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Karaca S, Yildiz Özer A, Karakurt S, Polat MG. Effects of body awareness therapy on balance and fear of falling in patients with chronic obstructive pulmonary disease: a randomized controlled trial. Biopsychosoc Med 2024; 18:6. [PMID: 38409129 PMCID: PMC10895779 DOI: 10.1186/s13030-024-00303-x] [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: 10/04/2023] [Accepted: 02/13/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Assessment of extrapulmonary comorbidities is essential in chronic obstructive pulmonary disease (COPD). Deterioration of balance and increasing fear of falling are two of the most significant extrapulmonary manifestations. Although pulmonary rehabilitation (PR) is well-known and effective for COPD patients, there is a need for alternative treatments to enhance balance and alleviate concerns about falling. This study aimed to investigate the effect of Body Awareness Therapy (BAT), in addition to the PR program, on balance and fear of falling in patients with COPD. METHODS Forty-three patients were randomized into two groups: the BAT + PR group (BAT: once a week, 60 min + PR: 30 min, seven days of the week) or the PR group (PR: 30 min, seven days of the week) for eight weeks. Primary (balance, fear of falling) and secondary (dyspnea, muscle strength, functional capacity) outcomes were assessed at two different times: the baseline and end of the eight weeks. RESULTS Significant improvements were found in dynamic balance (reaction time η2 = 0.777, movement velocity η2 = 0.789, endpoint excursion η2 = 0.687, maximal excursion η2 = 0.887), static balance on firm ground (eyes opened η2 = 0.679, eyes closed η2 = 0.705), dyspnea (η2 = 0.546), muscle strength (η2 = 0.803), and functional capacity (η2 = 0.859) of the BAT + PR group (p < 0.05 for all). The improvement in fear of falling was significantly greater in the BAT + PR group than in the PR group (p < 0.001, η2 = 0.331). CONCLUSION The BAT method added to PR was more effective than PR alone in improving balance and reducing the fear of falling in COPD patients. TRIAL REGISTRATION This randomized controlled study was registered at clinicaltrials.gov, NCT04212676 , Registered 28 December 2019.
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Affiliation(s)
- Seda Karaca
- Department of Physiotherapy and Rehabilitation, Cardiopulmonary Rehabilitation Department, Faculty of Health Sciences, Marmara University, Süreyyapaşa Başıbüyük Street, Number:4, B, Maltepe, Istanbul, 34854, Turkey.
| | - Aysel Yildiz Özer
- Department of Physiotherapy and Rehabilitation, Cardiopulmonary Rehabilitation Department, Faculty of Health Sciences, Marmara University, Süreyyapaşa Başıbüyük Street, Number:4, B, Maltepe, Istanbul, 34854, Turkey
| | - Sait Karakurt
- Department of Pulmonary Medicine, School of Medicine, Marmara University, Istanbul, Turkey
| | - Mine Gülden Polat
- Department of Physiotherapy and Rehabilitation, Cardiopulmonary Rehabilitation Department, Faculty of Health Sciences, Marmara University, Süreyyapaşa Başıbüyük Street, Number:4, B, Maltepe, Istanbul, 34854, Turkey
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2
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Alpay K, Sahin M. Effects of basic body awareness therapy on pain, balance, muscle strength and functionality in knee osteoarthritis: a randomised preliminary trial. Disabil Rehabil 2023; 45:4373-4380. [PMID: 36444879 DOI: 10.1080/09638288.2022.2151650] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 11/20/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE This study aimed to investigate the effects of basic body awareness therapy (BBAT) on pain, balance, muscle strength, and functionality in knee OA. METHODS Forty patients (mean age: 55.20 ± 6.40 years) with knee OA were randomly assigned to experimental and control groups. Both groups participated in a home-based exercise programme. The home-based exercise programme was performed daily for 6 weeks. In addition to the home-based programme, patients in the experimental group participated in BBAT 3 days a week for 6 weeks. The visual analogue scale, fall risk assessment, single-leg stability test, knee extension muscle strength, five times sit-to-stand test, joint range of motion assessment, Western Ontario and McMaster Universities Osteoarthritis Index, 6-minute walk test, and stair climb test were performed at baseline and after 6 weeks. RESULTS All outcomes in the experimental group significantly improved after 6 weeks (p < 0.05). There were significant differences between the two groups in terms of the experimental group in muscle strength (p = 0.018, η2= 0.191), five times sit-to-stand test (p < 0.001, η2= 0.510), and the stair climbing test (p = 0.012, η2=0.212). CONCLUSION This study showed that BBAT, in addition to a home-based exercise programme, can improve muscle strength and functionality in patients with knee OA. CLINICAL TRIAL REGISTRATION NUMBER NCT04165187.
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Affiliation(s)
- Kubra Alpay
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bezmialem Vakif University, Istanbul, Turkey
- Health Sciences Institute, Istanbul Medipol University, Istanbul, Turkey
| | - Mustafa Sahin
- Department of Orthopaedics and Traumatology, Faculty of Medicine, Istanbul Medipol University, Istanbul, Turkey
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3
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Ahola S, Piirainen A, Vuoskoski P. Perceptions of learning and teaching human movement in physiotherapy: A systematic review and metasynthesis of qualitative studies. Int J Qual Stud Health Well-being 2023; 18:2225943. [PMID: 38016038 PMCID: PMC10294735 DOI: 10.1080/17482631.2023.2225943] [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: 11/16/2022] [Accepted: 06/12/2023] [Indexed: 11/30/2023] Open
Abstract
PURPOSE Human movement is essential for health and well-being. Understanding human movement is pivotal in physiotherapy, but also an important element of physiotherapy education. This review identified, critically appraised, and synthesized the available evidence on learning and teaching human movement in physiotherapy as perceived by students, therapists, and instructors. METHODS The databases MEDLINE, CINAHL, ERIC, PsycINFO, MEDIC and FINNA, were searched. The search was conducted in March/April 2020 and updated in March 2022. The systematic review followed the JBI methodology for systematic reviews of qualitative evidence and was conducted in accordance with an a priori protocol. RESULTS The overall quality of the 17 included studies was scored low on ConQual but dependability and credibility were rated as moderate. Four synthesized findings aggregated from 17 categories and 147 findings described the perceived significance of 1) being present in movement, 2) movement quality, 3) movement transfer, and 4) contextual factors for the learning or teaching of human movement in physiotherapy. CONCLUSION The synthesized findings indicate that the perceived significance of contextual factors, movement quality and transfer, and being present in movement should be considered in all learning and teaching of movement in physiotherapy. However, the evidence of the review findings was evaluated as low-level, which should be considered when applying these results to physiotherapy education or practice.
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Affiliation(s)
- Sirpa Ahola
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyvaskyla, Finland
- Physiotherapy, Metropolia University of Applied Sciences, Helsinki, Finland
| | - Arja Piirainen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyvaskyla, Finland
| | - Pirjo Vuoskoski
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyvaskyla, Finland
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4
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Serrada I, Williams L, Hordacre B, Hillier S. Key constructs of body awareness impairments post-stroke: a scoping review of assessment tools and interventions. Disabil Rehabil 2023; 45:3177-3198. [PMID: 36189909 DOI: 10.1080/09638288.2022.2123053] [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: 07/28/2021] [Revised: 08/24/2022] [Accepted: 08/29/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE To summarise body awareness assessment tools and interventions relevant for stroke rehabilitation using a framework that categorises key body awareness constructs, disorders and impairments. MATERIALS AND METHODS Online electronic databases and trial registries were searched from inception until July 2021, in addition to hand searching reference lists of included studies and reviews. Study selection included any study design where the investigation involved assessing and/or intervening in body awareness following stroke. Data were extracted based on predefined criteria by two independent reviewers and mapped to the emergent framework. RESULTS The final analysis included 144 papers that reported 43 assessment tools and 8 types of interventions for body awareness. Consensus was reached on a synthesised body awareness framework. This comprised specific impairments and disorders, constructs, sub-categories and main categories leading to the overarching term of body awareness. Clinical and psychometric properties of the assessment tools were not reported or poorly evaluated, and the interventions lacked robust study designs and rigorous methods. CONCLUSIONS The framework produced will enable future research and clinical practice to be based on consistent concepts and definitions. Clinicians can also use this information to cautiously select assessment tools and/or interventions but are reminded of the limitations identified in this review.Implications for rehabilitationThere is limited understanding, compounded by inconsistent terminology and definitions regarding body awareness after stroke.A synthesized framework to define key constructs and definitions of body awareness is proposed.Assessment tools and interventions reported in the literature are mapped to the proposed framework.Psychometric properties of available tools are reported.Significant work remains to refine concepts of body awareness, develop and evaluate assessment tools and interventions.
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Affiliation(s)
- Ines Serrada
- Allied Health and Human Performance, Innovation, Implementation and Clinical Translation (IIMPACT) in Health, University of South Australia, City East Campus, Adelaide, SA, Australia
| | - Lindy Williams
- Allied Health and Human Performance, Innovation, Implementation and Clinical Translation (IIMPACT) in Health, University of South Australia, City East Campus, Adelaide, SA, Australia
| | - Brenton Hordacre
- Allied Health and Human Performance, Innovation, Implementation and Clinical Translation (IIMPACT) in Health, University of South Australia, City East Campus, Adelaide, SA, Australia
| | - Susan Hillier
- Allied Health and Human Performance, Innovation, Implementation and Clinical Translation (IIMPACT) in Health, University of South Australia, City East Campus, Adelaide, SA, Australia
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5
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Sarıçan Y, Erdoğanoğlu Y, Pepe M. The effect of body awareness on trunk control, affected upper extremity function, balance, fear of falling, functional level, and level of independence in patients with stroke. Top Stroke Rehabil 2023:1-10. [PMID: 36871579 DOI: 10.1080/10749357.2023.2185995] [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: 03/07/2023]
Abstract
OBJECTIVES This study was conducted to examine the effects of body awareness on trunk control, affected upper extremity function, balance, fear of falling, functional level, and level of independence in patients with stroke. METHODS 35 individuals between the ages of 21 and 78 who were diagnosed with stroke were included in the study. The body awareness of the individuals participating in the study was determined with the Body Awareness Questionnaire (BAQ), trunk control with Trunk Impairment Scale (TIS), the affected upper extremity functions with Motor Activity Log-28 (MAL,-28), and Fugl-Meyer Upper Extremity Assessment (FMUEA), balance with Berg Balance Scale (BBS), fear of falling with Tinetti Falls Efficacy Scale (TFES), functional level with Barthel Activities of Daily Living Index (BI) and level of independence with Functional Independence Measures (FIM). RESULTS For patients participating in the study, 26% were female, 74% were male and 43% showed left, 57% showed right hemisphere involvement. In simple linear regression analysis, BAQ measurement had a statistically significant effect on TIS (F = 25.439 p = 0.001), MAL-28 (F = 7.852 p = 0.008), FMUEA (F = 12.155 p = 0.001), BBS (F = 13.506 p = 0.001), TFES (F = 13.119 p = 0.001), BI (F = 19.977 p = 0.001) and FIM (F = 22.014 p = 0.001) in patients with stroke. CONCLUSIONS In conclusion, body awareness was found to be one of the factors affecting trunk control, affected upper extremity function, balance, fear of falling, functional level, and level of independence in patients with stroke. It was thought that there was a need for assessment of body awareness and include bodyawareness in rehabilitation programs in patients with stroke.
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Affiliation(s)
- Yusuf Sarıçan
- Physiotherapy and Rehabilitation Department, Institute of Health Sciences, Üsküdar University, İstanbul, Türkiye
| | - Yıldız Erdoğanoğlu
- Physiotherapy and Rehabilitation Department, Faculty of Health Sciences, Antalya Bilim University, Antalya, Türkiye
| | - Murad Pepe
- Physiotherapy and Rehabilitation Department, Faculty of Health Sciences, Antalya Bilim University, Antalya, Türkiye
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Lo TLT, Lee JLC, Ho RTH. Recovery beyond functional restoration: a systematic review of qualitative studies of the embodied experiences of people who have survived a stroke. BMJ Open 2023; 13:e066597. [PMID: 36759032 PMCID: PMC9923291 DOI: 10.1136/bmjopen-2022-066597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
OBJECTIVE To synthesise the qualitative evidence of embodied experiences of people who have survived a stroke, the experiences of making sense of oneself, others and the world in the poststroke bodies.DesignQualitative systematic review. DATA SOURCES Five electronic databases, PsycINFO, PubMed, MEDLINE, CINAHL Plus and Cochrane Library, were employed to search for qualitative studies published up to February 2022. INCLUSION CRITERIA Literature in English that employed qualitative methods to investigate the embodied experiences of people who have survived a stroke. QUALITY APPRAISAL Two reviewers independently appraised the quality of the included studies based on the tool developed by Salter et al in 2008. It consists of seven questions assessing the credibility and relevance of the studies. Discrepancies were resolved until a consensus was reached. DATA EXTRACTION AND SYNTHESIS Thematic synthesis was applied to synthesise the related findings from all the included studies. Two reviewers were involved in the process. RESULTS 1482 records were identified. After the screening process, 34 studies were included in this review. Three analytical themes and their related descriptive themes emerged. Analytical themes included 'disconnection between oneself, others and the world,' 'the transitional period: exploring and negotiating,' and 'reconnecting with oneself, others and the world'. CONCLUSION The findings demonstrated that the embodied experiences of people who have survived a stroke progressed from feeling disconnected to reconnecting with themselves, others and the world. Stroke recovery should not only be limited to functional restoration. Approaching 're-embodiment', the realignment between oneself and one's body, is crucial in reintegrating with others and the world on the trajectory toward recovery. PROSPERO REGISTRATION NUMBER CRD42020183125.
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Affiliation(s)
- Temmy Lee Ting Lo
- Centre on Behavioral Health, The University of Hong Kong, Hong Kong, Hong Kong SAR
| | - Janet Lok Chun Lee
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR
| | - Rainbow Tin Hung Ho
- Centre on Behavioral Health, The University of Hong Kong, Hong Kong, Hong Kong SAR
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, Hong Kong SAR
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Vancampfort D, Brunner E, Van Damme T, Stubbs B. Efficacy of basic body awareness therapy on functional outcomes: A systematic review and meta-analysis of randomized controlled trials. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2023; 28:e1975. [PMID: 36103584 DOI: 10.1002/pri.1975] [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: 05/01/2022] [Revised: 06/09/2022] [Accepted: 08/28/2022] [Indexed: 01/04/2023]
Abstract
PURPOSE This study examined the efficacy of basis body awareness therapy (BBAT) on functional outcomes and quality of life (QoL) in patients with mental health problems and long-lasting conditions including musculoskeletal disorders, chronic and psychosomatic pain, and neurological conditions. MATERIAL AND METHODS Randomized controlled trials (RCTs) were obtained from MEDLINE, EMBASE, CINAHL, CENTRAL, and PEDro from inception to April 1st, 2022. A random effects meta-analysis was performed to explore the efficacy of BBAT versus non-active and active control conditions. RESULTS Eight RCTs (n BBAT = 307, n controls = 428) were included. There was no evidence for reductions in anxiety (standardized mean difference [SMD] = -1.42, 95% confidence interval [CI] = -3.30 to 0.46, p = 0.14), depression (SMD = -0.82, 95% CI = -1.85 to 0.21, p = 0.12), and no improvements in global assessment of functioning for functioning (GAF-F) (SMD = 0.58, 95% CI = -0.03 to 1.19, p = 0.06) or for symptoms (GAF-S) (SMD = 0.76, 95% CI = -0.44 to 1.96, p = 0.21) in BBAT versus non-active control conditions. BBAT reduced anxiety significantly more than active interventions (SMD = -0.84, 95% CI = -1.17 to -0.51, p < 0.001). No significant differences between BBAT and active control conditions were found for reduction in depression (SMD = -1.16, 95% CI = -2.74 to 0.41, p = 0.15) or in self-reported pain (SMD = 0.08, 95% CI = -0.25 to 0.40, p = 0.65). Active control conditions were superior in improving QoL (SMD = 0.83, 95% CI = 0.49 to 1.17, p < 0.001), GAF-F (SMD = 1.58, 95% CI = 0.29 to 2.86, p = 0.016) and GAF-S (SMD = 1.19, 95% CI = 0.85 to 1.53, p < 0.001). CONCLUSIONS Physiotherapists should be cautious in adopting BBAT, noting there is no high-quality evidence to support its' use to improve functionality and QoL in patients with mental health problems and/or long-lasting conditions.
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Affiliation(s)
- Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium.,University Psychiatric Center KU Leuven, Leuven, Kortenberg, Belgium
| | - Emanuel Brunner
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium.,Department Gesundheit, Ostschweizer Fachhochschule, St. Gallen, Switzerland.,Institut für Therapie und Rehabilitation, Kantonsspital Winterthur, Winterthur, Switzerland
| | - Tine Van Damme
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium.,University Psychiatric Center KU Leuven, Leuven, Kortenberg, Belgium
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK.,Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
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Marsico P, Mercer TH, van Hedel HJA, van der Linden ML. What are the relevant categories, modalities, and outcome measures for assessing lower limb somatosensory function in children with upper motor neuron lesions? A Delphi study. Disabil Rehabil 2022:1-10. [PMID: 35906774 DOI: 10.1080/09638288.2022.2102257] [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: 11/03/2022]
Abstract
PURPOSE Somatosensory function of the lower limbs is rarely assessed in children with upper motor neuron lesions despite its potential relevance for motor function. We explored consensus regarding somatosensory categories (exteroception, proprioception, interoception, and body awareness), modalities, and outcome measures relevant to lower limb motor function. METHODS Fifteen international experts with experience of somatosensory function assessment participated in this Delphi study. Surveys of four rounds, conducted online, included questions on the relevance of somatosensory categories and modalities for motor function and on the use of potential outcome measures in clinical practice. RESULTS The experts reached consensus on the relevance of six modalities of the categories exteroception, proprioception, and body awareness. Based on their feedback, we formulated three core criteria for somatosensory outcome measures, namely suitability for clinical practice, child-friendliness, and relevance for motor function. None of the nine available outcome measures fulfilled each criterion. The experts also highlighted the importance of using and interpreting the tests in relation to the child's activity and participation. CONCLUSION There was expert consensus on three categories and six modalities of somatosensory function relevant for lower limb motor function. However, existing outcome measures will need to be adapted for use in paediatric clinical practice. IMPLICATION FOR REHABILITATIONConsensus was established for the categories and modalities of somatosensory function relevant for lower limb motor function of children with UMN lesion.Outcome measures should cover tactile function, joint movement and joint position and dynamic position sense, and spatial and structural body representation.None of the nine existing outcome measures fulfilled the core criteria: feasibility for clinical practice, child-friendliness, and relevance to motor function.
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Affiliation(s)
- Petra Marsico
- Research Department, Swiss Children's Rehab, University Children's Hospital Zurich, Affoltern am Albis, Switzerland.,Children's Research Center CRC, University Children's Hospital Zurich, Zurich, Switzerland.,Centre for Health, Activity and Rehabilitation Research, Queen Margaret University, Edinburgh, UK
| | - Tom H Mercer
- Centre for Health, Activity and Rehabilitation Research, Queen Margaret University, Edinburgh, UK
| | - Hubertus J A van Hedel
- Research Department, Swiss Children's Rehab, University Children's Hospital Zurich, Affoltern am Albis, Switzerland.,Children's Research Center CRC, University Children's Hospital Zurich, Zurich, Switzerland.,Centre for Health, Activity and Rehabilitation Research, Queen Margaret University, Edinburgh, UK
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Serrada I, Fryer C, Hordacre B, Hillier S. Can body awareness training improve recovery following stroke: A study to assess feasibility and preliminary efficacy. Clin Rehabil 2022; 36:650-659. [PMID: 35243909 DOI: 10.1177/02692155221083492] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Impairments in body awareness are common after stroke and are associated with decreased participation and performance in everyday activities. OBJECTIVES To explore the feasibility and safety of a body awareness program after stroke, and identify the preliminary efficacy of class-based lessons compared to home-based lessons on sensation, body awareness, motor impairment and quality of life. METHODS A two-armed pilot randomized controlled trial with a nested qualitative descriptive study was conducted. Individuals with a diagnosis of stroke (at least three months post injury) were randomized to either class-based face-to-face body awareness lessons or home-based individually performed body awareness lessons. Outcome measures were safety, feasibility, sensation, body awareness, motor impairment, self-efficacy and quality of life. Semi-structured interviews were used to allow greater exploration and understanding of participants' experience of the program. RESULTS Twenty participants were randomized, 16 participants completed the program. Feasibility was greater in the class-based group. No adverse events were detected. The class-based group led to improvement in body awareness (p = 0.002), quality of life (p = 0.002), and the arm (p = 0.025) and leg (p = 0.005) motor impairment scores. Qualitative data similarly indicated that the class-based group experienced a stronger sense of awareness, achievement and connection than the home-based group. CONCLUSIONS Body awareness training was safe, feasible and acceptable in people with stroke. Individuals in the class-based group showed greater benefit compared to those receiving home-based therapy.
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Affiliation(s)
- Ines Serrada
- Allied Health and Human Performance, Innovation, Implementation and Clinical Translation (IIMPACT) in Health, 1067University of South Australia, City East Campus, Adelaide SA 5000, Australia
| | - Caroline Fryer
- Allied Health and Human Performance, Innovation, Implementation and Clinical Translation (IIMPACT) in Health, 1067University of South Australia, City East Campus, Adelaide SA 5000, Australia
| | - Brenton Hordacre
- Allied Health and Human Performance, Innovation, Implementation and Clinical Translation (IIMPACT) in Health, 1067University of South Australia, City East Campus, Adelaide SA 5000, Australia
| | - Susan Hillier
- Allied Health and Human Performance, Innovation, Implementation and Clinical Translation (IIMPACT) in Health, 1067University of South Australia, City East Campus, Adelaide SA 5000, Australia
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10
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Serrada I, Hordacre B, Hillier S. Recovery of Body Awareness After Stroke: An Observational Study. Front Neurol 2021; 12:745964. [PMID: 34912283 PMCID: PMC8666978 DOI: 10.3389/fneur.2021.745964] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 10/19/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Body awareness (BA) is a process that involves sensory awareness originating from the body's physiological states, processes and actions, and is shaped by one's attitudes, perceptions, beliefs and experience of social and cultural context. Impairments in body awareness after stroke are believed to be common and may be an important influence on recovery outcomes. However, recovery of body awareness is poorly understood and receives little consideration in rehabilitation. Aims: To investigate if body awareness changes over time following stroke; and identify if body awareness after stroke is associated with sensation, motor impairment, self-efficacy and quality of life. Methods: An exploratory longitudinal observational study was performed. Participants with a stroke diagnosis and associated motor impairment were recruited from an acute stroke unit. An assessment battery consisting of sensory and motor impairment and function, body awareness, self-efficacy and quality of life measures were used at baseline, 1, 3 and 6 months. Results: A total of 105 people with stroke were recruited. Most recovery in sensation and body awareness occurred within the first month after stroke (all p < 0.01). Sensation and body awareness were correlated with other clinical outcomes (motor impairment, self-efficacy and quality of life), demographics, and stroke specific clinical characteristics (all p < 0.01). Conclusions: This is the first study to track recovery of body awareness after stroke and investigate the relationship it may have in recovery of sensation, motor impairment and function, self-efficacy and quality of life. Further research is now warranted to continue investigation of body awareness and to develop effective stroke-specific assessment and intervention strategies.
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Affiliation(s)
- Ines Serrada
- Allied Health and Human Performance, Innovation, Implementation and Clinical Translation in Health, University of South Australia, Adelaide, SA, Australia
| | - Brenton Hordacre
- Allied Health and Human Performance, Innovation, Implementation and Clinical Translation in Health, University of South Australia, Adelaide, SA, Australia
| | - Susan Hillier
- Allied Health and Human Performance, Innovation, Implementation and Clinical Translation in Health, University of South Australia, Adelaide, SA, Australia
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11
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Barriers and Facilitators to Engagement in Rehabilitation Among Stroke Survivors: An Integrative Review. Rehabil Nurs 2021; 46:340-347. [PMID: 34149000 DOI: 10.1097/rnj.0000000000000340] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Approximately 795,000 Americans experience a new or recurrent stroke every year, and it remains one of the leading causes of disability worldwide. Patient engagement in rehabilitation and physical activity has been associated with improvements in functional outcomes during inpatient rehabilitation. There is limited knowledge of the barriers and facilitators to patients' engagement in stroke rehabilitation. METHODS An integrative review with a systematic approach was conducted to explore the current available literature on barriers and facilitators to patient engagement in stroke inpatient rehabilitation. RESULTS Twenty-five studies were included in the final review. Four major themes described the identified barriers and facilitators: (1) stroke impact, (2) self-efficacy, (3) therapeutic relationship, and (4) motivating factors. Individualized patient-centered goal setting was a commonly studied intervention found to successfully increase engagement. CONCLUSION Engagement in stroke rehabilitation is associated with improved patient outcomes. Using the identified themes from this review, nurses can develop focused interventions aimed at reducing barriers and increasing stroke patient engagement.
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12
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Ahn SN. Differences in body awareness and its effects on balance function and independence in activities of daily living for stroke. J Phys Ther Sci 2018; 30:1386-1389. [PMID: 30464371 PMCID: PMC6220104 DOI: 10.1589/jpts.30.1386] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 08/27/2018] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The present study aimed to investigate the association between body awareness with postural control and independence in performing activities of daily living in patients with hemispheric stroke. Eighty-one patients who were diagnosed with stroke participated in this study. [Participants and Methods] The participants were divided into three groups according to their risk for falls. Furthermore, these participants were classified into four groups according to their degree of independence in performing activities of daily living. This study used three measuring tools, namely the body awareness questionnaire, Berg balance scale, and modified Barthel index. [Results] Body awareness was significantly correlated with balance function in the group with low risk for falls compared with that in the group with high risk for falls. Body awareness was significantly correlated with the degree of independence in performing activities of daily living in the group that needed minimal assistance compared with the groups that needed moderate and severe assistance. Results showed that body awareness was associated with postural control and the degree of independence in performing activities of daily living in individuals with hemiparetic stroke. [Conclusion] Body awareness is among the primary factors that affect the motor function of patients with stroke in rehabilitation settings.
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Affiliation(s)
- Si-Nae Ahn
- Department of Occupational Therapy, College of Health and Medical Science, Cheongju University: 298 Daeseong-ro, Cheongwon-gu, Cheongju-si, Chungcheongbuk-do 28503, Republic of Korea
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13
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Skjaerven LH, Mattsson M, Catalan-Matamoros D, Parker A, Gard G, Gyllensten AL. Consensus on core phenomena and statements describing Basic Body Awareness Therapy within the movement awareness domain in physiotherapy. Physiother Theory Pract 2018; 35:80-93. [DOI: 10.1080/09593985.2018.1434578] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- LH. Skjaerven
- Department of Occupational Therapy, Physiotherapy and Radiography, Western Norway University of Applied Sciences, Campus Kronstad, Bergen, Norway
| | - M. Mattsson
- Department of Clinical Sciences, Division of Psychiatry, Umeå University, Umeå, Sweden
| | - D. Catalan-Matamoros
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, Almeria, Spain
- Faculty of Humanities, Communication and Documentation, University Carlos III of Madrid, Madrid, Spain
| | - A. Parker
- Physiotherapy Department, Royal Edinburgh Hospital, Edinburgh, UK
| | - G. Gard
- Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
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14
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Ambolt A, Gard G, Hammarlund CS. Therapeutically efficient components of Basic Body Awareness Therapy as perceived by experienced therapists - A qualitative study. J Bodyw Mov Ther 2017; 21:503-508. [PMID: 28750956 DOI: 10.1016/j.jbmt.2016.07.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 07/14/2016] [Accepted: 07/18/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Basic Body Awareness Therapy (BBAT) is a physiotherapeutic method used in rehabilitation to increase physical and emotional balance. The aim was to identify and describe perceived therapeutically efficient components of BBAT. METHODS Twenty-four experienced BBAT therapists participated in focus group interviews. The data were analysed with content analysis. RESULTS One central theme, the therapeutic space consisted of two categories; the therapeutic encounter and the therapeutic tools, which emerged as the core of the perceived therapeutically efficient components. The therapeutic encounter entailed the therapeutic approach, affect attunement, continuous interaction during treatment, affect mirroring and communicating by use of a person-centred approach. The therapeutic tools included adjustment and adaptation, the use of manual, verbal and non-verbal guiding, and creating an atmosphere of safety and sanctuary. CONCLUSION The significance of interaction by use of a person-centred approach combined with the ability to continuously adjust the treatment constituted useful guidelines when designing rehabilitation using BBAT treatment.
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Affiliation(s)
- Amelie Ambolt
- Department of Health Sciences, Lund University, Lund, Sweden; Department of Psychiatry, Rehabilitation, Ward 4, Baravägen 1G, Lund University Hospital, SE-221 85 Lund, Sweden.
| | - Gunvor Gard
- Department of Health Sciences, Lund University, Lund, Sweden
| | - Catharina Sjödahl Hammarlund
- Department of Health Sciences, Lund University, Lund, Sweden; The PRO-CARE Group, School of Health and Society, Kristianstad University, Kristianstad, Sweden
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15
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Ulanowski EA, Danzl MM, Sims KM. Physical Therapy for a Patient with Essential Tremor and Prolonged Deep Brain Stimulation: A Case Report. TREMOR AND OTHER HYPERKINETIC MOVEMENTS (NEW YORK, N.Y.) 2017; 7:448. [PMID: 28316875 PMCID: PMC5357321 DOI: 10.7916/d8x92h0g] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 02/27/2017] [Indexed: 01/22/2023]
Abstract
Background There is a lack of evidence examining the role of physical therapy (PT) to address movement dysfunction for individuals with essential tremor (ET). Case Report A 61-year-old male with ET and prolonged bilateral deep brain stimulation (DBS) completed 14 sessions of outpatient PT that emphasized balance, functional movements, and proximal stability training with an integration of principles of body awareness training and visual motor coordination. Improvements were noted in all outcome measures. Discussion This report describes a novel PT approach that offers a promising means of improving functional mobility and balance while decreasing falls risk in patients with ET.
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Affiliation(s)
- Elizabeth A Ulanowski
- Doctor of Physical Therapy Program, School of Movement and Rehabilitation Sciences, College of Health Professions, Bellarmine University, Louisville, KY, USA; Bellarmine University/Norton Healthcare Neurologic Physical Therapy Residency, Louisville, KY, USA
| | - Megan M Danzl
- Doctor of Physical Therapy Program, School of Movement and Rehabilitation Sciences, College of Health Professions, Bellarmine University, Louisville, KY, USA; Bellarmine University/Norton Healthcare Neurologic Physical Therapy Residency, Louisville, KY, USA
| | - Kara M Sims
- Bellarmine University/Norton Healthcare Neurologic Physical Therapy Residency, Louisville, KY, USA
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