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Abd El-Kafy EM, Alayat MS, Alwhaibi RM, Basuodan RM. Spiral strapping for improving upper extremity motor functions in individuals with stroke: A randomized controlled trial. Prosthet Orthot Int 2024:00006479-990000000-00208. [PMID: 38170804 DOI: 10.1097/pxr.0000000000000325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 11/17/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND The rehabilitation process for the upper extremities of individuals with stroke requires therapists to use splints for supportive and corrective purposes. The aim of this study was to assess the effectiveness of spiral strapping in inhibiting spasticity and improving the upper extremity motor functions of individuals with chronic stroke. METHODS Forty Saudi individuals aged 50-60 years with chronic stroke participated in this study. Their degrees of spasticity according to the Modified Ashworth Scale ranged across grades 1, 1+, and 2. Participants were randomly assigned to experimental and control groups. Participants in both groups received 1 h of conventional physical therapy for 3 d/wk to improve the motor functions of their upper extremities. In addition, participants in the experimental group wore an upper-limb spiral strapping with a hand splint 10 h/d for 6 d/wk. The treatment program for both groups was delivered for 4 weeks. Changes in the scores of Action Research Arm Test for elbow joint spasticity, active range of motion of the shoulder, elbow, and forearm joints, and hand grip strength were evaluated before and after treatment in both groups. RESULTS Significant improvements in all measured variables after treatment were reported in both groups, except for elbow joint spasticity in the control group. The experimental group showed significant post-treatment improvement in the scores for all measured variables compared with the control group. CONCLUSIONS Spiral strapping was beneficial in inhibiting mild degrees of spasticity and improving the motor functions of the upper extremities of stroke patients.
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Affiliation(s)
- Ehab Mohamed Abd El-Kafy
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
- Department of Pediatric Physical Therapy, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Mohamad Salaheldien Alayat
- Department of Physical Therapy, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
- Department of Basic Sciences, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Reem M Alwhaibi
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Reem M Basuodan
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
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Campanini I, Bò MC, Bassi MC, Damiano B, Scaltriti S, Lusuardi M, Merlo A. Outcome measures for assessing the effectiveness of physiotherapy interventions on equinus foot deformity in post-stroke patients with triceps surae spasticity: A scoping review. PLoS One 2023; 18:e0287220. [PMID: 37824499 PMCID: PMC10569611 DOI: 10.1371/journal.pone.0287220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 06/01/2023] [Indexed: 10/14/2023] Open
Abstract
OBJECTIVE Equinus foot deformity (EFD) is the most common deviation after stroke. Several physiotherapy interventions have been suggested to treat it. However, studies evaluating the efficacy of these treatments vary widely in terms of assessment modalities, type of data analysis, and nomenclature. This scoping review aimed to map current available evidence on outcome measures and the modalities employed to assess the effectiveness of physiotherapy programs for the reduction of triceps surae (TS) spasticity and EFD in patients with stroke. METHODS Scoping review methodological frameworks have been used. Three databases were investigated. Primary literature addressing TS spasticity in adult patients with stroke using physiotherapy interventions was included. Findings were systematically summarized in tables according to the intervention used, intervention dosage, control group, clinical, and instrumental outcome measures. RESULTS Of the 642 retrieved studies, 53 papers were included. TS spasticity was assessed by manual maneuvers performed by clinicians (mainly using the Ashworth Scale), functional tests, mechanical evaluation through robotic devices, or instrumental analysis and imaging (such as the torque-angle ratio, the H-reflex, and ultrasound images). A thorough critical appraisal of the construct validity of the scales and of the statistics employed was provided, particularly focusing on the choice of parametric and non-parametric approaches when using ordinal scales. Finally, the complexity surrounding the concept of "spasticity" and the possibility of assessing the several underlying active and passive causes of EFD, with a consequent bespoke treatment for each of them, was discussed. CONCLUSION This scoping review provides a comprehensive description of all outcome measures and assessment modalities used in literature to assess the effectiveness of physiotherapy treatments, when used for the reduction of TS spasticity and EFD in patients with stroke. Clinicians and researchers can find an easy-to-consult summary that can support both their clinical and research activities.
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Affiliation(s)
- Isabella Campanini
- Neuromotor and Rehabilitation Department, LAM–Motion Analysis Laboratory, San Sebastiano Hospital, Azienda USL-IRCCS di Reggio Emilia, Correggio (Reggio Emilia), Correggio, Italy
| | - Maria Chiara Bò
- Neuromotor and Rehabilitation Department, LAM–Motion Analysis Laboratory, San Sebastiano Hospital, Azienda USL-IRCCS di Reggio Emilia, Correggio (Reggio Emilia), Correggio, Italy
- Merlo Bioengineering, Parma, Italy
| | | | - Benedetta Damiano
- Neuromotor and Rehabilitation Department, LAM–Motion Analysis Laboratory, San Sebastiano Hospital, Azienda USL-IRCCS di Reggio Emilia, Correggio (Reggio Emilia), Correggio, Italy
| | - Sara Scaltriti
- Neuromotor and Rehabilitation Department, LAM–Motion Analysis Laboratory, San Sebastiano Hospital, Azienda USL-IRCCS di Reggio Emilia, Correggio (Reggio Emilia), Correggio, Italy
| | - Mirco Lusuardi
- Neuromotor and Rehabilitation Department, Azienda USL-IRCCS Reggio Emilia, Correggio, Italy
| | - Andrea Merlo
- Neuromotor and Rehabilitation Department, LAM–Motion Analysis Laboratory, San Sebastiano Hospital, Azienda USL-IRCCS di Reggio Emilia, Correggio (Reggio Emilia), Correggio, Italy
- Merlo Bioengineering, Parma, Italy
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Campanini I, Bò MC, Salsi F, Bassi MC, Damiano B, Scaltriti S, Lusuardi M, Merlo A. Physical therapy interventions for the correction of equinus foot deformity in post-stroke patients with triceps spasticity: A scoping review. Front Neurol 2022; 13:1026850. [DOI: 10.3389/fneur.2022.1026850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 09/30/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveEquinus foot deformity (EFD) is the most common deformity following a stroke. Several approaches have been suggested for its correction, including pharmacological, surgical, and physical therapy (PT) interventions. This scoping review aims to map and synthesize the available evidence focusing on physical therapy treatments for EFD caused by triceps surae (TS) spasticity.MethodsScoping review methodological frameworks have been used. Pubmed, Cinahl, and Cochrane databases were searched for primary literature. Studies focusing on the treatment of EFD in adult stroke patients were included only when the intervention involved PT treatments and presented at least one outcome measure for the functional and/or structural condition of the TS. Data were systematically collected and reported in tables inclusive of type of intervention, sample characteristics, dosage, comparators, outcomes, follow-up timeline, and treatment efficacy. A narrative synthesis was also added.ResultsOf the 642 experimental or observational screened studies, 53 were included, focusing on stretching exercises, shock waves, electrical stimulation, dry needling, TENS, vibration therapy, ultrasounds, cryotherapy, and active physiotherapy. Patients with EFD benefited from specific physical therapy treatments. These usually resulted in Modified Ashworth Scale reduction, typically by 1 point, and an increase in ROM. Interventions consisting of shock waves, dry needling, and electrostimulation showed the best results in reducing EFD. Heterogeneous dosage and delivery mode generally limited conclusions.ConclusionsThis scoping review summarized available primary literature based on PT treatments for the correction of EFD. By highlighting the remaining gaps in knowledge, it provides a reference for future studies on this pathology. Further investigations are necessary to pinpoint the best dosage and delivery methods. Future studies should investigate whether early rehabilitation programs started during the acute phase might help prevent or limit the development of secondary deformities.
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Nazari N, Ansari NN, Naghdi S, Gallego PH, Honarpisheh R. A Clinical Trial Protocol to Compare the Effect of Dry Needling and Acupoint Dry Needling on Wrist Flexor Spasticity after Stroke. J Acupunct Meridian Stud 2022; 15:273-278. [DOI: 10.51507/j.jams.2022.15.4.273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 09/05/2021] [Accepted: 05/05/2022] [Indexed: 11/03/2022] Open
Affiliation(s)
- Najmeh Nazari
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Noureddin Nakhostin Ansari
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
- Research Center for War-affected People, Tehran University of Medical Sciences, Tehran, Iran
| | - Soofia Naghdi
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
- Research Center for War-affected People, Tehran University of Medical Sciences, Tehran, Iran
| | - Pablo Herrero Gallego
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
| | - Roshanak Honarpisheh
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
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Pradines M, Ghédira M, Bignami B, Vielotte J, Bayle N, Marciniak C, Burke D, Hutin E, Gracies JM. Do Muscle Changes Contribute to the Neurological Disorder in Spastic Paresis? Front Neurol 2022; 13:817229. [PMID: 35370894 PMCID: PMC8964436 DOI: 10.3389/fneur.2022.817229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 02/01/2022] [Indexed: 11/13/2022] Open
Abstract
Background At the onset of stroke-induced hemiparesis, muscle tissue is normal and motoneurones are not overactive. Muscle contracture and motoneuronal overactivity then develop. Motor command impairments are classically attributed to the neurological lesion, but the role played by muscle changes has not been investigated. Methods Interaction between muscle and command disorders was explored using quantified clinical methodology-the Five Step Assessment. Six key muscles of each of the lower and upper limbs in adults with chronic poststroke hemiparesis were examined by a single investigator, measuring the angle of arrest with slow muscle stretch (XV1) and the maximal active range of motion against the resistance of the tested muscle (XA). The coefficient of shortening CSH = (XN-XV1)/XN (XN, normally expected amplitude) and of weakness CW = (XV1-XA)/XV1) were calculated to estimate the muscle and command disorders, respectively. Composite CSH (CCSH) and CW (CCW) were then derived for each limb by averaging the six corresponding coefficients. For the shortened muscles of each limb (mean CSH > 0.10), linear regressions explored the relationships between coefficients of shortening and weakness below and above their median coefficient of shortening. Results A total of 80 persons with chronic hemiparesis with complete lower limb assessments [27 women, mean age 47 (SD 17), time since lesion 8.8 (7.2) years], and 32 with upper limb assessments [18 women, age 32 (15), time since lesion 6.4 (9.3) years] were identified. The composite coefficient of shortening was greater in the lower than in the upper limb (0.12 ± 0.04 vs. 0.08 ± 0.04; p = 0.0002, while the composite coefficient of weakness was greater in the upper limb (0.28 ± 0.12 vs. 0.15 ± 0.06, lower limb; p < 0.0001). In the lower limb shortened muscles, the coefficient of weakness correlated with the composite coefficient of shortening above the 0.15 median CSH (R = 0.43, p = 0.004) but not below (R = 0.14, p = 0.40). Conclusion In chronic hemiparesis, muscle shortening affects the lower limb particularly, and, beyond a threshold of severity, may alter descending commands. The latter might occur through chronically increased intramuscular tension, and thereby increased muscle afferent firing and activity-dependent synaptic sensitization at the spinal level.
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Affiliation(s)
- Maud Pradines
- UR 7377 BIOTN, Laboratoire Analyse et Restauration du Mouvement, Université Paris Est Créteil (UPEC), Créteil, France.,AP-HP, Service de Rééducation Neurolocomotrice, Unité de Neurorééducation, Hôpitaux Universitaires Henri Mondor, Créteil, France
| | - Mouna Ghédira
- UR 7377 BIOTN, Laboratoire Analyse et Restauration du Mouvement, Université Paris Est Créteil (UPEC), Créteil, France.,AP-HP, Service de Rééducation Neurolocomotrice, Unité de Neurorééducation, Hôpitaux Universitaires Henri Mondor, Créteil, France
| | - Blaise Bignami
- AP-HP, Service de Rééducation Neurolocomotrice, Unité de Neurorééducation, Hôpitaux Universitaires Henri Mondor, Créteil, France
| | - Jordan Vielotte
- AP-HP, Service de Rééducation Neurolocomotrice, Unité de Neurorééducation, Hôpitaux Universitaires Henri Mondor, Créteil, France
| | - Nicolas Bayle
- UR 7377 BIOTN, Laboratoire Analyse et Restauration du Mouvement, Université Paris Est Créteil (UPEC), Créteil, France.,AP-HP, Service de Rééducation Neurolocomotrice, Unité de Neurorééducation, Hôpitaux Universitaires Henri Mondor, Créteil, France
| | - Christina Marciniak
- Department of Physical Medicine and Rehabilitation, Northwestern University and the Shirley Ryan AbilityLab, Chicago, IL, United States.,Department of Neurology, Northwestern University and the Shirley Ryan AbilityLab, Chicago, IL, United States
| | - David Burke
- Department of Neurology, Royal Prince Alfred Hospital and the University of Sydney, Sydney, NSW, Australia
| | - Emilie Hutin
- UR 7377 BIOTN, Laboratoire Analyse et Restauration du Mouvement, Université Paris Est Créteil (UPEC), Créteil, France.,AP-HP, Service de Rééducation Neurolocomotrice, Unité de Neurorééducation, Hôpitaux Universitaires Henri Mondor, Créteil, France
| | - Jean-Michel Gracies
- UR 7377 BIOTN, Laboratoire Analyse et Restauration du Mouvement, Université Paris Est Créteil (UPEC), Créteil, France.,AP-HP, Service de Rééducation Neurolocomotrice, Unité de Neurorééducation, Hôpitaux Universitaires Henri Mondor, Créteil, France
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Gomez-Cuaresma L, Lucena-Anton D, Gonzalez-Medina G, Martin-Vega FJ, Galan-Mercant A, Luque-Moreno C. Effectiveness of Stretching in Post-Stroke Spasticity and Range of Motion: Systematic Review and Meta-Analysis. J Pers Med 2021; 11:jpm11111074. [PMID: 34834426 PMCID: PMC8619362 DOI: 10.3390/jpm11111074] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 10/21/2021] [Accepted: 10/22/2021] [Indexed: 01/29/2023] Open
Abstract
Spasticity is one of the most frequent and disabling clinical manifestations of patients with stroke. In clinical practice, stretching is the most widely used physiotherapeutic intervention for this population. However, there is no solid evidence for its effectiveness. The aim of this study was to evaluate the effectiveness of different types of stretching in reducing post-stroke spasticity. Research was carried out until March 2021 in the following scientific databases: PubMed, CINAHL, Scopus, Cochrane Library, Web of Science, and PEDro. The PEDro scale and the Cochrane collaboration tool were used to assess the methodological quality and risk of bias of the studies. Eight articles were selected for qualitative analysis; six of them contributed information to the meta-analysis. No conclusive evidence was obtained on the effectiveness of stretching in terms of treating spasticity and range of motion in patients with stroke. Further research is necessary in order to determine the effectiveness of the use of stretching in this population, considering the different types of stretching (static and dynamic), the time of application, the measurement of the different components of spasticity, and the extrapolation of functional results.
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Affiliation(s)
- Laura Gomez-Cuaresma
- Department of Nursing and Physiotherapy, University of Cádiz, 11009 Cádiz, Spain; (L.G.-C.); (G.G.-M.); (F.J.M.-V.); (A.G.-M.); (C.L.-M.)
| | - David Lucena-Anton
- Department of Nursing and Physiotherapy, University of Cádiz, 11009 Cádiz, Spain; (L.G.-C.); (G.G.-M.); (F.J.M.-V.); (A.G.-M.); (C.L.-M.)
- Intell-SOK (TIC-256) Research Group, Department of Informatics Engineering, University of Cádiz, 11519 Cádiz, Spain
- Correspondence: ; Tel.: +34-635695203
| | - Gloria Gonzalez-Medina
- Department of Nursing and Physiotherapy, University of Cádiz, 11009 Cádiz, Spain; (L.G.-C.); (G.G.-M.); (F.J.M.-V.); (A.G.-M.); (C.L.-M.)
- Investigation Group CTS-986, Physical Therapy and Health (FISA), University Institute of Research in Social Sustainable Development (INDESS), University of Cádiz, 11009 Cádiz, Spain
| | - Francisco Javier Martin-Vega
- Department of Nursing and Physiotherapy, University of Cádiz, 11009 Cádiz, Spain; (L.G.-C.); (G.G.-M.); (F.J.M.-V.); (A.G.-M.); (C.L.-M.)
| | - Alejandro Galan-Mercant
- Department of Nursing and Physiotherapy, University of Cádiz, 11009 Cádiz, Spain; (L.G.-C.); (G.G.-M.); (F.J.M.-V.); (A.G.-M.); (C.L.-M.)
- MOVE-IT Research Group, Department of Physical Education, Faculty of Education, Sciences University of Cádiz, 11002 Cádiz, Spain
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, University of Cádiz, 11002 Cádiz, Spain
| | - Carlos Luque-Moreno
- Department of Nursing and Physiotherapy, University of Cádiz, 11009 Cádiz, Spain; (L.G.-C.); (G.G.-M.); (F.J.M.-V.); (A.G.-M.); (C.L.-M.)
- Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain
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Sobrinho ACDS, de Almeida ML, Rodrigues GDS, Finzeto LC, Silva VRR, Bernatti RF, Bueno Junior CR. Effect of Flexibility Training Associated with Multicomponent Training on Posture and Quality of Movement in Physically Inactive Older Women: A Randomized Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010709. [PMID: 34682455 PMCID: PMC8536106 DOI: 10.3390/ijerph182010709] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 08/04/2021] [Accepted: 08/06/2021] [Indexed: 12/22/2022]
Abstract
Background: Multicomponent training has considerable adherence among older populations, but there is a lack of literature on the benefits of this training on older people’s posture. Literature also lacks stretching protocols that work the body in an integrated/unified way and respect the principle of individuality in exercise training. We evaluated the effect of a multicomponent training protocol combined or not with flexibility training in improving the posture and quality of movement in physically inactive older women, according to a score lower than 9.11 in the Modified Baecke Questionnaire for the Elderly (MBQE). Methods: 142 participants were evaluated and randomized in three training groups: multicomponent training (MT = 52), multicomponent and flexibility training (MFT = 43), and a control group (CG = 47). We evaluated joint amplitude using goniometry, flexibility with sit and reach and hands behind the back tests, quality of movement with the functional movement screen, and posture using biophotogammetry. Results: The MFT group had 15 parameters—flexibility and posture—with a very large effect size (ES > 1.30) and nine with average ES (0.50–0.79). MT presented two variables with large ES (0.80–1.25) and seven with average ES. CG presented three variables with high ES and five with average ES. Both interventions improved the quality of movement. Conclusions: These results demonstrate that 14 weeks of multicomponent and flexibility training in a group intervention can improve flexibility and posture levels in physically inactive older women.
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Affiliation(s)
- Andressa Crystine da Silva Sobrinho
- School of Medicine of Ribeirao Preto, University of Sao Paulo (USP), Avenida Bandeirantes 3900, Ribeirao Preto 14049-900, SP, Brazil; (A.C.d.S.S.); (G.d.S.R.)
| | - Mariana Luciano de Almeida
- College of Nursing of Ribeirao Preto, University of Sao Paulo (USP), Avenida Bandeirantes 3900, Ribeirao Preto 14049-900, SP, Brazil;
| | - Guilherme da Silva Rodrigues
- School of Medicine of Ribeirao Preto, University of Sao Paulo (USP), Avenida Bandeirantes 3900, Ribeirao Preto 14049-900, SP, Brazil; (A.C.d.S.S.); (G.d.S.R.)
| | - Larissa Chacon Finzeto
- School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo (USP), Avenida Bandeirantes 3900, Ribeirao Preto 14049-900, SP, Brazil;
| | - Vagner Ramon Rodrigues Silva
- School of Applied Sciences, University of Campinas (UNICAMP), Rua Pedro Zaccaria 1300, Limeira 13484-350, SP, Brazil;
| | - Rodrigo Fenner Bernatti
- University of Franca (UNIFRAN), Avenida Dr. Armando de Sáles Oliveira 201, Franca 14404-600, SP, Brazil;
| | - Carlos Roberto Bueno Junior
- School of Medicine of Ribeirao Preto, University of Sao Paulo (USP), Avenida Bandeirantes 3900, Ribeirao Preto 14049-900, SP, Brazil; (A.C.d.S.S.); (G.d.S.R.)
- College of Nursing of Ribeirao Preto, University of Sao Paulo (USP), Avenida Bandeirantes 3900, Ribeirao Preto 14049-900, SP, Brazil;
- School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo (USP), Avenida Bandeirantes 3900, Ribeirao Preto 14049-900, SP, Brazil;
- Correspondence: ; Tel.: +55-(16)-3315-0346
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Morphological and Functional Changes of the Tibialis Anterior Muscle After Combined Mirror Visual Feedback and Electromyographic Biofeedback in Poststroke Patients: A Randomized Trial. Am J Phys Med Rehabil 2021; 100:766-773. [PMID: 33105154 DOI: 10.1097/phm.0000000000001628] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of the study was to investigate the morphological and functional changes of the tibialis anterior muscle after mirror visual feedback combined with electromyographic biofeedback in poststroke patients. DESIGN A total of 46 poststroke patients were randomly divided into three groups: a mirror visual feedback + electromyographic biofeedback group, a mirror visual feedback group, and a control group. The mirror visual feedback + electromyographic biofeedback group was treated with both mirror visual feedback and electromyographic biofeedback, and the mirror visual feedback group was treated with mirror visual feedback alone. The morphological parameters, including the pennation angle, muscle thickness, and fascicle length, were assessed. RESULTS After 4 wks of treatment, the pennation angle and muscle thickness values were significantly increased in the mirror visual feedback + electromyographic biofeedback and mirror visual feedback groups (P < 0.05). The increase of these values in the mirror visual feedback + electromyographic biofeedback group was significantly greater than that in both metrics in the mirror visual feedback and control groups (P < 0.05), and those in the mirror visual feedback group were greater than those in the control group (P < 0.05). There was no significant difference in the fascicle length value among the three groups as a result of the treatment. After the treatment, the neurological functions were all increased in three groups (P < 0.05). CONCLUSIONS A combination of mirror visual feedback and electromyographic biofeedback seems to be an effective therapy for improving the motor function of the tibialis anterior muscle in poststroke patients.Clinical trial registration number: ChiCTR1800017050.
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Ekechukwu END, Olowoyo P, Nwankwo KO, Olaleye OA, Ogbodo VE, Hamzat TK, Owolabi MO. Pragmatic Solutions for Stroke Recovery and Improved Quality of Life in Low- and Middle-Income Countries-A Systematic Review. Front Neurol 2020; 11:337. [PMID: 32695058 PMCID: PMC7336355 DOI: 10.3389/fneur.2020.00337] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 04/07/2020] [Indexed: 12/22/2022] Open
Abstract
Background: Given the limited healthcare resources in low and middle income countries (LMICs), effective rehabilitation strategies that can be realistically adopted in such settings are required. Objective: A systematic review of literature was conducted to identify pragmatic solutions and outcomes capable of enhancing stroke recovery and quality of life of stroke survivors for low- and middle- income countries. Methods: PubMed, HINARI, and Directory of Open Access Journals databases were searched for published Randomized Controlled Trials (RCTs) till November 2018. Only completed trials published in English with non-pharmacological interventions on adult stroke survivors were included in the review while published protocols, pilot studies and feasibility analysis of trials were excluded. Obtained data were synthesized thematically and descriptively analyzed. Results: One thousand nine hundred and ninety six studies were identified while 347 (65.22% high quality) RCTs were found to be eligible for the review. The most commonly assessed variables (and outcome measure utility) were activities of daily living [75.79% of the studies, with Barthel Index (37.02%)], motor function [66.57%; with Fugl Meyer scale (71.88%)], and gait [31.12%; with 6 min walk test (38.67%)]. Majority of the innovatively high technology interventions such as robot therapy (95.24%), virtual reality (94.44%), transcranial direct current stimulation (78.95%), transcranial magnetic stimulation (88.0%) and functional electrical stimulation (85.00%) were conducted in high income countries. Several traditional and low-cost interventions such as constraint-induced movement therapy (CIMT), resistant and aerobic exercises (R&AE), task oriented therapy (TOT), body weight supported treadmill training (BWSTT) were reported to significantly contribute to the recovery of motor function, activity, participation, and improvement of quality of life after stroke. Conclusion: Several pragmatic, in terms of affordability, accessibility and utility, stroke rehabilitation solutions, and outcome measures that can be used in resource-limited settings were found to be effective in facilitating and enhancing post-stroke recovery and quality of life.
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Affiliation(s)
- Echezona Nelson Dominic Ekechukwu
- Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, College of Medicine, University of Nigeria, Enugu, Nigeria
- LANCET Physiotherapy and Wellness and Research Centre, Enugu, Nigeria
| | - Paul Olowoyo
- Department of Medicine, Federal Teaching Hospital, Ido Ekiti, Nigeria
- College of Medicine and Health Sciences, Afe Babalola University, Ado Ekiti, Nigeria
| | - Kingsley Obumneme Nwankwo
- Stroke Control Innovations Initiative of Nigeria, Abuja, Nigeria
- Fitness Global Consult Physiotherapy Clinic, Abuja, Nigeria
| | - Olubukola A Olaleye
- Department of Physiotherapy, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | | | - Talhatu Kolapo Hamzat
- Department of Physiotherapy, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Mayowa Ojo Owolabi
- Department of Medicine, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria
- University College Hospital, Ibadan, Nigeria
- Blossom Specialist Medical Centre, Ibadan, Nigeria
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Effect of chronic stretching interventions on the mechanical properties of muscles in patients with stroke: A systematic review. Ann Phys Rehabil Med 2020; 63:222-229. [DOI: 10.1016/j.rehab.2019.12.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 12/02/2019] [Accepted: 12/14/2019] [Indexed: 01/01/2023]
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