 53706, USA; Department of Kinesiology, University of Wisconsin - Madison, Madison, WI 53706, USA
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Embrechts E, Schröder J, Nijboer TCW, van der Waal C, Lafosse C, Truijen S, Saeys W. Does visuospatial neglect contribute to standing balance within the first 12 weeks post-stroke? A prospective longitudinal cohort study. BMC Neurol 2024; 24:37. [PMID: 38254026 PMCID: PMC10801963 DOI: 10.1186/s12883-023-03475-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 11/24/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Visuospatial neglect (VSN) has been suggested to limit standing balance improvement post-stroke. However, studies investigating this association longitudinally by means of repeated within-subject measurements early post-stroke are lacking. This prospective longitudinal cohort study evaluates the longitudinal association of egocentric and allocentric VSN severity with 1) standing balance independence and 2) postural control and weight-bearing asymmetry (WBA) during quiet standing, in the first 12 weeks post-stroke. METHODS Thirty-six hemiplegic individuals after a first-ever unilateral stroke were evaluated at weeks 3, 5, 8 and 12 post-stroke. Egocentric and allocentric VSN severity were evaluated using the Broken Hearts Test. The standing unperturbed item of the Berg Balance Scale (BBS-s) was used to clinically evaluate standing independence. Posturographic measures included measures of postural control (mediolateral (ML)/anteroposterior (AP) net center-of-pressure velocities (COPvel)) and WBA during quiet standing. A linear mixed model was used to examine longitudinal associations between egocentric and allocentric VSN, and BBS-s, COPvel-ML, COPvel-AP and WBA within the first 12 weeks post-stroke. RESULTS Egocentric (β = -0.08, 95%CI[-0.15;-0.01], P = .029) and allocentric VSN severity (β = -0.09, 95%CI[-0.15; -0.04], P = .002) were significant independent factors for BBS-s scores in the first 12 weeks post-stroke. Egocentric and allocentric VSN were no significant independent factors for COPvel-ML, COPvel-AP and WBA in the first 12 weeks post-stroke. CONCLUSIONS Allocentric and egocentric VSN severity were significantly associated with decreased standing independence, but not impaired postural control or greater asymmetric weight-bearing, in the early subacute post-stroke phase. This may involve traditional VSN measures being not sensitive enough to detect fine-grained VSN deficits due to a ceiling effect between 5 and 8 weeks post-stroke, once the individual regains standing ability. Future studies may require more sensitive VSN measurements to detect such deficits. Trial registration Clinicaltrials.gov. unique identifier NCT05060458.
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Affiliation(s)
- Elissa Embrechts
- Department of Rehabilitation Sciences and Physiotherapy (REVAKI), Research Group MOVANT, University of Antwerp, Wilrijk, Belgium.
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands.
| | - Jonas Schröder
- Department of Rehabilitation Sciences and Physiotherapy (REVAKI), Research Group MOVANT, University of Antwerp, Wilrijk, Belgium
| | - Tanja C W Nijboer
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
- Center of Excellence for Rehabilitation Medicine, UMC Brain Center, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Charlotte van der Waal
- Department of Rehabilitation Sciences and Physiotherapy (REVAKI), Research Group MOVANT, University of Antwerp, Wilrijk, Belgium
| | - Christophe Lafosse
- Department of Neurorehabilitation, RevArte Rehabilitation Hospital, Edegem, Belgium
| | - Steven Truijen
- Department of Rehabilitation Sciences and Physiotherapy (REVAKI), Research Group MOVANT, University of Antwerp, Wilrijk, Belgium
| | - Wim Saeys
- Department of Rehabilitation Sciences and Physiotherapy (REVAKI), Research Group MOVANT, University of Antwerp, Wilrijk, Belgium
- Department of Neurorehabilitation, RevArte Rehabilitation Hospital, Edegem, Belgium
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Kim J, Cho J. Effectiveness of mid thoracic spine mobilization on postural balance and gait ability in subacute stroke patients: A randomized clinical trial. J Back Musculoskelet Rehabil 2024; 37:233-240. [PMID: 37718778 DOI: 10.3233/bmr-230144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
BACKGROUND Although mulligan sustained natural apophyseal glides (SNAG) and maitland mobilization (MM) are common interventions for musculoskeletal disease, no study has directly compared the effectiveness of mid-thoracic spine mobilization in subacute stroke patients. OBJECTIVE To investigate the effects of mid-thoracic spine mobilization (SNAG vs. MM) on postural balance and gait ability in subacute stroke patients. METHODS Fifty subacute stroke patients were randomly allocated to the SNAG (n= 17), MM (n= 16), and control (n= 17) groups, each receiving a neuro-developmental therapy program for four successive weeks. The SNAG and MM groups additionally received mid-thoracic spine mobilization (T4∼8). The primary outcome measure was postural sway, and secondary outcome measures included the five times sit-to-stand test (FTSST), functional reach test (FRT), 10-m walk test (10MWT), 6-minute walk test (6MWT) and global rating of change (GRC). RESULTS Participants reported no adverse events, and there was no loss to follow-up. The SNAG and MM group patients demonstrated significant improvements (p< 0.05) in postural sway, FTSST, FRT, 10MWT, and 6MWT compared with those in the control group, with no between-group differences. CONCLUSIONS Mid-thoracic spine mobilization allows significant improvements in postural balance and gait ability in subacute stroke patients, with no differences between the SNAG and MM techniques.
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Affiliation(s)
- Jinhong Kim
- Rehabilitation Medical Research Center, Korea Worker's Compensation & Welfare Service, Incheon Hospital, Incheon, Korea
| | - Juchul Cho
- Department of Physical Therapy, Daejeon Health Institute of Technology Chungjeong-ro, Dong-gu, Daejeon, Korea
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Qurat-ul-ain, Ahmad Z, Ilyas S, Ishtiaq S, Tariq I, Nawaz Malik A, Liu T, Wang J. Comparison of a single session of tDCS on cerebellum vs. motor cortex in stroke patients: a randomized sham-controlled trial. Ann Med 2023; 55:2252439. [PMID: 38100750 PMCID: PMC10732189 DOI: 10.1080/07853890.2023.2252439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 08/20/2023] [Indexed: 12/17/2023] Open
Abstract
OBJECTIVE The purpose of this study was to determine whether a single session of trans-cranial direct current stimulation (tDCS) of the cerebellum and M1 has any advantages over one another or sham stimulation in terms of balance, gait and lower limb function. METHODS A total of 66 patients who had experienced their first ever stroke were recruited into three groups for this double-blinded, parallel, randomized, sham-controlled trial: cerebellar stimulation group (CbSG), M1 stimulation group (MSG) and sham stimulation group (SSG). A single session of anodal tDCS with an intensity of 2 mA for a duration of 20 min was administered in addition to gait and balance training based on virtual reality using an Xbox 360 with Kinect. Balance, gait, cognition and risk of fall were assessed using outcome measures before intervention (T0), immediately after intervention (T1) and an hour after intervention (T2). RESULTS Across group analysis of all outcome measures showed statistically non-significant results (p > .05) except for Six Minute Walk Test (p value T0 = .003, p value T1 = .025, p value T2 = .016). The training effect difference showed a significant difference in balance, gait and cognition, as well as cerebral and cerebellar stimulation, in comparison to sham stimulation (p < .05). The risk of falls remained unaffected by any stimulation (p > .05). CONCLUSIONS In addition to Xbox Kinect-based rehabilitation training, a single session of anodal tDCS to the M1 or cerebellum may be beneficial for improving lower limb function, balance and gait performance.
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Affiliation(s)
- Qurat-ul-ain
- School of Life Science and Technology, The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Health and Rehabilitation Science, Xi’an Jiaotong University, Xi’an, PR China
- National Engineering Research Center for Healthcare Devices, Guangzhou, PR China
- The Key Laboratory of Neuro-informatics & Rehabilitation Engineering of Ministry of Civil Affairs, Xi’an, PR China
| | - Zafran Ahmad
- Department of Logistics Engineering, Kunming University of Science & Technology, Kunming, China
| | - Saad Ilyas
- Faculty of Computing, Capital University of Science and Technology, Islamabad, Pakistan
- Department of Computing, Shifa Tameer-e-Millat University, Islamabad, Pakistan
| | - Summaiya Ishtiaq
- Faculty of Rehabilitation & Allied Health Sciences, Riphah College of Rehabilitation & Allied Health Sciences, Islamabad, Pakistan
| | - Iqbal Tariq
- Faculty of Rehabilitation & Allied Health Sciences, Riphah College of Rehabilitation & Allied Health Sciences, Islamabad, Pakistan
| | - Arshad Nawaz Malik
- Faculty of Rehabilitation & Allied Health Sciences, Riphah College of Rehabilitation & Allied Health Sciences, Islamabad, Pakistan
| | - Tian Liu
- School of Life Science and Technology, The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Health and Rehabilitation Science, Xi’an Jiaotong University, Xi’an, PR China
- National Engineering Research Center for Healthcare Devices, Guangzhou, PR China
- The Key Laboratory of Neuro-informatics & Rehabilitation Engineering of Ministry of Civil Affairs, Xi’an, PR China
| | - Jue Wang
- School of Life Science and Technology, The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Health and Rehabilitation Science, Xi’an Jiaotong University, Xi’an, PR China
- National Engineering Research Center for Healthcare Devices, Guangzhou, PR China
- The Key Laboratory of Neuro-informatics & Rehabilitation Engineering of Ministry of Civil Affairs, Xi’an, PR China
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Awosika OO, Garver A, Drury C, Sucharew HJ, Boyne P, Schwab SM, Wasik E, Earnest M, Dunning K, Bhattacharya A, Khatri P, Kissela BM. Insufficiencies in sensory systems reweighting is associated with walking impairment severity in chronic stroke: an observational cohort study. Front Neurol 2023; 14:1244657. [PMID: 38020645 PMCID: PMC10656616 DOI: 10.3389/fneur.2023.1244657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 10/20/2023] [Indexed: 12/01/2023] Open
Abstract
Background Walking and balance impairment are common sequelae of stroke and significantly impact functional independence, morbidity, and mortality. Adequate postural stability is needed for walking, which requires sufficient integration of sensory information between the visual, somatosensory, and vestibular centers. "Sensory reweighting" describes the normal physiologic response needed to maintain postural stability in the absence of sufficient visual or somatosensory information and is believed to play a critical role in preserving postural stability after stroke. However, the extent to which sensory reweighting successfully maintains postural stability in the chronic stages of stroke and its potential impact on walking function remains understudied. Methods In this cross-sectional study, fifty-eight community-dwelling ambulatory chronic stroke survivors underwent baseline postural stability testing during quiet stance using the modified Clinical test of Sensory Interaction in Balance (mCTSIB) and assessment of spatiotemporal gait parameters. Results Seventy-six percent (45/58) of participants showed sufficient sensory reweighting with visual and somatosensory deprivation for maintaining postural stability, albeit with greater postural sway velocity indices than normative data. In contrast, survivors with insufficient reweighting demonstrated markedly slower overground walking speeds, greater spatiotemporal asymmetry, and limited acceleration potential. Conclusion Adequate sensory system reweighting is essential for chronic stroke survivors' postural stability and walking independence. Greater emphasis should be placed on rehabilitation strategies incorporating multisensory system integration testing and strengthening as part of walking rehabilitation protocols. Given its potential impact on outcomes, walking rehabilitation trials may benefit from incorporating formal postural stability testing in design and group stratification.
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Affiliation(s)
- Oluwole O. Awosika
- Department of Neurology and Rehabilitation Medicine, College of Medicine, University of Cincinnati, Cincinnati, OH, United States
| | - Amanda Garver
- Department of Neurology and Rehabilitation Medicine, College of Medicine, University of Cincinnati, Cincinnati, OH, United States
| | - Colin Drury
- Department of Neurology and Rehabilitation Medicine, College of Medicine, University of Cincinnati, Cincinnati, OH, United States
| | - Heidi J. Sucharew
- Department of Emergency Medicine, University of Cincinnati, Cincinnati, OH, United States
| | - Pierce Boyne
- Department of Rehabilitation, Exercise and Nutrition Sciences, College of Allied Health Sciences, University of Cincinnati, Cincinnati, OH, United States
| | - Sarah M. Schwab
- Department of Rehabilitation, Exercise and Nutrition Sciences, College of Allied Health Sciences, University of Cincinnati, Cincinnati, OH, United States
| | - Emily Wasik
- Department of Rehabilitation, Exercise and Nutrition Sciences, College of Allied Health Sciences, University of Cincinnati, Cincinnati, OH, United States
| | - Melinda Earnest
- Department of Rehabilitation, Exercise and Nutrition Sciences, College of Allied Health Sciences, University of Cincinnati, Cincinnati, OH, United States
| | - Kari Dunning
- Department of Rehabilitation, Exercise and Nutrition Sciences, College of Allied Health Sciences, University of Cincinnati, Cincinnati, OH, United States
| | - Amit Bhattacharya
- EDDI Lab—Early Detection of Degenerative Disorders and Innovative Solutions, Department of Environmental Health, University of Cincinnati, Cincinnati, OH, United States
| | - Pooja Khatri
- Department of Neurology and Rehabilitation Medicine, College of Medicine, University of Cincinnati, Cincinnati, OH, United States
| | - Brett M. Kissela
- Department of Neurology and Rehabilitation Medicine, College of Medicine, University of Cincinnati, Cincinnati, OH, United States
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Zhang M, Liang Z, Li Y, Meng J, Jiang X, Xu B, Li H, Liu T. The effect of balance and gait training on specific balance abilities of survivors with stroke: a systematic review and network meta-analysis. Front Neurol 2023; 14:1234017. [PMID: 38020595 PMCID: PMC10653323 DOI: 10.3389/fneur.2023.1234017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 09/28/2023] [Indexed: 12/01/2023] Open
Abstract
Background Stroke, which is a common clinical cerebrovascular disease, causes approximately 83% of survivors to suffer from balance impairments. Balance and gait training (BGT) is widely used to restore balance in patients with stroke. However, its wide variety presents clinicians with a dilemma when selecting interventions. This study aimed to compare and rank BGT interventions by quantifying information based on randomized controlled trials (RCTs). Methods We conducted a network meta-analysis (NMA) of non-gait-trained controls and head-to-head RCTs and compared the effects of 12 BGT interventions. A total of nine literature databases, including Medline, Embase, Cochrane Library, Web of Science, Scopus, SPORTDiscus, ClinicalTrials.gov, CNKI, and Chinese biomedical literature databases, were searched from their database inception to August 2023. Two authors independently selected studies and extracted data. The difference in outcomes, which were expressed as standardized mean differences and confidence intervals (CIs) of 95%, were explored in this meta-analysis. Results A total of 66 studies with 1,933 participants were included. Effect size estimates showed that not all BGT interventions were more effective than controls, with treadmill training as the least effective for balance test batteries (SMD = -0.41, 95% CI [-1.09, 0.27]) and proactive balance (SMD = -0.50, 95% CI [-1.14, 0.14]). Body-weight-supported treadmill training with external stimulation was most effective for proactive balance and dynamic steady-state balance (SMD = 1.57, 95% CI [-0.03, 3.16]); SMD = 1.18, 95% CI [0.67, 1.68]. Virtual reality gait training (SMD = 1.37, 95% CI [0.62, 2.11]) had the best effect on improving balance test batteries, while dual-task BGT (SMD = 1.64, 95% CI [0.50, 2.78]) had the best effect on static steady-state balance. After analyses for possible impact covariates, the findings through the outcomes did not change substantially. Confidence in the evidence was generally low or very low. Conclusion This NMA suggested that virtual reality gait training was the most effective BGT modality for improving balance test batteries. Body-weight support treadmill training with external stimulation was the most effective for improving active and dynamic balance. In addition, dual-task BGT was the best choice for improving static balance. However, balance is a multidimensional concept, and patients' different needs should be considered when selecting BGT. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022316057, ID: CRD42022316057.
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Affiliation(s)
- Meng Zhang
- Postgraduate Department, Xi’an Physical Education University, Xi’an, China
| | - Zhide Liang
- School of Physical Education, Qingdao University, Qingdao, China
| | - Yali Li
- Postgraduate Department, Xi’an Physical Education University, Xi’an, China
| | - Jun Meng
- School of Physical Education, Gunagxi Minzu Normal University, Chongzuo, China
| | - Xu Jiang
- Postgraduate Department, Xi’an Physical Education University, Xi’an, China
| | - Bichan Xu
- Postgraduate Department, Xi’an Physical Education University, Xi’an, China
| | - Haojie Li
- School of Physical Education, Gunagxi Minzu Normal University, Chongzuo, China
| | - Tao Liu
- School of Exercise and Health Sciences, Xi’an Physical Education University, Xi’an, China
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Su Z, Guo Z, Wang W, Liu Y, Liu Y, Chen W, Zheng M, Michael N, Lu S, Wang W, Xiao H. The effect of telerehabilitation on balance in stroke patients: is it more effective than the traditional rehabilitation model? A meta-analysis of randomized controlled trials published during the COVID-19 pandemic. Front Neurol 2023; 14:1156473. [PMID: 37265467 PMCID: PMC10229885 DOI: 10.3389/fneur.2023.1156473] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 04/04/2023] [Indexed: 06/03/2023] Open
Abstract
Objective Telerehabilitation and telemedicine have gradually gained popularity. In 2019, the outbreak of COVID-19 started in Wuhan and then spread across the world. To date, most countries have opted to coexist with the virus. However, patients, especially those who have suffered a stroke, should take measures to avoid being infected with any disease as much as possible since any infectious disease can lead to adverse events for them. Telerehabilitation can be beneficial to stroke patients as they are less likely to be infected by the virus. In recent years, several studies on telerehabilitation have been conducted globally. This meta-analysis aimed to investigate the effects of telerehabilitation on the balance ability of stroke patients, compare the efficacy of conventional rehabilitation with telerehabilitation, explore the characteristics of telerehabilitation and conventional rehabilitation, and provide recommendations for rehabilitation programs in the context of the global pandemic. Methods We searched Pubmed, Embase, the Web of Science, and The Cochrane Library databases from 1 January 2020 to 31 December 2022 for randomized controlled trials published in English that evaluated the improvement of balance function in stroke patients after telerehabilitation and compared the differences between telerehabilitation (TR) and conventional rehabilitation (CR). The random-effects model was utilized to calculate mean differences (MDs) with 95% confidence intervals (CIs) to estimate intervention effects. Statistical heterogeneity was assessed according to the I2 values. The risk of bias was measured using the Cochrane risk-of-bias assessment tool. Results We included nine studies in the system evaluation, all of which were included in the pooled analysis. All outcomes in the experimental and control groups improved over time. The comparison between groups concluded that people who received the telerehabilitation intervention had a significant improvement in the Berg Balance Scale (MD = 2.80; 95% CI 0.61, 4.98, P < 0.05, I2 = 51.90%) and the Fugl-Meyer Assessment (MD = 8.12; 95% CI 6.35, 9.88, P < 0.05, I2 = 0) compared to controls. The Timed Up and Go test (MD = -4.59; 95% CI -5.93, -.25, P < 0.05, I2 = 0) and Tinetti Performance-Oriented Mobility Assessment-Balance (MD = 2.50; 95% CI 0.39, 4.61, P < 0.05) scored better in the control group than in the experimental group. There were no significant differences in other outcomes between the two groups. Conclusion Studies on changes in medical conditions during the COVID-19 pandemic also demonstrated that, for stroke patients, telerehabilitation achieves similar effects as the conventional rehabilitation model and can act as a continuation of the conventional rehabilitation model. Owing to the different equipment and intervention programs of telerehabilitation, its curative effect on the static balance and reactive balance of stroke patients may be different. Currently, telerehabilitation may be more conducive to the rehabilitation of patients' static balance abilities, while conventional rehabilitation is more effective for the rehabilitation of patients' reactive balance. Therefore, further studies are needed for investigating the difference in efficacy between varied devices and telerehabilitation programs. Further research is needed on static and reactive balance. In addition, such research should have a large body of literature and a large sample size to support more definitive findings based on the context of the COVID-19 pandemic. Systematic review registration CRD42023389456.
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Affiliation(s)
- Zhaoyin Su
- The First Clinical College of Medicine, Lanzhou University, Lanzhou, China
| | - Zhenxia Guo
- Department of Trauma Surgery, First Hospital of Lanzhou University, Lanzhou, China
| | - Weitao Wang
- The First Clinical College of Medicine, Lanzhou University, Lanzhou, China
| | - Yao Liu
- The First Clinical College of Medicine, Lanzhou University, Lanzhou, China
| | - Yatao Liu
- Department of Trauma Surgery, First Hospital of Lanzhou University, Lanzhou, China
- Department of Anesthesia Surgery, First Hospital of Lanzhou University, Lanzhou, China
| | - Wanqiang Chen
- Department of Rehabilitation, First Hospital of Lanzhou University, Lanzhou, China
| | - Maohua Zheng
- Department of Neurosurgery, First Hospital of Lanzhou University, Lanzhou, China
| | - Nerich Michael
- Department of Trauma Surgery, University Medical Center Regensburg, Regensburg, Germany
| | - Shuai Lu
- The First Clinical College of Medicine, Lanzhou University, Lanzhou, China
| | - Weining Wang
- School of Stomatology, Lanzhou University, Lanzhou, China
| | - Handan Xiao
- The Second Clinical College of Medicine, Lanzhou University, Lanzhou, China
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11
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Pérennou D, Chauvin A, Piscicelli C, Hugues A, Dai S. Determining an optimal posturography dataset to identify standing behaviors in the post-stroke subacute phase. Cross-sectional study. Ann Phys Rehabil Med 2023; 66:101707. [PMID: 36182062 DOI: 10.1016/j.rehab.2022.101707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 08/04/2022] [Accepted: 08/11/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND A key issue for posturography is the expression of robust results, in a simplified way. Most studies of individuals post-stroke concern the chronic phase, with small sample sizes. OBJECTIVES By reducing the number of posturographic indices, we aimed to determine an optimal dataset and understand typical postural behaviors in the subacute post-stroke phase. METHODS In this cross-sectional study ancillary to the DOBRAS cohort, individuals were assessed as soon they could complete a full posturography session (with and without vision) after a first hemispheric stroke. Body-weight distribution on the mediolateral (ML) axis, position of the center of pressure on the antero-posterior (AP) axis, and postural sway on both axes were computed. Balance ability in daily life was quantified with the Postural Assessment Scale for Stroke. Data were analyzed by principal component and hierarchical clustering analyses as well as multiple linear regression. RESULTS We enrolled 95 individuals (median age: 67.0 years [Q1; Q3 56.0; 72.0]; 68% males). Vision suppression had a marginal effect, only increasing postural sway. Regardless of the visual condition, posturographic behavior was captured by a set of 3 indices that explained almost all the information. One postural sway index (ML or AP) gave more information (48%) than both position indices (ML 26% and AP 15%). These 3 indices identified 3 standing behaviors: 1) stable and symmetric, 2) asymmetric, unstable, and positioned backward, and 3) very unstable and positioned forward. Balance ability in daily life was explained (49% of the information, 95%CI [35; 63]) by weight-bearing asymmetry and postural sway on the ML axis, which played an independent role (both p<10-5), with similar impact. CONCLUSIONS Three typical behaviors allow standing after stroke: described by only 3 posturographic indices. Weight-bearing asymmetry is not the primary parameter and should not be considered in isolation as an outcome. To increase the feasibility of posturography in the early subacute phase and to simplify evaluation sessions, trials could be limited to eyes open. REGISTRATION NCT03203109.
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Affiliation(s)
- Dominic Pérennou
- Univ. Grenoble-Alpes, UMR CNRS 5105 Neuropsychology and Neurocognition, CHU Grenoble Alpes, Department of NeuroRehabilitation South Hospital, CS 10217, 38043 Grenoble cedex 9, France.
| | - Adèle Chauvin
- Univ. Grenoble-Alpes, UMR CNRS 5105 Neuropsychology and Neurocognition, CHU Grenoble Alpes, Department of NeuroRehabilitation South Hospital, CS 10217, 38043 Grenoble cedex 9, France
| | - Céline Piscicelli
- Univ. Grenoble-Alpes, UMR CNRS 5105 Neuropsychology and Neurocognition, CHU Grenoble Alpes, Department of NeuroRehabilitation South Hospital, CS 10217, 38043 Grenoble cedex 9, France
| | - Aurélien Hugues
- Univ. Grenoble-Alpes, UMR CNRS 5105 Neuropsychology and Neurocognition, CHU Grenoble Alpes, Department of NeuroRehabilitation South Hospital, CS 10217, 38043 Grenoble cedex 9, France
| | - Shenhao Dai
- Univ. Grenoble-Alpes, UMR CNRS 5105 Neuropsychology and Neurocognition, CHU Grenoble Alpes, Department of NeuroRehabilitation South Hospital, CS 10217, 38043 Grenoble cedex 9, France
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Pellicciari L, Sodero A, Campagnini S, Guolo E, Basagni B, Castagnoli C, Hochleitner I, Paperini A, Gnetti B, Avila L, Romano E, Grippo A, Hakiki B, Carrozza MC, Mannini A, Macchi C, Cecchi F. Factors influencing trunk control recovery after intensive rehabilitation in post-stroke patients: a multicentre prospective study. Top Stroke Rehabil 2023; 30:109-118. [PMID: 34994302 DOI: 10.1080/10749357.2021.2016099] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Trunk control plays a crucial role in the stroke rehabilitation, but it is unclear which factors could influence the trunk control after an intensive rehabilitation treatment. OBJECTIVES To study which demographic, clinical and functional variables could predict the recovery of trunk control after intensive post-stroke inpatient rehabilitation. METHODS Subjects with acute, first-ever stroke were enrolled and clinical and data were collected at admission and discharge. The primary outcome was considered the trunk control measured by the Trunk Control Test (TCT). The data were analyzed by a univariate and multivariate logistic regressions. RESULTS Two hundred forty-one post-stroke patients were included. All baseline variables significantly associated to TCT at discharge in the univariate analysis (i.e. gender, NIHSS neglect item at admission, presence of several complexity markers, TCT total score at admission, NIHSS total score, pre-stroke modified Rankin Scale, Fugl-Meyer Assessment motor and sensitivity score) were entered in the multivariate analysis. The multivariate regression showed that age (p = .003), admission NIHSS total score (p = .001), admission TCT total score (p < .001) and presence of depression (p = .027) independently influenced the TCT total score at discharge (R2 = 61.2%). CONCLUSIONS Age, admission neurological impairment (NIHSS total score), trunk control at the admission (TCT total score), and presence of depression independently influenced the TCT at discharge. These factors should be carefully assessed at the baseline to plan a tailoring rehabilitation treatment achieving the best trunk control performance at discharge.
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Affiliation(s)
| | - Alessandro Sodero
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy.,NEUROFARBA Department, Neuroscience Section, University of Florence, Florence, Italy
| | - Silvia Campagnini
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy.,Istituto di Biorobotica, Scuola Superiore Sant'Anna, Pontedera, Italy
| | - Erika Guolo
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | | | | | | | | | | | - Lucia Avila
- Fondazione Don Carlo Gnocchi, Marina di Massa, Italy
| | | | - Antonello Grippo
- SOD Neurofisiopatologia, Dipartimento Neuromuscolo-Scheletrico e degli Organi di Senso, Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - Bahia Hakiki
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | | | - Andrea Mannini
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy.,Istituto di Biorobotica, Scuola Superiore Sant'Anna, Pontedera, Italy
| | - Claudio Macchi
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Francesca Cecchi
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
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Aloraini SM, Abu Mismar AA, Aloqaily HF, Aldaihan MM. Balance assessment tools and their psychometric properties among individuals post-stroke: a systematic review. PHYSICAL THERAPY REVIEWS 2023. [DOI: 10.1080/10833196.2023.2168850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Saleh M. Aloraini
- Department of Physical Therapy, College of Medical Rehabilitation, Qassim University, Saudi Arabia
| | - Arwa A. Abu Mismar
- Department of Physical Therapy, College of Medical Rehabilitation, Qassim University, Saudi Arabia
| | - Haifa F. Aloqaily
- Department of Physical Therapy, College of Medical Rehabilitation, Qassim University, Saudi Arabia
| | - Mishal M. Aldaihan
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Saudi Arabia
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14
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Hung MH, Chen HY, Chang YC, Chiu CW, Chang HY. Effects of the direction of Kinesio taping on sensation and postural control before and after muscle fatigue in healthy athletes. Sci Rep 2023; 13:1282. [PMID: 36690648 PMCID: PMC9871022 DOI: 10.1038/s41598-023-27801-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 01/09/2023] [Indexed: 01/25/2023] Open
Abstract
In this study, Kinesio tape (KT) was applied in two different directions to the gastrocnemius muscle, the most important muscle in stance stability, to investigate the effect of different taping directions on overall balance and sensation systems before versus after muscle fatigue. The participants, comprising 45 healthy athletes, were randomly divided into three groups: the placebo taping group (PTG), the facilitation KT group (FKTG), and the inhibition KT group (IKTG). The tests involved in this study were a balance test, a superficial sensory function test, and a combined cortical sensation test. The data from these tests were collected before taping, after taping and a 10-min rest, and immediately after continuous heel raises were performed to fatigue. The results of the balance tests showed no significant group × time interaction, whether subjects stood barefoot on one foot or stood on a soft mat with eyes open or closed (p > 0.05). Only the sway distance and sway velocity of the center of pressure (COP) when subjects stood barefoot on one foot with eyes open were significantly higher in the inhibition taping group than in the placebo taping group (p < 0.05). In addition, significant differences were noted in the sway area and sway distance of the COP before taping, after taping, and after exercise to fatigue when the participants stood on the soft mat with their eyes open (p < 0.05). When the participants stood on the soft mat on one foot with their eyes closed, no significant differences were noted among the groups. When subjects stood on a soft mat on one foot with eyes open, significant improvements were noted after fatiguing exercise versus before taping for all three groups (p < 0.05). The results of the superficial sensory test showed no significant group × time interaction and no difference among the three taping conditions or before/after taping and after fatiguing exercise. Only in the two-point discrimination test was a sensory difference observed, with the facilitation taping group having a significantly shorter discrimination distance than the placebo taping and inhibition taping groups (p < 0.05). The present study showed that KT application for a simple balance task (e.g., barefoot on a hard floor with eyes open) may slightly influence postural control, especially when the inhibition method is used. However, more difficult balance tasks (e.g., barefoot on a soft mat with eyes closed) show no effect of KT application-either the facilitation method or the inhibition method-on posture control.
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Affiliation(s)
- Min-Hao Hung
- Physical Education Office, National Chin-Yi University of Technology, Taichung, Taiwan
| | - Hui-Ya Chen
- Department of Physical Therapy, Chung Shan Medical University, Taichung, Taiwan
| | - Yun-Chi Chang
- Department of Physical Education, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Chun-Wen Chiu
- Institute of Athletic and Coaching Science, National Taiwan Sport University, Taoyuan, Taiwan
| | - Hsiao-Yun Chang
- Department of Athletic Training and Health, National Taiwan Sport University, Taoyuan, Taiwan.
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15
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Zhou Z, Hu Z, Bao W, Yang Y, Chen K. Does the patellar tendon reflex affect the postural stability in stroke patients with blocked vision? Transl Neurosci 2023; 14:20220283. [PMID: 37082611 PMCID: PMC10111209 DOI: 10.1515/tnsci-2022-0283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 03/19/2023] [Accepted: 03/27/2023] [Indexed: 04/22/2023] Open
Abstract
Background Stroke patients often show postural instability. The patellar tendon reflex is a basic physical examination for stroke patients. This study aimed to explore the correlation between patellar tendon reflex grade and postural stability among stroke patients. Methods A total of 37 elderly stroke patients, each with the same quadriceps muscle strength but different patellar tendon reflex levels, were tested on a force platform under eyes-open (EO) and eyes-closed (EC) conditions. Parametric analysis, detrended fluctuation analysis (DFA), and power spectral density (PSD) analysis were used in centre of pressure (COP) signal processing. The correlation between the results of measured data processing and the level of patellar tendon reflex was analysed. Results All three parameters of COP (the length of the sway trajectory, the mean range of the sway trajectory in the mediolateral [ML] direction [R x ], and the mean range of the sway trajectory in the anterior-posterior [AP] directions [R y ]) were negatively correlated with the patient's patellar tendon reflex grade under the EC condition. The DFA results showed that a higher grade of patellar tendon reflex was associated with a smaller value of the crossover point in the AP direction. Only the PSD values of each frequency band in the AP direction were negatively correlated with patellar tendon reflex grade with EO and became negatively correlated in both AP and ML directions with EC. Overall, the results showed a strong correlation between patellar tendon reflex and postural stability in stroke patients when vision was blocked. Significance The strong correlation with EC may provide insights into clinic evaluation and treatment for rehabilitation or fall risks of stroke patients.
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Affiliation(s)
- Ziyou Zhou
- Department of Mechanical Engineering, School of Mechanical Engineering, Hangzhou Dianzi University, No.1158, Xiasha 2nd Street, Jianggan District, Hangzhou, Zhejiang310018, China
| | - Zhen Hu
- Department of Neurology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University, Shanghai200000, China
| | - Wei Bao
- Department of Mechanical Engineering, School of Mechanical Engineering, Hangzhou Dianzi University, No.1158, Xiasha 2nd Street, Jianggan District, Hangzhou, Zhejiang310018, China
| | - Ying Yang
- Department of Mechanical Engineering, School of Mechanical Engineering, Hangzhou Dianzi University, No.1158, Xiasha 2nd Street, Jianggan District, Hangzhou, Zhejiang310018, China
| | - Kai Chen
- Department of Mechanical Engineering, School of Mechanical Engineering, Hangzhou Dianzi University, No.1158, Xiasha 2nd Street, Jianggan District, Hangzhou, Zhejiang310018, China
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16
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Changes in Trunk Muscle Activity during Unilateral Weight Bearing and Abnormal Postural Gait in Healthy Individuals. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58121800. [PMID: 36557001 PMCID: PMC9785953 DOI: 10.3390/medicina58121800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 11/30/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022]
Abstract
Background and Objectives: Many people tend to carry their bags or baggage on only one side of their body. Due to smartphone use, people also tend to walk bent forward in a kyphotic posture. In this study, we aimed to assess trunk muscle activity changes due to weight-bearing, carried in the left or right hand, and using three different gait postures. Materials and Methods: We recruited 27 healthy participants (aged 19−75 years) with no history of LBP within the last 6 months before study participation. Electromyographic activities of the lower back and the abdominal muscles of the participants were evaluated using four-channel surface electromyography (EMG). Surface EMG recordings were obtained from four trunk muscles, including the flexor (rectus abdominis (RA), external oblique (EO)) and extensor muscles (lumbar erector spinae (LE), and the superficial lumbar multifidus (LM)), during unilateral weight-bearing tasks and with different gait postures (normal gait, with a sway back, and thoracic kyphosis). Results: In the “unilateral weight-bearing task”, there was a significant difference in the activity of all the trunk muscles between the weight-bearing limb side and the opposite side (p < 0.05). The activation of the left trunk muscle was greater than that of the right trunk muscle when the dumbbell was lifted using the right hand. The other side showed the same result. In the “gait posture task” performed by the participants using a sway-back posture, the RA and EO had a higher level of activity in the stance and swing phases compared with that in a neutral gait (p < 0.05). Moreover, in the participants with a thoracic kyphosis posture, the LE and LM had a higher level of activity compared with that in a neutral gait (p < 0.05). Conclusions: Our results indicate that abnormal gait posture and unilateral weight-bearing tasks may impair the balance of trunk muscles, increasing the incidence of LBP. However, further large-scale, prospective, controlled studies are warranted to corroborate our results.
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Ostrowska PM, Studnicki R, Rykaczewski M, Spychała D, Hansdorfer-Korzon R. Evaluation of the Effect of SPIDER System Therapy on Weight Shifting Symmetry in Chronic Stroke Patients-A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16214. [PMID: 36498288 PMCID: PMC9735549 DOI: 10.3390/ijerph192316214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 11/30/2022] [Accepted: 12/02/2022] [Indexed: 06/17/2023]
Abstract
(1) Background: The Strengthening Program for Intensive Developmental Exercises and Activities for Reaching Health Capability (SPIDER) system is dedicated to patients with motor deficits resulting from damage to the peripheral or central nervous system (including post-stroke patients). It enables the conduct of forced-weight-bearing therapy to the lower limb affected by the paresis. In this study, the TYMO® measuring platform was used to quantify the impact of therapy using the SPIDER system and therapy that did not use this system. The TYMO® device is a portable posturography platform that monitors the tilting of the body's center of mass and reports the results of the rehabilitation process. (2) Objective: To evaluate the effect of therapy based on neurophysiological methods (proprioceptive neuromuscular facilitation (PNF), neurodevelopmental treatment according to the Bobath concept (NDT-Bobath)) and the SPIDER system on body weight transfer shifting, in post-stroke patients in the chronic phase, compared to therapy based on neurophysiological methods (PNF, NDT-Bobath), without the use of the SPIDER system. (3) Methods: This is a randomized controlled trial in which patients (n = 120; adults, post-ischemic stroke-first stroke episode, in chronic phase-up to 5 years after the stroke incident) were assigned to one of two groups: study, n = 60 (with therapy using PNF, NDT-Bobath methods and the SPIDER system); and control, n = 60 (with therapy using PNF and NDT-Bobath methods, without the SPIDER system). In patients in both groups, before and after the training (2 weeks of therapy), body weight distribution was measured on the TYMO® platform. (4) Results and Conclusions: The results of the statistical analysis demonstrated a greater reduction in the tilt of the body's center of mass in therapy using the SPIDER system, compared to therapy in which the system was not used.
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Affiliation(s)
| | - Rafał Studnicki
- Department of Physiotherapy, Medical University of Gdańsk, 7 Dębinki Street, 80-211 Gdańsk, Poland
| | - Marcin Rykaczewski
- Second Department of Radiology, Medical University of Gdańsk, 17 M. Smoluchowskiego St., 80-214 Gdańsk, Poland
| | - Dawid Spychała
- Department of Physiotherapy, Medical University of Gdańsk, 7 Dębinki Street, 80-211 Gdańsk, Poland
| | - Rita Hansdorfer-Korzon
- Department of Physiotherapy, Medical University of Gdańsk, 7 Dębinki Street, 80-211 Gdańsk, Poland
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18
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Effects of multi-directional step exercise with weight-shifting as an adjunct to conventional exercises on balance and gait in stroke patients. Sci Rep 2022; 12:17053. [PMID: 36224226 PMCID: PMC9556514 DOI: 10.1038/s41598-022-21073-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 09/22/2022] [Indexed: 12/30/2022] Open
Abstract
Stroke patients have gait dysfunctions that affect their activities of daily living. Stroke patients should be able to take multi-directional steps as it is necessary to achieve an independent gait. The study aimed to examine the effects of multi-directional step exercises (MSE) along with weight-shifting as an adjunct to conventional therapeutic exercises (CTE) on functional gait performance and balance in patients with stroke. Twenty-four stroke patients (mean age 56.75 years) participated in the study and were divided into experimental and control groups. The experimental group (EG) included MSE along with weight shifting and CTE. The control group (CG) included only CTE. Treatment intervention lasted for 4 weeks. Gait and balance were measured using the functional gait assessment (FGA) and the berg balance scale (BBS), respectively. EG showed a significant improvement (p = 0.000) in both the BBS and FGA scores. In CG, a significant improvement (p = 0.000) was observed only in FGA scores. EG showed a greater improvement in scores of BBS (p = 0.000) and FGA (p = 0.000) than CG. Four weeks of MSE in conjunction with CTE were more effective in improving balance and functional gait performance compared to CTE alone in the selected stroke population.
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Buvarp D, Rafsten L, Abzhandadze T, Sunnerhagen KS. A cohort study on longitudinal changes in postural balance during the first year after stroke. BMC Neurol 2022; 22:324. [PMID: 36042404 PMCID: PMC9425943 DOI: 10.1186/s12883-022-02851-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 08/24/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Many patients with strokes report increased incidence of fall that can be due to impaired postural balance. The recovery of balance in patients with varying degrees of impairments and activity limitations is less studied, and whether individuals with mild paresis can recover their balance faster is unclear. Better knowledge about factors influencing the recovery of postural balance can be used to guide clinical management after stroke to provide the right rehabilitation to the right person at the right time, and thus to avoid potential fall incidences. OBJECTIVE This study aims to examine longitudinal changes in postural balance during the first year after stroke. METHODS Postural balance was assessed using the Berg Balance Scale (BBS) within 5 days, 1, 2, and 3 months and 1-year post-stroke. Stroke severity was stratified using a cluster analysis by including multidimensional baseline measures. A longitudinal mixed-effect model was constructed to analyze changes in proportional balance impairment by stroke severity over time. Individuals with a cut-off of BBS below 45 scores were identified through a classification algorithm using baseline predictors. RESULTS A total of 135 patients were stratified to mild stroke (77 [57%] patients) or moderate stroke (58 [43%] patients). Ninety-three patients were included in the longitudinal analysis. Significant recovery was found at 1-year for moderate stroke (48% recovery from the initial impaired postural balance, adjusted P < 0.001), but not for mild stroke, after adjusting for age and cognition. Both stroke severities had a maximal recovery in postural balance at 3 months post-stroke, but the moderate stroke group deteriorated after that. Patients with higher age and worse cognition had more severe balance impairments. The classification model achieved a sensitivity of 0.95 (95% confidence interval [CI]: 0.91-0.98) and a specificity of 0.99 (95% CI: 0.98-1.0) for classifying individuals with BBS below 45 points. CONCLUSIONS This study indicates that continuous improvements in postural balance ends at 3 months regardless for mild or moderate stroke groups, and patients with moderate stroke significantly deteriorate in postural balance after 3 months.
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Affiliation(s)
- Dongni Buvarp
- Rehabilitation Medicine Research Group, Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, University of Gothenburg, Per Dubbsgatan 14, 40530, Gothenburg, Sweden. .,Sahlgrenska University Hospital, Gothenburg, Sweden.
| | - Lena Rafsten
- Rehabilitation Medicine Research Group, Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, University of Gothenburg, Per Dubbsgatan 14, 40530, Gothenburg, Sweden.,Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Tamar Abzhandadze
- Rehabilitation Medicine Research Group, Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, University of Gothenburg, Per Dubbsgatan 14, 40530, Gothenburg, Sweden.,Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Katharina S Sunnerhagen
- Rehabilitation Medicine Research Group, Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, University of Gothenburg, Per Dubbsgatan 14, 40530, Gothenburg, Sweden.,Sahlgrenska University Hospital, Gothenburg, Sweden
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Changes in postural sway during upright stance after short-term lower limb physical inactivity: A prospective study. PLoS One 2022; 17:e0272969. [PMID: 36001574 PMCID: PMC9401126 DOI: 10.1371/journal.pone.0272969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 07/28/2022] [Indexed: 12/04/2022] Open
Abstract
Previous studies have reported that motor behavior is affected by short-term physical inactivity using cast immobilization; however, the effects of inactivity on postural sway are not well-understood. This study aimed to investigate the effects of short-term lower limb disuse on postural sway in the upright position after cast removal. Twenty-two healthy young adults were enrolled, and each participant’s lower limb on one side was fixed with a soft bandage and medical splint made from metal and soft urethane for 10 h. Fluctuations in the center of pressure (COP) were measured before and after immobilization; the total trajectory length, mean velocity, COP root mean square (RMS) area, mean medial-lateral (M-L) COP, and mean anterior-posterior (A-P) COP were selected as evaluation parameters. Compared with the postural sway before cast application, we noted an increase and shift (from the fixed to the nonfixed side) in the postural sway after cast removal. Our results therefore suggest that short-term disuse may cause acute changes in COP movements during quiet standing. Moreover, patients may maintain their standing posture by adopting a compensatory strategy involving lateral control, similar to individuals with stroke and patients who have undergone total knee arthroplasty.
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21
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Dehmiyani A, Mehdizadeh H, Azad A, Cheraghifard M, Jamali S, Davoudi M, Shokouhyan SM, Taghizadeh G. Apathy exacerbates postural control impairments in stroke survivors: The potential effects of cognitive dual-task for improving postural control. Neuropsychologia 2022; 174:108344. [PMID: 35964781 DOI: 10.1016/j.neuropsychologia.2022.108344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 07/15/2022] [Accepted: 08/01/2022] [Indexed: 10/15/2022]
Abstract
Apathy is a stressor and debilitating common condition for both stroke survivors and their caregivers. However, its effects on the postural control of these patients have not yet been investigated. Improved postural stability through withdrawing attention from postural control by concurrent cognitive task (i.e. dual-task condition) has been reported previously, but the effect of apathy, as a confounding factor, remains unknown. This study aimed to examine the effects of apathy and dual-task condition on postural control of chronic stroke survivors from biomechanical and neurophysiological perspectives. Twenty non-apathetic stroke survivors, 20 apathetic stroke survivors, and 20 sex-, age-, weight-, and height-matched healthy subjects were assessed using different postural sway measures and electromyography activity of ankle and hip muscles while quietly standing on rigid and foam surfaces under single-task, easy dual-task, and difficult dual-task conditions. The results showed postural instability and neuromuscular stiffening of stroke survivors, particularly apathetic stroke survivors, compared with healthy controls as evidenced by significantly greater postural sway measures and increased co-contraction of ankle muscles as well as hip muscles. Notably, concurrently performing a cognitive task significantly reduced postural instability and neuromuscular stiffening in chronic stroke survivors even in those with apathy. In conclusion, apathy exacerbates postural control impairments in chronic stroke survivors promoting an inefficient conscious mode of postural control. It is recommended that distracting the attention away from postural control by performing a concurrent cognitive task can be considered an effective strategy while designing interventions for improving postural control in apathetic stroke survivors.
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Affiliation(s)
- Arian Dehmiyani
- Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Hajar Mehdizadeh
- Department of Neurosciences, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Akram Azad
- Rehabilitation Research Center, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Moslem Cheraghifard
- Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Shamsi Jamali
- Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mehrdad Davoudi
- Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran; Clinic for Orthopaedics and Trauma Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Ghorban Taghizadeh
- Rehabilitation Research Center, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
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22
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Yu B, Xie Q, Xu J, Chen L, Zhang J, Yin H, Jia J, Qiu Y, Xu W. Impairments and Compensations of Static Balance and Plantar Load Distribution in Patients With Chronic Stroke: An Observational Study. J Manipulative Physiol Ther 2022; 44:734-742. [PMID: 35752501 DOI: 10.1016/j.jmpt.2022.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 02/18/2022] [Accepted: 03/08/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVES The purpose of this study was to explore impairment and compensation characteristics of static balance and plantar load distribution in patients with chronic stroke. METHODS We recruited 68 patients who had chronic stroke who could stand independently (stroke group) and 30 healthy individuals (control group) with the Zebris FDM platform. Static balance parameters, including center of pressure (COP) ellipse sway area, COP path length, and angle-θ between y and major axis, were compared between 2 groups under standard standing posture. In the stroke group, balance parameters were re-tested under their preferring standing posture. Plantar load distribution was also assessed. Another 8 patients with chronic stroke who could not stand independently and had to rely on a crutch were enrolled to analyze the characteristics of balance compensation. RESULTS In the stroke group, the ellipse sway area, COP path length, and angle-θ were significantly larger than those of the control group. Sixty-one (89.7%) patients preferred standing with the affected foot outward-forward supporting, and their preferring standing balance was better than that of standard standing. All patients who could not stand independently tended to compensate for balance with a crutch supporting laterally and also preferred standing with a typical posture- the affected foot was outward-forward. CONCLUSIONS In patients post stroke, static balance is impaired mainly at the lateral direction, and patients commonly locate the crutch laterally for compensation of lateral balance. Patients preferred standing with the affected foot outward-forward supporting, and their preferring standing balance was better than that of standard standing, which challenged the necessity of training standing symmetrically.
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Affiliation(s)
- Baofu Yu
- Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China; The Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Qian Xie
- Department of Radiology, Jing'an District Center Hospital, Fudan University, Shanghai, China
| | - Jing Xu
- Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China; Department of Hand and Upper Extremity Surgery, Jing'an District Center Hospital, Fudan University, Shanghai, China; Shanghai Clinical Medical Center for Limb Function Reconstruction, Shanghai, China
| | - Liwen Chen
- Department of Hand and Upper Extremity Surgery, Jing'an District Center Hospital, Fudan University, Shanghai, China; Shanghai Clinical Medical Center for Limb Function Reconstruction, Shanghai, China
| | - Jionghao Zhang
- Shanghai Clinical Medical Center for Limb Function Reconstruction, Shanghai, China; Department of Orthopaedic Surgery, Jing'an District Center Hospital, Fudan University, Shanghai, China
| | - Huawei Yin
- Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China; Department of Hand and Upper Extremity Surgery, Jing'an District Center Hospital, Fudan University, Shanghai, China; Shanghai Clinical Medical Center for Limb Function Reconstruction, Shanghai, China
| | - Jie Jia
- Shanghai Clinical Medical Center for Limb Function Reconstruction, Shanghai, China; Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Yanqun Qiu
- Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China; Department of Hand and Upper Extremity Surgery, Jing'an District Center Hospital, Fudan University, Shanghai, China; Shanghai Clinical Medical Center for Limb Function Reconstruction, Shanghai, China; National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China; Research Unit of Synergistic Reconstruction of Upper and Lower Limbs After Brain Injury, Chinese Academy of Medical Sciences, Shanghai, China.
| | - Wendong Xu
- Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China; Shanghai Clinical Medical Center for Limb Function Reconstruction, Shanghai, China; Shanghai Clinical Medical Center for Limb Function Reconstruction, Shanghai, China; Research Unit of Synergistic Reconstruction of Upper and Lower Limbs After Brain Injury, Chinese Academy of Medical Sciences, Shanghai, China; Research Unit of Synergistic Reconstruction of Upper and Lower Limbs After Brain Injury, Chinese Academy of Medical Sciences, Shanghai, China
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23
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Nguyen PT, Chou LW, Hsieh YL. Proprioceptive Neuromuscular Facilitation-Based Physical Therapy on the Improvement of Balance and Gait in Patients with Chronic Stroke: A Systematic Review and Meta-Analysis. Life (Basel) 2022; 12:life12060882. [PMID: 35743913 PMCID: PMC9225353 DOI: 10.3390/life12060882] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 06/03/2022] [Accepted: 06/08/2022] [Indexed: 11/16/2022] Open
Abstract
The present study aims to determine the potential benefits of PNF on balance and gait function in patients with chronic stroke by using a systematic review and meta-analysis. Systematic review in the following databases: MEDLINE/PubMed, Physiotherapy Evidence Database (PEDro), Cochrane Library and Google Scholar. Studies up to September 2020 are included. A systematic database search was conducted for randomized control trials (RCTs) that investigated the effects of PNF intervention in patients with chronic stroke using balance and gait parameters as outcome measures. The primary outcomes of interest were Berg Balance Scale (BBS), Functional Reach Test (FRT), Timed Up and Go Test (TUG) and 10-Meter Walking Test (10MWT). Nineteen studies with 532 participants were included, of which twelve studies with 327 participants were included for meta-analysis. When the data were pooled, PNF made statistically significant improvements in balance with BBS, FRT and TUG (p < 0.05) or gait velocity with 10MWT (p < 0.001) when compared to the control. This review indicates that PNF is a potential treatment strategy in chronic stroke rehabilitation on balance and gait speed. Further high-quality research is required for concluding a consensus of intervention and research on PNF.
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Affiliation(s)
- Phan The Nguyen
- Department of Physical Therapy, Graduate Institute of Rehabilitation Science, China Medical University, Taichung 406040, Taiwan; (P.T.N.); (L.-W.C.)
- Department of Physical Therapy, Faculty of Nursing and Medical Technology, University of Medicine and Pharmacy, Ho Chi Minh City 8428, Vietnam
| | - Li-Wei Chou
- Department of Physical Therapy, Graduate Institute of Rehabilitation Science, China Medical University, Taichung 406040, Taiwan; (P.T.N.); (L.-W.C.)
- Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung 406040, Taiwan
- Department of Rehabilitation, Asia University Hospital, Taichung 413505, Taiwan
| | - Yueh-Ling Hsieh
- Department of Physical Therapy, Graduate Institute of Rehabilitation Science, China Medical University, Taichung 406040, Taiwan; (P.T.N.); (L.-W.C.)
- Correspondence:
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24
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Meidian AC, Wahyuddin, Amimoto K. Rehabilitation interventions of unilateral spatial neglect based on the functional outcome measure: A systematic review and meta-analysis. Neuropsychol Rehabil 2022; 32:764-793. [PMID: 33106080 DOI: 10.1080/09602011.2020.1831554] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 09/28/2020] [Indexed: 10/23/2022]
Abstract
ABSTRACTThis review aimed to examine the bottom-up and top-down rehabilitation intervention effectiveness based on the functional outcome measure as immediate effect and long-term effect for unilateral spatial neglect conditions. The RCT studies were collected by searching in three databases J-Stage, PubMed, and PEDro from 2008 through 2018. The studies which used the following instruments: BI, CBS, FMA, and FIM, as the functional outcome with the PEDro score of six and above, were eligible for inclusion. A total of 492 participants in 13 studies included from 291 studies initially identified. The meta-analysis for overall ES revealed that BI and CBS had a significant mean of SMD = 0.65 (95% CI, 0.23-1.07; p = 0.003; I2 = 65%), and SMD = -0.23 (95% CI, -0.45 to -0.01; p = 0.04; I2 = 35%) respectively, while FMA and FIM had an insignificant mean of SMD = 0.14 (95% CI, -0.08-0.37; p = 0.22; I2 = 0%), and SMD = -0.22 (95% CI, -0.69-0.25; p = 0.37; I2 = 0%) respectively. Based on the results, although indicated the heterogeneity representation across studies, it showed that the top-down intervention approach of high-frequency rTMS was more effective in enhancing the functional abilities and ADL of unilateral spatial neglect patients on the immediate effects but not necessarily in the long-term effects.
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Affiliation(s)
- Abdul Chalik Meidian
- Department of Physical Therapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
- Faculty of Physiotherapy, Esa Unggul University, Jakarta, Indonesia
| | - Wahyuddin
- Faculty of Physiotherapy, Esa Unggul University, Jakarta, Indonesia
| | - Kazu Amimoto
- Department of Physical Therapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
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25
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Tashiro H, Sato Y, Fukumoto K, Toki M, Kozuka N. Spatiotemporal Characteristics of Lateral Reactive Stepping in Individuals with Chronic Stroke. J Mot Behav 2022; 54:744-754. [DOI: 10.1080/00222895.2022.2080172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Hideyuki Tashiro
- Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Hokkaido, Japan
| | - Yui Sato
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Hokkaido, Japan
| | - Kanta Fukumoto
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Hokkaido, Japan
| | - Megumi Toki
- Department of Rehabilitation Medicine, School of Medicine, Sapporo Medical University, Sapporo, Hokkaido, Japan
| | - Naoki Kozuka
- Department of Physical Therapy, School of Health Sciences, Sapporo Medical University, Sapporo, Hokkaido, Japan
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Inoue M, Amimoto K, Shida K, Sekine D, Hasegawa D, Fukata K, Fujino Y, Makita S, Takahashi H. Effects of Dynamic Sitting Exercise with Delayed Visual Feedback in the Early Post-Stroke Phase: A Pilot Double-Blinded Randomized Controlled Trial. Brain Sci 2022; 12:brainsci12050670. [PMID: 35625055 PMCID: PMC9139189 DOI: 10.3390/brainsci12050670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/09/2022] [Accepted: 05/18/2022] [Indexed: 11/16/2022] Open
Abstract
Sitting ability in the early post-stroke phase affects functional balance ability and other prognoses. We investigated whether dynamic sitting exercise with delayed visual feedback in the mediolateral and anteroposterior directions affected postural control in the early post-stroke phase. In this pilot randomized controlled trial, 27 hemiparetic stroke patients were randomized to experimental (n = 13) and control (n = 14) groups. Dynamic sitting exercise (30 times/day, 5 days/week) in the mediolateral and anteroposterior directions, with 500-ms-delayed (experimental group) or real-time (control group) visual feedback on a computer, was added to usual physical therapy. We evaluated the postural assessment scale for stroke (PASS), static and dynamic sitting balance tasks, the five-times sit-to-stand test, trunk impairment scale, functional ambulation category, and functional independence measure−motor items. In intention-to-treat analysis, the experimental group demonstrated a significant intervention effect on the PASS score (p < 0.05). The mean percentage of body weight on the moving side in the lateral sitting task and the number of successes in the five-times sit-to-stand test were significantly higher in the experimental group than those in the control group (p < 0.05). Thus, the proposed exercise improves postural control, dynamic sitting balance, and sit-to-stand ability in early post-stroke patients.
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Affiliation(s)
- Masahide Inoue
- Department of Rehabilitation, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan; (M.I.); (K.S.); (D.S.); (D.H.); (K.F.); (S.M.); (H.T.)
- Department of Physical Therapy, Tokyo Metropolitan University, 7-2-10 Higashiogu, Arakawa-ku, Tokyo 116-8551, Japan
| | - Kazu Amimoto
- Department of Physical Therapy, Tokyo Metropolitan University, 7-2-10 Higashiogu, Arakawa-ku, Tokyo 116-8551, Japan
- Correspondence: ; Tel.: +81-3-3819-1211
| | - Kohei Shida
- Department of Rehabilitation, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan; (M.I.); (K.S.); (D.S.); (D.H.); (K.F.); (S.M.); (H.T.)
- Department of Physical Therapy, Tokyo Metropolitan University, 7-2-10 Higashiogu, Arakawa-ku, Tokyo 116-8551, Japan
| | - Daisuke Sekine
- Department of Rehabilitation, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan; (M.I.); (K.S.); (D.S.); (D.H.); (K.F.); (S.M.); (H.T.)
| | - Daichi Hasegawa
- Department of Rehabilitation, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan; (M.I.); (K.S.); (D.S.); (D.H.); (K.F.); (S.M.); (H.T.)
| | - Kazuhiro Fukata
- Department of Rehabilitation, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan; (M.I.); (K.S.); (D.S.); (D.H.); (K.F.); (S.M.); (H.T.)
| | - Yuji Fujino
- Department of Physical Therapy, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan;
| | - Shigeru Makita
- Department of Rehabilitation, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan; (M.I.); (K.S.); (D.S.); (D.H.); (K.F.); (S.M.); (H.T.)
| | - Hidetoshi Takahashi
- Department of Rehabilitation, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan; (M.I.); (K.S.); (D.S.); (D.H.); (K.F.); (S.M.); (H.T.)
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27
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Nam SM, Lee DY. Effects of Visual Cue Deprivation Balance Training with Head Control on Balance and Gait Function in Stroke Patients. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:629. [PMID: 35630046 PMCID: PMC9148052 DOI: 10.3390/medicina58050629] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 04/28/2022] [Accepted: 04/29/2022] [Indexed: 11/16/2022]
Abstract
Background and Objectives: Visual cue deprivation is the instability of head control is increased. The purpose of this study is to investigate the effects of visual cue deprivation balance training by applying head control feedback to the balance and gait ability of stroke patients. Materials and Methods: The study was conducted on 41 patients diagnosed with hemiplegia due to stroke. Subjects were randomly assigned to any of the following groups: the experimental group I, the experimental group II or the control group. The randomization method used a simple randomization method. To evaluate changes in balance function, a LOS (Limit of Stability) and a BBS (Berg Balance Scale) were performed. In addition, to evaluate changes in ST (stride time), SL (stride length), and cadence, a LEGSys were performed. Results: A two-way repeated ANOVA was conducted to analyze the differences between groups. There were significant differences between groups in all variables for the balance function. There were significant differences between groups in all variables for the balance function. There were significant differences between groups in SL and cadence for the gait function. Conclusions: Visual cue deprivation balance training applying head control feedback is effective in improving dynamic balance ability and cadence. It is necessary to constantly maintain the head orientation by feedback and to properly control the head movement.
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Affiliation(s)
- Seung-Min Nam
- Department of Sports Rehabilitation & Exercise Management, Yeungnam University College, Daegu-si 42415, Korea;
| | - Do-Youn Lee
- Department of Physical Therapy, Daegu University, Gyeongsan-si 38541, Korea
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28
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Schröder J, Saeys W, Yperzeele L, Kwakkel G, Truijen S. Time Course and Mechanisms Underlying Standing Balance Recovery Early After Stroke: Design of a Prospective Cohort Study With Repeated Measurements. Front Neurol 2022; 13:781416. [PMID: 35265023 PMCID: PMC8899509 DOI: 10.3389/fneur.2022.781416] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 01/17/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Although most stroke survivors show some spontaneous neurological recovery from motor impairments of the most-affected leg, the contribution of this leg to standing balance control remains often poor. Consequently, it is unclear how spontaneous processes of neurological recovery contributes to early improvements in standing balance. Objective We aim to investigate (1) the time course of recovery of quiet stance balance control in the first 12 weeks poststroke and (2) how clinically observed improvements of lower limb motor impairments longitudinally relate to this limb's relative contribution to balance control. Methods and Analysis In this prospective longitudinal study, a cohort of 60 adults will be recruited within the first 3 weeks after a first-ever hemispheric stroke and mild-to-severe motor impairments. Individual recovery trajectories will be investigated by means of repeated measurements scheduled at 3, 5, 8, and 12 weeks poststroke. The Fugl-Meyer Motor Assessment and Motricity Index of the lower limb serve as clinical measures of motor impairments at the hemiplegic side. As soon as subjects are able to stand independently, bilateral posturography during quietly standing will be measured. First, the obtained center-of-pressure (COP) trajectories at each foot will be used for synchronization and contribution measures that establish (a-)symmetries between lower limbs. Second, the COP underneath both feet combined will be used to estimate overall stability. Random coefficient analyses will be used to model time-dependent changes in these measures and, subsequently, a hybrid model will be used to investigate longitudinal associations with improved motor impairments. Discussion The current study aims to investigate how stroke survivors "re-learn" to maintain standing balance as an integral part of daily life activities. The knowledge gained through this study may contribute to recommending treatment strategies for early stroke rehabilitation targeting behavioral restitution of the most-affected leg or learning to compensate with the less-affected leg.
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Affiliation(s)
- Jonas Schröder
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy, Faculty of Health Sciences, University of Antwerp, Wilrijk, Belgium.,M2OCEAN Lab, The Multidisciplinary Motor Centre Antwerp, Faculty of Health Sciences, University of Antwerp, Edegem, Belgium
| | - Wim Saeys
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy, Faculty of Health Sciences, University of Antwerp, Wilrijk, Belgium.,M2OCEAN Lab, The Multidisciplinary Motor Centre Antwerp, Faculty of Health Sciences, University of Antwerp, Edegem, Belgium.,RevArte Rehabilitation Hospital, Edegem, Belgium
| | - Laetitia Yperzeele
- Department of Neurology, Neurovascular Reference Center, Antwerp University Hospital, Edegem, Belgium.,Research Group Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Gert Kwakkel
- Department of Rehabilitation Medicine and Amsterdam Neuroscience, Amsterdam Movement Sciences, Amsterdam University Medical Centre, Amsterdam, Netherlands.,Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States.,Department of Neurorehabilitation, Amsterdam Rehabilitation Research Centre, Reade, Amsterdam, Netherlands
| | - Steven Truijen
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy, Faculty of Health Sciences, University of Antwerp, Wilrijk, Belgium.,M2OCEAN Lab, The Multidisciplinary Motor Centre Antwerp, Faculty of Health Sciences, University of Antwerp, Edegem, Belgium
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29
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Summers SJ, Antcliff S, Waddington G, Wallwork S. Reliability and learning effects of repeated exposure to the Bertec Balance Advantage sensory organisation test in healthy individuals. Gait Posture 2022; 93:205-211. [PMID: 35183837 DOI: 10.1016/j.gaitpost.2022.02.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 01/17/2022] [Accepted: 02/08/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND The Sensory Organisation Test (SOT) of computerised dynamic posturography (CDP) is a well-established clinical test used to measure postural control. Advances in technology have enabled new CDP systems to use immersive virtual reality, such as the Bertec® Balance Advantage®. While the Bertec provides an innovative approach to posturography, the reliability and learning effects of the Bertec in administering the SOT has not been thoroughly investigated. RESEARCH QUESTION To evaluate the reliability and performance during repeated administration of the Bertec® Balance Advantage® SOT. METHODS Fourteen healthy adults (age 27.17 ± 5.5years; 10 females) participated. Each participant performed five SOTs over three sessions. The first two sessions were approximately two days apart and the third one month later. In the first two sessions, two SOTs were conducted, and in the third session, one was performed. Composite, equilibrium, and ratio scores were used for analysis. RESULTS Poor within-session reliability was found in the first session for the composite score (ICC: 0.73, 95% CI: 0.32-0.91), which improved by the second session (ICC: 0.84, 95% CI: 0.58-0.94). Poor within-session reliability (ICC <0.5) was found for all ratio and equilibrium scores, except for the equilibrium score of condition 3, which demonstrated moderate reliability (ICC: 0.84, 95% CI: 0.57-0.95). Poor between-session reliability was found for all outcomes. There was an increase in the composite and equilibrium scores for conditions 5 and 6 over the 5 tests, which plateaued after the fourth test, and were retained at 1 month. SIGNIFICANCE The data demonstrate a steady increase in performance with repeated exposure to the Bertec SOT, which was maintained one month later, indicating a learning effect. We recommend that a minimum of two familiarisation sessions should be administered to establish baseline performance and improve reliability.
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Affiliation(s)
- Simon J Summers
- Discipline of Sport and Exercise Science, Faculty of Health, University of Canberra, ACT, Australia; Brain Stimulation and Rehabilitation (BrainStAR) Lab, Western Sydney University, NSW, Australia.
| | - Susan Antcliff
- Research Institute for Sport and Exercise, University of Canberra, ACT, Australia
| | - Gordon Waddington
- Research Institute for Sport and Exercise, University of Canberra, ACT, Australia
| | - Sarah Wallwork
- IIMPACT in Health, Allied Health and Human Performance, University of South Australia, SA, Australia; Research Institute for Sport and Exercise, University of Canberra, ACT, Australia
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30
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Inoue S, Otaka Y, Kumagai M, Sugasawa M, Mori N, Kondo K. Effects of Balance Exercise Assist Robot training for patients with hemiparetic stroke: a randomized controlled trial. J Neuroeng Rehabil 2022; 19:12. [PMID: 35090517 PMCID: PMC8796441 DOI: 10.1186/s12984-022-00989-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 01/08/2022] [Indexed: 02/05/2023] Open
Abstract
Background Robot-assisted rehabilitation for patients with stroke is promising. However, it is unclear whether additional balance training using a balance-focused robot combined with conventional rehabilitation programs supplements the balance function in patients with stroke. The purpose of this study was to compare the effects of Balance Exercise Assist Robot (BEAR) training combined with conventional inpatient rehabilitation training to those of conventional inpatient rehabilitation only in patients with hemiparetic stroke. We also aimed to determine whether BEAR training was superior to intensive balance training. Methods This assessor-blinded randomized controlled trial included 60 patients with first-ever hemiparetic stroke, admitted to rehabilitation wards between December 2016 and February 2019. Patients were randomly assigned to one of three groups, robotic balance training and conventional inpatient rehabilitation (BEAR group), intensive balance training and conventional inpatient rehabilitation (IBT group), or conventional inpatient rehabilitation-only (CR group). The intervention duration was 2 weeks, with assessments conducted pre- and post-intervention, and at 2 weeks follow-up. The primary outcome measure was a change in the Mini-Balance Evaluation Systems Test (Mini-BESTest) score from baseline. Results In total, 57 patients completed the intervention, and 48 patients were evaluated at the follow-up. Significant improvements in Mini-BESTest score were observed in the BEAR and IBT groups compared with in the CR group post-intervention and after the 2-week follow-up period (P < 0.05). Conclusions The addition of balance exercises using the BEAR alongside conventional inpatient rehabilitation improved balance in patients with subacute stroke. Trial registration https://www.umin.ac.jp/ctr; Unique Identifier: UMIN000025129. Registered on 2 December 2016.
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Kimura N, Kawasaki S, Tsuruda A, Nogi S, Ohata K. The centre of pressure position determined by capacity of weight-shifting in stride stances in individuals with post-stroke. Clin Biomech (Bristol, Avon) 2022; 91:105534. [PMID: 34871914 DOI: 10.1016/j.clinbiomech.2021.105534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 11/09/2021] [Accepted: 11/16/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND The dynamics of shifting the centre-of-pressure in stride stances are essential for postural control during the double-limb support phase of gait. Impaired loading onto a paretic limb following stroke causes a biased self-centred position (defined as the centre-of-pressure position in a static stride stance) between legs, which may be related to the capacity of the centre-of-pressure movements. This study investigated anteroposterior centre-of-pressure movements relative to two different positions in stride stances and determine their relationship with the self-centred position and clinical measures after stroke. METHODS Sixteen chronic post-stroke individuals performed anteroposterior weight-shifting in stride stances with the anterior and posterior paretic foot on a plantar pressure platform. The maximum anterior and posterior centre-of-pressure movements in stride stances were quantified relative to the self-centred position and the origin of the platform. FINDINGS The self-centred position was biased towards the non-paretic limb to maintain identical anterior and posterior centre-of-pressure movements between stride stances with the anterior and posterior paretic foot. Furthermore, the self-centred position was related to the capacity of anteroposterior centre-of-pressure movements in stride stances. Especially, impaired balance function was associated with the self-centred position and decreased posterior centre-of-pressure movement in stride stance with the posterior paretic foot. INTERPRETATIONS The assessment of the self-centred position in stride stances can be beneficial in understanding the capability to control weight-shifting. In particular, the improvement of balance control in stride stance with the posterior paretic foot would help to improve postural control during the double-limb support phase following stroke.
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Affiliation(s)
- Nodoka Kimura
- Center for Information and Neural Networks (CiNet), Advanced ICT Research Institute, National Institute of Information and Communications Technology (NICT), 1-4 Yamadaoka, Suita, Osaka 565-0871, Japan..
| | - Shihomi Kawasaki
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53, Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Akihiro Tsuruda
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53, Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Shiori Nogi
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53, Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Koji Ohata
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53, Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
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Feitosa JA, Fernandes CA, Casseb RF, Castellano G. Effects of virtual reality-based motor rehabilitation: a systematic review of fMRI studies. J Neural Eng 2021; 19. [PMID: 34933281 DOI: 10.1088/1741-2552/ac456e] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 12/21/2021] [Indexed: 11/11/2022]
Abstract
BACKGROUND The use of virtual reality (VR) as a rehabilitation tool has been shown to induce motor and cognitive improvements in different populations. Functional magnetic resonance imaging (fMRI) has been used to investigate neuroplasticity resulting from these treatments. We hypothesize that VR rehabilitation induces functional improvement and brain changes that can be detected by fMRI. OBJECTIVE To systematically review the effects of VR intervention on the cortical reorganization measured by fMRI and associated with functional improvement. METHODS We performed a systematic review of studies published between 2005 and 2021. Papers were retrieved from six databases using the following keywords: "motor rehabilitation", "fMRI" and "virtual reality". Case studies, pre-post studies, cross-sectional studies, and randomized controlled trials published were included. Manuscripts were assessed by The NIH Study Quality Assessment Tools to determine their quality. RESULTS Twenty-three articles met our eligibility criteria: 18 about VR rehabilitation in stroke and five on other clinical conditions (older adults, cerebral palsy, and Parkinson's disease). Changes in neural patterns of activation and reorganization were revealed in both the ipsilesional and the contralesional hemispheres. Results were located mainly in the primary motor cortex, sensorimotor cortex and supplementary motor area in post-stroke patients in the acute, subacute, and chronic rehabilitation phases, and were associated with functional improvement after VR intervention. Similar effects were observed in older adults and in patients with other neurological diseases with improved performance. CONCLUSION Most stroke-related studies showed either restoration to normal or increase of activation patterns or relateralization at/to the ipsilesional hemisphere, with some also reporting a decrease in activity or extent of activation after VR therapy. In general, VR intervention demonstrated evidence of efficacy both in neurological rehabilitation and in performance improvement of older adults, accompanied by fMRI evidence of brain reorganization.
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Affiliation(s)
- Jamille A Feitosa
- University of Campinas, Institute of Physics Gleb Wataghin, R. Sérgio Buarque de Holanda, nº 777, Campinas, SP, 13083-872, BRAZIL
| | - Corina A Fernandes
- University of Campinas, Institute of Physics Gleb Wataghin, R. Sérgio Buarque de Holanda, nº 777, Campinas, SP, 13083-872, BRAZIL
| | - Raphael F Casseb
- University of Campinas, Neuroimaging Laboratory - Rua Vital Brasil, 251, Cidade Universitaria "Zeferino Vaz", Campinas, SP, Brazil, Campinas, 13083-888, BRAZIL
| | - Gabriela Castellano
- Department of Cosmic Rays and Chronology, University of Campinas - UNICAMP, Institute of Physics Gleb Wataghin, R. Sérgio Buarque de Holanda, nº 777, Cidade Universitária, Campinas, SP, 13083-859, BRAZIL
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Tohyama T, Kondo K, Otaka Y. Effects of Galvanic Vestibular Stimulation on Visual Verticality and Standing Posture Differ Based on the Polarity of the Stimulation and Hemispheric Lesion Side in Patients With Stroke. Front Neurol 2021; 12:768663. [PMID: 34858316 PMCID: PMC8631773 DOI: 10.3389/fneur.2021.768663] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 10/08/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction: There is growing evidence supporting the relationship of vertical misperception and poor balance control with asymmetrical standing posture in patients with stroke. Although the vestibular system has been shown to be responsible for vertical misperception and balance disorders, the effect of galvanic vestibular stimulation (GVS) on both vertical misperception and postural asymmetry after stroke remains elusive. The aim of this study was to investigate the effects of GVS on visual verticality and postural asymmetry after stroke and to clarify whether the effects differ depending on the polarity of the stimulation and hemispheric lesion side. Methods: We measured the subjective visual vertical (SVV) and body weight distribution on each foot in an upright stance in 24 patients with a hemispheric stroke (10 with a left hemisphere lesion and 14 with a right hemisphere lesion) and nine age-matched healthy controls. During the measurements, bipolar GVS (1.5 mA) was applied over the bilateral mastoid processes in three stimulation conditions: contralesional-anodal and ipsilesional-cathodal vestibular stimulation, ipsilesional-anodal and contralesional-cathodal vestibular stimulation, and no stimulation. To examine whether GVS modulates visual verticality and standing posture, SVV and weight-bearing in the three conditions were analyzed. Results: During no stimulation, the SVV deviated to the contralesional side in patients with a right hemisphere lesion, while more weight-bearing was observed on the ipsilesional limb than on the contralesional limb in both patient groups than in the controls. The SVV was modulated by reversing the polarity of GVS in all the groups when the cathodal stimulus side was either ipsilateral or contralateral to the lesion while the ipsilesional-cathodal vestibular stimulation reduced weight-bearing asymmetry in only the patients with a right hemisphere lesion. Conclusions: These findings demonstrate that the effects of GVS on the SVV and standing posture differ depending on the polarity of GVS and the hemispheric lesion side. Patients with a right hemisphere lesion have difficulty maintaining their preferred standing posture under visual verticality modulation evoked by GVS. The application of GVS may clarify whether the vestibular system has neural redundancy after stroke to suppress any effects of the stimulation, including modulation of the visual verticality, on balance.
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Affiliation(s)
- Takamichi Tohyama
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Narashino, Japan.,Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Kunitsugu Kondo
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Narashino, Japan
| | - Yohei Otaka
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Narashino, Japan.,Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
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Hugues A, Guinet-Lacoste A, Bin S, Villeneuve L, Lunven M, Pérennou D, Giraux P, Foncelle A, Rossetti Y, Jacquin-Courtois S, Luauté J, Rode G. Effects of prismatic adaptation on balance and postural disorders in patients with chronic right stroke: protocol for a multicentre double-blind randomised sham-controlled trial. BMJ Open 2021; 11:e052086. [PMID: 34819284 PMCID: PMC8614142 DOI: 10.1136/bmjopen-2021-052086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 10/21/2021] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Patients with right stroke lesion have postural and balance disorders, including weight-bearing asymmetry, more pronounced than patients with left stroke lesion. Spatial cognition disorders post-stroke, such as misperceptions of subjective straight-ahead and subjective longitudinal body axis, are suspected to be involved in these postural and balance disorders. Prismatic adaptation has showed beneficial effects to reduce visuomotor disorders but also an expansion of effects on cognitive functions, including spatial cognition. Preliminary studies with a low level of evidence have suggested positive effects of prismatic adaptation on weight-bearing asymmetry and balance after stroke. The objective is to investigate the effects of this intervention on balance but also on postural disorders, subjective straight-ahead, longitudinal body axis and autonomy in patients with chronic right stroke lesion. METHODS AND ANALYSIS In this multicentre randomised double-blind sham-controlled trial, we will include 28 patients aged from 18 to 80 years, with a first right supratentorial stroke lesion at chronic stage (≥12 months) and having a bearing ≥60% of body weight on the right lower limb. Participants will be randomly assigned to the experimental group (performing pointing tasks while wearing glasses shifting optical axis of 10 degrees towards the right side) or to the control group (performing the same procedure while wearing neutral glasses without optical deviation). All participants will receive a 20 min daily session for 2 weeks in addition to conventional rehabilitation. The primary outcome will be the balance measured using the Berg Balance Scale. Secondary outcomes will include weight-bearing asymmetry and parameters of body sway during static posturographic assessments, as well as lateropulsion (measured using the Scale for Contraversive Pushing), subjective straight-ahead, longitudinal body axis and autonomy (measured using the Barthel Index). ETHICS AND DISSEMINATION The study has been approved by the ethical review board in France. Findings will be submitted to peer-reviewed journals relative to rehabilitation or stroke. TRIAL REGISTRATION NUMBER NCT03154138.
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Affiliation(s)
- Aurélien Hugues
- Service de médecine physique et réadaptation, hôpital Henry Gabrielle, Hospices Civils de Lyon, Saint-Genis Laval, France
- Equipe 'Trajectoires', Centre de Recherche en Neurosciences de Lyon, Inserm UMR-S 1028, CNRS UMR 5292, Université de Lyon, Université Lyon 1, Bron, France
- Plate-forme 'Mouvement et Handicap', hôpital Henry Gabrielle, Hospices Civils de Lyon, Saint-Genis-Laval, France
| | - Amandine Guinet-Lacoste
- Service de médecine physique et réadaptation, hôpital Henry Gabrielle, Hospices Civils de Lyon, Saint-Genis Laval, France
- Equipe 'Trajectoires', Centre de Recherche en Neurosciences de Lyon, Inserm UMR-S 1028, CNRS UMR 5292, Université de Lyon, Université Lyon 1, Bron, France
- Plate-forme 'Mouvement et Handicap', hôpital Henry Gabrielle, Hospices Civils de Lyon, Saint-Genis-Laval, France
| | - Sylvie Bin
- Service de Recherche Clinique et Epidémiologique, Pôle de Santé Publique, Hospices Civils de Lyon, Lyon, France
| | - Laurent Villeneuve
- Service de Recherche Clinique et Epidémiologique, Pôle de Santé Publique, Hospices Civils de Lyon, Lyon, France
- EMR 3738, Université Lyon 1, Villeurbanne, France
| | - Marine Lunven
- Département d'Etudes Cognitives, École normale supérieure, PSL University, Paris, France
- Hôpital Henri Mondor-Albert Chenevier, Centre de référence Maladie de Huntington, Service de Neurologie, AP-HP, Créteil, France
- INSERM U955, Institut Mondor de Recherche Biomédicale, Equipe NeuroPsychologie Interventionnelle, Université Paris Est Créteil, Créteil, France
| | - Dominic Pérennou
- Département de médecine physique et de réadaptation, Institut de rééducation, Hôpital sud, Centre Hospitalier Universitaire Grenoble-Alpes, Grenoble, France
- Laboratoire Neurosciences Cognitives, CNRS UMR5105, Université Grenoble Alpes, Grenoble, France
| | - Pascal Giraux
- Service de médecine physique et réadaptation, Hôpital Bellevue, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
- Laboratoire Inter-universitaire de Biologie de la Motricité (LIBM, EA 7424), Université Jean Monnet Saint-Etienne, Université de Lyon, Saint-Etienne, France
| | - Alexandre Foncelle
- Equipe 'Trajectoires', Centre de Recherche en Neurosciences de Lyon, Inserm UMR-S 1028, CNRS UMR 5292, Université de Lyon, Université Lyon 1, Bron, France
| | - Yves Rossetti
- Service de médecine physique et réadaptation, hôpital Henry Gabrielle, Hospices Civils de Lyon, Saint-Genis Laval, France
- Equipe 'Trajectoires', Centre de Recherche en Neurosciences de Lyon, Inserm UMR-S 1028, CNRS UMR 5292, Université de Lyon, Université Lyon 1, Bron, France
- Plate-forme 'Mouvement et Handicap', hôpital Henry Gabrielle, Hospices Civils de Lyon, Saint-Genis-Laval, France
| | - Sophie Jacquin-Courtois
- Service de médecine physique et réadaptation, hôpital Henry Gabrielle, Hospices Civils de Lyon, Saint-Genis Laval, France
- Equipe 'Trajectoires', Centre de Recherche en Neurosciences de Lyon, Inserm UMR-S 1028, CNRS UMR 5292, Université de Lyon, Université Lyon 1, Bron, France
- Plate-forme 'Mouvement et Handicap', hôpital Henry Gabrielle, Hospices Civils de Lyon, Saint-Genis-Laval, France
| | - Jacques Luauté
- Service de médecine physique et réadaptation, hôpital Henry Gabrielle, Hospices Civils de Lyon, Saint-Genis Laval, France
- Equipe 'Trajectoires', Centre de Recherche en Neurosciences de Lyon, Inserm UMR-S 1028, CNRS UMR 5292, Université de Lyon, Université Lyon 1, Bron, France
- Plate-forme 'Mouvement et Handicap', hôpital Henry Gabrielle, Hospices Civils de Lyon, Saint-Genis-Laval, France
| | - Gilles Rode
- Service de médecine physique et réadaptation, hôpital Henry Gabrielle, Hospices Civils de Lyon, Saint-Genis Laval, France
- Equipe 'Trajectoires', Centre de Recherche en Neurosciences de Lyon, Inserm UMR-S 1028, CNRS UMR 5292, Université de Lyon, Université Lyon 1, Bron, France
- Plate-forme 'Mouvement et Handicap', hôpital Henry Gabrielle, Hospices Civils de Lyon, Saint-Genis-Laval, France
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Bruyneel AV, Dubé F. Best Quantitative Tools for Assessing Static and Dynamic Standing Balance after Stroke: A Systematic Review. Physiother Can 2021; 73:329-340. [PMID: 34880537 DOI: 10.3138/ptc-2020-0005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose: Our objective was to examine the psychometric qualities (reliability and validity) and clinical utility of quantitative tools in measuring the static and dynamic standing balance of individuals after stroke. Method: We searched four databases (PubMed/MEDLINE, PEDro, Embase, and CINAHL) for studies published from January 2018 through September 2019 and included those that assessed the psychometric properties of standing balance tests with an adult stroke population. We evaluated the quality of the studies using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist and assessed each test on a utility assessment scale. Results: A total of 22 studies met the inclusion criteria, and 18 quantitative tools for assessing static or dynamic standing balance of individuals with stroke were analyzed. Findings support good or excellent reliability for all tests, whereas correlations for validity ranged from weak to strong. Study quality was variable. Dynamic balance tests had better clinical utility scores than static ones. Five tests had complete psychometric analyses: quiet standing on a force platform, five-step test, sideways step, step length, and turn tests.
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Affiliation(s)
- Anne-Violette Bruyneel
- Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts, Delémont, Western Switzerland, Switzerland
| | - François Dubé
- School of Rehabilitation, Université de Montréal, Montreal, Quebec, Canada.,Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Ȋle-de-Montréal, Montreal, Quebec, Canada
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Ranjan S, Rezaee Z, Dutta A, Lahiri U. Feasibility of Cerebellar Transcranial Direct Current Stimulation to Facilitate Goal-Directed Weight Shifting in Chronic Post-Stroke Hemiplegics. IEEE Trans Neural Syst Rehabil Eng 2021; 29:2203-2210. [PMID: 34694998 DOI: 10.1109/tnsre.2021.3122202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Neurological disorder such as stroke can adversely affect one's weight-bearing symmetry leading to dysfunctional postural control. Recovery after stroke is facilitated through functionally-relevant neuroplastic modulation. Functionally-relevant cerebellum coordinates voluntary movements. Specifically, the dentate nuclei and lower limb representations (lobules VII-IX) of the cerebellum are involved in error-correction, crucial for postural control. It is postulated that cerebellar transcranial direct current stimulation (ctDCS) of the dentate nuclei and lobules VII-IX can modulate postural control in chronic stroke survivors. The objectives of this work were to (1) present a refined Virtual Reality (VR)-based balance training platform (VBaT) that can measure Center of Pressure (CoP) and (2) carry out a study to understand the implication of ctDCS stimulating the dentate nuclei (PhaseD) and lobules VII-IX (PhaseL) on the postural control of chronic stroke patients when they interacted with VBaT. Also, we investigated whether hemiplegic patients (with intact cerebellum) having Basal Ganglia (BG) infarction had any differential abilities to correct postural sway from those with no BG infarction (while shifting weight to the Affected side). Results of a single-session single-blind crossover study on randomized PhaseD and PhaseL stimulation (with an intermediate resting state bipolar bilateral ctDCS) on 12 chronic hemiplegic patients on separate days indicated differentiated findings (post stimulation) on CoP-related indices. We observed an incremental effect on one's postural control during PhaseD and inhibitory effect on the dentate nuclei during PhaseL. Clustering analysis showed that those with BG infarction demonstrated poor postural control and deficit in error correction ability irrespective of the ctDCS Phase.
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Proprioceptive Neuromuscular Facilitation Kinesio Taping Improves Range of Motion of Ankle Dorsiflexion and Balance Ability in Chronic Stroke Patients. Healthcare (Basel) 2021; 9:healthcare9111426. [PMID: 34828473 PMCID: PMC8619064 DOI: 10.3390/healthcare9111426] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/13/2021] [Accepted: 10/19/2021] [Indexed: 11/25/2022] Open
Abstract
This study aimed to determine the effect of a proprioceptive neuromuscular facilitation (PNF) pattern Kinesio taping (KT) application on the ankle dorsiflexion range of motion (DF-ROM) and balance ability in patients with chronic stroke. This crossover study included 18 patients with stroke. The subjects were randomly assigned to three interventions: barefoot, ankle KT (A-KT), and PNF-KT. The A-KT was applied to the gastrocnemius and tibialis anterior (TA) muscles, and subtalar eversion. The PNF-KT was applied on the extensor hallucis, extensor digitorum, and TA muscles. DR-ROM was measured using the iSen™, a wearable sensor. Balance ability was assessed based on static balance, measured by the Biodex Balance System (BBS), and dynamic balance, measured by the timed up and go (TUG) test and dynamic gait index (DGI). Compared with the barefoot and A-KT interventions, PNF-KT showed significant improvements in the ankle DF-ROM and BBS scores, TUG, and DGI. PNF-KT, for functional muscle synergy, improved the ankle DF-ROM and balance ability in patients with chronic stroke. Therefore, the application of PNF-KT may be a feasible therapeutic method for improving ankle movement and balance in patients with chronic stroke. Additional research is recommended to identify the long-term effects of the PNF-KT.
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Sharony AF, Engel-Yeger B. Sensory Modulation and Participation in Daily Occupations in Stroke Survivors. The Canadian Journal of Occupational Therapy 2021; 88:375-383. [PMID: 34632801 DOI: 10.1177/00084174211047372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background. Stroke may alter sensory modulation and restrict participation in daily occupations. Although studies highlight the relationship between altered sensory modulation and reduced participation, this relationship in stroke survivors has not been studied enough. Purpose. To examine the prevalence of altered sensory modulation among stroke survivors; to compare sensory modulation and participation between stroke survivors and healthy controls; to estimate the relationship between sensory modulation and participation among stroke survivors. Method. Thirty stroke survivors and 30 healthy controls, aged 18-70, completed the MoCA, the Adolescent-Adult Sensory Profile and the Activity Card Sort. Findings. Altered sensory modulation was more prevalent among stroke survivors. Their participation was significantly restricted as compared to healthy controls. Lower tendency to seek sensory input predicted lower participation in social activities. Implications. Occupational therapists should screen for altered sensory modulation in stroke survivors and understand their impacts on participation, in order to improve intervention outcomes.
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Junata M, Cheng KCC, Man HS, Lai CWK, Soo YOY, Tong RKY. Kinect-based rapid movement training to improve balance recovery for stroke fall prevention: a randomized controlled trial. J Neuroeng Rehabil 2021; 18:150. [PMID: 34635141 PMCID: PMC8503723 DOI: 10.1186/s12984-021-00922-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 08/12/2021] [Indexed: 11/18/2022] Open
Abstract
Background Falls are more prevalent in stroke survivors than age-matched healthy older adults because of their functional impairment. Rapid balance recovery reaction with adequate range-of-motion and fast response and movement time are crucial to minimize fall risk and prevent serious injurious falls when postural disturbances occur. A Kinect-based Rapid Movement Training (RMT) program was developed to provide real-time feedback to promote faster and larger arm reaching and leg stepping distances toward targets in 22 different directions. Objective To evaluate the effectiveness of the interactive RMT and Conventional Balance Training (CBT) on chronic stroke survivors’ overall balance and balance recovery reaction. Methods In this assessor-blinded randomized controlled trial, chronic stroke survivors were randomized to receive twenty training sessions (60-min each) of either RMT or CBT. Pre- and post-training assessments included clinical tests, as well as kinematic measurements and electromyography during simulated forward fall through a “lean-and-release” perturbation system. Results Thirty participants were recruited (RMT = 16, CBT = 14). RMT led to significant improvement in balance control (Berg Balance Scale: pre = 49.13, post = 52.75; P = .001), gait control (Timed-Up-and-Go Test: pre = 14.66 s, post = 12.62 s; P = .011), and motor functions (Fugl-Meyer Assessment of Motor Recovery: pre = 60.63, post = 65.19; P = .015), which matched the effectiveness of CBT. Both groups preferred to use their non-paretic leg to take the initial step to restore stability, and their stepping leg’s rectus femoris reacted significantly faster post-training (P = .036). Conclusion The RMT was as effective as conventional balance training to provide beneficial effects on chronic stroke survivors’ overall balance, motor function and improving balance recovery with faster muscle response. Trial registration: The study was registered at Clinicaltrials.gov (https://clinicaltrials.gov/ct2/show/NCT03183635, NCT03183635) on 12 June 2017.
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Affiliation(s)
- Melisa Junata
- Department of Biomedical Engineering, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Kenneth Chik-Chi Cheng
- Department of Biomedical Engineering, The Chinese University of Hong Kong, Hong Kong, SAR, China.,Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Hok Sum Man
- Department of Biomedical Engineering, The Chinese University of Hong Kong, Hong Kong, SAR, China.,Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | | | - Yannie Oi-Yan Soo
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Raymond Kai-Yu Tong
- Department of Biomedical Engineering, The Chinese University of Hong Kong, Hong Kong, SAR, China.
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SZAKÁCS J, DUICA LC, RACHERIU M. Quality of Life and Negative Affectivity at the Patients with Stroke and Musculoskeletal Disorders. BALNEO AND PRM RESEARCH JOURNAL 2021. [DOI: 10.12680/balneo.2021.449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction. Stroke can be a severe debilitating medical condition due to its medical consequences. When it occurs at an individual with pre-existent musculoskeletal disorders, the medical recovery becomes more problematic. Some consequences, like negative affectivity and a reduced quality of life intervene to varying degrees.
Material and method. Our study included 150 outpatients who were diagnosed with stroke and one of five types of musculoskeletal disorders (low back pain, osteoporosis, hand disorders, hip osteoarthritis, knee osteoarthritis). We divided all the patients in five sub-groups. To assess the negative affectivity (anxiety) and quality of life we administered to the patients two scales: the State Trait Anxiety Inventory (STAI) form X1 (anxiety a s a state) and form X2 (anxiety as a trait) and The Quality of Life (QOL).
Results. In patients diagnosed with stroke and osteoporosis, the quality of life was 83.92% of the maximum value. Anxiety as a state rated at an average of 50.5 and anxiety as a trait rated at an average of 45. In the case of stroke and degenerative diseases at the lower limbs, we registered the quality of life of 77.68% in knee osteoarthritis and 75.89% in hip osteoarthritis; anxiety as a condition had an average value of 65 and, as a trait, a value of 63 in knee osteoarthritis, while in hip osteoarthritis the anxiety as a condition, and, in the same time, as a trait, rated both at 49.5. Low back pain in stroke patients had a quality of life of 77.86% of the maximum value; anxiety as a condition was 48 and the anxiety trait has the value of 47. For the patients with stroke and hand disease, the quality of life was assessed at 88.83%. Anxiety as a condition recorded an average value of 48 and the average value of 51 for anxiety as a trait recorded an average value of 51.
Conclusions. The lowest score of quality of life is recorded in the patient diagnosed with stroke and hip osteoarthritis (75.89% of the maximum value). This association converges with body dynamics, as the overlap of these two medical conditions may explain reduced functionality. The value of anxiety as a condition and also as a trait was higher in patients with stroke and osteoarthritis of the knee (65 and 63, respectively). The latter result is understandable, as intense pain and, therefore, discomfort related to osteoarthritis of the knee is well known.
Keywords: stroke, anxiety, quality of life, musculoskeletal conditions,
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Affiliation(s)
- Juliánna SZAKÁCS
- George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Faculty of Medicine, Department of Biophysics, Targu Mureș, Romania
| | - Lavinia-Corina DUICA
- Lucian Blaga University of Sibiu, Faculty of Medicine, Sibiu, Romania 3Hospital of Psychiatry „Doctor Gheorghe Preda” Sibiu, România
| | - Mihaela RACHERIU
- Lucian Blaga University of Sibiu, Faculty of Medicine, Sibiu, Romania, County Clinical Emergency Hospital, Sibiu, Romania
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Inoue M, Amimoto K, Chiba Y, Sekine D, Fukata K, Fujino Y, Takahashi H, Makita S. Effect of Exercise Involving Standing Weight Shifting to the Nonparetic Side on an Inclined Surface in the Early Phase After a Stroke: A Randomized Controlled Trial. Phys Ther 2021; 101:6254128. [PMID: 33909896 DOI: 10.1093/ptj/pzab114] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 01/24/2021] [Accepted: 03/18/2021] [Indexed: 11/14/2022]
Abstract
OBJECTIVE This study aimed to clarify whether an exercise involving weight shifting to the nonparetic side while standing on an inclined surface improves standing balance in the early phase after stroke. METHODS This assessor-blinded, randomized controlled trial included people undergoing inpatient rehabilitation at a university hospital. Participants (N = 52) with hemiparesis caused by a stroke were randomly assigned to an experimental group (n = 26) or control group (n = 26). Participants performed a weight-shifting exercise to the nonparetic side using a goal-directed reaching strategy while standing on an inclined surface that was elevated 5 degrees to the nonparetic side in the experimental group or a flat surface in the control group. The reaching exercise was conducted 30 times per day for 5 days. Primary outcome was the Berg Balance Scale. Secondary outcomes were the posturographic examination (static standing and lateral weight shifting to the nonparetic and paretic sides), Trunk Control Test, Trunk Impairment Scale, Functional Ambulation Category, and Functional Independent Measure motor item scores. RESULTS Through intention-to-treat analysis, no significant intervention effects were observed between groups on the Berg Balance Scale. A significant intervention effect was observed, however, with the experimental group on the lateral weight shifting to the nonparetic side in the mean percentage bodyweight values and center-of-pressure moving distance and to the paretic side in center-of-pressure moving distance and Functional Ambulation Category. There were no significant interaction effects concerning other outcomes. CONCLUSION These results suggest that standing reaching exercises to the nonparetic side while standing on an inclined surface could improve lateral weight-shifting capacity and gait ability in participants in the early poststroke phase. IMPACT This intervention should be incorporated into standard treatment programs focusing on the paretic side during early stroke rehabilitation.
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Affiliation(s)
- Masahide Inoue
- Department of Rehabilitation, Saitama Medical University International Medical Center, Yamane, Hidaka, Saitama, Japan.,Department of Physical Therapy, Tokyo Metropolitan University, Higashiogu, Arakawa-ku, Tokyo, Japan
| | - Kazu Amimoto
- Department of Physical Therapy, Tokyo Metropolitan University, Higashiogu, Arakawa-ku, Tokyo, Japan
| | - Yuya Chiba
- Department of Rehabilitation, Saitama Medical University International Medical Center, Yamane, Hidaka, Saitama, Japan
| | - Daisuke Sekine
- Department of Rehabilitation, Saitama Medical University International Medical Center, Yamane, Hidaka, Saitama, Japan
| | - Kazuhiro Fukata
- Department of Rehabilitation, Saitama Medical University International Medical Center, Yamane, Hidaka, Saitama, Japan
| | - Yuji Fujino
- Department of Physical Therapy, Juntendo University, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Hidetoshi Takahashi
- Department of Rehabilitation, Saitama Medical University International Medical Center, Yamane, Hidaka, Saitama, Japan
| | - Shigeru Makita
- Department of Rehabilitation, Saitama Medical University International Medical Center, Yamane, Hidaka, Saitama, Japan
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Moisan G, Chayasit P, Boonsinsukh R, Nester CJ, Hollands K. Postural control during quiet standing and voluntary stepping response tasks in individuals post-stroke: a case-control study. Top Stroke Rehabil 2021; 29:465-472. [PMID: 34170215 DOI: 10.1080/10749357.2021.1943803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background: Postural control impairments following a stroke have an impact on mobility, reduce independence, and increase the risk of falls. Assessing these impairments during tasks representative of real-life situations, such as quiet standing (QS) and voluntary stepping response (VSR), will enhance our understanding of how the postural control system is impaired in individuals post-stroke (IPS). It will also inform the development of a more targeted and effective rehabilitation to prevent falls in IPS.Objectives: Identify the postural control impairments encountered by IPS during QS and VSR.Methods: Twenty IPS and 16 healthy controls were recruited to perform QS and VSR tasks, while ground reaction forces and whole-body motion were measured. Displacement and speed variation of the COM, center of pressure (COP) displacement and spatiotemporal data were calculated and compared between groups.Results: During QS, IPS exhibited greater maximal COP displacement in mediolateral direction, COM displacement in vertical direction and COM speed excursions compared to controls. During VSR, IPS exhibited smaller step length, braking force, posterior foot placement in relation to the pelvis and COM anteroposterior excursion compared to controls. IPS presented less static and dynamic postural stability compared to controls.Conclusions: Greater postural sway during QS, smaller anteroposterior COM displacement before losing balance and altered voluntary recovering steps during VSR could place IPS at more risk of falling when they face a postural challenge in the community. These novel results will improve the current knowledge base and should be considered in IPS rehabilitation.
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Affiliation(s)
- Gabriel Moisan
- Department of Human Kinetics, Université Du Québec À Trois-Rivières, Trois-Rivières, Canada.,School of Health Sciences, University of Salford, Salford, UK
| | - Pornprom Chayasit
- Faculty of Physical Therapy, Srinakharinwirot University, Nakhon Nayok, Thailand
| | - Rumpa Boonsinsukh
- Faculty of Physical Therapy, Srinakharinwirot University, Nakhon Nayok, Thailand
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Ishiwatari M, Honaga K, Tanuma A, Takakura T, Hatori K, Kurosu A, Fujiwara T. Trunk Impairment as a Predictor of Activities of Daily Living in Acute Stroke. Front Neurol 2021; 12:665592. [PMID: 34220674 PMCID: PMC8247912 DOI: 10.3389/fneur.2021.665592] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 05/07/2021] [Indexed: 11/13/2022] Open
Abstract
Background and purpose: Trunk function plays a key role in performing activities of daily living (ADL) including locomotion and sitting. Sitting and ADL should be performed as early as possible especially during the acute phase of stroke rehabilitation. Therefore, this study aimed to assess trunk function among patients with acute stroke using the Trunk Impairment Scale (TIS) and to predict its functional outcomes. Methods: Overall, 67 patients with acute stroke (i.e., within 2 days of occurrence of the stroke) were included. The following clinical assessment items were obtained within 48 h after stroke onset and on the day before discharge from the hospital. Trunk function was examined using TIS and Trunk Control Test (TCT). The motor function of the upper and lower extremities was assessed using the stroke impairment assessment set motor (SIAS-M) score, and ADL was assessed using functional independence measure motor (FIM-M) items. Results: Multiple regression analysis was performed using the stepwise regression method, using the total FIM-M score following discharge as the dependent variable and age, TIS, TCT, SIAS-M, and FIM-M within 48 h after stroke onset as the independent variables. Age, TIS, and FIM-M within 48 h after stroke onset were selected as the input variables and showed a high-adjusted determination coefficient (R2 = 0.79; P < 0.001). Conclusion: TIS is a reliable method for evaluating trunk control function and is an early predictor of ADL among patients with acute stroke.
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Affiliation(s)
- Masahiro Ishiwatari
- Department of Rehabilitation Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Rehabilitation, Kiminomori Rehabilitation Hospital, Chiba, Japan
| | - Kaoru Honaga
- Department of Rehabilitation Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Akira Tanuma
- Department of Rehabilitation Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Tomokazu Takakura
- Department of Rehabilitation Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kozo Hatori
- Department of Rehabilitation Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Akihiro Kurosu
- Department of Rehabilitation Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Toshiyuki Fujiwara
- Department of Rehabilitation Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Physical Therapy, Juntendo University Faculty of Health Science, Tokyo, Japan
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Liu YT, Tsai HT, Hsu CY, Lin YN. Effects of orthopedic insoles on postural balance in patients with chronic stroke: A randomized crossover study. Gait Posture 2021; 87:75-80. [PMID: 33894465 DOI: 10.1016/j.gaitpost.2021.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Revised: 04/03/2021] [Accepted: 04/09/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Orthopedic insoles (OIs) with medial arch support and heel cushion are widely used to manage lower extremity injuries, but their effects on postural balance in patients with chronic stroke have not been adequately explored. METHODS Design: Double-blinded, sham-controlled, randomized crossover trial. PARTICIPANTS A total of 32 ambulatory patients (20 men and 12 women, aged between 30 and 76 years) with more than 6 months since stroke onset. INTERVENTIONS All participants received one assessment session wearing OIs and one session wearing sham insole (SI) in a random order with a 1-day interval. OUTCOMES Our primary outcome was the Berg Balance Scale score. Secondary outcomes included the Functional Reach Test, Timed Up and Go test, and computerized posturography. All were performed in both sessions. Subgroup analyses regarding demographic and functional variables were conducted to identify potential responders. RESULTS Significant between-insole differences favoring OIs were seen in all clinical tests (P < 0.05), but were seen only in the static medial-lateral sway in computerized posturography assessment (P = 0.04). An approximate 2-point difference in the BBS score favoring OIs was observed in all subgroups, not reaching the minimal clinically important difference. CONCLUSION The use of OIs generated small but significant positive effects on improving postural balance among patients with chronic stroke. Additional biomechanical and clinical studies are required to evaluate their potential for routine clinical use. TRIAL REGISTRATION NCT03194282.
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Affiliation(s)
- Yen-Ting Liu
- Department of Physical Medicine and Rehabilitation, Wang Fang Hospital, Taipei Medical University, Taipei, Taiwan.
| | - Han-Ting Tsai
- Department of Physical Medicine and Rehabilitation, Wang Fang Hospital, Taipei Medical University, Taipei, Taiwan.
| | - Chih-Yang Hsu
- Department of Physical Medicine and Rehabilitation, Wang Fang Hospital, Taipei Medical University, Taipei, Taiwan.
| | - Yen-Nung Lin
- Department of Physical Medicine and Rehabilitation, Wang Fang Hospital, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei, Taiwan.
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45
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Dong K, Meng S, Guo Z, Zhang R, Xu P, Yuan E, Lian T. The Effects of Transcranial Direct Current Stimulation on Balance and Gait in Stroke Patients: A Systematic Review and Meta-Analysis. Front Neurol 2021; 12:650925. [PMID: 34113308 PMCID: PMC8186497 DOI: 10.3389/fneur.2021.650925] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 04/06/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: Balance dysfunction after stroke often results in individuals unable to maintain normal posture, limits the recovery of gait and functional independence. We explore the short-term effects of transcranial direct current stimulation (tDCS) on improving balance function and gait in stroke patients. Methods: We systematically searched on PubMed, Web of Science, EMBASE, Cochrane Central Register of Controlled Trials, and Google Scholar for studies that explored the effects of tDCS on balance after stroke until August 2020. All involved studies used at least one measurement of balance, gait, or postural control as the outcome. Results: A total of 145 studies were found, of which 10 (n = 246) met the inclusion criteria and included in our studies. The present meta-analysis showed that active tDCS have beneficial effects on timed up and go test (TUGT) [mean difference (MD): 0.35; 95% confidence interval (CI): 0.11 to 0.58] and Functional Ambulation Category (FAC) (MD: −2.54; 95% CI: −3.93 to −1.15) in stroke patients. However, the results were not significant on the berg balance scale (BBS) (MD: −0.20; 95% CI: −1.44 to 1.04), lower extremity subscale of Fugl-Meyer Assessment (FMA-LE) (MD: −0.43; 95% CI: −1.70 to 0.84), 10-m walk test (10 MWT) (MD: −0.93; 95% CI: −2.68 to 0.82) and 6-min walking test (6 MWT) (MD: −2.55; 95% CI: −18.34 to 13.23). Conclusions: In conclusion, we revealed that tDCS might be an effective option for restoring walking independence and functional ambulation for stroke patients in our systematic review and meta-analysis. Systematic Review Registration: CRD42020207565.
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Affiliation(s)
- Ke Dong
- Department of Rehabilitation Medicine, First Hospital of Shanxi Medical University, Taiyuan, China.,First Clinical Medical College, Shanxi Medical University, Taiyuan, China
| | - Shifeng Meng
- Department of Rehabilitation Medicine, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Ziqi Guo
- Department of Rehabilitation Medicine, First Hospital of Shanxi Medical University, Taiyuan, China.,First Clinical Medical College, Shanxi Medical University, Taiyuan, China
| | - Rufang Zhang
- Department of Rehabilitation Medicine, First Hospital of Shanxi Medical University, Taiyuan, China.,First Clinical Medical College, Shanxi Medical University, Taiyuan, China
| | - Panpan Xu
- Department of Rehabilitation Medicine, First Hospital of Shanxi Medical University, Taiyuan, China.,First Clinical Medical College, Shanxi Medical University, Taiyuan, China
| | - Erfen Yuan
- Department of Rehabilitation Medicine, First Hospital of Shanxi Medical University, Taiyuan, China.,First Clinical Medical College, Shanxi Medical University, Taiyuan, China
| | - Tao Lian
- Department of Rehabilitation Medicine, First Hospital of Shanxi Medical University, Taiyuan, China
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Nakamura A, Suzuki Y, Milosevic M, Nomura T. Long-Lasting Event-Related Beta Synchronizations of Electroencephalographic Activity in Response to Support-Surface Perturbations During Upright Stance: A Pilot Study Associating Beta Rebound and Active Monitoring in the Intermittent Postural Control. Front Syst Neurosci 2021; 15:660434. [PMID: 34093142 PMCID: PMC8175801 DOI: 10.3389/fnsys.2021.660434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 04/29/2021] [Indexed: 11/13/2022] Open
Abstract
Movement related beta band cortical oscillations, including beta rebound after execution and/or suppression of movement, have drawn attention in upper extremity motor control literature. However, fewer studies focused on beta band oscillations during postural control in upright stance. In this preliminary study, we examined beta rebound and other components of electroencephalogram (EEG) activity during perturbed upright stance to investigate supraspinal contributions to postural stabilization. Particularly, we aimed to clarify the timing and duration of beta rebound within a non-sustained, but long-lasting postural recovery process that occurs more slowly compared to upper extremities. To this end, EEG signals were acquired from nine healthy young adults in response to a brief support-surface perturbation, together with the center of pressure, the center of mass and electromyogram (EMG) activities of ankle muscles. Event-related potentials (ERPs) and event-related spectral perturbations were computed from EEG data using the perturbation-onset as a triggering event. After short-latency (<0.3 s) ERPs, our results showed a decrease in high-beta band oscillations (event-related desynchronization), which was followed by a significant increase (event-related synchronization) in the same band, as well as a decrease in theta band oscillations. Unlike during upper extremity motor tasks, the beta rebound in this case was initiated before the postural recovery was completed, and sustained for as long as 3 s with small EMG responses for the first half period, followed by no excessive EMG activities for the second half period. We speculate that those novel characteristics of beta rebound might be caused by slow postural dynamics along a stable manifold of the unstable saddle-type upright equilibrium of the postural control system without active feedback control, but with active monitoring of the postural state, in the framework of the intermittent control.
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Affiliation(s)
| | | | | | - Taishin Nomura
- Department of Mechanical Science and Bioengineering, Graduate School of Engineering Science, Osaka University, Osaka, Japan
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Abstract
Even for a stereotyped task, sensorimotor behavior is generally variable due to noise, redundancy, adaptability, learning or plasticity. The sources and significance of different kinds of behavioral variability have attracted considerable attention in recent years. However, the idea that part of this variability depends on unique individual strategies has been explored to a lesser extent. In particular, the notion of style recurs infrequently in the literature on sensorimotor behavior. In general use, style refers to a distinctive manner or custom of behaving oneself or of doing something, especially one that is typical of a person, group of people, place, context, or period. The application of the term to the domain of perceptual and motor phenomenology opens new perspectives on the nature of behavioral variability, perspectives that are complementary to those typically considered in the studies of sensorimotor variability. In particular, the concept of style may help toward the development of personalised physiology and medicine by providing markers of individual behaviour and response to different stimuli or treatments. Here, we cover some potential applications of the concept of perceptual-motor style to different areas of neuroscience, both in the healthy and the diseased. We prefer to be as general as possible in the types of applications we consider, even at the expense of running the risk of encompassing loosely related studies, given the relative novelty of the introduction of the term perceptual-motor style in neurosciences.
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Affiliation(s)
- Pierre-Paul Vidal
- CNRS, SSA, ENS Paris Saclay, Université de Paris, Centre Borelli, 75005 Paris, France
- Institute of Information and Control, Hangzhou Dianzi University, Hangzhou, China
| | - Francesco Lacquaniti
- Department of Systems Medicine, Center of Space Biomedicine, University of Rome Tor Vergata, 00133 Rome, Italy
- Laboratory of Neuromotor Physiology, Santa Lucia Foundation IRCCS, 00179 Rome, Italy
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Atalan P, Bērziņa G, Sunnerhagen KS. Influence of mobility restrictions on post-stroke pain. Brain Behav 2021; 11:e02092. [PMID: 33650788 PMCID: PMC8119861 DOI: 10.1002/brb3.2092] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 01/28/2021] [Accepted: 02/10/2021] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVES The objective of this study was to investigate the role of mobility limitations and vitality, as well as additional factors such as comorbidities, to predict post-stroke pain. MATERIALS & METHODS This study included cross-sectional data from 214 participants living in varied settings in different parts of Sweden. Participants were asked to complete the Stroke Impact Scale, Medical Outcomes Study Short Form 36, and Self-administered Comorbidity Questionnaire to evaluate mobility, vitality, comorbidities, and pain. Descriptive statistics were used for demographic and clinical characteristics. Binary logistic regression analysis was performed to predict the pain domain score on Medical Outcomes Study Short Form 36. RESULTS The mean age of all participants in the sample was 66 years (SD 14); 43.4% of the study population were women. After analyses, "standing without losing balance and vitality'' were found to be significant predictors in the model which explained the pain score on Medical Outcomes Study Short Form 36. CONCLUSIONS In conclusion, the results suggest that restrictions in mobility and low vitality have an important role on the occurrence of post-stroke pain. Having post-stroke pain could be due to not able to stand without losing balance and low vitality. Thus, rehabilitation professionals may consider the importance of these factors, especially mobility restrictions, in preventing post-stroke pain.
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Affiliation(s)
- Pelin Atalan
- Institute of Health Sciences, Department of Physiotherapy and Rehabilitation, Gazi University, Ankara, Turkey
| | - Guna Bērziņa
- Department of Rehabilitation, Riga Stradiņš University, Riga, Latvia
| | - Katharina S Sunnerhagen
- Institute of Neuroscience and Physiology, Section for Clinical Neuroscience, The Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
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Gallamini M, Piastra G, Lucarini S, Porzio D, Ronchi M, Pirino A, Scoppa F, Masiero S, Tognolo L. Revisiting the Instrumented Romberg Test: Can Today's Technology Offer a Risk-of-Fall Screening Device for Senior Citizens? An Experience-Based Approach. Life (Basel) 2021; 11:life11020161. [PMID: 33672455 PMCID: PMC7923416 DOI: 10.3390/life11020161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 02/09/2021] [Accepted: 02/12/2021] [Indexed: 11/16/2022] Open
Abstract
Risk of fall (ROF) is a worldwide major concern for its prevalence and consequent dramatic outcomes in the elderly population. The growing age-related risk appears to be associated with increasing motor, sensory, and cognitive problems in the elderly population. There is a consensus on the need to screen for these balance dysfunctions, but the available methods are largely based on subjectively assessed performances. The instrumented Romberg test using a force plate represents a validated assessment process for the evaluation of balance performances. The purpose of this study is to propose an innovative instrumental method to identify balance deficits, assess their severity, and give an automated indication of the most likely etiology. The proposed new method was applied to the instrumented Romberg test, using force plate data recorded in a cohort of 551 females aged >65 participating in adapted physical activity courses. The method allowed us to identify 145 dysfunctional subjects and to determine the likely origin of their deficit: 21 central, 5 vestibular, 9 visual, 59 proprioceptive (musculoskeletal etiology), and 51 functional. Based on the preliminary findings of the study, this test could be an efficient and cost-effective mass screening tool for identifying subjects at risk of fall, since the procedure proves to be rapid, non-invasive, and apparently devoid of any contraindications.
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Affiliation(s)
- Michele Gallamini
- Eng. Freelance MD Consultant, Sal. Maggiolo di Nervi, 16167 Genoa, Italy;
- Ben-Essere Sport and Wellness Association Rapallo, Third-Sector Liguria Region Registry, 16135 Genoa, Italy; (D.P.); (M.R.)
| | - Giorgio Piastra
- ASL 4 Liguria (Liguria Regional Health Service), Sports Medicine, N.S. di Montallegro Hospital, 16035 Rapallo, Italy;
| | - Simonetta Lucarini
- ASL 4 Liguria (Liguria Regional Health Service), Geriatric Service, Chiavari, 16043 Chiavari, Italy;
| | - Debora Porzio
- Ben-Essere Sport and Wellness Association Rapallo, Third-Sector Liguria Region Registry, 16135 Genoa, Italy; (D.P.); (M.R.)
| | - Matteo Ronchi
- Ben-Essere Sport and Wellness Association Rapallo, Third-Sector Liguria Region Registry, 16135 Genoa, Italy; (D.P.); (M.R.)
| | - Alessio Pirino
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy;
| | - Fabio Scoppa
- Faculty of Medicine and Dental Surgery, Sapienza University of Rome, 00185 Rome, Italy;
- Chinesis I.F.O.P. Istituto di Formazione in Osteopatia e in Posturologia, Osteopathy School, 00152 Rome, Italy
| | - Stefano Masiero
- Department of Neurosciences, Physical Medicine and Rehabilitation School, University of Padua, 35128 Padua, Italy;
- Rehabilitation Unit, Laboratory of Robotic and Bioengineering and Clinical of Movement, Padua University-General Hospital, 35128 Padua, Italy
| | - Lucrezia Tognolo
- Department of Neurosciences, Physical Medicine and Rehabilitation School, University of Padua, 35128 Padua, Italy;
- Correspondence: ; Tel.: +39-0498-213-353
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Kurul R, Cankaya T, Yildirim NU. Kinesio taping techniques for ankle stabilisation in patients with stroke: a single-blinded randomised controlled study. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2021. [DOI: 10.12968/ijtr.2019.0082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/AimsAnkle proprioception and neuromuscular feedback from this region provides the sensory input needed for balance. The aim of this study was to investigate the effects of repeated correction taping applied on the ankle and peroneus longus and peroneus brevis muscles on balance and gait in patients with stroke.MethodsA total of 61 patients with stroke with a mean age of 62.25 ± 7.04 years were included in this study. The patients were randomly divided into two groups. The control group (n=30) received 1 hour of rehabilitation, which took place during weekdays over the course of 2 weeks. The intervention group (n=31) received 1 hour of daily rehabilitation as well as having kinesio tape applied to their ankle. Both groups were assessed with the Balance Evaluating Systems Test, Timed Up and Go Test, Functional Reach Test, Tetrax Balance System and Barthel Index. Clinical assessments were performed at baseline, immediately after the first application, 1 week and 2 weeks later, following the first taping.ResultsThere was a significant improvement in the Balance Evaluating Systems and Functional Reach Tests scores between the first and last measurements in favour of the intervention group (P<0.05). There were no significant changes between baseline and immediately after assessment for all measurements (P>0.05). There was no significant difference in Tetrax scores, Timed Up and Go Test and Barthel Index scores (P>0.05).ConclusionsIn this study, it was found that dynamic balance was improved by taping the peroneus longus and peroneus brevis muscles, but the static balance did not change. One week of kinesio taping would be beneficial; however, prolonged use would not provide further improvement.
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Affiliation(s)
- Ramazan Kurul
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Tamer Cankaya
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Necmiye Un Yildirim
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Saglık Bilimleri University, Ankara, Turkey
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