Importance of core stability for coordinated movement of the human body in stroke rehabilitation

Effect of Core Exercises on Motor Function Recovery in Stroke Survivors with Very Severe Motor Impairment

Paresis of the upper and lower limbs is a typical issue in stroke survivors. This study aims to determine whether core exercises help stroke survivors with very severe motor impairment recover their motor function. This study employed a within-subjects design. Eleven hemiparetic stroke patients with very severe motor impairment (FMA score < 35) and ages ranging from 24 to 52 years old were enrolled in this study. All participants engaged in supervised core exercise training twice a week for 12 weeks. The main outcome measures were Fugl-Meyer Assessment Lower Extremity (FMA-LE) and Fugl-Meyer Assessment Upper Extremity (FMA-UE), which were measured before training and at intervals of four weeks during training. Repeated measures ANOVA was used to analyze the effect of core exercises on motor function performance and lower extremity motor function and upper extremity motor function recovery. There were significant differences in the mean scores for motor function performance, lower extremity motor function, and upper extremity motor function throughout the four time points. A post-hoc pairwise comparison using the Bonferroni correction revealed that mean scores significantly increased and were statistically different between the initial assessment and follow-up assessments four, eight, and twelve weeks later. This study suggests that 12 weeks of core exercise training is effective for improving motor function recovery in patients with very severe motor impairment.

Effect of the Trunk and Upper Limb Passive Stabilization on Hand Movements and Grip Strength Following Various Types of Strokes—An Observational Cohort Study

Almost half of the patients surveyed report impaired function of the upper limbx and handx after stroke. The effect of the passive trunk and shoulder stabilization on the recovery of coordinated hand movement is unclear. This study examined whether passive stabilization of the trunk and shoulder could improve the functional state of the hands after various types of strokes. It is an observational prospective cohort study conducted at the Rehabilitation Clinic in two parallel groups of patients with four different types of strokes (hemorrhagic and ischemic of the brain, similar to the cerebellum). A total of 120 patients were analyzed. Patients were examined in various positions: sitting without a backrest with the upper limb adjacent to the body, supine with the upper limb perpendicular to the body, and supine with the arm stabilized in relation to the patient’s body. Hand Tutor devices and a hand dynamometer were used for the measurements. The frequency and maximum range of motion as well as the grip strength were measured in three different positions of the trunk and upper limb. Passive stabilization of the trunk and shoulder showed more statistically significant differences in Group II. In group II, both in patients after hemorrhagic stroke (wrist Hz p = 0.019; wrist ROM p = 0.005; Hz F5 p = 0.021; Hz F4 p = 0.016; Hz F3 p = 0.019; Hz F2 p = 0.021) and ischemic stroke (p = 0.001 for wrist Hz, wrist ROM, Hz F from 5 to F2; and ROM F1; ROM F3 p = 0.009; ROM F2 p = 0.010), and hemorrhagic cerebellum, improvement of parameters was observed. Stabilization of the upper limb and passive stabilization of the trunk improved the frequency and range of movements in the radiocarpal joint and in the fingers of patients after stroke, regardless of the type of stroke.

The Use of Armeo®Spring Device to Assess the Effect of Trunk Stabilization Exercises on the Functional Capabilities of the Upper Limb-An Observational Study of Patients after Stroke

Almost half of stroke patients report impaired function of the upper limb and hand. Stability of the trunk is required for the proper movement of the body, including the legs and arms. The aim of the study was to analyze the effect of trunk stabilization exercises on coordinated movement of the affected upper limb in patients after stroke, using an Armoe®Spring device and the “wall” and “abacus” functional tests. Materials and methods: This is a randomized, double-blinded study. The research was carried out in the Rehabilitation Clinic on a group of 60 stroke patients who were randomly assigned to groups differing in the rehabilitation program. The study group had physiotherapy based on the NDT Bobath concept and the control group used classic exercises. The importance of the trunk for upper limb coordination was assessed on the Armeo®Spring device using three evaluation programs, “perpendicular fishing”; “horizontal fishing”; “reaction time”, and two proprietary tests, “wall” and “abacus”. Results: The post-treatment analysis showed significantly better results in the study group for the abacus (p < 0.001), wall (p = 0.003) tests, and a significantly higher percentage of task completion in the vertical fishing (p = 0.036) and reaction time (p = 0.009) tests. Conclusions: Physiotherapy including exercises to stabilize the trunk had a significant effect on increasing the functional efficiency of the affected upper limb and on improving the handgrip strength. The Armeo®Spring device is a good device for the functional assessment of the upper limb before and after therapy.