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Muñoz-Gómez E, Aguilar-Rodríguez M, Mollà-Casanova S, Sempere-Rubio N, Inglés M, Serra-Añó P. A randomized controlled trial on the effectiveness of mirror therapy in improving strength, range of movement and muscle activity, in people with carpal tunnel syndrome. J Hand Ther 2024:S0894-1130(24)00008-5. [PMID: 38458950 DOI: 10.1016/j.jht.2024.02.007] [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] [Received: 09/07/2023] [Revised: 01/07/2024] [Accepted: 02/09/2024] [Indexed: 03/10/2024]
Abstract
BACKGROUND There is little information on the potential effects of mirror therapy (MT) on motor recovery in individuals with Carpal Tunnel Syndrome (CTS). PURPOSE To compare the effectiveness of a MT protocol versus a therapeutic exercise (TE) protocol, in improving strength, range of motion (ROM), muscle activity, pain, and functionality in patients with CTS. STUDY DESIGN Randomized clinical trial. METHODS Thirty-nine participants with unilateral CTS were divided into two groups: (i) MT group (n = 20) that followed an exercise protocol applied to the unaffected hand reflected in a mirror, and (ii) TE group (n = 19) that followed the same exercise protocol using the unaffected hand but without a mirror. Strength, wrist ROM, muscle activity, pain and functionality, were assessed at baseline (T0), after treatment (T1) and one month after treatment (T2). RESULTS At T1, the MT group showed significantly higher wrist flexion-extension ROM compared to TE (p = 0.04, d = 0.8), maintained at T2 (p = 0.02, d = 0.8). No significant changes were observed in ulnar-radius deviation, pronosupination, or fatigue following either MT or TE (p > 0.05). MT exhibited enhanced handgrip strength at T1 (p = 0.001, d = 0.7), as well as an increase in the extensor carpi radialis (ECR) and flexor carpi radialis (FCR) maximum muscle activity (p = 0.04, d = 1.0; p = 0.03, d = 0.4). At T1, both groups decreased pain (p = 0.002, d = 1.1; p = 0.02, d = 0.7), and improved functionality (p < 0.001, d = 0.8; p = 0.01, d = 0.5) (MT and TE respectively). DISCUSSION MT led to enhancements in wrist flexion-extension movement, handgrip strength and functionality unlike TE. MT notably increased muscle activity, particularly in the ECR and FCR muscles. CONCLUSIONS MT is a favorable strategy to improve wrist flexion-extension ROM, handgrip strength, ECR and FCR muscle activity, and functionality in people with unilateral CTS.
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Affiliation(s)
- Elena Muñoz-Gómez
- Research Unit in Clinical Biomechanics (UBIC), Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
| | - Marta Aguilar-Rodríguez
- Research Unit in Clinical Biomechanics (UBIC), Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain.
| | - Sara Mollà-Casanova
- Research Unit in Clinical Biomechanics (UBIC), Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
| | - Nuria Sempere-Rubio
- Research Unit in Clinical Biomechanics (UBIC), Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
| | - Marta Inglés
- Research Unit in Clinical Biomechanics (UBIC), Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
| | - Pilar Serra-Añó
- Research Unit in Clinical Biomechanics (UBIC), Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
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Carson RG, Morley A. Is a mirror necessary for mirror therapy? Neural Regen Res 2023; 18:2703-2704. [PMID: 37449631 DOI: 10.4103/1673-5374.373701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023] Open
Affiliation(s)
- Richard G Carson
- Trinity College Institute of Neuroscience and School of Psychology, Trinity College Dublin, Dublin, Ireland; School of Psychology, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Alannah Morley
- School of Medicine, Trinity College Dublin, Dublin, Ireland
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Muñoz-Gómez E, Inglés M, Aguilar-Rodríguez M, Sempere-Rubio N, Mollà-Casanova S, Serra-Añó P. Effects of mirror therapy on spasticity and sensory impairment after stroke: Systematic review and meta-analysis. PM R 2023; 15:1478-1492. [PMID: 36787183 DOI: 10.1002/pmrj.12964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 01/09/2023] [Accepted: 01/25/2023] [Indexed: 02/15/2023]
Abstract
OBJECTIVE To review and synthesize existing evidence on the effectiveness of mirror therapy (MT) compared to active exercise-based interventions (ie, cross-training and conventional exercise) for reducing spasticity and sensory impairment in stroke survivors. TYPE: Systematic Review and Metanalysis. LITERATURE SURVEY Pubmed/MEDLINE, Cochrane, Embase, CINAHL, and Physiotherapy Evidence Database (PEDro), were searched. METHODOLOGY Randomized controlled trials (RCTs) that investigated MT effectiveness in improving spasticity and sensory impairment in stroke survivors compared to a control group. SYNTHESIS Fifteen RCTs (653 volunteers) were included. Spasticity improvements achieved with MT were similar to those obtained with cross-training (standard mean difference [SMD]: 0.12, 95% confidence interval [CI]: -0.43 to 0.68). In addition, when further combined with conventional exercise, spasticity improved similarly in both groups (SMD: 0.10, 95% CI: -0.16, 0.36). Lastly, when MT plus exercise was compared to exercise alone, spasticity decreased in both groups (SMD: 0.16, 95% CI: -0.16 to 0.48). Nevertheless, none of the Interventions seem effective on sensory impairment (SMD: 0.27, 95% CI: -0.28 to 0.81). CONCLUSIONS MT is equally effective as other exercise therapies, such as cross-training and conventional exercise, for improving spasticity in stroke survivors, whereas none of the explored interventions yielded beneficial effects on sensory impairment. Further well-designed RCTs are needed to confirm the results.
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Affiliation(s)
- Elena Muñoz-Gómez
- UBIC Research Group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
| | - Marta Inglés
- UBIC Research Group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
| | - Marta Aguilar-Rodríguez
- UBIC Research Group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
| | - Núria Sempere-Rubio
- UBIC Research Group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
| | - Sara Mollà-Casanova
- UBIC Research Group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain
| | - Pilar Serra-Añó
- UBIC Research Group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, 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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Voskuil CC, Andrushko JW, Huddleston BS, Farthing JP, Carr JC. Exercise prescription and strategies to promote the cross-education of strength: a scoping review. Appl Physiol Nutr Metab 2023; 48:569-582. [PMID: 37156010 DOI: 10.1139/apnm-2023-0041] [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: 05/10/2023]
Abstract
The cross-education of strength is moderated by exercise design and prescription in clinical and non-clinical populations. This review synthesizes the available evidence regarding exercise design strategies for unilateral resistance training and provides evidence-based recommendations for the prescription of unilateral training to maximize the cross-education of strength. Greater insights regarding the timing and effectiveness of cross-education interventions in clinical scenarios will strengthen the use of unilateral resistance training for individuals who may benefit from its use.
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Affiliation(s)
- Caleb C Voskuil
- Department of Kinesiology, Texas Christian University, Fort Worth TX, USA
| | - Justin W Andrushko
- Faculty of Medicine, Department of Physical Therapy, The University of British Columbia, Vancouver BC, Canada
| | - Boglarka S Huddleston
- Health Sciences Librarian, Mary C. Burnett Library, Texas Christian University, Fort Worth TX, USA
| | | | - Joshua C Carr
- Department of Kinesiology, Texas Christian University, Fort Worth TX, USA
- Department of Medical Education, Texas Christian University School of Medicine, Fort Worth TX, USA
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Lim H, Madhavan S. Non-paretic leg movements can facilitate cortical drive to the paretic leg in individuals post stroke with severe motor impairment: Implications for motor priming. Eur J Neurosci 2023; 58:2853-2867. [PMID: 37354080 PMCID: PMC10530620 DOI: 10.1111/ejn.16069] [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: 03/02/2023] [Revised: 06/07/2023] [Accepted: 06/10/2023] [Indexed: 06/26/2023]
Abstract
Cross-education, a phenomenon where unilateral strength (or skill) training enhances strength (or skill) in the contralateral untrained limb, has been well studied in able-bodied individuals. Cross-education effect accompanies bilateral changes of corticomotor activity in the motor cortex (M1). Recent reports demonstrated greater cross-education effect in stroke survivors compared to healthy individuals, however, corticomotor responses to cross-education in stroke remains unclear. This study aimed to determine the effects of non-paretic leg movements on corticomotor excitability (CME) and reaction time of the paretic leg in severely impaired stroke survivors. Seventeen post stroke individuals with severe leg motor impairment (Fugl-Meyer lower extremity score less than 21 and absence of motor evoked potential in the paretic leg) performed three 20-min motor trainings using their non-paretic ankle: skill (targeted dynamic movements), strength (isometric resistance) and sham (sub-threshold electrical nerve stimulation). During training, verbal instructions were given to the participants to limit their movement to the non-paretic leg and this was confirmed with visual observation of the paretic leg. Transcranial magnetic stimulation measured CME of the contralateral pathways from the non-lesioned M1 to the non-paretic tibialis anterior (TA) muscle, ipsilateral pathways to the paretic TA and transcallosal inhibition (TCI) from the non-lesioned to lesioned M1. Paretic ankle reaction time was measured using a reaction time paradigm. All outcomes were measured before, immediately post, 30-min post and 60-min post priming. CME of the non-paretic TA increased after skill (.08 ± .10 mV) and strength (.06 ± .05 mV) training (p < .01). Ipsilateral CME of the paretic TA (.02 ± .01 mV) and TCI (.01 ± .01 s, ipsilateral silent period; more inhibition to the lesioned M1) increased after skill (p < .05) but not strength training. Reaction time of the paretic ankle improved after skill and strength training (-.11 ± .2 and -.13 ± .20 s, respectively; p < .05) and was sustained at 60 min. No changes were observed during the sham condition. Our findings may inform future studies for using non-paretic leg movements as a priming modality, especially for those who are contraindicated to other priming paradigms (e.g., brain stimulation) or unable to perform paretic leg movements. Conclusion: Non-paretic leg movements can be used as a priming modality, especially for those who are contraindicated to other priming paradigms (e.g., brain stimulation) or unable to perform paretic leg movements.
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Affiliation(s)
- Hyosok Lim
- Brain Plasticity Laboratory, Department of Physical Therapy, University of Illinois at Chicago, Chicago, IL, USA
- Graduate Program in Rehabilitation Sciences, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Sangeetha Madhavan
- Brain Plasticity Laboratory, Department of Physical Therapy, University of Illinois at Chicago, Chicago, IL, USA
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Lim H, Madhavan S. Effects of Cross-Education on Neural Adaptations Following Non-Paretic Limb Training in Stroke: A Scoping Review with Implications for Neurorehabilitation. J Mot Behav 2022; 55:111-124. [PMID: 35940590 DOI: 10.1080/00222895.2022.2106935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Current stroke rehabilitation interventions focus on intensive task specific training of the paretic limb, which may not be feasible for individuals with higher levels of impairment or in the early phase of stroke. Cross-education, a mechanism that improves strength or skill of the untrained limb following unilateral motor training, has high clinical relevance for stroke rehabilitation. Despite its potential benefits, our knowledge on the application and efficacy of cross-education in stroke is limited. We performed a scoping review to synthesize the current evidence regarding neurophysiological and motor effects of cross-education training in stroke. Low to strong evidence from five studies demonstrated strength gains ranging from 31-200% in the untrained paretic limb following non-paretic muscle training. Neurophysiological mechanisms underlying cross-education were unclear as the three studies that used transcranial magnetic stimulation to probe functional connectivity demonstrated mixed results in low sample size. Our review suggests that cross-education is a promising clinical approach in stroke, however high quality studies focusing on neurophysiological mechanisms are required to establish the efficacy and underlying mechanisms of cross-education in stroke. Recommendations regarding future directions and clinical utility are provided.
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Affiliation(s)
- Hyosok Lim
- Brain Plasticity Laboratory, Department of Physical Therapy, University of Illinois at Chicago, Chicago, IL, USA.,Graduate Program in Rehabilitation Sciences, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Sangeetha Madhavan
- Brain Plasticity Laboratory, Department of Physical Therapy, University of Illinois at Chicago, Chicago, IL, USA
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Calvert GHM, Carson RG. Neural mechanisms mediating cross education: With additional considerations for the ageing brain. Neurosci Biobehav Rev 2021; 132:260-288. [PMID: 34801578 DOI: 10.1016/j.neubiorev.2021.11.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 11/03/2021] [Accepted: 11/16/2021] [Indexed: 12/14/2022]
Abstract
CALVERT, G.H.M., and CARSON, R.G. Neural mechanisms mediating cross education: With additional considerations for the ageing brain. NEUROSCI BIOBEHAV REV 21(1) XXX-XXX, 2021. - Cross education (CE) is the process whereby a regimen of unilateral limb training engenders bilateral improvements in motor function. The contralateral gains thus derived may impart therapeutic benefits for patients with unilateral deficits arising from orthopaedic injury or stroke. Despite this prospective therapeutic utility, there is little consensus concerning its mechanistic basis. The precise means through which the neuroanatomical structures and cellular processes that mediate CE may be influenced by age-related neurodegeneration are also almost entirely unknown. Notwithstanding the increased incidence of unilateral impairment in later life, age-related variations in the expression of CE have been examined only infrequently. In this narrative review, we consider several mechanisms which may mediate the expression of CE with specific reference to the ageing CNS. We focus on the adaptive potential of cellular processes that are subserved by a specific set of neuroanatomical pathways including: the corticospinal tract, corticoreticulospinal projections, transcallosal fibres, and thalamocortical radiations. This analysis may inform the development of interventions that exploit the therapeutic utility of CE training in older persons.
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Affiliation(s)
- Glenn H M Calvert
- Trinity College Institute of Neuroscience and School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - Richard G Carson
- Trinity College Institute of Neuroscience and School of Psychology, Trinity College Dublin, Dublin, Ireland; School of Psychology, Queen's University Belfast, Belfast, Northern Ireland, UK; School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia.
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Nogueira NGDHM, Parma JO, Leão SESDA, Sales IDS, Macedo LC, Galvão ACDR, de Oliveira DC, Murça TM, Fernandes LA, Junqueira C, Lage GM, Ferreira BDP. Mirror therapy in upper limb motor recovery and activities of daily living, and its neural correlates in stroke individuals: A systematic review and meta-analysis. Brain Res Bull 2021; 177:217-238. [PMID: 34626693 DOI: 10.1016/j.brainresbull.2021.10.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 10/01/2021] [Accepted: 10/04/2021] [Indexed: 11/26/2022]
Abstract
Available literature indicates that 30-66% of stroke survivors present persistent upper limb impairment. Considering the importance of upper limb function for activities of daily living, it is necessary to investigate neurorehabilitation therapies that could improve the upper limb function. Among stroke complementary therapies, mirror therapy has shown promising results. Thus, the aim of this systematic review and meta-analyses was to review and synthesize clinical evidence on the use of mirror therapy on motor recovery of the upper limb and activities of daily living, and its neural correlates in stroke patients. The literature search was carried out in PubMed, ISI Web of Science, and Scopus databases. Twenty-nine studies met all the inclusion criteria. Two meta-analyses were conducted to compare mirror therapy with sham therapy on two general measures, upper limb assessment and activities of daily living. Results suggest that mirror therapy was better than sham therapy, mainly in the subacute phase, but the meta-analyses were nonsignificant. In addition, mirror therapy and cortical reorganization showed potential neural correlates, such as the primary motor cortex, precuneus, and posterior cingulate cortex.
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Affiliation(s)
| | | | | | - Izabella de Souza Sales
- School of Physical Education, Physiotherapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Lilian Carla Macedo
- School of Physical Education, Physiotherapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Dalva Cadeu de Oliveira
- School of Physical Education, Physiotherapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil; School of Kinesiology, Auburn University, Auburn, USA; Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil; Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil; Department of Physical Education, Universidade Federal de Juiz de Fora, Governador Valadares, MG, Brazil
| | - Tatiane Moisés Murça
- Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Cristiani Junqueira
- School of Physical Education, Physiotherapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Guilherme Menezes Lage
- School of Physical Education, Physiotherapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Bárbara de Paula Ferreira
- School of Physical Education, Physiotherapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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Identification of Good Practices in Long-Term Exercise-Based Rehabilitation Programs in Stroke Patients. BIOMED RESEARCH INTERNATIONAL 2021; 2021:9202716. [PMID: 34616849 PMCID: PMC8490068 DOI: 10.1155/2021/9202716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 09/15/2021] [Indexed: 11/30/2022]
Abstract
Physical activity is an important factor for primary and secondary stroke prevention. The process of stroke rehabilitation includes early and late physical activity and exercise, which prevents further stoke and improve patients' quality of life. MY WAY project, an ERASMUS+ SPORT program, is aimed at analyzing and developing or transferring best innovative practices related to physical activity and exercise enhancing health in poststroke patients. The aim of the study was to identify, analyze, and present the good practices and strategies to encourage participation in sport and physical activity and engage and motivate chronic stroke patients to perform physical activity changing their lifestyle and to maintain a high adherence to long-term exercise-based rehabilitation programs. Our results demonstrated that unified European stroke long-term exercise-based rehabilitation guidelines do not exist. It seems that low training frequency with high aerobic exercise intensity may be optimal for improved physical performance and quality of life in combination with a high adherence. It is important to optimize the training protocols suitable for each patient. The continuous education and training of the specialized professionals in this field and the presence of adequate structures and cooperation between different healthcare centers are important contributors. The clear objective for each country should be to systematically make the necessary steps to enhance overall exercise-based stroke rehabilitation attendance in the long term. Long-term interventions to support the importance of physical exercise and lifelong exercise-based rehabilitation in chronic stroke patients should be created, what coincides with the goal of the MY WAY project.
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Sato S, Yoshida R, Kiyono R, Yahata K, Yasaka K, Nosaka K, Nakamura M. Cross-education and detraining effects of eccentric vs. concentric resistance training of the elbow flexors. BMC Sports Sci Med Rehabil 2021; 13:105. [PMID: 34488881 PMCID: PMC8419922 DOI: 10.1186/s13102-021-00298-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 06/10/2021] [Indexed: 12/14/2022]
Abstract
Background Unilateral resistance training increases the strength of the contralateral non-trained homologous muscles known as the cross-education effect. We tested the hypothesis that unilateral eccentric resistance training (ET) would induce greater and longer-lasting cross-education effect when compared with concentric resistance training (CT). Methods Young (20–23 y) participants were allocated to ET (5 males, 4 females) or CT (5 males, 4 females) group that performed unilateral progressive ET or CT of the elbow flexors, twice a week for 5 weeks (10 sessions) followed by a 5-week detraining, and control group (7 males, 6 females) that did not perform any training. Maximum voluntary isometric contraction torque of the elbow flexors (MVIC), one-repetition maximum of concentric dumbbell curl (1-RM), and biceps brachii and brachialis muscle thickness (MT) were measured from the trained and non-trained arms before, several days after the last training session, and 5 weeks later. A ratio between the trained and non-trained arms for the change in MVIC or 1-RM from pre- to post-training (cross-body transfer ratio) was compared between ET and CT groups. Results The control group did not show significant changes in any variables. Both ET and CT increased (P < 0.05) MVIC (22.5 ± 12.3 % vs. 26.0 ± 11.9 %) and 1-RM (28.8 ± 6.6 % vs. 35.4 ± 12.9 %) of the trained arm without a significant difference between groups. MVIC was maintained after detraining for ET but returned to the baseline for CT, and 1-RM was maintained after detraining for both ET and CT. For the non-trained arm, MVIC (22.7 ± 17.9 % vs. 12.2 ± 10.2 %) and 1-RM (19.9 ± 14.6 % vs. 24.0 ± 10.6 %) increased similarly (P > 0.05) after ET and CT, and MVIC returned to the baseline after detraining, but 1-RM was maintained for both groups. An increase (P < 0.05) in MT was found only after ET for the trained arm (7.1 ± 6.1 %). The cross-body transfer ratio for MVIC was greater (P < 0.05) for ET (90.9 ± 46.7 %) than CT (49.0 ± 30.0 %). Conclusions These results did not support the hypothesis and showed similar changes in the most of the variables between ET and CT for the trained and non-trained arms, and strong cross-education effects on MVIC and 1-RM, but less detraining effect after ET than CT on MVIC of the trained arm. Trial registration University Hospital Medical Information Network Clinical Trials Registry (UMIN000044477; Jun 09, 2021).
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Affiliation(s)
- Shigeru Sato
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata, 950-3198, Niigata, Japan
| | - Riku Yoshida
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Ryosuke Kiyono
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata, 950-3198, Niigata, Japan
| | - Kaoru Yahata
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata, 950-3198, Niigata, Japan
| | - Koki Yasaka
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Kazunori Nosaka
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Masatoshi Nakamura
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata, 950-3198, Niigata, Japan. .,Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan.
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