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Han B, Lee J, Yim S, Kim D. Effects of rehabilitation exercise program types on dynamic balance in patients with stroke: a meta-analysis of randomized controlled trials. Top Stroke Rehabil 2024; 31:681-691. [PMID: 38598557 DOI: 10.1080/10749357.2024.2329849] [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: 11/29/2023] [Accepted: 02/29/2024] [Indexed: 04/12/2024]
Abstract
PURPOSE The purposes of meta-analysis are to evaluate evidence about the effects of Rehabilitation Exercise Program on the balance of post-stroke patients, evaluated by the Berg Balance Scale (BBS). METHODS The search was conducted 'stroke,' 'rehabilitation,' 'dynamic balance,' 'Berg Balance Scale,' 'exercise' and 'randomized controlled trial'using MEDLINE (accessed by PubMed), Web of Science (WoS), ProQuest, and Google Scholar for journal studies published from January 2018 to October 2022. Two independent reviewers performed the article selection, data extraction, and methodological quality assessment. The main outcome was dynamic balance assessed by the Berg Balance scale. RESULTS The review included 30 papers and a total of 540 patients. The overall effect size was 0.550, a medium effect size according to the Cohen's standard. It was observed that gender has moderate effect size in male (0.551), female (0.458) and higher in male. Exercise type results showed large effect sizes in balance training (0.966), and aquatic activities (0.830), moderate effect sizes in virtual reality (0.762), moderate effect sizes in physically active (0.581), gait training (0.541), dual-task (0.478), trunk control (0.284), and small effect sizes in resistance training (0.128). CONCLUSIONS Exercise programs are effective in improving dynamic balance in stroke patients. Especially, the meta-analysis showed higher Effect Size for balance training and virtual reality than for other programs making this relevant interventions for future head to head superiority studies that compare different balance interventions in stroke.
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Affiliation(s)
- Byumsuk Han
- Department of Sports Medicine, Kyunghee University, Yongin-si, South Korea
| | - Jaewon Lee
- Department of Special Physical Education, Yongin University, Yongin-si, South Korea
| | - Sanghun Yim
- Department of Special Physical Education, Yongin University, Yongin-si, South Korea
| | - Dongmin Kim
- Department of Special Physical Education, Yongin University, Yongin-si, South Korea
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El Naamani K, Musmar B, Gupta N, Ikhdour O, Abdelrazeq H, Ghanem M, Wali MH, El-Hajj J, Alhussein A, Alhussein R, Tjoumakaris SI, Gooch MR, Rosenwasser RH, Jabbour PM, Herial NA. The Artificial Intelligence Revolution in Stroke Care: A Decade of Scientific Evidence in Review. World Neurosurg 2024; 184:15-22. [PMID: 38185459 DOI: 10.1016/j.wneu.2024.01.012] [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: 08/14/2023] [Revised: 01/01/2024] [Accepted: 01/02/2024] [Indexed: 01/09/2024]
Abstract
BACKGROUND The emergence of artificial intelligence (AI) has significantly influenced the diagnostic evaluation of stroke and has revolutionized acute stroke care delivery. The scientific evidence evaluating the role of AI, especially in areas of stroke treatment and rehabilitation is limited but continues to accumulate. We performed a systemic review of current scientific evidence evaluating the use of AI in stroke evaluation and care and examined the publication trends during the past decade. METHODS A systematic search of electronic databases was conducted to identify all studies published from 2012 to 2022 that incorporated AI in any aspect of stroke care. Studies not directly relevant to stroke care in the context of AI and duplicate studies were excluded. The level of evidence and publication trends were examined. RESULTS A total of 623 studies were examined, including 101 reviews (16.2%), 9 meta-analyses (1.4%), 140 original articles on AI methodology (22.5%), 2 case reports (0.3%), 2 case series (0.3%), 31 case-control studies (5%), 277 cohort studies (44.5%), 16 cross-sectional studies (2.6%), and 45 experimental studies (7.2%). The highest published area of AI in stroke was diagnosis (44.1%) and the lowest was rehabilitation (12%). A 10-year trend analysis revealed a significant increase in AI literature in stroke care. CONCLUSIONS Most research on AI is in the diagnostic area of stroke care, with a recent noteworthy trend of increased research focus on stroke treatment and rehabilitation.
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Affiliation(s)
- Kareem El Naamani
- Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Basel Musmar
- School of Medicine, An-Najah National University, Nablus, Palestine
| | - Nithin Gupta
- Jerry M. Wallace School of Osteopathic Medicine, Campbell University, Lillington, North Carolina, USA
| | - Osama Ikhdour
- School of Medicine, An-Najah National University, Nablus, Palestine
| | | | - Marc Ghanem
- Gilbert and Rose-Marie Chaghoury School of Medicine, Lebanese American University, Byblos, Lebanon
| | - Murad H Wali
- College of Public Health, Temple University, Philadelphia, Pennsylvania, USA
| | - Jad El-Hajj
- School of Medicine, St. George's University, St. George, Grenada
| | - Abdulaziz Alhussein
- Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Reyoof Alhussein
- Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Stavropoula I Tjoumakaris
- Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Michael R Gooch
- Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Robert H Rosenwasser
- Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Pascal M Jabbour
- Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Nabeel A Herial
- Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
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Oberholster CK, Taylor CJ, Huynh M, Gordon BA. The immediate and lasting balance outcomes of clinical falls-prevention programs: A non-randomised study. PLoS One 2024; 19:e0299146. [PMID: 38483927 PMCID: PMC10939286 DOI: 10.1371/journal.pone.0299146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 02/05/2024] [Indexed: 03/17/2024] Open
Abstract
PURPOSE Exercise-based falls-prevention programs are cost-effective population-based approaches to reduce the risk of falling for older adults. The aim was to evaluate the short-term and long-term efficacy of three existing falls-prevention programs. METHODS A non-randomized study design was used to compare the immediate-post and long-term physical outcome measures for three falls prevention programs; one high-level land-based program, one low-level land-based program and a water-based Ai Chi program. Timed-up-and-go (TUG), five-times sit-to-stand (5xSTS), six-minute walk test (6MWT) and six-meter walk test were assessed at baseline, post-program, and at six-months follow-up. Linear mixed models were used to analyze between- and within- group differences, with the high-level land-based program used as the comparator. RESULTS Thirty-two participants completed post-program assessment and 26 returned for follow-up. There was a difference in the age (years) of participants between programs (p = 0.049). The intercept for TUG and six-meter walk test time was 47.70% (23.37, 76.83) and 32.31s (10.52, 58.41), slower for the low-level group and 40.49% (17.35, 69.89) and 36.34s (12.75, 64.87), slower for the Ai Chi group (p < 0.01), compared with the high-level group. Mean time taken to complete the TUG was less both immediately post-program and at 6-month follow-up (p = 0.05). Walking speed for the six-meter walk test was only faster at six-months (p < 0.05). The 5xSTS duration was significantly reduced only at post-intervention (p < 0.05). CONCLUSION These results indicate land-based and water-based falls-prevention programs improve physical outcome measures associated with falls-risk and many improvements are maintained for six months after the completion of the program. (Retrospective trial registration: ACTRN1262300119069).
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Affiliation(s)
- Candice K. Oberholster
- Holsworth Research Initiative, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
- The Royal Melbourne Hospital, Allied Health (Physiotherapy and Exercise Physiology), Melbourne, Victoria, Australia
| | - Carolyn J. Taylor
- La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Minh Huynh
- La Trobe School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Brett A. Gordon
- Holsworth Research Initiative, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
- La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
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Chen K, Zhu S, Tang Y, Lan F, Liu Z. Advances in balance training to prevent falls in stroke patients: a scoping review. Front Neurol 2024; 15:1167954. [PMID: 38375467 PMCID: PMC10875131 DOI: 10.3389/fneur.2024.1167954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 01/18/2024] [Indexed: 02/21/2024] Open
Abstract
Objective To summarize the status and characteristics of the available evidence, research gaps, and future research priorities for preventing falls in stroke patients through balance training. Methods We used a scoping review framework. A systematic search of PUBMED, Embase, and Cochrane databases for main articles was conducted. Our study only included articles that on balance training and fall-related indicators in stroke patients. Two researchers independently screened the literature according to the inclusion and exclusion criteria. The data of demographic, clinical characteristics, intervention, sample, and outcome indicators were extracted. The characteristics and limitations of the included literature were comprehensively analyzed. Results Of the 1,058 studies, 31 were included. The methods of balance training include regular balance training, Tai Chi, Yoga, task balance training, visual balance training, multisensory training, aquatic balance training, perturbation-based balance training, cognitive balance training, system-based balance training, and robot-assisted balance training. The commonly used outcome measures include clinical balance test, such as Berg balance scale (BBS), Timed Up-and-Go Test (TUG), Fall Risk Index assessment (FRI), Fall Efficacy Scale score (FES), and instrumented balance tests. Conclusion This scoping review summarizes the existing primary research on preventing falls in stroke patients by balance training. Based on the summary of the existing evidence, the characteristics of balance training and their relation to falls in stroke patients were found. The future researches should explore how to develop personalized training program, the sound combination of various balance training, to more effectively prevent falls.
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Affiliation(s)
- Kehan Chen
- Department of Rehabilitation Medicine, Rehabilitation Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- West China School of Nursing, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Siyi Zhu
- Department of Rehabilitation Medicine, Rehabilitation Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yidan Tang
- Department of Rehabilitation Medicine, Rehabilitation Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Fuxia Lan
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zuoyan Liu
- Department of Rehabilitation Medicine, Rehabilitation Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- West China School of Nursing, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Rodríguez-Huguet M, Ayala-Martínez C, Vinolo-Gil MJ, Góngora-Rodríguez P, Martín-Valero R, Góngora-Rodríguez J. Transcranial direct current stimulation in physical therapy treatment for adults after stroke: A systematic review. NeuroRehabilitation 2024; 54:171-183. [PMID: 38143386 DOI: 10.3233/nre-230213] [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: 12/26/2023]
Abstract
BACKGROUND Stroke is a clinical syndrome that can cause neurological disorders due to a reduction or interruption in the blood flow at the brain level. Transcranial direct current stimulation (TDCS) is a non-invasive electrotherapy technique with the ability to modulate the function of nervous tissue. OBJECTIVE The aim of this review is to analyze the effects derived from the application of the TDCS for post-stroke patients on functionality and mobility. METHODS The data search was conducted in PubMed, PEDro, Cochrane Library, Web of Science and Scopus between July and August 2023. The search focused on randomized clinical trials conducted in the period of 2019-2023, and according to the selection criteria, seven studies were obtained. RESULTS The results found are mainly focused on the analysis of the scales Fugl-Meyer Assessment for Upper Extremity and Wolf Motor Function Test. CONCLUSION The application of TDCS presents benefits in post-stroke individuals on functionality, mobility and other secondary studied variables.
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Affiliation(s)
| | | | - Maria Jesus Vinolo-Gil
- Department of Nursing and Physiotherapy, University of Cádiz, Cádiz, Spain
- Rehabilitation Clinical Management Unit, Interlevels-Intercenters Hospital Puerta del Mar, Hospital Puerto Real, Cádiz, Spain
- Biomedical Research and Innovation Institute of Cádiz (INiBICA), Research Unit, Puerta del Mar University Hospital, University of Cádiz, Cádiz, Spain
| | | | - Rocío Martín-Valero
- Department of Physiotherapy, Faculty of Health Science, CTS-1071 Research Group, University of Málaga, Málaga, Spain
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Paolucci T, Agostini F, Mussomeli E, Cazzolla S, Conti M, Sarno F, Bernetti A, Paoloni M, Mangone M. A rehabilitative approach beyond the acute stroke event: a scoping review about functional recovery perspectives in the chronic hemiplegic patient. Front Neurol 2023; 14:1234205. [PMID: 37789885 PMCID: PMC10542412 DOI: 10.3389/fneur.2023.1234205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 08/14/2023] [Indexed: 10/05/2023] Open
Abstract
Background Stroke is a main cause of disability worldwide and its neuro-rehabilitative management is not limited to the acute phase but requires continuity in the rehabilitation approach especially in the chronic phase. The aim of this scoping review was to highlight the different treatment opportunities available in neurorehabilitation, effective for patients with chronic stroke sequelae, not only in terms of maintaining motor function but also improving it. Methods The literature search was conducted using the following databases: MEDLINE (PubMed), PEDro, Scopus, Web of Science (WOS), Cochrane from 2012 to February 2023. We selected Randomized Clinical Trials in English dealing with neurorehabilitation strategies in chronic hemiplegic patients after stroke focusing on motor function, muscular strength, gait, postural balance, spasticity, and quality of life. Results According to the inclusion criteria, 47 articles were selected for our review. All of them were analyzed following the primary outcome and the rehabilitation technique used. Despite the different protocols used within the same technique and despite the chronicity of the disease, all studies report an improvement after the rehabilitation treatment of motor function and quality of life. Conclusion The literature analyzed invites us to reflect respect to neurorehabilitation approach to the patient with chronic stroke sequelae often considered to have as its objective the maintenance of the present motor function and contain disability: instead, the review reports how, even in chronicity, the patient always reports margins of statistically and clinically significant improvement. The chronic stroke rehabilitation over 6 months has been proved effective in obtaining recovery in different settings.
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Affiliation(s)
- Teresa Paolucci
- Department of Medical, Oral and Biotechnological Science (DSMOB), University “G. d’Annunzio” of Chieti-Pescara, Chieti, Italy
| | - Francesco Agostini
- Department of Anatomy, Histology Forensic Medicine and Orthopedics, Sapienza University, Rome, Italy
| | - Elena Mussomeli
- Department of Anatomy, Histology Forensic Medicine and Orthopedics, Sapienza University, Rome, Italy
| | - Sara Cazzolla
- Department of Anatomy, Histology Forensic Medicine and Orthopedics, Sapienza University, Rome, Italy
| | - Marco Conti
- Department of Anatomy, Histology Forensic Medicine and Orthopedics, Sapienza University, Rome, Italy
| | - Francescapia Sarno
- Department of Medical, Oral and Biotechnological Science (DSMOB), University “G. d’Annunzio” of Chieti-Pescara, Chieti, Italy
| | - Andrea Bernetti
- Department of Anatomy, Histology Forensic Medicine and Orthopedics, Sapienza University, Rome, Italy
| | - Marco Paoloni
- Department of Anatomy, Histology Forensic Medicine and Orthopedics, Sapienza University, Rome, Italy
| | - Massimiliano Mangone
- Department of Anatomy, Histology Forensic Medicine and Orthopedics, Sapienza University, Rome, Italy
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Tang L, Liu S, Gan L, Ding H, Huang QM, Gao F, Li Y. Effects of dry needling intervention on lower limb dysfunction after stroke: study protocol for a randomised controlled trial. BMJ Open 2022; 12:e062494. [PMID: 36288843 PMCID: PMC9615970 DOI: 10.1136/bmjopen-2022-062494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Lower limb dysfunction is among the common sequelae of patients who had a poststroke and often results in the reduction of the quality of life. This study aims to assess the short and interim-term efficacy of dry needling (DN) intervention on lower extremity function, balance and gait in lower limb dysfunction after stroke. METHODS AND ANALYSIS This protocol entails an assessor and statistician-blinded, single-centre study with a randomised controlled trial. Forty-four patients who had a poststroke will be randomly allocated (1:1) to either the conventional treatment group (n=22) or the DN group (n=22). The conventional treatment group will receive conventional rehabilitation treatment once a day for 40 min each time. The treatment will be performed five times a week for 2 weeks. In the DN group, participants will be treated with DN on the basis of the conventional treatment. The intervention will be performed thrice a week for 2 weeks. The primary outcome that determines the efficacy of lower limb dysfunction will be the change in the Fugl-Meyer Assessment of Lower Extremity scale. The secondary indicators include the range of motion of knee and ankle joints, limits of stability, modified Clinical Test of Sensory Interaction on Balance, Timed Up and Go test, Modified Ashworth Scale and Barthel Index. Results will be evaluated at baseline, at 24 hours after intervention, at 2 weeks after intervention and at 3-month follow-up. Data will be released after the completion of the study. Adverse events will be reported. ETHICS AND DISSEMINATION The experiment was approved by the Ethical Committee of Shanghai Tong Ren Hospital in October 2021 (approval number: 202105702). The results of this study will be published in peer-reviewed journals. TRIAL REGISTRATION NUMBER ChiCTR2000040754.
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Affiliation(s)
- Li Tang
- Department of Rehabilitation, Tong Ren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shanshan Liu
- Department of Rehabilitation, Tong Ren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lin Gan
- Department of Rehabilitation, Tong Ren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hao Ding
- Department of Rehabilitation, Tong Ren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiang-Min Huang
- Department of Sport Rehabilitation, School of kinesiology, Shanghai University of Sport, Shanghai, China
| | - Fang Gao
- Department of Rehabilitation, Tong Ren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yan Li
- Department of Rehabilitation, Tong Ren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Artificial Intelligence for Physiotherapy and Rehabilitation. Artif Intell Med 2022. [DOI: 10.1007/978-3-030-64573-1_339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Effects of Ai-Chi Practice on Balance and Left Cerebellar Activation during High Working Memory Load Task in Older People: A Controlled Pilot Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312756. [PMID: 34886482 PMCID: PMC8656797 DOI: 10.3390/ijerph182312756] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/25/2021] [Accepted: 11/29/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Normal aging is associated with balance and working memory decline. From a neurobiological standpoint, changes in cerebellar functional plasticity may mediate the decline in balance and working memory for older adults. Mounting evidence suggests that physical activity is beneficial for decreasing aging effects. Previous studies have focused on land-based physical activity and research concerning the aquatic environment is scarce. This study investigated the effectiveness of Ai-Chi on balance abilities and cerebral activation during a high working memory load task among community-dwelling older people. METHODS A total of 19 people aged 65-86 years were allocated to receive Ai-Chi practice (n = 6), structured on-land Ai-Chi practice (n = 7) or guided-imagery of Ai-Chi practice (n = 6) for a bi-weekly, 30-min exercise session for 12 weeks. Balance was measured by the Tinetti balance sub-test and working memory was measured by the N-back test during functional-MRI scan. RESULTS The Ai-Chi practice group presented a significant change in balance between pre and post intervention (balance t = -4.8, p < 0.01). In the whole-brain analysis, during high working memory load task, the Ai-Chi practice group presented a decrease in left cerebellar activation. Region of interest analyses yielded similar results by which pre-cerebellar activation was higher than post-intervention (t = 2.77, p < 0.05). CONCLUSIONS Ai-Chi is an available, non-invasive intervention method that may serve as a tool to improve cerebellar activation that in turn might improve balance. In addition, our findings may provide new insights into the neuronal mechanisms that underlie both motor and cognitive abilities.
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Adigwe G. Quality of life of stroke survivors in Nigeria (Low-income country). Can outcome be predicted? J Clin Hypertens (Greenwich) 2021; 23:1459-1462. [PMID: 34196105 PMCID: PMC8678786 DOI: 10.1111/jch.14258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/31/2021] [Accepted: 04/01/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Gloria Adigwe
- School of Health and Bioscience, University of East London, London, UK
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Veldema J, Jansen P. Aquatic therapy in stroke rehabilitation: systematic review and meta-analysis. Acta Neurol Scand 2021; 143:221-241. [PMID: 33141446 DOI: 10.1111/ane.13371] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 10/26/2020] [Accepted: 10/28/2020] [Indexed: 12/29/2022]
Abstract
The main object of this systematic review and meta-analysis is to collect the available evidence of aquatic therapy in stroke rehabilitation and to investigate the effect of this intervention in supporting stroke recovery. The PubMed, the Cochrane Central Register of Controlled Trials and the PEDro databases were searched from their inception through to 31/05/2020 on randomized controlled trials evaluating the effect of aquatic therapy on stroke recovery. Subjects´ characteristics, methodological aspects, intervention description, and outcomes were extracted. Effect sizes were calculated for each study and outcome. Overall, 28 appropriate studies (N = 961) have been identified. A comparison with no intervention indicates that aquatic therapy is effective in supporting walking, balance, emotional status and health-related quality of life, spasticity, and physiological indicators. In comparison with land-based interventions, aquatic therapy shows superior effectiveness on balance, walking, muscular strength, proprioception, health-related quality of life, physiological indicators, and cardiorespiratory fitness. Only on independence in activities of daily living the land- and water-based exercise induce similar effects. Established concepts of water-based therapy (such as the Halliwick, Ai Chi, Watsu, or Bad Ragaz Ring methods) are the most effective, aquatic treadmill walking is the least effective. The current evidence is insufficient to support this therapy form within evidence-based rehabilitation. However, the available data indicate that this therapy can significantly improve a wide range of stroke-induced disabilities. Future research should devote more attention to this highly potent intervention.
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Affiliation(s)
- Jitka Veldema
- Faculty of Human Sciences University of Regensburg Regensburg Germany
| | - Petra Jansen
- Faculty of Human Sciences University of Regensburg Regensburg Germany
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Artificial Intelligence for Physiotherapy and Rehabilitation. Artif Intell Med 2021. [DOI: 10.1007/978-3-030-58080-3_339-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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