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Yanuck SB, Fox SK, Harting BR, Motyka TM. Effect of manual manipulation on mechanical gait parameters. J Osteopath Med 2024; 0:jom-2023-0203. [PMID: 38807459 DOI: 10.1515/jom-2023-0203] [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: 08/31/2023] [Accepted: 04/09/2024] [Indexed: 05/30/2024]
Abstract
CONTEXT A variety of manual manipulation techniques are utilized in clinical practice to alleviate pain and improve musculoskeletal function. Many manual practitioners analyze gait patterns and asymmetries in their assessment of the patient, and an increasing number of gait motion capture studies are taking place with recent improvements in motion capture technology. This study is the first systematic review of whether these manual modalities have been shown to produce an objectively measurable change in gait mechanics. OBJECTIVES This study was designed to perform a systematic review of the literature to assess the impact of manual medicine modalities on biomechanical parameters of gait. METHODS A master search term composed of keywords and Medical Subject Headings (MeSH) search terms from an initial scan of relevant articles was utilized to search six databases. We screened the titles and abstracts of the resulting papers for relevance and then assessed their quality with the Cochrane Risk of Bias Tool. Clinical trials that featured both a manual manipulation intervention and multiple mechanical gait parameters were included. Case reports and other studies that only measured gait speed or other subjective measures of mobility were excluded. RESULTS We included 20 studies in our final analysis. They utilize manipulation techniques primarily from osteopathic, chiropractic, massage, and physiotherapy backgrounds. The conditions studied primarily included problems with the back, knee, and ankle, as well as healthy patients and Parkinson's patients. Control groups were highly variable, if not absent. Most studies measured their gait parameters utilizing either multicamera motion capture systems or force platforms. CONCLUSIONS Twelve of 20 papers included in the final analysis demonstrated a significant effect of manipulation on gait variables, many of which included either step length, walking speed, or sagittal range of motion (ROM) in joints of the lower extremity. However, the results and study design are too heterogeneous to draw robust conclusions from these studies as a whole. While there are initial indications that certain modalities may yield a change in certain gait parameters, the quality of evidence is low and there is insufficient evidence to conclude that manual therapies induce changes in biomechanical gait parameters. Studies are heterogeneous with respect to the populations studied and the interventions performed. Comparators were variable or absent across the studies, as were the outcome variables measured. More could be learned in the future with consistent methodology around blinding and sham treatment, and if the gait parameters measured were standardized and of a more robust clinical significance.
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Affiliation(s)
- Solomon B Yanuck
- Leon Levine Hall of Medical Sciences, 364432 Campbell University Jerry M. Wallace School of Osteopathic Medicine , Lillington, NC, USA
| | - Sarah K Fox
- Leon Levine Hall of Medical Sciences, 364432 Campbell University Jerry M. Wallace School of Osteopathic Medicine , Lillington, NC, USA
| | - Bethany R Harting
- Leon Levine Hall of Medical Sciences, 364432 Campbell University Jerry M. Wallace School of Osteopathic Medicine , Lillington, NC, USA
| | - Thomas M Motyka
- Department of Osteopathic Manipulative Medicine, 364432 Campbell University Jerry M. Wallace School of Osteopathic Medicine , Lillington, NC, USA
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2
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Raghavan P. Top-Down and Bottom-Up Mechanisms of Motor Recovery Poststroke. Phys Med Rehabil Clin N Am 2024; 35:235-257. [PMID: 38514216 DOI: 10.1016/j.pmr.2023.07.006] [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] [Indexed: 03/23/2024]
Abstract
Stroke remains a leading cause of disability. Motor recovery requires the interaction of top-down and bottom-up mechanisms, which reinforce each other. Injury to the brain initiates a biphasic neuroimmune process, which opens a window for spontaneous recovery during which the brain is particularly sensitive to activity. Physical activity during this sensitive period can lead to rapid recovery by potentiating anti-inflammatory and neuroplastic processes. On the other hand, lack of physical activity can lead to early closure of the sensitive period and downstream changes in muscles, such as sarcopenia, muscle stiffness, and reduced cardiovascular capacity, and blood flow that impede recovery.
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Affiliation(s)
- Preeti Raghavan
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, MD 21287, USA; Department of Neurology, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, MD 21287, USA.
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3
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Kim SY, Lim JH, Park CB, Kim BG. Immediate effects of a vibrating foam roller on dorsiflexion rom, balance, and gait in stroke patients: a randomized controlled trial. J Exerc Rehabil 2024; 20:76-82. [PMID: 38737466 PMCID: PMC11079548 DOI: 10.12965/jer.2448034.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 02/06/2024] [Accepted: 02/11/2024] [Indexed: 05/14/2024] Open
Abstract
The purpose of this study was to investigate the immediate effects of vibration foam rolling on dorsiflexion range of motion (ROM), balance, and gait in stroke patients. Thirty stroke patients volunteered to participate and were randomly assigned to the vibrating foam roller group (n=15) and the foam roller group (n=15). The vibrating foam roller group performed a 30-min foam roller exercise program, with participants subjected to vibration at 28 Hz. The foam roller group performed the same exercise program as the vibrating foam roller group, but without vibration. Dorsiflexion lunge test, limits of stability, and Timed Up and Go were used to evaluate dorsiflexion ROM, balance, and gait before and after each intervention. The results revealed that the vibration foam roller group showed significant differences in dorsiflexion ROM and gait after the intervention, while the foam roller group exhibited a significant difference only in dorsiflexion ROM (P<0.05). In comparisons between the vibration foam roller group and the foam roller group, significant differences were observed in dorsiflexion ROM and gait (P<0.05). However, there were no significant differences in balance, both before and after the intervention, as well as in the comparisons between the two groups (P>0.05). This study confirmed that a single-session vibrating foam roller exercise program improves dorsiflexion ROM and gait in stroke patients. Further studies with extended exercise program durations are needed to address limitations and explore long-term effects.
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Affiliation(s)
- So-Yeong Kim
- Department of Physical Therapy, Graduate School, Nambu University, Gwangju,
Korea
- Rehabilitation Center, Gwangju 365 Rehabilitation Hospital, Gwangju,
Korea
| | - Jae-Hyun Lim
- Department of Physical Therapy, Graduate School, Nambu University, Gwangju,
Korea
- Physical Therapy Room, Wise Rehabilitation Hospital, Gwangju,
Korea
| | - Chi-Bok Park
- Department of Physical Therapy, Nambu University, Gwangju,
Korea
| | - Byeong-Geun Kim
- Department of Physical Therapy, Nambu University, Gwangju,
Korea
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Maillard B, Boutaayamou M, Cassol H, Pirnay L, Kaux JF. Gait Analysis of Hemiparetic Adult Patients with a Quadripod Cane and a Rolling Cane. Healthcare (Basel) 2024; 12:464. [PMID: 38391839 PMCID: PMC10888135 DOI: 10.3390/healthcare12040464] [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: 12/26/2023] [Revised: 02/07/2024] [Accepted: 02/08/2024] [Indexed: 02/24/2024] Open
Abstract
Stroke consequences include hemiparesis and difficulty walking. Several types of canes exist to overcome these alterations, but little data compares the quadripod cane and the rolling cane in hemiparetic patients. The objective of this work is twofold: to determine whether the gait speed-the most often used parameter to assess gait performance-depends on the type of cane, and to establish which spatiotemporal parameters have the most influence. Thirty-four hemiparetic patients performed 10 m walking tests at comfortable and fast speed conditions, using both canes on two different days. To objectively analyze their gait patterns, we used a tri-axial Inertial Measurement Units (IMU)-based system to record the walking signals from which we extracted the gait spatiotemporal parameters. We particularly examined the speed, stride length, and durations of stance, swing, and double support phases. The results showed that hemiparetic patients walked faster with the rolling cane during both speed conditions. These speed increases could be explained by the decrease in the stance phase duration of the affected leg, the decrease in the double support duration, and the increase in cadence. Our findings suggest that the rolling cane allows safe and faster walking.
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Affiliation(s)
- Bérengère Maillard
- Physical Medicine, Rehabilitation and Sports Traumatology Department, University Hospital of Liège, 4000 Liège, Belgium
| | - Mohamed Boutaayamou
- Department of Electrical Engineering and Computer Science, University of Liège, 4000 Liège, Belgium
- Laboratory of Movement Analysis (LAM-Motion Lab), University of Liège, 4000 Liège, Belgium
| | - Helena Cassol
- Physical Medicine, Rehabilitation and Sports Traumatology Department, University Hospital of Liège, 4000 Liège, Belgium
| | - Laurence Pirnay
- Physical Medicine, Rehabilitation and Sports Traumatology Department, University Hospital of Liège, 4000 Liège, Belgium
| | - Jean-François Kaux
- Physical Medicine, Rehabilitation and Sports Traumatology Department, University Hospital of Liège, 4000 Liège, Belgium
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Zhang R, Zhang R, Zhou T, Wang F, Zhou CX, Wang H, Zhang QB, Zhou Y. Preliminary investigation on the effect of extracorporeal shock wave combined with traction on joint contracture based on PTEN-PI3K/AKT pathway. J Orthop Res 2024; 42:339-348. [PMID: 37676080 DOI: 10.1002/jor.25687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 05/13/2023] [Accepted: 08/24/2023] [Indexed: 09/08/2023]
Abstract
To investigate the intervention effect of extracorporeal shock wave combined with manual traction on fixation-induced knee contracture and its influence on PTEN-PI3K/AKT signaling pathway. Thirty-six SD male rats were randomly divided into six groups. The left knee joints were not fixed in the control group (C group). Rats in other groups underwent brace fixation in the extended position of the left knee. After 4 weeks of bracing, it is randomly divided into five groups: Model group (M group), natural recovery group (NR group), extracorporeal shock wave treatment group (ET group), manual traction group (MT group), and extracorporeal shock wave combined with manual traction group (CT group). Joint range of motion (ROM) of left knee was carried out to assess joint function. Hematoxylin and eosin (HE) staining and Masson staining were respectively used to assess the cell number and collagen deposition expression. Immunohistochemical staining and Western blot were used to assess protein levels of phosphatase and tensin homolog (PTEN), phosphatidylinositol 3-kinase (PI3K), and protein kinase B (AKT). The combined therapy was more effective than extracorporeal shock wave therapy or manual traction alone against the joint ROM, cell number and the collagen deposition, low-expression of PTEN, and overexpression of PI3K/AKT in the anterior joint capsule of rats with knee extension contracture. Extracorporeal shock wave combined with manual traction can promote the histopathological changes of anterior joint capsule fibrosis, upregulate the protein expression of PTEN and downregulate the protein expression of PI3K/AKT in the fibrotic joint capsule in a rat joint contracture model.
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Affiliation(s)
- Rui Zhang
- School of Basic Medical Sciences, Anhui Medical University, Hefei, China
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
- Research Center for Translational Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Run Zhang
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
- Research Center for Translational Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Ting Zhou
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
- Research Center for Translational Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Feng Wang
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
- Research Center for Translational Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Chen Xu Zhou
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
- Research Center for Translational Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Hua Wang
- Department of Toxicology, School of Public Health, Anhui Medical University, Hefei, China
| | - Quan Bing Zhang
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
- Research Center for Translational Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yun Zhou
- School of Basic Medical Sciences, Anhui Medical University, Hefei, China
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
- Research Center for Translational Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
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García-Rueda L, Cabanas-Valdés R, Salgueiro C, Rodríguez-Sanz J, Pérez-Bellmunt A, López-de-Celis C. Immediate Effects of TECAR Therapy on Gastrocnemius and Quadriceps Muscles with Spastic Hypertonia in Chronic Stroke Survivors: A Randomized Controlled Trial. Biomedicines 2023; 11:2973. [PMID: 38001972 PMCID: PMC10668938 DOI: 10.3390/biomedicines11112973] [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: 10/03/2023] [Revised: 10/31/2023] [Accepted: 11/02/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND The aim of this study was to assess changes in muscle properties after a single session of capacitive and resistive energetic transfer (TECAR) therapy on spastic gastrocnemius and quadriceps muscles in chronic post-stroke. METHODS A total of 36 chronic stroke survivors with lower limb hypertonia were enrolled in a double-blind randomized controlled trial. The experimental group (n = 18) received a single 30 min session of TECAR therapy in combination with functional massage (FM) on the gastrocnemius and quadriceps muscles. The control group (n = 18) received a sham treatment of TECAR therapy (without electrical stimulation) in combination with real FM. The primary outcome was muscle tone of the lower limb muscles assessed with the Modified Ashworth Scale (MAS). The secondary outcomes were goniometric degrees of the MAS (goniometer), neuromuscular properties of the gastrocnemius/quadriceps (myotonometer), and passive range of motion (inclinometer). All measurements were performed at baseline (T0), immediately after treatment (T1), and at 30 min post-treatment (T2) by a blinded assessor. RESULTS The MAS score ankle dorsiflexion significantly decreased at T0-T1 (p = 0.046), and the change was maintained at T0-T2 (p = 0.019) in the experimental group. Significant improvements were noted in the passive range of motion for knee flexion (p = 0.012) and ankle dorsiflexion (p = 0.034) at T2. In addition, knee flexion improved at T1 (p = 0.019). CONCLUSION A single session of Tecar therapy at the same time with FM on the gastrocnemius and rectus femoris immediately reduces muscle tone and increases the passive range of motion of both ankle and knee in chronic stroke survivors. There were no significant changes in the neuromuscular properties measured with myotonometer.
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Affiliation(s)
- Laura García-Rueda
- Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, 08195 Barcelona, Spain;
| | - Rosa Cabanas-Valdés
- Department of Physiotherapy, Faculty of Medicine and Health Sciences, Universitat International de Catalunya, 08195 Barcelona, Spain;
| | - Carina Salgueiro
- Clínica de Neurorehabilitación Sant Cugat del Vallés, 08195 Barcelona, Spain;
| | - Jacobo Rodríguez-Sanz
- Department of Basic Sciences, Faculty of Medicine and Health Sciences, Universitat International de Catalunya, 08195 Barcelona, Spain;
- ACTIUM Functional Anatomy Group, 08195 Barcelona, Spain
| | - Albert Pérez-Bellmunt
- Department of Basic Sciences, Faculty of Medicine and Health Sciences, Universitat International de Catalunya, 08195 Barcelona, Spain;
- ACTIUM Functional Anatomy Group, 08195 Barcelona, Spain
| | - Carlos López-de-Celis
- Department of Physiotherapy, Faculty of Medicine and Health Sciences, Universitat International de Catalunya, 08195 Barcelona, Spain;
- ACTIUM Functional Anatomy Group, 08195 Barcelona, Spain
- Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, Spain
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7
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Lepesis V, Marsden J, Rickard A, Latour JM, Paton J. Systematic review and meta-analysis of the effects of foot and ankle physical therapy, including mobilisations and exercises, in people with diabetic peripheral neuropathy on range of motion, peak plantar pressures and balance. Diabetes Metab Res Rev 2023; 39:e3692. [PMID: 37431167 DOI: 10.1002/dmrr.3692] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 05/05/2023] [Accepted: 06/17/2023] [Indexed: 07/12/2023]
Abstract
To evaluate the effects of foot and ankle physical therapy on ankle and first metatarsophalangeal joint range of motion (ROM), peak plantar pressures (PPPs) and balance in people with diabetes. MEDLINE, EBSCO, Cochrane Database of Systematic Reviews, Joanna Briggs Institute Database of Systematic Reviews, PROSPERO, EThOS, Web of Science and Google Scholar were searched in April 2022. Randomised Controlled Trials (RCT), quasi-experimental, pre-post experimental design and prospective cohort studies were included. Participants were people with diabetes, neuropathy and joint stiffness. Interventions included physical therapy such as mobilisations, ROM exercises and stretches. Outcome measures focused on ROM, PPPs and balance. Methodological quality was assessed with Critical Appraisal Skills Programme RCT and Risk-of-Bias 2 tool. Meta-analyses used random-effects models and data was analysed using the inverse variance method. In total, 9 studies were included. Across all studies, participant characteristics were similar; however, type and exercise dosage varied greatly. Meta-analysis was performed with four studies. Meta-analysis showed significant effects of combined exercise interventions in increasing total ankle ROM (3 studies: MD, 1.76; 95% CI, 0.78-2.74; p = 0; I2 = 0%); and reducing PPPs in the forefoot area (3 studies; MD, -23.34; 95% CI, -59.80 to 13.13; p = 0.21, I2 = 51%). Combined exercise interventions can increase ROM in the ankle and reduce PPPs in the forefoot. Standardisation of exercise programmes with or without the addition of mobilisations in the foot and ankle joints needs further research.
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Affiliation(s)
- Vasileios Lepesis
- School of Health Professions, Faculty of Health, University of Plymouth, Plymouth, UK
| | - Jonathan Marsden
- School of Health Professions, Faculty of Health, University of Plymouth, Plymouth, UK
| | - Alec Rickard
- School of Health Professions, Faculty of Health, University of Plymouth, Plymouth, UK
| | - Jos M Latour
- School of Nursing and Midwifery, Faculty of Health, University of Plymouth, Plymouth, UK
| | - Joanne Paton
- School of Health Professions, Faculty of Health, University of Plymouth, Plymouth, UK
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Lee JE, Akimoto T, Chang J, Lee HS. Effects of joint mobilization combined with acupuncture on pain, physical function, and depression in stroke patients with chronic neuropathic pain: A randomized controlled trial. PLoS One 2023; 18:e0281968. [PMID: 37616239 PMCID: PMC10449141 DOI: 10.1371/journal.pone.0281968] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 07/04/2023] [Indexed: 08/26/2023] Open
Abstract
OBJECTIVE To investigate the effectiveness of joint mobilization (JM) combined with acupuncture (AC) for the treatment of pain, physical function and depression in poststroke patients. METHODS A total of 69 poststroke patients were randomly assigned to the JM+AC group (n = 23), the JM group (n = 23), and the control group (n = 23). Patients in the JM+AC group and the JM group received JM for 30 minutes, twice a week for 12 weeks, and the JM+AC group received AC for 30 minutes separately once a week. The control group did not receive JM or AC. Pain (visual analog scale, shoulder pain and disability index, Western Ontario and McMaster universities osteoarthritis index), physical function (range of motion, 10-m walking speed test, functional gait assessment, manual function test, activities of daily living scale, instrumental activities of daily living scale), and depression (center for epidemiologic studies depression scale, Beck depression inventory) were assessed for each patient before and after the 12 weeks of intervention. RESULTS Pain and physical function were improved significantly in the JM+AC group compared with the JM and control groups. Physical function and depression were improved significantly in the JM+AC and JM groups compared with the control group. CONCLUSION The treatment of JM combined with AC improved pain, depression, and physical function of poststroke patients with chronic neuropathic pain in this study. This valuable finding provides empirical evidence for the designing therapeutic interventions and identifying potential therapeutic targets.
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Affiliation(s)
- Ji-Eun Lee
- Department of Exercise and Medical Science, Dankook University, Cheonan, Republic of Korea
| | - Takayuki Akimoto
- Laboratory of Muscle Biology, Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Jisuk Chang
- Department of Sports Management, Dankook University, Cheonan, Republic of Korea
| | - Ho-Seong Lee
- Department of Exercise and Medical Science, Dankook University, Cheonan, Republic of Korea
- Institute of Medical-Sports, Dankook University, Cheonan, Republic of Korea
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Li Y, Wang Q, Liu XL, Hui R, Zhang YP. Effect of the physical rehabilitation program based on self-care ability in patients with acute ischemic stroke: a quasi-experimental study. Front Neurol 2023; 14:1181651. [PMID: 37360351 PMCID: PMC10288520 DOI: 10.3389/fneur.2023.1181651] [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: 03/07/2023] [Accepted: 05/10/2023] [Indexed: 06/28/2023] Open
Abstract
Introduction It is the most practical goal of limb rehabilitation for stroke patients to make the upper limb, trunk, and lower limb joints link together as a whole and restore the ability to self-care. However, many previous studies focused on the single joint or single muscle group movement of stroke patients and did not integrate self-care ability training into the whole process of rehabilitation, which lacks accuracy, integrity, and systematization. Methods A quasi-experimental study was conducted in a tertiary hospital. Eligible patients were recruited according to the inclusion criteria and exclusion criteria and then divided into an experimental group (n = 80) and a control group (n = 80) by the medical district. The control group received the routine physical rehabilitation intervention. The experimental group adopted the physical rehabilitation program based on self-care ability led by the nurses specializing in stroke rehabilitation to carry out the multi-joint coordinated exercise based on the control group. The training time and frequency were the same in both groups (45 min per session, one session per day for three consecutive months). The primary outcome was myodynamia. Secondary outcomes were the modified Barthel Index (MBI) and Stroke Specific Quality of Life Scale (SS-QOL). The primary and secondary outcomes were assessed before the intervention and at 1 and 3 months of intervention. In this study, the TREND checklist was followed for non-randomized controlled trials. Results A total of 160 participants completed the study. The physical rehabilitation program based on self-care ability was better than the routine rehabilitation program. With the prolongation of intervention time, all outcomes improved gradually in the experimental group (P < 0.05), and the myodynamia of lower limbs recovered faster than that of upper limbs. In the control group, the myodynamia of the affected limb was not significantly improved (P > 0.05), with only a small increase in MBI and SS-QOL scores (P < 0.05). Conclusion The physical rehabilitation program based on self-care ability after stroke was beneficial for acute ischemic stroke patients and improved the patient's myodynamia, quality of life, and self-care ability within the third month.
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Affiliation(s)
- Ying Li
- Department of Nursing, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
- Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- School of Nursing, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Qian Wang
- Department of Neurology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
| | - Xiao-Ling Liu
- Department of Neurology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
| | - Rong Hui
- Department of Nursing, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
| | - Yin-Ping Zhang
- School of Nursing, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
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Lee JH, Kim EJ. The Effects of Shock Wave Therapy on Spasticity and Walking Ability in People with Stroke: A Comparative Study of Different Application Sites. Brain Sci 2023; 13:brainsci13040687. [PMID: 37190652 DOI: 10.3390/brainsci13040687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/18/2023] [Accepted: 04/19/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND This study was conducted to investigate the effects of extracorporeal shock wave therapy on the improvement of walking ability through a reduction in spasticity in stroke patients. METHODS Thirty-three patients diagnosed with ischemic stroke by a rehabilitation medicine specialist were randomly assigned to three groups. The patients were divided into experimental group 1 in which shock waves were applied to the muscle-tendon junction, experimental group 2 in which shock waves were applied to the middle of the muscle, and experimental group 3 in which shock waves were applied to both the muscle-tendon junction and the middle of the muscle. The MAS was used to evaluate spasticity in the subjects, and the Dartfish software was used to measure knee and ankle angles during heel-off when walking. RESULTS Based on the results of the study, a significant decrease in spasticity and increased joint angles were found in experimental groups 1 and 3 compared to experimental group 2, and the change in joint angle was significantly greater in experimental group 3 than in experimental groups 1 and 2. CONCLUSIONS These results indicate that treatment effect may vary depending on the application site of the shock wave, and to obtain the best treatment effect, the shock wave should be applied to both the muscle-tendon junction and the middle part of the muscle.
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Affiliation(s)
- Jung-Ho Lee
- Department of Physical Therapy, Kyungdong University, 815, Gyeonhwon-ro, Munmak-eup, Wonju-si 26495, Gang-won-do, Republic of Korea
| | - Eun-Ja Kim
- Department of Physical Therapy, Kyungdong University, 815, Gyeonhwon-ro, Munmak-eup, Wonju-si 26495, Gang-won-do, Republic of Korea
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11
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Choi W, Lee J, Lee S. Effects of lumbar joint mobilization on trunk function, postural balance, and gait in patients with chronic stroke: A randomized pilot study. J Back Musculoskelet Rehabil 2023; 36:79-86. [PMID: 35938238 DOI: 10.3233/bmr-200046] [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] [Indexed: 02/04/2023]
Abstract
BACKGROUND Patients with stroke have hypomobility in the facet joint of affected side. Lumbar joint mobilization could be used to maintain function and mobility of the joints. OBJECTIVE This study aimed to investigate the effects of lumbar joint mobilization on trunk function, postural balance, and gait in patients with stroke. METHODS Thirty patients with stroke were randomly assigned to two groups. Lumbar joint mobilization was provided for 15 min, 5 times a week for 6 weeks to patients who were allocated into the experimental group. Patients who were allocated into the control group received a sham intervention. Trunk function (trunk impairment scale), postural balance (weight distribution, Berg balance scale, and timed up and go test), and walking (10 m walk test, functional gait assessment, step length, and stride length) were evaluated before and after the experiment for all the patients. RESULTS Lumbar joint mobilization significantly improved trunk function, postural balance, and gait compared with pre-test values in the experimental group (P< 0.05). Significant differences were seen in trunk function, postural balance, and walking between the two groups (P< 0.05). CONCLUSION Lumbar joint mobilization might be an effective intervention for trunk function, postural balance, and walking in patients with stroke.
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Affiliation(s)
- Wonjae Choi
- Department of Physical Therapy, Joongbu University, Geumsan-gun, Chungcheongnam-do, Korea
| | - Jieun Lee
- Department of Physical Therapy, Graduate School of Sahmyook University, Seoul, Korea
| | - Seungwon Lee
- Department of Physical Therapy, Joongbu University, Geumsan-gun, Chungcheongnam-do, Korea.,Department of Physical Therapy, Sahmyook University, Seoul, Korea
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Ferry B, Compagnat M, Yonneau J, Bensoussan L, Moucheboeuf G, Muller F, Laborde B, Jossart A, David R, Magne J, Marais L, Daviet JC. Awakening the control of the ankle dorsiflexors in the post-stroke hemiplegic subject to improve walking activity and social participation: the WAKE (Walking Ankle isoKinetic Exercise) randomised, controlled trial. Trials 2022; 23:661. [PMID: 35974379 PMCID: PMC9380386 DOI: 10.1186/s13063-022-06545-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 07/13/2022] [Indexed: 11/17/2022] Open
Abstract
Background Stroke is the leading cause of acquired disability in France. While 90% of patients recover the ability to walk, it is often limited with a steady speed of approximately 0.7 m/s. This limitation of walking activity is partly related to a decrease in strength associated with more or less significant spasticity. In particular, it seems that the strength of the dorsiflexor muscles is directly related to walking speed. We hypothesise that a protocol based on gestural repetition targeted at the ankle during the subacute phase potentiates the recovery of motor control, improving walking activity, and participates in recovering better social participation. Methods An estimated total of 60 patients with subacute stroke will be recruited to participate in this multicentre, interventional, prospective, randomised controlled trial. All participants will benefit from conventional rehabilitation. In addition, the experimental group will take part in an ankle isokinetic rehabilitation programme for 6 weeks (at least 25 sessions). The control group will receive the same duration of conventional rehabilitation. The primary outcome measure will be a 10-m walking speed at post-intervention. Secondary outcomes will include social participation, walking spatio-temporal parameters, and dorsiflexor strength. Outcome measurements will be taken at baseline, immediately after treatment (6 weeks), then at 6 months and 1 year of follow-up. Discussion This study aims to provide scientific evidence that a protocol based on an early over-solicitation of the ankle dorsiflexor muscles to promote their “awakening” can serve to achieve a more effective walking activity, which in turn encourages social participation following discharge from the hospital. This protocol should also help optimise physical medicine and rehabilitation practices: the more systematic use of the isokinetic dynamometer as a technique associated with, and integrated into the conventional rehabilitation protocol would allow an objective evaluation of the rehabilitation benefits and should increase the rehabilitation gain in central nervous system disorders. Trial registration Limoges University Hospital is the sponsor of this research (Unique Protocol ID: 87RI18_0010) This research is supported by the French Ministry of Health (PHRC 2020-A03328-31) and is conducted with the support of DGOS (PHRC interregional – GIRCI SOHO). The study protocol was approved by the French Human Subjects Protection Review Board (Comité de Protection des Personnes Nord-Ouest III) on February 23, 2021. The trial was registered in the ClinicalTrials.gov registry (NCT04800601) on March 16, 2021.
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Affiliation(s)
- Béatrice Ferry
- Laboratoire HAVAE (UR 20217), EA6310, Université de Limoges, Limoges, France
| | - Maxence Compagnat
- Laboratoire HAVAE (UR 20217), EA6310, Université de Limoges, Limoges, France.,Médecine Physique et de Réadaptation, CHU Limoges, Limoges, France
| | - Jules Yonneau
- Médecine Physique et de Réadaptation, CHU Limoges, Limoges, France
| | - Laurent Bensoussan
- Institut Universitaire de Réadaptation, Marseille, France.,Médecine Physique et Réadaptation, AP-HM, Marseille, France
| | | | - François Muller
- Médecine Physique et Réadaptation, Centre Rééducation Les Embruns, Bidart, France
| | - Bertrand Laborde
- Médecine Physique et Réadaptation, Centre Rééducation Les Embruns, Bidart, France
| | - Anne Jossart
- Médecine Physique et Réadaptation, CHU Poitiers, Poitiers, France
| | - Romain David
- Médecine Physique et Réadaptation, CHU Poitiers, Poitiers, France
| | - Julien Magne
- Centre d'Epidémiologie de Biostatistiques et Méthodologie de la Recherche, CHU Limoges, Limoges, France
| | - Loïc Marais
- Direction de la Recherche et de l'Innovation, CHU Limoges, Limoges, France
| | - Jean-Christophe Daviet
- Laboratoire HAVAE (UR 20217), EA6310, Université de Limoges, Limoges, France. .,Médecine Physique et de Réadaptation, CHU Limoges, Limoges, France.
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Youn PS, Cho KH, Park SJ. Changes in Ankle Range of Motion, Gait Function and Standing Balance in Children with Bilateral Spastic Cerebral Palsy after Ankle Mobilization by Manual Therapy. CHILDREN (BASEL, SWITZERLAND) 2020; 7:E142. [PMID: 32961844 PMCID: PMC7552781 DOI: 10.3390/children7090142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 09/14/2020] [Accepted: 09/15/2020] [Indexed: 11/16/2022]
Abstract
The aim of this study was to investigate the effect of ankle joint mobilization in children with cerebral palsy (CP) to ankle range of motion (ROM), gait, and standing balance. We recruited 32 children (spastic diplegia) diagnosed with CP and categorized them in two groups: the ankle joint mobilization (n = 16) group and sham joint mobilization (n = 16) group. Thus, following a six-week ankle joint mobilization, we examined measures such as passive ROM in ankle dorsiflexion in the sitting and supine position, center of pressure (COP) displacements (sway length, area) with eyes open (EO) and closed (EC), and a gait function test (timed up and go test (TUG) and 10-m walk test). The dorsiflexion ROM, TUG, and 10-m walk test significantly increased in the mobilization group compared to the control group. Ankle joint mobilization can be regarded as a promising method to increase dorsiflexion and improve gait in CP-suffering children.
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Affiliation(s)
- Pong Sub Youn
- Department of Physical Therapy, Kyungbok University, Namyangju-si 425, Korea;
| | - Kyun Hee Cho
- AVENS Hospital, Dongan-gu, Anyang-si 307, Korea;
| | - Shin Jun Park
- Department of Physical Therapy, Gangdong University, Daehak-gil 278, Korea
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