Reliability and validity of the trunk position sense and modified functional reach tests in individuals after stroke

The effects of trunk repositioning errors on trunk and extremity functions in stroke

AIM

The aim of this study was to analyze the TRE in three directions including forward flexion, lateral flexion to the hemiparetic side, and rotation to the hemiparetic side in patients with stroke and to compare the errors with age- and sex-matched healthy subjects. In addition, it was investigated which functional outcomes were explanatory for TRE in patients with stroke.

METHODS

Forty-one patients with subacute/chronic stroke (age 59 ± 14.5 years) and 41 healthy subjects (age 57 ± 12.8 years) were included in the study. Demographic and clinical data were collected. TREs were measured using an inclinometer. The Trunk Impairment Scale (TIS), Fugl-Meyer Assessment (FMA), Wolf Motor Function Test (WMFT), Timed Up and Go Test, and 10-m walk test (10MWT) were also used to assess trunk control, motor impairment, upper extremity function, and lower extremity function, respectively, in patients with stroke.

RESULTS

TRE scores in three directions were higher in patients with stroke than in healthy subjects (p < 0.001). TREs in three directions were significantly strongly correlated with all functional outcomes (ρ > 0.60, r < 0.001). Multiple regression analysis determined 10MWT, WMFT-Performance, TIS, and FMA-Upper Extremity as explanatory factors for TRE.

CONCLUSION

The model presented in this study could help clinicians and researchers to predict the TRE in patients with stroke. Gait speed, upper extremity motor ability, upper extremity motor impairment, and trunk control should be considered for TRE after a stroke.

The reliability and validity of the balance tests in hearing-impaired athletes

BACKGROUND

It is known that balance is affected in hearing-impaired athletes and its effects on performance. However, studies on the reliability and validity of scales evaluating balance are insufficient.

AIM

To analyze and demonstrate the effectiveness of various clinical tests using assessment balance for hearing-impaired athletes.

METHOD

The study included 60 elite athletes (aged between 18 and 25) with (n = 30) and without (n = 30) hearing impairment. The static balance was evaluated with the Flamingo Test (FT) and the dynamic balance with the Functional Reach Test (FRT), Four-Step Square Test (FSST), Star Excursion Balance Test (SEBT), and Y Balance Test (YBT). All balance tests were repeated at 1-week intervals. Test-retest reliability, known-group validity, and predictive validity of the scales were investigated.

RESULT

All balancing tests demonstrated strong test-retest reliability. FT and FSST had known-group and predictive validity. While FRT and the components of both YBT and SEBT involving anterior reaching were not valid tests for hearing-impaired individuals, YBT and SEBT had validity considering the composite score and other components.

CONCLUSION

It was revealed that the balance of hearing-impaired athletes was comparable to the balance of healthy athletes in test conditions in which visual information could be used effectively. For this reason, it is important to consider the visual information factor when evaluating the balance of hearing-impaired athletes. Additionally, taking into account time and tiredness, FT for static balance and FSST for dynamic balance may be helpful to evaluate hearing-impaired athletes.

Effect of the Dynamic Orthotic Garment on Postural Control, and Endurance in Children with Spastic Diplegic Cerebral Palsy: A Randomized Controlled Trial

Purpose

To investigate the effect of dynamic orthotic garments (Thera togs) on foot pressure distribution, postural control, and endurance in children with spastic diplegic CP.

Patients and Methods

This is a single-blind randomized controlled clinical trial involving 34 (8-10 years) with spastic diplegic CP. The control group received conventional physical therapy (CPT), whereas the study group received CPT in addition to wearing TheraTogs. We recorded foot pressure distribution, trunk control measurement scale, trunk position sense, Pediatric Berg Balance Scale (PBS), and six-minute walking distance (6MWD).

Results

Both groups showed improvement. The study group had significant improvement in foot pressure distribution (p-value 0.003, 0.001, <0.001 for forefoot, midfoot, and rearfoot mean pressures respectively, and 0.005, <0.001, and 0.005 for forefoot, midfoot, and rearfoot peak pressures respectively), Pediatric balance scale, The trunk control measurement scale, and Trunk position sense (p-value < 0.001) and six-minute walking distance (p-value 0.029). Our data suggest that adding TheraTogs to conventional physiotherapy improves foot pressure, postural control, and endurance in children with spastic diplegic cerebral palsy.

Conclusion

Both TheraTogs and conventional physical therapy corrected foot pressure distribution, trunk control, improved balance, and increased 6MWD in children with spastic diplegic CP but the improvement was more significant in TheraTogs group.

Clinical Trial Registration

NCT05271149.

Effects of trunk stabilization exercises using laser pointer visual feedback in patients with chronic stroke: A randomized controlled study

BACKGROUND

Many previous studies have cited the importance of trunk stabilization exercises in patients with stroke. However, the evidence for optimal trunk stabilization exercises for patients with stroke is still lacking.

OBJECTIVE

To investigate the effects of laser pointer visual feedback in trunk stabilization exercises that are important for improving trunk dysfunction in patients with stroke.

METHODS

In total, 30 patients with chronic stroke were randomly assigned to experimental and control groups. The experimental group underwent a traditional stroke rehabilitation program and trunk stabilization exercises using laser pointer visual feedback. The control group underwent a traditional stroke rehabilitation program and trunk stabilization exercises without visual feedback. Pre- and postintervention results after 6 weeks were evaluated using the Berg Balance Scale, static and dynamic plantar pressure, 10-m walk test, and the Korean version of the Fall Efficacy Scale. The results were analyzed using a general linear repeated measurement model.

RESULTS

Both groups showed significant improvements in BBS scores, static plantar pressure, dynamic plantar pressure, 10 MWT, and K-FES scores after 6 weeks of intervention (P< 0.05). Compared to the control group, significant improvements were observed in the experimental group in the Berg Balance Scale scores, dynamic paretic posterior plantar pressure, 10-m walk test, and Korean version of the Fall Efficacy Scale scores (P< 0.025).

CONCLUSION

Our results demonstrated the effectiveness of visual feedback during trunk stabilization exercises for resolving trunk dysfunction in patients with stroke. Trunk stabilization exercises using laser pointer visual feedback have been found to be more effective in balance, walking, and fall efficacy in patients with stroke.