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Carretti G, Spano F, Sgambati E, Manetti M, Marini M. Adapted Training to Boost Upper Body Sensorimotor Control and Daily Living Functionality in Visually Impaired Baseball Players. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1136. [PMID: 39064565 PMCID: PMC11279096 DOI: 10.3390/medicina60071136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Revised: 07/10/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024]
Abstract
Background and Objectives: Vision significantly contributes to postural control, balance, coordination, and body kinematics, thus deeply influencing everyday functionality. Sight-impaired subjects often show upper body anatomofunctional and kinetic chain alterations negatively impacting daily living efficiency and autonomy. The present study aimed to investigate and train, for the first time, upper body sensorimotor control in an Italian blind baseball team to boost global and segmental functionality while contemporarily prevent injuries. Materials and Methods: The whole team underwent a validated test battery using both quantitative traditional tools, such as goniometric active range of motion and muscular/functional tests, and an innovative biofeedback-based device, a Libra proprioceptive board. Consequently, a 6-week adapted training protocol was designed and leaded to improve sensorimotor control and, hence, counteract disability-related deficits and sport-specific overuse syndromes. Results: Statistically significant improvements were observed in all the investigated parameters. Noteworthy, an overall boost of global and segmental stability was detected through an orthostatic dynamic balance enhancement during the Y Balance test (p = 0.01) and trunk multiplanar control improvement on the Libra board (p = 0.01). Concurrently, the comparison of baseline vs. post-intervention outcomes revealed a consistent increase in upper body mobility (p < 0.05 for all the assessed districts), core recruitment (p = 0.01 for all the administered functional tests), and proprioceptive postural control (p = 0.01 for the Libra board validated test). Conclusions: Our findings suggest that a tailored sensorimotor training, conceived and led by an adapted physical activity kinesiologist, may effectively improve upper body functional prerequisites and global proprioceptive control, thus potentially promoting autonomy, quality of life, and physical activity/sport practice adherence in visually impaired individuals.
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Affiliation(s)
- Giuditta Carretti
- Department of Experimental and Clinical Medicine, Section of Anatomy and Histology, University of Florence, 50134 Florence, Italy; (G.C.); (F.S.); (M.M.)
| | - Francesca Spano
- Department of Experimental and Clinical Medicine, Section of Anatomy and Histology, University of Florence, 50134 Florence, Italy; (G.C.); (F.S.); (M.M.)
| | - Eleonora Sgambati
- Department of Biosciences and Territory, University of Molise, 86090 Pesche, Italy;
| | - Mirko Manetti
- Department of Experimental and Clinical Medicine, Section of Anatomy and Histology, University of Florence, 50134 Florence, Italy; (G.C.); (F.S.); (M.M.)
| | - Mirca Marini
- Department of Experimental and Clinical Medicine, Section of Anatomy and Histology, University of Florence, 50134 Florence, Italy; (G.C.); (F.S.); (M.M.)
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Carretti G, Dabraio A, Manetti M, Marini M. Biofeedback-Based Proprioceptive Training to Improve Functional Prerequisites of Dragon Boating in Breast Cancer Survivors. Eur J Investig Health Psychol Educ 2024; 14:1351-1368. [PMID: 38785587 PMCID: PMC11120340 DOI: 10.3390/ejihpe14050089] [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: 03/28/2024] [Revised: 05/09/2024] [Accepted: 05/10/2024] [Indexed: 05/25/2024] Open
Abstract
Breast cancer (BC)-related sequelae drastically impact the psychophysical functioning and quality of life of affected women. Adapted physical activity (APA) has proved to effectively counteract these impairments in a non-medicalized framework. In particular, dragon boats are able to promote body functionality, social interaction, and quality of life in BC survivors, but the literature on specific motor gestures is scarce and practice is still based more on a re-educative perspective than a performative one. In this context, the present longitudinal study investigated the benefits of an adapted biofeedback-based sensorimotor training intervention on upper body functionality in a team of dragon ladies. The 8-week intervention was conceived as integrated dry workout sessions led by an APA kinesiologist and applied a novel sensorized proprioceptive device, such as a Libra board. Post-protocol evaluation revealed a significant improvement in bilateral upper limb mobility, core endurance, and trunk stability along with a distress decrease and quality of life enhancement through validated assessment tools. Our findings suggest that integrating biofeedback-based workout sessions can effectively promote upper body functionality in BC survivors practicing dragon boating. Furthermore, our innovative approach could help spread methodological hints able to boost exercise adherence in this target population, thus counteracting cancer recurrence while promoting overall well-being.
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Affiliation(s)
| | | | | | - Mirca Marini
- Department of Experimental and Clinical Medicine, Section of Anatomy and Histology, University of Florence, 50134 Florence, Italy; (G.C.); (A.D.); (M.M.)
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Korka ZG, Dehkordi SN, Sohani SM, Yassin M. Validity and reliability of the Persian version of the trunk impairment scale in people with multiple sclerosis. Mult Scler Relat Disord 2024; 81:105098. [PMID: 38000131 DOI: 10.1016/j.msard.2023.105098] [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: 06/10/2023] [Revised: 10/13/2023] [Accepted: 10/21/2023] [Indexed: 11/26/2023]
Abstract
BACKGROUND In order to provide an important measuring tool for the assessment, prognosis of recovery, and treatment of people with multiple sclerosis (PWMS), the aim of this research is to examine the validity and reliability of the Trunk Impairment Scale (TIS) in Persian. METHODS The research included 105 PWMS. The TIS questionnaire was translated and culturally equivalent according to the IQOLA approach. The Intra Class Correlations (ICC) and Cronbach's alpha were used to assess the internal consistency of the questionnaire. Barthel Index (BI), Time Up and Go (TUG), Multiple Sclerosis Walking Scale-12 (MSWS-12), and Trunk Control Test (TCT) scores were correlated with the TIS score in order to assess validity. RESULTS 86 of 105 participants in this study were female. For several subscales, the ICC correlation coefficient ranged from 0.89 to 0.98. The Cronbach's alpha value of the TIS total score indicates that the TIS questionnaire has quite good internal consistency. (Cronbach's alpha=0.97). The TIS and the MSWS-12, BI, TUG, and TCT questionnaires have correlation coefficients of 0.78, 0.72, 0.60, and 0.71, respectively, indicating strong construct and concurrent validity. CONCLUSION The results of the research showed that the TIS in Persian is a relevant and reliable tool for assessing trunk abnormalities in Persian-speaking PWMS.
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Affiliation(s)
- Zahra Ghadimi Korka
- Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Shohreh Noorizadeh Dehkordi
- Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
| | - Soheil Mansour Sohani
- Iranian Center of Excellence in Physiotherapy, Department of Physiotherapy, Rehabilitation Research Center, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Marzieh Yassin
- Iranian Center of Excellence in Physiotherapy, Department of Physiotherapy, Rehabilitation Research Center, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
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Far SS, Amiri B, Sahebozamani M, Ebrahimi HA, Zemková E. The effect of multi-function swing suspension training on upper and lower extremities function and quality of life in multiple sclerosis women with different disability status. Mult Scler Relat Disord 2023; 80:105113. [PMID: 37924713 DOI: 10.1016/j.msard.2023.105113] [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: 07/30/2023] [Revised: 10/05/2023] [Accepted: 10/27/2023] [Indexed: 11/06/2023]
Abstract
BACKGROUND Multiple sclerosis (MS) can lead to impaired upper and lower extremity function (ULEF), which reduces the quality of life (QoL). Exercise is beneficial for symptom management, but newer approaches like multi-function swing suspension training (MFSST) need further investigation. Additionally, tailoring exercises to individual needs remains a challenging area of investigation. AIM To investigate the effect of an MFSST program on ULEF, and QoL in MS women according to the expanded disability status scale (EDSS) score. METHODS Forty-seven MS women meeting selection criteria were randomly assigned to intervention groups A (EDSS 2-4) and B (EDSS 4.5-6.5), and the control group (EDSS 2-6.5). Intervention groups did an 8-week MFSST program with 3 × 1hr sessions/week. Prior to the intervention, and after 4, 6, and 8 weeks, the 9-hole peg test (9HPT) and the timed 25-foot walk (T25FW) test were performed for both the intervention groups and the control group. The Short Form questionnaire (SF-36) was used to measure their QoL. RESULTS Significant main effects for time were observed in both the 9HPT (F = 52.48, p = 0.001, Pη2 = 0.78) and the T25FW (F = 85.63, p = 0.000, Pη2 = 0.859). Speed increased between the pre-test, 4th week, 6th week, and 8th week in both tests. These tests revealed significant interaction effects between group and time. The 9HPT had an F-value of 9.01 (p = 0.001, Pη2 = 0.392), while the T25FW had an F-value of 13.812 (p = 0.000, Pη2 = 0.497). Across both tests, Group B, with higher EDSS scores, demonstrated greater speed improvement over the three-time measurements (4th week, 6th week, and 8th week) than Group A. The control group did not exhibit any improvement in speed. Intervention groups showed improvement in all QoL subscales except emotional role limitation. CONCLUSIONS An 8-week MFSST improves ULEF and QoL in women with MS, particularly those with higher EDSS scores (more than 4.5). Notably, significant improvements were observed after four weeks of the intervention. The incorporation of a variety of exercises in a single device provides a significant advantage over traditional exercise programs. Therefore, MFSST can be a valuable and efficient tool for improving symptoms and QoL in MS patients. TRIAL REGISTRATION IRCT20220526054997N1.
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Affiliation(s)
- Sara Sepehri Far
- Department of Sports Injuries and Corrective Exercises, Faculty of Physical Education and Sport, Shahid Bahonar University of Kerman, Kerman, Iran
| | - Banafsheh Amiri
- Department of Sports Injuries and Corrective Exercises, Faculty of Physical Education and Sport, Shahid Bahonar University of Kerman, Kerman, Iran; Department of Biological and Medical Sciences, Faculty of Physical Education and Sport, Comenius University in Bratislava, Slovakia
| | - Mansour Sahebozamani
- Department of Sports Injuries and Corrective Exercises, Faculty of Physical Education and Sport, Shahid Bahonar University of Kerman, Kerman, Iran.
| | | | - Erika Zemková
- Department of Biological and Medical Sciences, Faculty of Physical Education and Sport, Comenius University in Bratislava, Slovakia
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Ozkan T, Ataoglu NEE, Soke F, Karakoc S, Bora HAT. Investigation of the relationship between trunk control and balance, gait, functional mobility, and fear of falling in people with Alzheimer's disease. Ir J Med Sci 2023; 192:2401-2408. [PMID: 36656422 DOI: 10.1007/s11845-023-03279-9] [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: 11/07/2022] [Accepted: 12/19/2022] [Indexed: 01/20/2023]
Abstract
INTRODUCTION Optimal trunk control relies on adequate musculoskeletal, motor, and somatosensory systems that are often affected in people with Alzheimer's disease (AD). Therefore, the aim of this study was to compare trunk control between people with AD and healthy older adults, and investigate the relationship between trunk control and balance, gait, functional mobility, and fear of falling in people with AD. METHODS The study was completed with 35 people with AD and 33 healthy older adults with matching age and gender. Trunk control was evaluated with Trunk Impairment Scale (TIS); balance with Berg Balance Scale (BBS), Functional Reach Test (FRT), One-Leg Standing Test (OLST) and Five-Repeat Sit-and-Stand Test (5STS); gait with Dynamic Gait Index (DGI); functional mobility with Timed Up and Go (TUG) Test; fear of falling with Falls Efficacy Scale-International (FES-I). RESULTS BBS, FRT, OLST, and DGI scores were lower and 5STS and TUG Test scores were higher in people with AD compared to healthy older adults (p < 0.05). There was no difference in FES-I score between people with AD and healthy older adults (p > 0.05). TIS was associated with BBS, FRT, OLST, 5STS, DGI, TUG Test, and FES-I (r between - 0.341 and 0.738; p < 0.05 for all). CONCLUSION Trunk control is affected and related with balance, gait, functional mobility, and fear of falling in people with AD. For this reason, we think that trunk control should be evaluated in the early period, and applications for trunk control should be included in rehabilitation approaches in order to improve balance, gait, functional mobility, and reduce fear of falling.
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Affiliation(s)
- Taskin Ozkan
- Giresun University, Vocational School of Health Services, Therapy and Rehabilitation, Giresun, 28200, Turkey.
| | | | - Fatih Soke
- Gulhane Faculty of Physiotherapy and Rehabilitation, University of Health Sciences, Ankara, Turkey
| | - Selda Karakoc
- University of Health Sciences, Gulhane Institute of Health Sciences, Ankara, Turkey
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Grange E, Solaro C, Di Giovanni R, Marengo D. The correlation between 9-HPT and patient-reported measures of upper limb function in multiple sclerosis: a systematic review and meta-analysis. J Neurol 2023; 270:4179-4191. [PMID: 37294322 PMCID: PMC10421783 DOI: 10.1007/s00415-023-11801-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/30/2023] [Accepted: 05/30/2023] [Indexed: 06/10/2023]
Abstract
Upper limb function is one of the most affected domains in people with multiple sclerosis (PwMS), as self-reported by 50% of patients. Heterogeneous results have been found about the correlation between objective and subjective upper limb function. The aim of the present study is to perform a systematic review and meta-analysis of studies presenting data on the strength of association between the gold standard for 9-Hole Peg Test scores and Patient-Reported Outcome Measures (PROMs) of manual ability. Primary research studies including assessments of 9-Hole Peg Test scores and Patient-Reported Outcome Measures were searched in Scopus, Web of Science, and PubMed. Meta analytical calculations were performed using a random-effects model. We retrieved n = 27 studies including n = 75 distinct effect sizes (N of subjects = 3263). The central tendency analysis showed a strong correlation between 9-HPT scores and PROMs (r = 0.51, 95% CI [0.44, 0.58]). Moderator analysis showed the effect size to be significantly larger in studies with a mean or median EDSS level indicating severe disability. The publication bias hypothesis was not supported; instead, we noted that studies based on larger samples also tend to report stronger effect sizes. Results of the study indicate that the correlation between 9-HPT and PROMs is strong, although the constructs measured by these instrument does not fully overlap. The correlation between 9-HPT and PROMs was stronger in larger studies and when samples include a sizeable subgroup of PwMS with severe disability, pointing out the importance of sample diversity.
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Affiliation(s)
- Erica Grange
- CRRF "Mons. Luigi Novarese", Moncrivello, VC, Italy
- Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Genoa, Italy
| | - Claudio Solaro
- CRRF "Mons. Luigi Novarese", Moncrivello, VC, Italy
- Neurology Unit, Galliera Hospital, Genoa, Italy
| | | | - Davide Marengo
- Department of Psychology, University of Turin, Turin, Italy.
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Söylemez B, Çetİşlİ-Korkmaz N, Tekİn S, Bİr LS, Şenol H. The effect of balance, walking capacity, and fear of falling on the level of community integration in individuals with Multiple Sclerosis: A cross-sectional study. Physiother Theory Pract 2023:1-7. [PMID: 37377114 DOI: 10.1080/09593985.2023.2229903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 06/08/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND Social participation levels of individuals with Multiple Sclerosis (iwMS) are lower than those of healthy individuals. OBJECTIVE This study aimed to evaluate to which extent the walking capacity, balance, and fear of falling (FoF) affect the community integration levels of iwMS. METHODS Thirty-nine iwMS were evaluated for their participation levels [The Community Integration Questionnaire (CIQ)], walking capacity [The Six-Minute Walk Test (6MWT)], balance [Kinesthetic Ability Trainer (SportKAT®)], and FoF [The Modified Falls Efficacy Scale (MFES)]. Correlation and regression analyses were performed to detect the effects of SportKAT®, 6MWT, and MFES on CIQ. RESULTS CIQ scores were significantly correlated with 6MWT (p = .043) and MFES (p = .005) scores, while CIQ was not related with static (for two feet test p = .356, for right single-leg stance test p = .412, for left single-leg stance test p = .730) and dynamic balance (for clockwise test p = .097, for counterclockwise test p = .540) measured with the SportKAT®. It was found that CIQ could be predicted by 6MWT and MFES at the level of 16% and 25%, respectively. CONCLUSION FoF and walking capacity are associated with community integration in iwMS. Therefore, physiotherapy and rehabilitation programs of iwMS should be combined with treatment goals to increase community integration, balance, and gait and decrease the disability and FoF from an early stage. Comprehensive studies examining other factors that may impact participation in iwMS with different levels of disability are needed.
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Affiliation(s)
- Betul Söylemez
- Department of Medical Services and Techniques, Burdur Vocational School of Health Services, Burdur Mehmet Akif Ersoy University, Burdur, Türkİye
| | - Nilüfer Çetİşlİ-Korkmaz
- Department of Neurological Rehabilitation, Faculty of Physiotherapy and Rehabilitation, Pamukkale University, Denizli, Türkİye
| | - Selma Tekİn
- Department of Neurology, Faculty of Medicine, Pamukkale University, Denizli, Türkİye
| | - Levent Sinan Bİr
- Department of Neurology, Faculty of Medicine, Pamukkale University, Denizli, Türkİye
| | - Hande Şenol
- Department of Biostatistics, Faculty of Medicine, Pamukkale University, Denizli, Türkİye
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Doğan M, Ayvat E, Kılınç M. Telerehabilitation versus virtual reality supported task-oriented circuit therapy on upper limbs and trunk functions in patients with multiple sclerosis: A randomized controlled study. Mult Scler Relat Disord 2023; 71:104558. [PMID: 36812718 DOI: 10.1016/j.msard.2023.104558] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/20/2023] [Accepted: 02/09/2023] [Indexed: 02/13/2023]
Abstract
INTRODUCTION The purpose of this study was to investigate the effects of two different technology-supported rehabilitation approaches which are mobile application based telerehabilitation (TR) and virtual reality supported task oriented circuit therapy groups (V-TOCT) on the upper limb (UL), trunk function, and functional activity kinematics in patients with Multiple Sclerosis (PwMS). METHODS Thirty-four patients with PwMS were included in this study. The participants were evaluated at baseline and after eight weeks of treatment by an experienced physiotherapist using the Trunk Impairment Scale (TIS), kinetic function sub-parameter of the International Cooperative Ataxia Rating Scale (K-ICARS), ABILHAND, Minnesota Manual Dexterity tests (MMDT), and trunk and UL kinematics using inertial sensors. The participants were randomized into the TR and V-TOCT groups with a 1:1 allocation ratio. All participants received interventions for 1 hour per session, 3 sessions per week, for 8 weeks. RESULTS Trunk impairment, ataxia severity, UL, and hand function showed statistically significant improvement in both groups. The functional range of motion (FRoM) of shoulder and wrist increased transversal plane and the FRoM of shoulder increased on sagittal plane in V-TOCT. Log Dimensionless Jerk (LDJ) decreased on transversal plane in V-TOCT group. The FRoM of the trunk joints increased on the coronal plane and the FRoM of the trunk joints increased on the transversal plane in TR. Dynamic balance of the trunk and K-ICARS improved better in V-TOCT than in TR (p < 0,05). CONCLUSIONS V-TOCT and TR improved UL function, TIS, and ataxia severity in PwMS. The V-TOCT was more effective than the TR in terms of dynamic trunk control and kinetic function. The clinical results were confirmed using the kinematic metrics of motor control.
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Affiliation(s)
- Mert Doğan
- Department of Neurological Rehabilitation, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey.
| | - Ender Ayvat
- Department of Neurological Rehabilitation, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Muhammed Kılınç
- Department of Neurological Rehabilitation, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
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Söke F, Ataoğlu NEE, Öztekin MF, Koçer B, Karakoç S, Gülşen Ç, Çomoğlu SS, Bora HA. Impaired trunk control and its relationship with balance, functional mobility, and disease severity in patients with cervical dystonia. Turk J Med Sci 2023; 53:405-412. [PMID: 36945943 PMCID: PMC10388090 DOI: 10.55730/1300-0144.5597] [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: 07/19/2022] [Accepted: 11/30/2022] [Indexed: 02/26/2023] Open
Abstract
BACKGROUND Impaired trunk control is common in neurological disorders; however, trunk control has not been examined in patients with cervical dystonia (CD). Therefore, the primary aim was to compare trunk control between patients with CD and healthy people. The secondary aim was to investigate the relationship between trunk control and balance, functional mobility, and disease severity in patients with CD. METHODS ]This cross-sectional study included 32 patients with CD and 32 healthy people. Trunk control was compared using the trunk impairment scale (TIS) that consists of three subscales: static sitting balance, dynamic sitting balance, and trunk coordination between two groups. Balance was assessed using Berg Balance Scale, four square step test, and one-leg stance test. The Timed Up and Go Test was measured to determine functional mobility. Toronto Western Spasmodic Torticollis Rating Scale was used to evaluate disease severity.]></AbstractText> <AbstractText Label="RESULTS"><![CDATA[ Patients with CD demonstrated worse performance on the TIS-total with TIS-dynamic sitting subscale and TIS-trunk coordination subscale (p < 0.001, p < 0.001, and p < 0.001), except for TIS-static sitting subscale (p = 0.078) compared to healthy people. TIS-total scores had moderate to strong correlations with balance, functional mobility, and disease severity (range r between 0.786 and 0.536, p < 0.05 for all). There was no correlation between TIS-total scores and disease severity (p = 0.102). DISCUSSION Patients with CD had impaired trunk control, especially in dynamic sitting balance and trunk coordination. Impaired trunk control was also associated with balance and functional mobility but not disease severity. These findings suggest that trunk control deficits should receive attention in the assessment and treatment of patients with CD.
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Affiliation(s)
- Fatih Söke
- Department of Physiotherapy and Rehabilitation, Gülhane Faculty of Physiotherapy and Rehabilitation, University of Health Sciences, Ankara, Turkey
| | | | - Mehmet Fevzi Öztekin
- Department of Neurology, Dışkapı Yıldırım Beyazıt Teaching and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Bilge Koçer
- Department of Neurology, Dışkapı Yıldırım Beyazıt Teaching and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Selda Karakoç
- Department of Physiotherapy and Rehabilitation, Gülhane Institute of Health Science, University of Health Sciences, Ankara, Turkey
| | - Çağrı Gülşen
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Selim Selçuk Çomoğlu
- Department of Neurology, Dışkapı Yıldırım Beyazıt Teaching and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Hatice Ayşe Bora
- Department of Neurology, Faculty of Medicine, Gazi University, Ankara, Turkey
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Sepehri Far S, Amiri B, Sahebozamani M, Ebrahimi HA. Improvement in the multiple sclerosis functional composite score by multi-function swing suspension training program. Mult Scler Relat Disord 2022; 67:104174. [PMID: 36174257 DOI: 10.1016/j.msard.2022.104174] [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: 05/29/2022] [Revised: 08/18/2022] [Accepted: 09/09/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Physical activity has been considered as a promising approach to slow down the disease process in Multiple Sclerosis (MS) patients. The functional impairments of MS have been studied in detail, while evidence of the efficacy of exercise training interventions on the Multiple Sclerosis functional composite (MSFC) score in these patients is limited. The aim of this study was to investigate the improvement in MSFC score by multi-function swing suspension training program (MFSST) in the women with MS. METHODS The patients were divided into two groups as the intervention and control groups. A total of 47 MS patients completed the MSFC components at baseline and after the intervention: the timed 25-foot walk (T25FW); the 9-hole peg test (9HPT); and paced auditory serial addition test (PASAT). Z scores were created for each test based on control means. RESULTS The MSFC score, 9HPT, T25FW, and PASAT showed a significant increment in comparison with the baseline levels in the four, six, and eight weeks following the first exercise session (all p<0.05). These differences in the control group were not significant. The improvement in the MSFC score and the component Z-scores in the intervention groups was found from the fourth week onwards. CONCLUSIONS The study findings highlight that the progression of MS disability can be partially compensated by physical exercise. Overall, these results indicate that MFSST can be used as an effective treatment method in patients suffering from MS. Longer (years) exercise studies with larger samples of MS patients, with different MS subtypes, and of different sex, are needed to evaluate the effect of other types of exercise interventions on the MSFC score in MS patients with different disabilities.
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Affiliation(s)
- Sara Sepehri Far
- Department of Sports Injuries and Corrective Exercises, Faculty of Physical Education and Sport, Kerman, Iran
| | - Banafsheh Amiri
- Department of Sports Injuries and Corrective Exercises, Faculty of Physical Education and Sport, Kerman, Iran; Department of Biological and Medical Sciences, Faculty of Physical Education and Sport, Comenius University in Bratislava, Slovakia.
| | - Mansour Sahebozamani
- Department of Sports Injuries and Corrective Exercises, Faculty of Physical Education and Sport, Kerman, Iran.
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Looft JM, Sjoholm R, Hansen AH, Fairhurst S, Voss G, Dellamano CA, Egginton J, Olney C, Goldish G. User-centered design and development of a trunk control device for persons with spinal cord injury: A pilot study. J Spinal Cord Med 2022; 45:585-594. [PMID: 33705266 PMCID: PMC9246101 DOI: 10.1080/10790268.2020.1863897] [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: 10/21/2022] Open
Abstract
CONTEXT/OBJECTIVE There are no wheelchair products designed to allow users to dynamically control trunk posture to both significantly improve functional reach and provide pressure relief during forward lean. This pilot study sought to (1) gather stakeholder desires regarding necessary features for a trunk control system and (2) subsequently develop and pilot test a first-generation trunk control prototype. DESIGN Multi-staged mixed methods study design. SETTING Minneapolis VA Health Care System, Minneapolis, MN. PARTICIPANTS Eight people with spinal cord injuries were recruited to participate in a focus group. Five participants returned to discuss, rate, and select a design concepts for prototype development. Two participants returned to test the first-generation trunk control prototype. INTERVENTIONS The focus group members selected a trunk control device design that uses backpack straps with a single cable as the most desired option. Our design team then manufactured the first-generation prototype at the Minneapolis VA. OUTCOME MEASURES Bimanual workspace capabilities (n = 1) and pressure map relief changes (n = 2) during supported forward lean were measured. Both participants also provided feedback on the trunk control devices usability. RESULTS Bimanual workspace (for Participant 1) was increased by 311% in the sagittal plane with use of the trunk control device as compared to without. Pressure relief during a forward lean was increased with an overall dispersion index reduction of 87.6% and 27.7% for Participant 1 and Participant 2 respectfully. CONCLUSION This pilot study successfully elicited desired features for a trunk control device from stakeholders and successfully developed and tested a first-generation trunk control prototype.
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Affiliation(s)
- John M. Looft
- Minneapolis VA Health Care System, Minneapolis, Minnesota, USA,Correspondence to: John M. Looft Prosthetic & Patient Services, Minneapolis Adaptive Design and Engineering (MADE) Program, Minneapolis VA Health Care System, Minneapolis, MN55417, USA; Ph: 612-725-2000, ext. 337091.
| | - Robert Sjoholm
- Minneapolis VA Health Care System, Minneapolis, Minnesota, USA,Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Andrew H. Hansen
- Minneapolis VA Health Care System, Minneapolis, Minnesota, USA,Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, Minnesota, USA,Division of Rehabilitation Science, University of Minnesota, Minneapolis, Minnesota, USA,Department of Biomedical Engineering, University of Minnesota, Minneapolis, Minnesota, USA
| | | | - Greg Voss
- Minneapolis VA Health Care System, Minneapolis, Minnesota, USA
| | - Clifford A. Dellamano
- Minneapolis VA Health Care System, Minneapolis, Minnesota, USA,Department of Biomedical Engineering, University of Minnesota, Minneapolis, Minnesota, USA
| | | | - Christine Olney
- Minneapolis VA Health Care System, Minneapolis, Minnesota, USA,College of Design, University of Minnesota, Minneapolis, Minnesota, USA
| | - Gary Goldish
- Minneapolis VA Health Care System, Minneapolis, Minnesota, USA,Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, Minnesota, USA
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Raats J, Lamers I, Merken I, Boeckmans J, Soler B, Normann B, Arntzen EC, Feys P. The content and effects of trunk rehabilitation on trunk and upper limb performance in people with multiple sclerosis: a systematic review. Eur J Phys Rehabil Med 2022; 58:26-32. [PMID: 34468108 PMCID: PMC9980506 DOI: 10.23736/s1973-9087.21.06689-2] [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: 11/03/2020] [Revised: 07/27/2021] [Accepted: 09/01/2021] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Persons with multiple sclerosis (pwMS) could have an impaired trunk and reduced postural control, which negatively impacts activities of daily living. Evidence is growing to consider the positive effects of trunk training on fall incidence and balance problems. Effects on trunk and upper limb performance is unknown. This systematic review provides an overview of trunk training programs and their effects in MS, specifically focusing on the content of training modalities and the effects on trunk and upper limb performance. EVIDENCE ACQUISITION Two electronic databases were used: PubMed and Web Of Science (WOS). Intervention studies (with- and without control group) published in English, investigating the effects of active trunk training on trunk and upper limb performance in pwMS, were included. EVIDENCE SYNTHESIS Sixteen studies met the criteria, investigating different rehabilitation modalities. The included interventions in the review varied between more generic postural interventions such as Pilates (N.=8) and Ai Chi (N.=1), with a focus on abdominal muscle activation, breathing, neutral position and lower extremity movements. Further, specifically developed trunk training programs like GroupCoreDIST/ SIT / CoDuSe (N.=6) and Bobath based trunk training (N.=1) are detected, with the main focus on trunk strengthening and dynamic movements. An overall improvement in trunk performance was reported in several tests on trunk strength, stability and coordination. While the majority of the programs integrated the upper limb, only half of them used upper limb outcome measures to evaluate the effect. Here, overall significant improvements were found for the upper limb. CONCLUSIONS This systematic review showed that different types of trunk training programs can improve trunk and upper limb function in PwMS. The findings of this review suggest that a focus on trunk training to achieve effects on upper limb is reasonable. Future research is needed to further explore relations and the effect sizes.
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Affiliation(s)
- Joke Raats
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium -
| | - Ilse Lamers
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
- Noorderhart Rehabilitation and MS Center, Pelt, Belgium
| | - Ine Merken
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
| | - Jolien Boeckmans
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
| | - Bernardita Soler
- Department of Neurology, Doctor Sótero del Río Hospital, Santiago, Chile
| | - Britt Normann
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
| | | | - Peter Feys
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
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Barss TS, Parhizi B, Porter J, Mushahwar VK. Neural Substrates of Transcutaneous Spinal Cord Stimulation: Neuromodulation across Multiple Segments of the Spinal Cord. J Clin Med 2022; 11:639. [PMID: 35160091 PMCID: PMC8836636 DOI: 10.3390/jcm11030639] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 01/17/2022] [Accepted: 01/18/2022] [Indexed: 02/01/2023] Open
Abstract
Transcutaneous spinal cord stimulation (tSCS) has the potential to promote improved sensorimotor rehabilitation by modulating the circuitry of the spinal cord non-invasively. Little is currently known about how cervical or lumbar tSCS influences the excitability of spinal and corticospinal networks, or whether the synergistic effects of multi-segmental tSCS occur between remote segments of the spinal cord. The aim of this review is to describe the emergence and development of tSCS as a novel method to modulate the spinal cord, while highlighting the effectiveness of tSCS in improving sensorimotor recovery after spinal cord injury. This review underscores the ability of single-site tSCS to alter excitability across multiple segments of the spinal cord, while multiple sites of tSCS converge to facilitate spinal reflex and corticospinal networks. Finally, the potential and current limitations for engaging cervical and lumbar spinal cord networks through tSCS to enhance the effectiveness of rehabilitation interventions are discussed. Further mechanistic work is needed in order to optimize targeted rehabilitation strategies and improve clinical outcomes.
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Affiliation(s)
- Trevor S. Barss
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB T6G 2R3, Canada; (T.S.B.); (B.P.)
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Alberta, Edmonton, AB T6G 2R3, Canada;
- Sensory Motor Adaptive Rehabilitation Technology (SMART) Network, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Behdad Parhizi
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB T6G 2R3, Canada; (T.S.B.); (B.P.)
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Alberta, Edmonton, AB T6G 2R3, Canada;
- Sensory Motor Adaptive Rehabilitation Technology (SMART) Network, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Jane Porter
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Alberta, Edmonton, AB T6G 2R3, Canada;
- Sensory Motor Adaptive Rehabilitation Technology (SMART) Network, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Vivian K. Mushahwar
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB T6G 2R3, Canada; (T.S.B.); (B.P.)
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Alberta, Edmonton, AB T6G 2R3, Canada;
- Sensory Motor Adaptive Rehabilitation Technology (SMART) Network, University of Alberta, Edmonton, AB T6G 2R3, Canada
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Abadi Marand L, Noorizadeh Dehkordi S, Roohi-Azizi M, Dadgoo M. Effect of dynamic neuromuscular stabilization on balance and trunk function in people with multiple sclerosis: protocol for a randomized control trial. Trials 2022; 23:69. [PMID: 35063011 PMCID: PMC8778496 DOI: 10.1186/s13063-022-06015-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 01/10/2022] [Indexed: 12/02/2022] Open
Abstract
Background Multiple sclerosis is a chronic and disabling neurological disease among young people. One of the major complaints in patients with multiple sclerosis (PWMS) is falling. There are a number of factors that risk factors for falling, including balance disorder and spasticity. Core stability (CS) exercises such as trunk muscle strengthening exercises can improve balance and mobility and reduce falling. Dynamic neuromuscular stabilization (DNS) exercise is a new functional rehabilitation strategy that optimizes motor function based on the principles of developmental kinesiology. This trial will evaluate the effectiveness of DNS in comparison to CS on balance, spasticity, and falling in PWMS. Methods A total of 64 PWMS, between 30 and 50 years old and expanded disability status scale (EDSS) between 2 to 5, will be recruited from neurophysiotherapy clinic, Faculty of Rehabilitation Sciences, Iran University of Medical Sciences to participate in this 2-armed parallel study. Participants will be randomly divided into two groups to receive CS exercise or DNS exercise. All participants will receive exercise treatment for 15 sessions during a period of 5 weeks (3 sessions per week). Primary outcome measures will be balance. Falling rate, fear of falling, patient mobility, as well as spasticity, will be measured as secondary outcomes. All outcome measures will be measured at baseline, the day after the completion of the 15th session, and after 17 weeks. Discussion Dynamic neurostabilization exercises utilize the subconscious stimulation of special zones to reflexively mediate the diaphragm and other core stabilization muscles, which is extremely effective for individuals with reduced somatosensory or movement awareness. Findings from the proposed study are expected to benefit the knowledge base of the physiotherapist, and it can be a good alternative for the rehabilitation program and even reduce medication use in patients with multiple sclerosis. These exercises are easy to understand and applicable for these patients and their partners as well. Trial registration The trial was registered in the Iran registry organization with code IRCT20140222016680N5 and was approved on April 7th, 2020. Address: IRCT administration team, Central Library Building, Iran University Campus, Hemmat Freeway, next to Milad tower, Tehran, Iran. postal code:14496-14535.
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What is the distribution of trunk impairments and its relationship with disability level in individuals with multiple sclerosis? Mult Scler Relat Disord 2022; 57:103325. [PMID: 35158441 DOI: 10.1016/j.msard.2021.103325] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 09/27/2021] [Accepted: 10/09/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Trunk control is essential for movement, balance and walking and is ignored in the regular medical follow-up. OBJECTIVE First, to describe the distribution of trunk impairments in the full range of disability levels in individuals with MS. Second, to identify the relationship between trunk control, measured by the Trunk Impairment Scale (TIS 2.0.), and general disability measured by the Expanded Disability Status Scale (EDSS). METHODS 154 individuals with MS were included (mean age 53.6; SD 11.06), EDSS ranging from 1.0- 8.5 (mean 4.47; SD 2.55). The relationship between EDSS and TIS 2.0. was calculated by Spearman correlation coefficient for the total sample and subgroups, EDSS ≤ 4 versus EDSS ≥ 4.5. RESULTS Trunk impairments were detected throughout the full range of disability, including individuals with low disability. Pelvic elevation and lower trunk rotation appeared most difficult to perform. In the total sample, a moderate correlation was found (rho= -0.608**) between disability (EDSS) and trunk performance (TIS 2.0.). Sub-analyses revealed a poor correlation (rho= -0.193) for the EDSS ≤ 4 subgroup and a strong correlation for the EDSS ≥ 4.5 subgroup (rho= -0.712**). CONCLUSION The results advocate for including trunk assessment already at early disease stages of MS, particularly of pelvic elevation and trunk rotation, and dedicated rehabilitation strategies.
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Evaluation of a Chair-Mounted Passive Trunk Orthosis: A Pilot Study on Able-Bodied Subjects. SENSORS 2021; 21:s21248366. [PMID: 34960472 PMCID: PMC8707933 DOI: 10.3390/s21248366] [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: 11/01/2021] [Revised: 12/11/2021] [Accepted: 12/13/2021] [Indexed: 11/21/2022]
Abstract
Trunk stability is important for adequate arm function due to their kinematic linkage. People with Duchenne muscular dystrophy (DMD) can benefit from trunk-assistive devices for seated daily activities, but existing devices limit trunk movement to forward bending. We developed a new trunk orthosis that has spring and pulley design. This study evaluated orthosis performance with 40 able-bodied subjects under with and without orthosis condition in 20 seated tasks for trunk rotation, forward bending, and side bending movements. Subjects adopted static posture in specific trunk orientation while their muscle activity was recorded. They also rated the subjective scales of perceived exertion and usability. A percent change in muscle activity for each task, due to orthosis use, is reported. Significant muscle activity reductions up to 31% and 65% were observed in lumbar and thoracic erector spinae muscles, respectively. Using three-way ANOVA, we found these reductions to be specific to the task direction and the choice of upper limb that is used to perform the asymmetric tasks. A total of 70% participants reported acceptable usability and ~1-point increase in exertion was found for maximum voluntary reaching with the orthosis. The outcomes of this study are promising, though tested on able-bodied subjects. Hence, orthosis mounted on wheelchairs should be further evaluated on DMD patients.
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Arkin I, Budak M. Trunk stabilization, body balance, body perception, and quality of life in professional physically disabled and able-bodied archers. SPORT SCIENCES FOR HEALTH 2021. [DOI: 10.1007/s11332-021-00744-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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18
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Haddad R, Turmel N, Chesnel C, Lagnau P, Breton FL, Amarenco G, Hentzen C. Functional independence measure predicts the outcome of clean intermittent catheterization training in patients with multiple sclerosis. Ann Phys Rehabil Med 2021; 65:101539. [PMID: 33984538 DOI: 10.1016/j.rehab.2021.101539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 02/01/2021] [Accepted: 03/09/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Clean intermittent catheterization (CIC) is the reference treatment of urinary retention in people with multiple sclerosis (pwMS). Predicting which patients could use this treatment, based on their motor and cognitive abilities, is crucial. OBJECTIVES To determine whether the Functional Independence Measure (FIM), used to assess degree of disability, can predict the outcome of CIC training in pwMS. METHODS All pwMS attending a tertiary neurourology department between 2011 and 2019 and eligible for CIC were included in this retrospective study. Level of disability was assessed with the FIM by an occupational therapist. Success for learning CIC, defined as the ability to perform at least 2 trials of the technique, was recorded at the end of the session by a continence nurse and a physiatrist. The association between the FIM and success for learning CIC was assessed by multivariable analysis. RESULTS We included 395 patients (mean [SD] age 49.8 [12.0] years; 70% women). More than half of patients had relapsing-remitting disease, and the Expanded Disability Status Scale score was ≥ 6. Mean FIM total, motor and cognitive scores were 108.0 (14.2), 75.9 (12.3) and 32.1 (3.7), respectively (maximal scores: 126, 91 and 35). At the end of the session, 87% of patients were successful in learning CIC. After adjustment of potential confounding variables including age, sex, obesity and EDSS score, FIM total, motor and cognitive subscores were significantly associated with success (odds ratio [95% confidence interval] 1.06 [1.03-1.08], 1.05 [1.03-1.08], 1.21 [1.12-1.32], respectively). CONCLUSIONS FIM was an independent predictor of successful CIC training in pwMS. A 1-point increase in FIM was associated with 6% increased odds of successfully mastering the CIC technique. A widespread use of the FIM could help determine the different cognitive and/or motor objectives that need to be improved before CIC teaching.
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Affiliation(s)
- Rebecca Haddad
- Sorbonne Université, GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hôpital Tenon, F-75020 Paris, France; Department of Urology, Ghent University Hospital, Ghent, Belgium; Faculty of Medicine and Health Sciences, Department of Human Structure and Repair, Ghent University, Ghent, Belgium.
| | - Nicolas Turmel
- Sorbonne Université, GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hôpital Tenon, F-75020 Paris, France
| | - Camille Chesnel
- Sorbonne Université, GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hôpital Tenon, F-75020 Paris, France
| | - Philippe Lagnau
- Sorbonne Université, GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hôpital Tenon, F-75020 Paris, France
| | - Frédérique Le Breton
- Sorbonne Université, GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hôpital Tenon, F-75020 Paris, France
| | - Gérard Amarenco
- Sorbonne Université, GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hôpital Tenon, F-75020 Paris, France
| | - Claire Hentzen
- Sorbonne Université, GRC 001, GREEN Groupe de Recherche Clinique en Neuro-Urologie, AP-HP, Hôpital Tenon, F-75020 Paris, France
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Hofstoetter US, Freundl B, Lackner P, Binder H. Transcutaneous Spinal Cord Stimulation Enhances Walking Performance and Reduces Spasticity in Individuals with Multiple Sclerosis. Brain Sci 2021; 11:brainsci11040472. [PMID: 33917893 PMCID: PMC8068213 DOI: 10.3390/brainsci11040472] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 03/31/2021] [Accepted: 04/06/2021] [Indexed: 12/16/2022] Open
Abstract
Gait dysfunction and spasticity are common debilitating consequences of multiple sclerosis (MS). Improvements of these motor impairments by lumbar transcutaneous spinal cord stimulation (tSCS) have been demonstrated in spinal cord injury. Here, we explored for the first time the motor effects of lumbar tSCS applied at 50 Hz for 30 min in 16 individuals with MS and investigated their temporal persistence post-intervention. We used a comprehensive protocol assessing walking ability, different presentations of spasticity, standing ability, manual dexterity, and trunk control. Walking ability, including walking speed and endurance, was significantly improved for two hours beyond the intervention and returned to baseline after 24 h. Muscle spasms, clonus duration, and exaggerated stretch reflexes were reduced for two hours, and clinically assessed lower-extremity muscle hypertonia remained at improved levels for 24 h post-intervention. Further, postural sway during normal standing with eyes open was decreased for two hours. No changes were detected in manual dexterity and trunk control. Our results suggest that transcutaneous lumbar SCS can serve as a clinically accessible method without known side effects that holds the potential for substantial clinical benefit across the disability spectrum of MS.
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Affiliation(s)
- Ursula S. Hofstoetter
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, 1090 Vienna, Austria
- Correspondence:
| | - Brigitta Freundl
- Neurological Center, Klinik Penzing—Wiener Gesundheitsverbund, 1140 Vienna, Austria; (B.F.); (P.L.); (H.B.)
| | - Peter Lackner
- Neurological Center, Klinik Penzing—Wiener Gesundheitsverbund, 1140 Vienna, Austria; (B.F.); (P.L.); (H.B.)
| | - Heinrich Binder
- Neurological Center, Klinik Penzing—Wiener Gesundheitsverbund, 1140 Vienna, Austria; (B.F.); (P.L.); (H.B.)
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Çelik G, Delioğlu K, Fırat T. The Relationship between Trunk Control and Upper Extremity Function in Children with Obstetric Brachial Plexus Palsy. Dev Neurorehabil 2021; 24:150-158. [PMID: 32729355 DOI: 10.1080/17518423.2020.1800856] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 07/01/2020] [Accepted: 07/21/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE This study aimed to assess sitting skills and trunk control in children with obstetric brachial plexus palsy (OBPP) and investigate the effect of these skills on upper extremity function. METHODS A total of 106 children with OBPP aged 10-18 months were included in this study. Injury severity was determined with Narakas Classification. The Gross Motor Function Measurement Sitting Sub-scale was used to assess sitting skills, while the Sitting Assessment Scale was used to evaluate the trunk control. The upper extremity functions were assessed with using the Active Movement Scale and the Modified Mallet Score. RESULTS As the severity of injury increased, sitting skills and trunk control values decreased (p = .0001). In addition, upper extremity function decreased with the decreasing sitting skills and trunk control (p = .0001). CONCLUSION Rehabilitation approaches should involve approaches that aim to increase trunk control in addition to programs targeting the extremity function in children with OBPP.
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Abd-Elfattah HM, Aly SM. Effect of Core Stability Exercises on Hand Functions in Children With Hemiplegic Cerebral Palsy. Ann Rehabil Med 2021; 45:71-78. [PMID: 33557483 PMCID: PMC7960954 DOI: 10.5535/arm.20124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 09/28/2020] [Indexed: 11/05/2022] Open
Abstract
Objective To investigate the effectiveness of core stability exercises on hand functions in children with hemiplegic cerebral palsy. Methods Fifty-two children with hemiplegic cerebral palsy ranging in age from 6 years to 8 years were enrolled in this study. They were randomly assigned to two (control and study) groups. The control group received the selected physiotherapy exercises, and the study group received the same selected physiotherapy exercise program and core stability exercises. Time motor performance, gross manual dexterity, and upper extremity skills assessed using the Jebsen Taylor Hand Function Test, Box and Block Test, and Quality Upper Extremity Skill Test, respectively, were measured before and after 12 weeks of the treatment program. Results There were significant improvements in both groups by comparing the mean values of all measured variables before and after treatment (p<0.05). There were significant differences between the control and study groups with respect to all measured variables when comparing the post-treatment outcomes (p<0.05). Conclusion This study suggests that core stability exercises can be an effective intervention that may improve hand functions in children with hemiplegic cerebral palsy.
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Affiliation(s)
- Hanaa Mohsen Abd-Elfattah
- Department of Physical Therapy for Pediatrics and Pediatric Surgery, Faculty of Physical Therapy, Badr University, Cairo, Egypt
| | - Sobhy Mahmoud Aly
- Department of Biomechanics, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
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ÖZKUL Ç, GÜÇLÜ GÜNDÜZ A, ESMER M, YILDIRIM MŞ, ELDEMİR K, İRKEÇ C. Mutual relationship between upper extremity function and core muscle endurance in patients with multiple sclerosis. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2021. [DOI: 10.33808/clinexphealthsci.809605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Analysis of Postural Control in Sitting by Pressure Mapping in Patients with Multiple Sclerosis, Spinal Cord Injury and Friedreich's Ataxia: A Case Series Study. SENSORS 2020; 20:s20226488. [PMID: 33202927 PMCID: PMC7698246 DOI: 10.3390/s20226488] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/09/2020] [Accepted: 11/11/2020] [Indexed: 11/20/2022]
Abstract
The postural control assessments in patients with neurological diseases lack reliability and sensitivity to small changes in patient functionality. The appearance of pressure mapping has allowed quantitative evaluation of postural control in sitting. This study was carried out to determine the evaluations in pressure mapping and verifying whether they are different between the three sample groups (multiple sclerosis, spinal cord injury and Friedreich’s ataxia), and to determine whether the variables extracted from the pressure mapping analysis are more sensitive than functional tests to evaluate the postural trunk control. A case series study was carried out in a sample of 10 adult patients with multiple sclerosis (n = 2), spinal cord injury (n = 4) and Friedreich’s ataxia (n = 4). The tests applied were: pressure mapping, seated Lateral Reach Test, seated Functional Reach Test, Berg Balance Scale, Posture and Postural Ability Scale, Function in Sitting Test, and Trunk Control Test. The participants with Friedreich’s ataxia showed a tendency to present a higher mean pressure on the seat of subject’s wheelchair compared to other groups. In parallel, users with spinal cord injury showed a tendency to present the highest values of maximum pressure and area of contact. People with different neurological pathologies and similar results in functional tests have very different results in the pressure mapping. Although it is not possible to establish a strong statistical correlation, the relationships between the pressure mapping variables and the functional tests seem to be numerous, especially in the multiple sclerosis group.
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Chiou SY, Morris L, Gou W, Alexander E, Gay E. Motor cortical circuits contribute to crossed facilitation of trunk muscles induced by rhythmic arm movement. Sci Rep 2020; 10:17067. [PMID: 33051482 PMCID: PMC7555543 DOI: 10.1038/s41598-020-74005-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 09/18/2020] [Indexed: 12/17/2022] Open
Abstract
Training of one limb improves performance of the contralateral, untrained limb, a phenomenon known as cross transfer. It has been used for rehabilitation interventions, i.e. mirror therapy, in people with neurologic disorders. However, it remains unknown whether training of the upper limb can induce the cross-transfer effect to the trunk muscles. Using transcranial magnetic stimulation over the primary motor cortex (M1) we examined motor evoked potentials (MEPs) in the contralateral erector spinae (ES) muscle before and after 30 min of unilateral arm cycling in healthy volunteers. ES MEPs were increased after the arm cycling. To understand the origin of this facilitatory effect, we examined short-interval intracrotical inhibition (SICI) and cervicomedullary MEPs (CMEPs) in neural populations controlling in the ES muscle. Notably, SICI reduced after the arm cycling, while CMEPs remained the same. Using bilateral transcranial direct current stimulation (tDCS) in conjunction with 20 min of the arm cycling, the amplitude of ES MEPs increased to a similar extent as with 30 min of the arm cycling alone. These findings demonstrate that a single session of unilateral arm cycling induces short-term plasticity in corticospinal projections to the trunk muscle in healthy humans. The changes are likely driven by cortical mechanisms.
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Affiliation(s)
- Shin-Yi Chiou
- School of Sport, Exercise, Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. .,Centre for Human Brain Health, University of Birmingham, Birmingham, UK.
| | - Laura Morris
- School of Sport, Exercise, Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Weidong Gou
- School of Sport, Exercise, Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Emma Alexander
- School of Sport, Exercise, Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Eliot Gay
- School of Sport, Exercise, Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
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25
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Paolucci T, Bernetti A, Sbardella S, La Russa C, Murgia M, Salomè A, Villani C, Altieri M, Santilli V, Paoloni M, Agostini F, Mangone M. Straighten your back! Self-correction posture and postural balance in "non rehabilitative instructed" multiple sclerosis patients. NeuroRehabilitation 2020; 46:333-341. [PMID: 32250329 DOI: 10.3233/nre-192987] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUD Patients with MS, regardless of the complexity of the activity or sensory conditions, commonly present a significant postural control deficit compared to healthy subjects. OBJECTIVE To investigate which postural self-correction strategies are adopted by patients with Multiple Sclerosis versus a group of healthy-subjects and how self-correction can influence the control of postural balance. METHODS A case-control prospective observational study was conducted. Person with Multiple Sclerosis and a group of healthy volunteers were enrolled. Patients included were instructed with vocal commands, to reach a self-correction posture, and they were compared to healthy subjects. Clinical assessments including Balance, Stabilometry and Postural evaluation of the spine were performed. RESULTS Sixty patients (30: control-group; 30: treatment-group) were enrolled. In the treatment group, the analysis reported a significant statistical difference between path length and center of pressure speed in self-correction posture with closed-eyes (p = 0,049; 0,047) and an improvement in C7 and L3 levels in self-correction posture (p < 0,01-C7; p < 0,01-L3). There are significant statistical differences about path length between the two groups in all examined conditions (p = 0,0001). At sagittal plane evaluation, results show an increase of all measurements in both posture (C7-neutral posture p = 0,0001; L3-neutral posture p = 0,0001; C7-self-correction posture p = 0,0001; L3-self-correction posture p = 0,0001). CONCLUSION Further study should investigate dynamic situations and different Multiple Sclerosis forms to complete balance analysis and to establish a correct rehabilitative program with self-correction exercise as powerful focus.
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Affiliation(s)
- Teresa Paolucci
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy
| | - Andrea Bernetti
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy
| | - Silvia Sbardella
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy
| | - Chiara La Russa
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy
| | - Massimiliano Murgia
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy
| | - Angela Salomè
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy
| | - Ciro Villani
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy
| | - Marta Altieri
- Multiple Sclerosis Center, Sapienza University of Rome, Rome, Italy
| | - Valter Santilli
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy
| | - Marco Paoloni
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy
| | - Francesco Agostini
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy
| | - Massimiliano Mangone
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy
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26
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Kalkan AC, Kahraman T, Ugut BO, Colakoglu BD, Genc A. A comparison of the relationship between manual dexterity and postural control in young and older individuals with Parkinson's disease. J Clin Neurosci 2020; 75:89-93. [PMID: 32201026 DOI: 10.1016/j.jocn.2020.03.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 03/09/2020] [Indexed: 11/12/2022]
Abstract
The motor symptoms of Parkinson's disease (PD) cause deterioration in manual dexterity. This deterioration affects independence in activities of daily living negatively. The loss of postural control, which occurs more frequently with disease progression, restricts physical functions and reduces mobility in patients with PD. Impaired postural control may affect distal mobility of an individual. The aim of this study was to investigate postural control and manual dexterity in individuals ≤ 65 and >65 years with PD and analyze the relationship between these variables according to age. Sixty-six individuals with PD participated in the study. The participants were categorized according to age (n = 29 for 65 years of age or younger and n = 37 for older). Manual dexterity (Dominant and Non-dominant hand) was assessed by the Nine Hole Peg Test (NHPT). Postural control was evaluated by the Limit of Stability Test (LoS) using a computerized balance measuring instrument. There was no statistically significant difference between the age groups on the combined dependent variables after controlling for disability, gender, weight, and height; F(7, 54) = 0.804, p = 0.587. Only LoS-Maximum Excursion was higher in the individuals ≤ 65 years (p = 0.035). Significant correlations were found between NHPT-Dominant and LoS-Reaction Time, LoS-Maximum Excursion; NHPT-Non-dominant and LoS-Reaction Time, LoS-Endpoint Excursion, LoS-Maximum Excursion in the older group (p < 0.05). There was no difference manual dexterity and postural control according to age except for LoS-Maximum Excursion. LoS-Maximum Excursion was higher in the young group. The manual dexterity was associated with postural control in individuals over 65 years of age with PD; however, not associated in younger individuals.
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Affiliation(s)
| | - Turhan Kahraman
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey
| | - Biron Onur Ugut
- Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey
| | | | - Arzu Genc
- School of Physical Therapy and Rehabilitation, Dokuz Eylul University, Izmir, Turkey
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