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Kim YJ, An J, Lee BH. Effects of Sling-Suspension-Based Active Shoulder Joint Exercise on Shoulder Joint Subluxation, Pain, Muscle Strength, and Upper Limb Function in Patients with Subacute Stroke. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1350. [PMID: 39202631 PMCID: PMC11356110 DOI: 10.3390/medicina60081350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 07/24/2024] [Accepted: 08/14/2024] [Indexed: 09/03/2024]
Abstract
Background and Objectives: We investigated the effects of sling-suspension-based active shoulder joint exercise training on shoulder joint subluxation, pain, muscle strength, and upper extremity function in patients with subacute stroke. Materials and Methods: Twenty-eight patients with subacute stroke were randomly assigned to either the sling-suspension-based active shoulder joint exercise (SASE) group (n = 14) or the motorized upper extremity exercise (MUEE) group (n = 14). The SASE group actively performed shoulder joint flexion, extension, abduction, adduction, external and internal rotation, and horizontal abduction and adduction using a sling suspension system, whereas the MUEE group underwent an exercise program using a motorized upper extremity exercise machine. All participants underwent a 4-week intervention with 30 min of exercise once a day for 5 days a week. Additionally, both groups received general physical therapy and functional electrical stimulation for 30 min twice a day for 5 days a week. Shoulder joint subluxation was measured by radiographic examination before and after training, and pain was evaluated in the splenius, upper trapezius, and infraspinatus muscles using pressure parameters. In addition, a manual muscle tester was used to assess the muscle strength of the shoulder joint flexors, extensors, abductors, adductors, and external and internal rotators, and the Fugl-Mayer Assessment (FMA) and Manual Functional Test (MFT) were used to evaluate upper extremity function. Results: A significant group-time interaction was observed for pain, with F-values of F(1, 26) = 7.470, p < 0.011 for the splenius and F(1, 26) = 9.623, p < 0.005 for the upper trapezius. A significant time-group interaction was observed for the muscle strength of the shoulder, with F-values of F(1, 26) = 13.211, p < 0.001; F(1, 26) = 4.974, p = 0.035 and F(1, 26) = 9.674, p = 0.004 for flexors, abductors, and external rotators, respectively. A significant time-group interaction was observed in the FMA, with F-values of F(1, 26) = 13.243, p < 0.001. When comparing the interaction effects between time and group for MFT scores, a significant difference was observed, with F-values of F(1, 26) = 32.386, p < 0.001. Conclusions: This study confirmed that sling-suspension-based active shoulder joint exercises are effective in improving shoulder joint subluxation, pain, muscle strength, and upper extremity function in patients with subacute stroke.
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Affiliation(s)
- Young-Jun Kim
- Graduate School of Physical Therapy, Sahmyook University, Seoul 01795, Republic of Korea;
| | - Jungae An
- Department of Physical Therapy, Sahmyook University, Seoul 01795, Republic of Korea;
| | - Byoung-Hee Lee
- Department of Physical Therapy, Sahmyook University, Seoul 01795, Republic of Korea;
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Rhee BS, Vishwanath N, Kumar S, Kalliainen LK. The Effect of Upper Extremity Slings (UESs) on Balance in Young Adults. Cureus 2023; 15:e42724. [PMID: 37654916 PMCID: PMC10466447 DOI: 10.7759/cureus.42724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2023] [Indexed: 09/02/2023] Open
Abstract
INTRODUCTION Upper extremity slings (UESs) are frequently provided for patients with a hand or forearm injury. However, their effect on balance has not been well explored. We sought to characterize the effect of a UES on balance in young adults. METHODS Healthy young adult participants with no injuries acting as a proxy for the general young adult patient population using UESs balanced on a BioDex Balance System platform: once while wearing a UES and once without wearing it, to serve as their own control. Participant weight, height, gender, hand dominance, overall stability index, anterior/posterior stability index, and medial/lateral stability index were recorded. Comparisons were analyzed with paired t-tests and linear regression analysis. Results: No significant difference in the three stability index scores were found between UES and no UES usage. Height and weight were found to have positive significant relationships with the overall stability index during UES usage. Conclusions: Our study demonstrates the feasibility of assessing balance discrepancies between the sling and nonsling usage in a broader patient population and suggests that height and weight may impact balance negatively during UES use.
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Affiliation(s)
- Ben S Rhee
- Medical School, The Warren Alpert Medical School of Brown University, Providence, USA
| | - Neel Vishwanath
- Medical School, The Warren Alpert Medical School of Brown University, Providence, USA
| | - Soryan Kumar
- Medical School, The Warren Alpert Medical School of Brown University, Providence, USA
| | - Loree K Kalliainen
- Plastic Surgery, The Warren Alpert Medical School of Brown University, Providence, USA
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Roostaei M, Raji P, Kalantari KK, Faghihzadeh E, Fragala-Pinkham M. Effect of upper extremity constraints on functional and dynamic postural control in children with hemiplegic cerebral palsy. Dev Neurorehabil 2022; 25:281-288. [PMID: 34971522 DOI: 10.1080/17518423.2021.2020351] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To compare the effects of upper extremity constraints on functional and dynamic postural control in children with hemiplegic cerebral palsy. MATERIALS AND METHODS Twelve children with hemiplegic cerebral palsy and 12 typically developing children ages 5 to 12 years (GMFCS I-II) were evaluated with the Timed Up and Go (TUG) and Biodex Balance System during three upper extremity (UE) conditions: 1) Free UEs (no constraints), 2) Simple UE constraint (unaffected/dominant UE constrained with a sling), and 3) Difficult UE constraint (Simple constraint plus the other UE holding cup of water). RESULTS The UE condition had significant effects on Overall Stability Index (OSI) (F(2,44) = 24.899, p < .001), Medial-Lateral Stability Index (MLSI) (F(2,44) = 4.380, p = .018), Anterior-Posterior Stability Index (F(2,44) = 6.187, p = .004), and TUG scores (F(2,44) = 113.372, p < .001). Group was significant for OSI (F(1,22) = 7.906, p = .010), MLSI (F(1,22) = 13.113, p = .002), and TUG (F(1,22) = 36.282, p < .001). CONCLUSIONS The upper extremity appears to have a role in maintaining functional balance and postural stability in children with hemiplegic cerebral palsy and should be considered during intervention programs.
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Affiliation(s)
- Meysam Roostaei
- Department of Occupational Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Parvin Raji
- Department of Occupational Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Khosro Khademi Kalantari
- Department of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elham Faghihzadeh
- Department of Biostatistics and Epidemiology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Maria Fragala-Pinkham
- Department of Physical Therapy and Occupational Therapy, Boston Children's Hospital, Boston, MA, USA
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Lee SH, Lee JH. Examining the effects of upper extremity function and arm sling type on balance, gait and fall risk in patients with hemiparesis. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2021. [DOI: 10.12968/ijtr.2020.0044] [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/aims Previous studies have reported conflicting results on the effects of arm slings on the balance and gait of patients with hemiparesis. These previous studies did not consider the ability to control the upper extremity on the affected side as a factor that could affect the patient's balance or gait when an arm sling was applied. Hence, the aim of this study was to investigate the effect of upper extremity function in the affected side and arm position according to the sling type on balance, gait and fall. Methods A total of 31 stroke patients participated in the study and were assigned to two groups according to upper extremity function (low-score group and high-score group). Under three conditions (no sling, forearm sling and shoulder sling), a fall risk test, postural stability test and limits of stability test were performed and speed, stride duration, step length and total time were measured. Results When the high-score group wore forearm slings, the static and dynamic balance ability decreased and the fall risk increased. When the low-score group wore forearm slings and shoulder slings, the static and dynamic balance ability increased and the fall risk decreased. The high-score group had a shorter gait time when wearing shoulder slings. When the low-score group wore forearm slings, the speed and step length increased and the total time decreased, enhancing the overall gait ability. Conclusions For stroke patients with better upper extremity control ability, shoulder slings are more appropriate. For patients with poor upper extremity control ability, forearm slings are more appropriate. Using the appropriate sling according to the upper extremity function can improve balance and gait ability and fall risk can be reduced.
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Affiliation(s)
- Seung-Hyuk Lee
- Department of Physical Therapy, Rehabilitation Center, Walkrun Hospital, Daejeon City, Republic of Korea
| | - Joon-Hee Lee
- Department of Physical Therapy, Rehabilitation Center, Walkrun Hospital, Daejeon City, Republic of Korea
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Effect of arm sling application on gait and balance in patients with post-stroke hemiplegia: a systematic review and meta-analysis. Sci Rep 2021; 11:11161. [PMID: 34045541 PMCID: PMC8160322 DOI: 10.1038/s41598-021-90602-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 05/12/2021] [Indexed: 12/03/2022] Open
Abstract
Hemiplegic shoulder pain and impairment are common poststroke outcomes, for which arm slings constitute long-used treatments. Although multiple studies have suggested association between gait pattern and sling application, results have varied. Accordingly, we conducted this meta-analysis to determine how arm sling use affects the gait and balance of patients with poststroke hemiplegia. The PubMed, Embase, and Cochrane Library databases were searched until April 21, 2021, for randomized or quasi-randomized controlled trials evaluating the effect of arm slings on gait or balance in patients with poststroke hemiplegia. The primary outcome was walking speed; the secondary outcomes were functional balance tests or walking evaluation parameters for which sufficient analytical data were available in three or more studies. Nine studies with a total of 235 patients were included, all of which were within-patient comparisons. Six studies reported significant between-group differences in walking speed with and without the use of arm slings. Patients wearing arm slings had higher walking speed (standardized mean difference = − 0.31, 95% confidence interval [CI] = − 0.55 to − 0.07, P = 0.01, n = 159; weighted mean difference = − 0.06, 95% CI − 0.10 to − 0.02, P = 0.001, n = 159). Our findings suggest that arm sling use improves gait performance, particularly walking speed, in patients with poststroke hemiplegia.
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AYDOĞAN ARSLAN S, UĞURLU K, DEMİRCİ C, KESKİN D. Investigating the relation between upper extremity function and trunk control, balance and functional mobility in individuals with stroke. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2021. [DOI: 10.32322/jhsm.830398] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Oki M, Matsumoto M, Yoshikawa Y, Fukushima M, Nagasawa A, Takakura T, Suzuki Y. Risk Factors for Falls in Patients with Alzheimer Disease: A Retrospective Study of Balance, Cognition, and Visuospatial Ability. Dement Geriatr Cogn Dis Extra 2021; 11:58-63. [PMID: 33976693 PMCID: PMC8077477 DOI: 10.1159/000514285] [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: 01/07/2021] [Accepted: 01/08/2021] [Indexed: 11/19/2022] Open
Abstract
Aim This study aimed to determine the main risk factors for falls in patients with Alzheimer disease (AD) by comparing balance, cognition, and visuospatial ability between those who have experienced a fall and those who have not. Methods Forty-seven AD patients were admitted to a ward for patients with dementia (22 men and 25 women). The balance of patients was evaluated using the Functional Reach Test (FRT), the one-leg standing duration, and the Timed Up and Go (TUG) test. The Mini-Mental State Examination-Japanese (MMSE-J) was used to evaluate cognition. For visuospatial ability assessment, the Clock-Drawing Test (CDT) as well as overlapping figure identification and shape discrimination in the Visual Perception Test for Agnosia (VPTA) were used. The patients were allocated to either the fall group or the nonfall group based on their history of falls in the past year. The relationships between patients' characteristics and evaluation outcomes were compared and examined. Logistic regression analysis was performed using a fall as the objective variable. The area under the curve (AUC) and the cutoff value were calculated. Results Of the 47 participants, 22 had experienced falls within the past year (46.8%). The results of the FRT, one-leg standing duration, the TUG, the CDT, and the VPTA were significantly lower in the fall group. No significant difference between the MMSE-J scores of the fall group and those of the nonfall group was observed. The results of the logistic regression analysis indicated that falls in AD patients were significantly associated with the FRT. It was found that a shorter FRT distance (cm) had a significant impact on falls. For the FRT, the fall-related AUC was 0.755. At a cutoff value of 24.5 cm, the level of sensitivity was 68.0%, and the level of specificity was 77.3%. Conclusions The findings of this study indicate that balance and visuospatial abilities are risks factors for falls in AD patients. In contrast, cognitive impairment was not a risk factor for falls. It was demonstrated that the FRT could be an appropriate risk predictor for falls in AD patients. In particular, falls in AD patients were strongly affected by a reduced dynamic balance.
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Affiliation(s)
- Mayuka Oki
- Department of Rehabilitation Medicine, Juntendo University Hospital, Tokyo, Japan
| | - Miyuki Matsumoto
- Department of Rehabilitation Medicine, Juntendo Tokyo Koto Geriatric Medical Center, Koto, Japan
| | - Yukiko Yoshikawa
- Department of Rehabilitation Medicine, Juntendo Tokyo Koto Geriatric Medical Center, Koto, Japan
| | - Mitsuko Fukushima
- Department of Rehabilitation Medicine, Juntendo Tokyo Koto Geriatric Medical Center, Koto, Japan
| | - Akira Nagasawa
- Department of Rehabilitation Medicine, Juntendo University Koshigaya Hospital, Koshigaya, Japan
| | - Tomokazu Takakura
- Department of Rehabilitation Medicine, Juntendo Tokyo Koto Geriatric Medical Center, Koto, Japan
| | - Yukiko Suzuki
- Department of Occupational Therapy, Kyorin University, Mitaka, Japan
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Efficacy of platelet-rich plasma in the treatment of hemiplegic shoulder pain. Neurol Sci 2020; 42:1977-1986. [PMID: 32990858 DOI: 10.1007/s10072-020-04710-0] [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: 05/07/2020] [Accepted: 09/04/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The aim of this study was to examine the effects of platelet-rich plasma (PRP) on pain and functional outcomes in patients with hemiplegic shoulder pain. We compared the effects of PRP against saline solution by designing a double blind, randomized, prospective study. DESIGN Forty-four patients with hemiplegia were included in this study. All patients received a total of 3 injections, 1 week apart. The first group received PRP injections while the second group received placebo injections. After 3 months of follow-up, 40 patients completed the trial. Primary outcome measure was movement-induced pain score (VAS), and secondary outcome measures were spontaneous pain score, shoulder passive range of motion (ROM), functional independence measure score, and the amount of paracetamol used. All subjects were evaluated at baseline, 1 week, 1 month, and 3 months after the completion of the last injection. RESULTS Both groups showed an improvement in spontaneous and movement-related pain scores and shoulder passive ROM values on 1st and 3rd month visits (p < 0.05). No significance difference was detected between groups (p > 0.05). Similarly, FIM scores improved significantly in both groups (p < 0.05) but no difference was found between groups. Paracetamol use did not differ significantly between groups. CONCLUSION The PRP injections were found not to be superior to placebo. Improvements in both groups can be attributed to the use of rehabilitation techniques and exercises in all patients. There is still need for further research to show whether PRP is a treatment option in the course of hemiplegic shoulder pain. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03931824.
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Jeong YG, Jeong YJ, Kim HS, Lee KH. Predictors of the effect of an arm sling on gait efficiency in stroke patients with shoulder subluxation: a pre-post design clinical trial. Physiother Theory Pract 2020; 38:729-736. [PMID: 32741231 DOI: 10.1080/09593985.2020.1799458] [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: 10/23/2022]
Abstract
BACKGROUND The predictors affecting the gait efficiency were not known for the arm sling, including general and stroke-related characteristics. PURPOSE This study investigated the predictors of gait efficiency when walking with and without an arm sling in individuals with hemiplegia with shoulder subluxation. METHODS A total of 57 individuals with shoulder subluxation were recruited. Individuals assigned odd numbers walked with the arm sling first and those with even numbers walked without the arm sling first in a pre-post design. Outcome measures were the energy cost, energy consumption, and heart rate during a 6-min walk test and a 10-m walk test. Gait efficiency is defined as energy consumption divided by the distance walked, with lower energy costs reflecting higher gait efficiency. Age, MMSE scores adjusted for education, and significant variables (p < .01) in the univariate analyses were entered into multiple regression analyses, to identify the predictors of changes of gait efficiency. RESULTS Energy cost and energy consumption were lower and walking endurance was higher when walking with an arm sling than when without an arm sling. Spasticity (p = .02), shoulder pain (p = .03), consistency of handedness and sling position worn (p = .02), function of upper extremity (p = .03) and walking aids (p = .01) were predictors of gait efficiency. CONCLUSION An arm sling may improve gait efficiency in individuals with hemiplegia and shoulder subluxation able to walk with a single cane, who have consistency in handedness and sling position, and with good upper extremity function, including no shoulder pain and reduced spasticity.
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Affiliation(s)
- Yeon-Gyu Jeong
- Department of Physical Therapy, Yeoju Institute of Technology, Yeoju-si, Republic of Korea
| | - Yeon-Jae Jeong
- Department of Physical Medicine and Rehabilitation, School of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Hyun-Sook Kim
- Department of Physical Therapy, Yeoju Institute of Technology, Yeoju-si, Republic of Korea
| | - Kyu Hoon Lee
- Department of Physical Medicine and Rehabilitation, School of Medicine, Hanyang University, Seoul, Republic of Korea
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Muci B, Keser I, Meric A, Karatas GK. What are the factors affecting dual-task gait performance in people after stroke? Physiother Theory Pract 2020; 38:621-628. [DOI: 10.1080/09593985.2020.1777603] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Birsen Muci
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Gazi University, Ankara, Turkey
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Ilke Keser
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Aydin Meric
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, European Unıversity of Lefke, Lefke, Northern Cyprus
| | - Gulcin Kaymak Karatas
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Gazi University, Ankara, Turkey
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VAN Bladel A, Cambier D, Lefeber N, Oostra K. The use of shoulder orthoses post-stroke: effects on balance and gait. A systematic review. Eur J Phys Rehabil Med 2020; 56:695-705. [PMID: 32539311 DOI: 10.23736/s1973-9087.20.06332-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Since there is no clear conclusion concerning the use of arm slings in the prevention or reduction of shoulder subluxation or shoulder pain in stroke patients, it seems important to explore other potentially beneficial effects. Earlier research already suggested that the upper limb might play a considerable role in efficient balance and gait in stroke patients. Therefore, the aim of this systematic review was to investigate the effects of wearing an arm sling on balance and/or gait in stroke patients. This information could support the decision-making concerning the use of shoulder orthoses after stroke. EVIDENCE ACQUISITION Four electronic databases (Pubmed/MEDLINE, Embase, Web of Science and CINAHL/EBSCO) were searched until April 8th, 2019. Search alerts were set and followed until January 2020 to assure no new eligible articles were published. Reference lists of included studies were hand searched. All studies examining the effect of wearing an upper limb orthosis on balance and gait in stroke patients were included. Two reviewers independently identified eligible studies and extracted data. The methodological quality of included trials was assessed using the QualSyst assessment tool for quantitative studies. Prospero registration number: CRD42019130282. EVIDENCE SYNTHESIS Ten studies, examining 283 stroke patients with moderate to low level of upper limb impairment, were included in the quantitative synthesis of the results. The pooled mean time since stroke was 21.88±9.03 months. Only minor effects on balance or gait related outcome parameters could be detected in favor of wearing an arm sling. However, these changes did not exceed the minimal clinical important difference (MCID). CONCLUSIONS So far no strong evidence is available regarding a potential benefit of wearing an arm sling on balance and gait for stroke patients. However, further research with longer intervention periods, can be useful to determine if stroke patients in the early phases after stroke or with persistent UL paresis might possibly benefit from wearing an arm sling.
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Affiliation(s)
- Anke VAN Bladel
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium - .,Department of Physical and Rehabilitation Medicine, Ghent University Hospital, Ghent, Belgium -
| | - Dirk Cambier
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Nina Lefeber
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Kristine Oostra
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium.,Department of Physical and Rehabilitation Medicine, Ghent University Hospital, Ghent, Belgium
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Yacoby A, Zeilig G, Weingarden H, Weiss R, Rand D. Feasibility of, Adherence to, and Satisfaction With Video Game Versus Traditional Self-Training of the Upper Extremity in People With Chronic Stroke: A Pilot Randomized Controlled Trial. Am J Occup Ther 2019; 73:7301205080p1-7301205080p14. [PMID: 30839263 DOI: 10.5014/ajot.2019.026799] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE We compared the feasibility of, adherence to, and satisfaction with a newly developed upper extremity (UE) self-training protocol using commercial video games with a traditional self-training program for people with chronic stroke. METHOD Twenty-four participants with mild to moderate UE weakness were randomized to a video game (n = 13) or traditional (n = 11) self-training program. Participants were requested to train 60 min/day, 6×/wk. During the 5-wk self-training program and 4-wk follow-up, participants documented their self-training time and rated their perceived enjoyment and exertion. RESULTS Eleven participants completed video game training; 9 completed traditional self-training. During the follow-up period, 8 participants (72.7%) continued the video game training, and 4 (44.4%) continued traditional training. Perceived enjoyment, satisfaction, and benefit for UE improvement were relatively high. CONCLUSIONS Participants demonstrated high adherence to and satisfaction with both self-training programs. More participants continued to play video games after the intervention, indicating its potential to maintain ongoing activity.
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Affiliation(s)
- Anat Yacoby
- Anat Yacoby, MSc, OT, is Occupational Therapist. She was Master's Student, Department of Occupational Therapy, The Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel, at the time of the study
| | - Gabi Zeilig
- Gabi Zeilig, MD, is Director, Neurological Rehabilitation Department, Chaim Sheba Medical Center at Tel-HaShomer, Tel-HaShomer, Israel, and Chair, Department of Physical Medicine and Rehabilitation, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Harold Weingarden
- Harold Weingarden, MD, is Senior Physician, Department of Neurological Rehabilitation, Chaim Sheba Medical Center at Tel-HaShomer, Tel-HaShomer, Israel
| | - Ronit Weiss
- Ronit Weiss, MSc, OT, is Occupational Therapist, Occupational Therapy Unit, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel. She was Master's Student, Department of Occupational Therapy, The Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel, at the time of the study
| | - Debbie Rand
- Debbie Rand, PhD, OT, is Senior Lecturer and Chair, Department of Occupational Therapy, The Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel;
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Reliability of the Functional Reach Test Using a Mobile Pole Versus the Traditional Fixed Ruler. JOURNAL OF ACUTE CARE PHYSICAL THERAPY 2019. [DOI: 10.1097/jat.0000000000000088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Gorst T, Rogers A, Morrison SC, Cramp M, Paton J, Freeman J, Marsden J. The prevalence, distribution, and functional importance of lower limb somatosensory impairments in chronic stroke survivors: a cross sectional observational study. Disabil Rehabil 2018; 41:2443-2450. [PMID: 29726732 DOI: 10.1080/09638288.2018.1468932] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Purpose: To investigate the prevalence and distribution of lower limb somatosensory impairments in community dwelling chronic stroke survivors and examine the association between somatosensory impairments and walking, balance, and falls. Methods: Using a cross sectional observational design, measures of somatosensation (Erasmus MC modifications to the (revised) Nottingham Sensory Assessment), walking ability (10 m walk test, Walking Impact Scale, Timed "Get up and go"), balance (Functional Reach Test and Centre of Force velocity), and falls (reported incidence and Falls Efficacy Scale-International), were obtained. Results: Complete somatosensory data was obtained for 163 ambulatory chronic stroke survivors with a mean (SD) age 67(12) years and mean (SD) time since stroke 29 (46) months. Overall, 56% (n = 92/163) were impaired in the most affected lower limb in one or more sensory modality; 18% (n = 30/163) had impairment of exteroceptive sensation (light touch, pressure, and pin-prick), 55% (n = 90/163) had impairment of sharp-blunt discrimination, and 19% (n = 31/163) proprioceptive impairment. Distal regions of toes and foot were more frequently impaired than proximal regions (shin and thigh). Distal proprioception was significantly correlated with falls incidence (r = 0.25; p < 0.01), and centre of force velocity (r = 0.22, p < 0.01). The Walking Impact Scale was the only variable that significantly contributed to a predictive model of falls accounting for 15-20% of the variance. Conclusion: Lower limb somatosensory impairments are present in the majority of chronic stroke survivors and differ widely across modalities. Deficits of foot and ankle proprioception are most strongly associated with, but not predictive, of reported falls. The relative contribution of lower limb somatosensory impairments to mobility in chronic stroke survivors appears limited. Further investigation, particularly with regard to community mobility and falls, is warranted. Implications for Rehabilitation Somatosensory impairments in the lower limb were present in approximately half of this cohort of chronic stroke survivors. Tactile discrimination is commonly impaired; clinicians should include an assessment of discriminative ability. Deficits of foot and ankle proprioception are most strongly associated with reported falls. Understanding post-stroke lower limb somatosensory impairments may help inform therapeutic strategies that aim to maximise long-term participation, minimise disability, and reduce falls.
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Affiliation(s)
- Terry Gorst
- a School of Health Professions , University of Plymouth , Plymouth , UK
| | - Alison Rogers
- b Faculty of Medicine and Health Sciences , Keele University , Keele , UK
| | | | - Mary Cramp
- d Department of Allied Health Professions , University of the West of England , Bristol , UK
| | - Joanne Paton
- a School of Health Professions , University of Plymouth , Plymouth , UK
| | - Jenny Freeman
- a School of Health Professions , University of Plymouth , Plymouth , UK
| | - Jon Marsden
- a School of Health Professions , University of Plymouth , Plymouth , UK
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Van Bladel A, Oostra K, Palmans T, Marquez CS, Cambier D. Immediate effects of arm slings on posture, balance and gait in sub-acute stroke patients: A case control study. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2018. [DOI: 10.12968/ijtr.2018.25.3.141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Anke Van Bladel
- Research assistant, Rehabilitation Sciences and Physiotherapy, Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Department of Physical and Rehabilitation Medicine, Ghent University Hospital, Ghent, Belgium
| | - Kristine Oostra
- Medical doctor, Physical and Rehabilitation Sciences, Department of Physical and Rehabilitation Medicine, Ghent University Hospital, Ghent, Belgium
| | - Tanneke Palmans
- Human kinetic engineer, Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium
| | - Cinthia Saucedo Marquez
- Postdoctoral researcher, Rehabilitation Sciences and Physiotherapy, Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium
| | - Dirk Cambier
- Professor, Rehabilitation Sciences and Physiotherapy, Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium
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Silva Filho EMD, Albuquerque JAD. Influência da terapia de restrição e indução do movimento no desempenho funcional de pacientes com acidente vascular encefálico: um ensaio clínico randomizado. FISIOTERAPIA E PESQUISA 2017. [DOI: 10.1590/1809-2950/16874424022017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO A terapia de restrição e indução ao movimento (TRIM) pode auxiliar na recuperação de pacientes com sequelas pós-acidente vascular encefálico. Objetivou-se avaliar se a TRIM modificada interfere no equilíbrio e na mobilidade funcional de indivíduos na fase crônica pós-AVE. Foi realizado um ensaio clínico, randomizado, cego, com 19 pacientes na fase crônica pós-AVE. O grupo 1, “sem restrição”, foi submetido apenas ao treinamento específico do membro superior (MS) parético (shaping). O grupo 2, “com restrição”, foi submetido ao treinamento específico do MS parético (shaping) e restrição no MS não parético. O treinamento foi realizado três vezes por semana, durante quatro semanas consecutivas. Os voluntários foram avaliados antes e imediatamente após as sessões com a Escala de Equilíbrio de Berg (EEB), Timed Up and Go (TUG), avaliação da velocidade da marcha e de subir e descer escada. O teste de Mann-Whitney mostrou que o equilíbrio (EEB) apresentou melhora significativa (p=0,014) no grupo que utilizou a restrição, na análise intragrupo. Houve melhora na velocidade da marcha (p=0,050) na análise intergrupos. Concluiu-se que a TRIM modificada influenciou no equilíbrio e na velocidade da marcha do grupo submetido ao treinamento específico do MS parético e restrição no MS não parético.
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Chanpimol S, Seamon B, Hernandez H, Harris-Love M, Blackman MR. Using Xbox kinect motion capture technology to improve clinical rehabilitation outcomes for balance and cardiovascular health in an individual with chronic TBI. Arch Physiother 2017; 7:6. [PMID: 28824816 PMCID: PMC5560163 DOI: 10.1186/s40945-017-0033-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 05/09/2017] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Motion capture virtual reality-based rehabilitation has become more common. However, therapists face challenges to the implementation of virtual reality (VR) in clinical settings. Use of motion capture technology such as the Xbox Kinect may provide a useful rehabilitation tool for the treatment of postural instability and cardiovascular deconditioning in individuals with chronic severe traumatic brain injury (TBI). The primary purpose of this study was to evaluate the effects of a Kinect-based VR intervention using commercially available motion capture games on balance outcomes for an individual with chronic TBI. The secondary purpose was to assess the feasibility of this intervention for eliciting cardiovascular adaptations. METHODS A single system experimental design (n = 1) was utilized, which included baseline, intervention, and retention phases. Repeated measures were used to evaluate the effects of an 8-week supervised exercise intervention using two Xbox One Kinect games. Balance was characterized using the dynamic gait index (DGI), functional reach test (FRT), and Limits of Stability (LOS) test on the NeuroCom Balance Master. The LOS assesses end-point excursion (EPE), maximal excursion (MXE), and directional control (DCL) during weight-shifting tasks. Cardiovascular and activity measures were characterized by heart rate at the end of exercise (HRe), total gameplay time (TAT), and time spent in a therapeutic heart rate (TTR) during the Kinect intervention. Chi-square and ANOVA testing were used to analyze the data. RESULTS Dynamic balance, characterized by the DGI, increased during the intervention phase χ2 (1, N = 12) = 12, p = .001. Static balance, characterized by the FRT showed no significant changes. The EPE increased during the intervention phase in the backward direction χ2 (1, N = 12) = 5.6, p = .02, and notable improvements of DCL were demonstrated in all directions. HRe (F (2,174) = 29.65, p = < .001) and time in a TTR (F (2, 12) = 4.19, p = .04) decreased over the course of the intervention phase. CONCLUSIONS Use of a supervised Kinect-based program that incorporated commercial games improved dynamic balance for an individual post severe TBI. Additionally, moderate cardiovascular activity was achieved through motion capture gaming. Further studies appear warranted to determine the potential therapeutic utility of commercial VR games in this patient population. TRIAL REGISTRATION Clinicaltrial.gov ID - NCT02889289.
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Affiliation(s)
- Shane Chanpimol
- Neurology Service, Veterans Affairs Medical Center, Washington, DC USA
- Physical Medicine and Rehabilitation Service, Veterans Affairs Medical Center, Washington, DC USA
| | - Bryant Seamon
- Physical Medicine and Rehabilitation Service, Veterans Affairs Medical Center, Washington, DC USA
- Muscle Morphology, Mechanics and Performance Laboratory, Clinical Research Center - Human Performance Research Unit, Veterans Affairs Medical Center, Washington, DC USA
| | - Haniel Hernandez
- Physical Medicine and Rehabilitation Service, Veterans Affairs Medical Center, Washington, DC USA
- Muscle Morphology, Mechanics and Performance Laboratory, Clinical Research Center - Human Performance Research Unit, Veterans Affairs Medical Center, Washington, DC USA
| | - Michael Harris-Love
- Muscle Morphology, Mechanics and Performance Laboratory, Clinical Research Center - Human Performance Research Unit, Veterans Affairs Medical Center, Washington, DC USA
- Geriatrics and Extended Care Service/Research Service, Veterans Affairs Medical Center, Washington, DC USA
- Department of Exercise and Nutritional Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC USA
| | - Marc R. Blackman
- Research Service, Veterans Affairs Medical Center, Washington, DC USA
- Departments of Medicine, Biochemistry and Molecular Medicine, George Washington University School of Medicine, Washington, DC USA
- Departments of Medicine and Rehabilitation Medicine, Georgetown University School of Medicine, Washington, DC USA
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Hwang YI, Yoon J. Changes in gait kinematics and muscle activity in stroke patients wearing various arm slings. J Exerc Rehabil 2017; 13:194-199. [PMID: 28503532 PMCID: PMC5412493 DOI: 10.12965/jer.1734898.449] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 03/31/2017] [Indexed: 11/22/2022] Open
Abstract
Stroke patients often use various arm slings, but the effects of different slings on the joint kinematics and muscle activity of the arm in the gait have not been investigated. The effects of joint kinematics and muscle activity in the gait were investigated to provide suggestions for gait training for stroke patients. In all, 10 chronic stroke patients were voluntarily recruited. An eight-camera three-dimensional motion analysis system was used to measure joint kinematics while walking; simultaneously, electromyography data were collected for the anterior and posterior deltoids and latissimus dorsi. The amplitude of pelvic rotation on the less-affected side differed significantly among the different arm slings (P<0.05). Changes in the knee kinematics of the less-affected side also differed significantly (P<0.05), while there were no significant differences in the muscle activity of the affected arm. In stroke patients, an extended arm sling is more useful than no sling or a flexed arm sling in terms of the amplitude of the rotation of the less-affected pelvic side in the stance phase while walking. The less-affected knee joint is flexed more without a sling than with any sling. All arm slings support the extension of the contralateral knee.
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Affiliation(s)
- Young-In Hwang
- Department of Physical Therapy, College of Biohealth Science, Hoseo University, Asan, Korea
| | - Jangwhon Yoon
- Department of Physical Therapy, College of Biohealth Science, Hoseo University, Asan, Korea
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Palermo E, Laut J, Nov O, Cappa P, Porfiri M. A natural user interface to integrate citizen science and physical exercise. PLoS One 2017; 12:e0172587. [PMID: 28231261 PMCID: PMC5322974 DOI: 10.1371/journal.pone.0172587] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2016] [Accepted: 02/07/2017] [Indexed: 11/25/2022] Open
Abstract
Citizen science enables volunteers to contribute to scientific projects, where massive data collection and analysis are often required. Volunteers participate in citizen science activities online from their homes or in the field and are motivated by both intrinsic and extrinsic factors. Here, we investigated the possibility of integrating citizen science tasks within physical exercises envisaged as part of a potential rehabilitation therapy session. The citizen science activity entailed environmental mapping of a polluted body of water using a miniature instrumented boat, which was remotely controlled by the participants through their physical gesture tracked by a low-cost markerless motion capture system. Our findings demonstrate that the natural user interface offers an engaging and effective means for performing environmental monitoring tasks. At the same time, the citizen science activity increases the commitment of the participants, leading to a better motion performance, quantified through an array of objective indices. The study constitutes a first and necessary step toward rehabilitative treatments of the upper limb through citizen science and low-cost markerless optical systems.
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Affiliation(s)
- Eduardo Palermo
- Department of Mechanical and Aerospace Engineering, New York University Tandon School of Engineering, Brooklyn, NY, United States of America
- Department of Mechanical and Aerospace Engineering, “Sapienza” University of Rome, Rome, Italy
| | - Jeffrey Laut
- Department of Mechanical and Aerospace Engineering, New York University Tandon School of Engineering, Brooklyn, NY, United States of America
| | - Oded Nov
- Department of Technology Management and Innovation, New York University Tandon School of Engineering, Brooklyn, NY, United States of America
| | - Paolo Cappa
- Department of Mechanical and Aerospace Engineering, New York University Tandon School of Engineering, Brooklyn, NY, United States of America
- Department of Mechanical and Aerospace Engineering, “Sapienza” University of Rome, Rome, Italy
| | - Maurizio Porfiri
- Department of Mechanical and Aerospace Engineering, New York University Tandon School of Engineering, Brooklyn, NY, United States of America
- * E-mail:
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Jang YY, Kim TH, Lee BH. Effects of Brain-Computer Interface-controlled Functional Electrical Stimulation Training on Shoulder Subluxation for Patients with Stroke: A Randomized Controlled Trial. Occup Ther Int 2016; 23:175-85. [PMID: 26876690 DOI: 10.1002/oti.1422] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Revised: 11/30/2015] [Accepted: 11/30/2015] [Indexed: 11/09/2022] Open
Abstract
The purpose of this study was to investigate the effects of brain-computer interface (BCI)-controlled functional electrical stimulation (FES) training on shoulder subluxation of patients with stroke. Twenty subjects were randomly divided into two groups: the BCI-FES group (n = 10) and the FES group (n = 10). Patients in the BCI-FES group were administered conventional therapy with the BCI-FES on the shoulder subluxation area of the paretic upper extremity, five times per week during 6 weeks, while the FES group received conventional therapy with FES only. All patients were assessed for shoulder subluxation (vertical distance, VD; horizontal distance, HD), pain (visual analogue scale, VAS) and the Manual Function Test (MFT) at the time of recruitment to the study and after 6 weeks of the intervention. The BCI-FES group demonstrated significant improvements in VD, HD, VAS and MFT after the intervention period, while the FES group demonstrated significant improvements in HD, VAS and MFT. There were also significant differences in the VD and two items (shoulder flexion and abduction) of the MFT between the two groups. The results of this study suggest that BCI-FES training may be effective in improving shoulder subluxation of patients with stroke by facilitating motor recovery. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Yun Young Jang
- Graduate School of Physical Therapy, Sahmyook University, Seoul, Korea
| | - Tae Hoon Kim
- Graduate School of Physical Therapy, Sahmyook University, Seoul, Korea.,The Post-Professional Doctor of Physical Therapy Program, Stockton University, Galloway, NJ, USA
| | - Byoung Hee Lee
- Graduate School of Physical Therapy, Sahmyook University, Seoul, Korea
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Sohn MK, Jee SJ, Hwang P, Jeon Y, Lee H. The Effects of Shoulder Slings on Balance in Patients With Hemiplegic Stroke. Ann Rehabil Med 2015; 39:986-94. [PMID: 26798614 PMCID: PMC4720776 DOI: 10.5535/arm.2015.39.6.986] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 06/23/2015] [Indexed: 11/12/2022] Open
Abstract
Objective To investigate the effects of a shoulder sling on balance in patients with hemiplegia. Methods Twenty-seven hemiplegic stroke patients (right 13, left 14) were enrolled in this study. The subjects' movement in their centers of gravity (COGs) during their static and dynamic balance tests was measured with their eyes open in each sling condition-without a sling, with Bobath's axillary support (Bobath sling), and with a simple arm sling. The percent times in quadrant, overall, anterior/posterior, and medial/lateral stability indexes were measured using a posturography platform (Biodex Balance System SD). Functional balance was evaluated using the Berg Balance Scale and the Trunk Impairment Scale. All balance tests were performed with each sling in random order. Results The COGs of right hemiplegic stroke patients and all hemiplegic stroke patients shifted to, respectively, the right and posterior quadrants during the static balance test without a sling (p<0.05). This weight asymmetry pattern did not improve with either the Bobath or the simple arm sling. There was no significant improvement in any stability index during either the static or the dynamic balance tests in any sling condition. Conclusion The right and posterior deviations of the hemiplegic stroke patients' COGs were maintained during the application of the shoulder slings, and there were no significant effects of the shoulder slings on the patients' balance in the standing still position.
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Affiliation(s)
- Min Kyun Sohn
- Department of Rehabilitation Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Sung Ju Jee
- Department of Rehabilitation Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Pyoungsik Hwang
- Department of Rehabilitation Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Yumi Jeon
- Department of Rehabilitation Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Hyunkeun Lee
- Department of Rehabilitation Medicine, Chungnam National University Hospital, Daejeon, Korea
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Hwang YI, An DH. Immediate effects of an elastic arm sling on walking patterns of chronic stroke patients. J Phys Ther Sci 2015; 27:35-7. [PMID: 25642032 PMCID: PMC4305591 DOI: 10.1589/jpts.27.35] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 07/04/2014] [Indexed: 11/24/2022] Open
Abstract
[Purpose] We developed a new arm sling with an elastic bandage which we hearafter refer to as "the elastic arm sling". This study investigated the immediate effects of the elastic arm sling on the gait patterns of stroke patients. [Subjects and Methods] Thirteen stroke patients were enrolled in this study after providing their informed consent. They walked on a GAITRite mat twice, with a 5-min rest between the trials. [Results] Significant improvements were seen in cadence and walking velocity during walking while wearing the elastic arm sling. Furthermore, patients who used the elastic arm sling showed significant increases in step lengths of the affected and unaffected limbs. The stride lengths of the affected and unaffected sides while wearing the elastic arm sling and those without the elastic arm sling also significantly differed. [Conclusion] These results demonstrate that the elastic arm sling is a useful tool for the gait training of stroke patients, especially cadence, walking velocity, and the step and stride lengths of both limbs. Therefore, therapists should use the elastic arm sling as a gait-training assistive device for stroke patients.
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Affiliation(s)
| | - Duk-Hyun An
- Department of Physical Therapy, College of Biomedical Science and Engineering, Inje University, Republic of Korea
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Arya KN, Pandian S, Abhilasha CR, Verma A. Does the motor level of the paretic extremities affect balance in poststroke subjects? Rehabil Res Pract 2014; 2014:767859. [PMID: 24967104 PMCID: PMC4055229 DOI: 10.1155/2014/767859] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Revised: 03/28/2014] [Accepted: 04/23/2014] [Indexed: 12/03/2022] Open
Abstract
Background. Poststroke impairment may lead to fall and unsafe functional performance. The underlying mechanism for the balance dysfunction is unclear. Objective. To analyze the relation between the motor level of the affected limbs and balance in poststroke subjects. Method. A prospective, cross-sectional, and nonexperimental design was conducted in a rehabilitation institute. A convenience sample of 44 patients was assessed for motor level using Brunnstrom recovery stage (BRS) and Fugl-Meyer Assessment: upper (FMA-UE) and lower extremities (FMA-LE). The balance was measured by Berg Balance Scale (BBS), Postural Assessment Scale for Stroke Patients (PASS), and Functional Reach Test (FRT). Results. BRS showed moderate correlation with BBS (ρ = 0.54 to 0.60; P < 0.001), PASS (r = 0.48 to 0.64; P < 0.001) and FRT (ρ = 0.48 to 0.59; P < 0.001). FMA-UE also exhibited moderate correlation with BBS (ρ = 0.59; P < 0.001) and PASS (ρ = 0.60; P < 0.001). FMA-LE showed fair correlation with BBS (ρ = 0.50; P = 0.001) and PASS (ρ = 0.50; P = 0.001). Conclusion. Motor control of the affected limbs plays an important role in balance. There is a moderate relation between the motor level of the upper and lower extremities and balance. The findings of the present study may be applied in poststroke rehabilitation.
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Affiliation(s)
- Kamal Narayan Arya
- Pandit Deendayal Upadhyaya Institute for the Physically Handicapped (University of Delhi), Ministry of Social Justice and Empowerment, Government of India, 4 VD Marg, New Delhi 110002, India
| | - Shanta Pandian
- Pandit Deendayal Upadhyaya Institute for the Physically Handicapped (University of Delhi), Ministry of Social Justice and Empowerment, Government of India, 4 VD Marg, New Delhi 110002, India
| | - C. R. Abhilasha
- Pandit Deendayal Upadhyaya Institute for the Physically Handicapped (University of Delhi), Ministry of Social Justice and Empowerment, Government of India, 4 VD Marg, New Delhi 110002, India
| | - Ashutosh Verma
- Pandit Deendayal Upadhyaya Institute for the Physically Handicapped (University of Delhi), Ministry of Social Justice and Empowerment, Government of India, 4 VD Marg, New Delhi 110002, India
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Min HW, Liu KM, Han XZ, Gu R. Management of multijoint stiffness of bilateral upper limbs secondary to heterotopic ossification: Case report and literature review. ACTA ACUST UNITED AC 2014; 51:497-502. [DOI: 10.1682/jrrd.2013.03.0073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Revised: 10/10/2013] [Indexed: 11/05/2022]
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Dohle CI, Rykman A, Chang J, Volpe BT. Pilot study of a robotic protocol to treat shoulder subluxation in patients with chronic stroke. J Neuroeng Rehabil 2013; 10:88. [PMID: 23914834 PMCID: PMC3751786 DOI: 10.1186/1743-0003-10-88] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Accepted: 06/14/2013] [Indexed: 12/17/2022] Open
Abstract
Background Shoulder subluxation is a frequent complication of motor impairment after stroke, leading to soft tissue damage, stretching of the joint capsule, rotator cuff injury, and in some cases pain, thus limiting use of the affected extremity beyond weakness. In this pilot study, we determined whether robotic treatment of chronic shoulder subluxation can lead to functional improvement and whether any improvement was robust. Methods 18 patients with chronic stroke (3.9 ± 2.9 years from acute stroke), completed 6 weeks of robotic training using the linear shoulder robot. Training was performed 3 times per week on alternate days. Each session consisted of 3 sets of 320 repetitions of the affected arm, and the robotic protocol alternated between training vertical arm movements, shoulder flexion and extension, in an anti-gravity plane, and training horizontal arm movements, scapular protraction and retraction, in a gravity eliminated plane. Results Training with the linear robot improved shoulder stability, motor power, and resulted in improved functional outcomes that were robust 3 months after training. Conclusion In this uncontrolled pilot study, the robotic protocol effectively treated shoulder subluxation in chronic stroke patients. Treatment of subluxation can lead to improved functional use of the affected arm, likely by increasing motor power in the trained muscles.
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Bibliography Current World Literature. CURRENT ORTHOPAEDIC PRACTICE 2012. [DOI: 10.1097/bco.0b013e3182434f58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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