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Yaşa ME, Aydoğan Arslan S, Yıldırım Şahan T, Çağlar D, Savcun Demirci C, Demir P. Validity and reliability of the Turkish version of the Ottawa Sitting Scale in patients with acute stroke. Disabil Rehabil 2024; 46:3992-3997. [PMID: 37665576 DOI: 10.1080/09638288.2023.2254233] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 07/22/2023] [Accepted: 08/26/2023] [Indexed: 09/05/2023]
Abstract
PURPOSE To investigate the validity and reliability of the Turkish version of the Ottawa Sitting Scale (OSS-T) in patients with acute stroke. MATERIALS AND METHODS The Berg Balance Scale (BBS) and Trunk Impairment Scale (TIS) were used to determine the validity of the OSS-T. The OSS-T was re-applied by the same rater after an interval of 7 days to determine the reliability. To test inter-rater reliability, the evaluation was repeated by a second rater 1 day after the first evaluation. Reliability was quantified using intraclass correlation coefficients (ICC), and validity was assessed by correlating the OSS-T scores with the results of the other measures. RESULTS The ICC of the total OSS-T score for inter-rater reliability was 0.996 and for intra-rater reliability, it was 0.951. The Cronbach's α coefficient used to determine internal consistency was 0.980, which indicates excellent reliability. A strong positive correlation was found between OSS-T and TIS (rho = 0.861, p < 0.001), and between OSS-T and BBS (rho = 0.875, p < 0.001). An evident 2-factor structure was shown by the results of the factor analysis. CONCLUSIONS The results of this study indicated that the OSS-T has strong measurement properties, making it a valid and reliable tool for research and clinical practice in patients with acute stroke.IMPLICATIONS FOR REHABILITATIONIndependent sitting function is an important indicator of functional recovery and discharge from hospital.Unlike other sitting balance tools, the Ottawa Sitting Scale can even categorize patients with low balance reserve by applying all the items with and without foot support.The Turkish version of the Ottawa Sitting Scale is a valid and reliable tool to evaluate sitting balance in patients with acute stroke.
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Affiliation(s)
- Mustafa Ertuğrul Yaşa
- Gulhane Faculty of Physiotherapy and Rehabilitation, University of Health Sciences Turkey, Ankara, Turkey
| | - Saniye Aydoğan Arslan
- Department of Physiotherapy and Rehabilitation, Faculty of Health Science, Kırıkkale University, Kırıkkale, Turkey
| | - Tezel Yıldırım Şahan
- Gulhane Faculty of Physiotherapy and Rehabilitation, University of Health Sciences Turkey, Ankara, Turkey
| | - Derya Çağlar
- Güneysu Vocational School of Physical Therapy and Rehabilitation, Recep Tayyip Erdoğan University, Rize, Turkey
| | - Cevher Savcun Demirci
- Department of Physiotherapy and Rehabilitation, Faculty of Health Science, Balıkesir University, Balıkesir, Turkey
| | - Pervin Demir
- Faculty of Medicine, Ankara Yıldırım Beyazıt University, Ankara, Turkey
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Güp AA, Ipek Dongaz Ö, Özen Oruk D, Deveci EE, Bayar B, Bayar K. Prediction of hospitalization time and independence level with functional outcomes for patients with acute stroke: a retrospective study. Neurol Res 2023; 45:947-956. [PMID: 37641526 DOI: 10.1080/01616412.2023.2252275] [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: 01/05/2023] [Accepted: 08/20/2023] [Indexed: 08/31/2023]
Abstract
OBJECTIVES The objective of this study was to develop predictive models for estimating the length of stay (LOS) with standardized clinical outcome measures (Functional Independence Measure, Trunk Impairment Scale, Postural Assessment Scale for Stroke Patients, Fugl Meyer Assessment Scale, and Functional Ambulation Category) during acute care setting. METHODS One hundred sixty-nine patients were included in the retrospective study. Predictors chosen for the LOS included scores of functional outcome measures at admission. We used Spearman's rank correlation coefficients to calculate correlations among clinical outcome measures and LOS, stepwise multiple regression analysis to develop a predictive model, and receiver operating characteristics curve to analyze the predictive value of explanatory factors obtained from the previous model for discharge Functional Independence Measure score. RESULTS The predictive equation explained 81% of the variance in LOS. The most important predictors were trunk impairment, motor function of the upper extremity, walking ability, and independence level at admission. The receiver operating characteristic curve was obtained with a cut-off score of 13 points for the Trunk Impairment Scale, 47 points for Fugl Meyer Assessment-Upper Extremity, and 2 points for Functional Ambulation Category, demonstrating the highest percentage of the accurately predicted ability of independence level at discharge. DISCUSSION The models presented in this study could help clinicians and researchers to predict the LOS and discharge independence level of clinical outcomes for patients with acute stroke enrolled in an acute care setting.
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Affiliation(s)
- Asalet Aybüke Güp
- Institute of Health Sciences, Department of Physiotherapy and Rehabilitation, Muğla Sıtkı Koçman University, Muğla, Türkiye
| | - Özge Ipek Dongaz
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Muğla Sıtkı Koçman University, Muğla, Türkiye
| | - Dilara Özen Oruk
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Muğla Sıtkı Koçman University, Muğla, Türkiye
| | - Emrah Emre Deveci
- Faculty of Medicine, Department of Neurology Diseases, Muğla Sıtkı Koçman University, Muğla, Türkiye
| | - Banu Bayar
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Muğla Sıtkı Koçman University, Muğla, Türkiye
| | - Kılıçhan Bayar
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Muğla Sıtkı Koçman University, Muğla, Türkiye
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Abstract
BACKGROUND Previous systematic reviews and randomised controlled trials have investigated the effect of post-stroke trunk training. Findings suggest that trunk training improves trunk function and activity or the execution of a task or action by an individual. But it is unclear what effect trunk training has on daily life activities, quality of life, and other outcomes. OBJECTIVES To assess the effectiveness of trunk training after stroke on activities of daily living (ADL), trunk function, arm-hand function or activity, standing balance, leg function, walking ability, and quality of life when comparing with both dose-matched as non-dose-matched control groups. SEARCH METHODS We searched the Cochrane Stroke Group Trials Register, CENTRAL, MEDLINE, Embase, and five other databases to 25 October 2021. We searched trial registries to identify additional relevant published, unpublished, and ongoing trials. We hand searched the bibliographies of included studies. SELECTION CRITERIA We selected randomised controlled trials comparing trunk training versus non-dose-matched or dose-matched control therapy including adults (18 years or older) with either ischaemic or haemorrhagic stroke. Outcome measures of trials included ADL, trunk function, arm-hand function or activity, standing balance, leg function, walking ability, and quality of life. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. Two main analyses were carried out. The first analysis included trials where the therapy duration of control intervention was non-dose-matched with the therapy duration of the experimental group and the second analysis where there was comparison with a dose-matched control intervention (equal therapy duration in both the control as in the experimental group). MAIN RESULTS: We included 68 trials with a total of 2585 participants. In the analysis of the non-dose-matched groups (pooling of all trials with different training duration in the experimental as in the control intervention), we could see that trunk training had a positive effect on ADL (standardised mean difference (SMD) 0.96; 95% confidence interval (CI) 0.69 to 1.24; P < 0.001; 5 trials; 283 participants; very low-certainty evidence), trunk function (SMD 1.49, 95% CI 1.26 to 1.71; P < 0.001; 14 trials, 466 participants; very low-certainty evidence), arm-hand function (SMD 0.67, 95% CI 0.19 to 1.15; P = 0.006; 2 trials, 74 participants; low-certainty evidence), arm-hand activity (SMD 0.84, 95% CI 0.009 to 1.59; P = 0.03; 1 trial, 30 participants; very low-certainty evidence), standing balance (SMD 0.57, 95% CI 0.35 to 0.79; P < 0.001; 11 trials, 410 participants; very low-certainty evidence), leg function (SMD 1.10, 95% CI 0.57 to 1.63; P < 0.001; 1 trial, 64 participants; very low-certainty evidence), walking ability (SMD 0.73, 95% CI 0.52 to 0.94; P < 0.001; 11 trials, 383 participants; low-certainty evidence) and quality of life (SMD 0.50, 95% CI 0.11 to 0.89; P = 0.01; 2 trials, 108 participants; low-certainty evidence). Non-dose-matched trunk training led to no difference for the outcome serious adverse events (odds ratio: 7.94, 95% CI 0.16 to 400.89; 6 trials, 201 participants; very low-certainty evidence). In the analysis of the dose-matched groups (pooling of all trials with equal training duration in the experimental as in the control intervention), we saw that trunk training had a positive effect on trunk function (SMD 1.03, 95% CI 0.91 to 1.16; P < 0.001; 36 trials, 1217 participants; very low-certainty evidence), standing balance (SMD 1.00, 95% CI 0.86 to 1.15; P < 0.001; 22 trials, 917 participants; very low-certainty evidence), leg function (SMD 1.57, 95% CI 1.28 to 1.87; P < 0.001; 4 trials, 254 participants; very low-certainty evidence), walking ability (SMD 0.69, 95% CI 0.51 to 0.87; P < 0.001; 19 trials, 535 participants; low-certainty evidence) and quality of life (SMD 0.70, 95% CI 0.29 to 1.11; P < 0.001; 2 trials, 111 participants; low-certainty evidence), but not for ADL (SMD 0.10; 95% confidence interval (CI) -0.17 to 0.37; P = 0.48; 9 trials; 229 participants; very low-certainty evidence), arm-hand function (SMD 0.76, 95% CI -0.18 to 1.70; P = 0.11; 1 trial, 19 participants; low-certainty evidence), arm-hand activity (SMD 0.17, 95% CI -0.21 to 0.56; P = 0.38; 3 trials, 112 participants; very low-certainty evidence). Trunk training also led to no difference for the outcome serious adverse events (odds ratio (OR): 7.39, 95% CI 0.15 to 372.38; 10 trials, 381 participants; very low-certainty evidence). Time post stroke led to a significant subgroup difference for standing balance (P < 0.001) in non-dose-matched therapy. In non-dose-matched therapy, different trunk therapy approaches had a significant effect on ADL (< 0.001), trunk function (P < 0.001) and standing balance (< 0.001). When participants received dose-matched therapy, analysis of subgroup differences showed that the trunk therapy approach had a significant effect on ADL (P = 0.001), trunk function (P < 0.001), arm-hand activity (P < 0.001), standing balance (P = 0.002), and leg function (P = 0.002). Also for dose-matched therapy, subgroup analysis for time post stroke resulted in a significant difference for the outcomes standing balance (P < 0.001), walking ability (P = 0.003) and leg function (P < 0.001), time post stroke significantly modified the effect of intervention. Core-stability trunk (15 trials), selective-trunk (14 trials) and unstable-trunk (16 trials) training approaches were mostly applied in the included trials. AUTHORS' CONCLUSIONS There is evidence to suggest that trunk training as part of rehabilitation improves ADL, trunk function, standing balance, walking ability, upper and lower limb function, and quality of life in people after stroke. Core-stability, selective-, and unstable-trunk training were the trunk training approaches mostly applied in the included trials. When considering only trials with a low risk of bias, results were mostly confirmed, with very low to moderate certainty, depending on the outcome.
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Affiliation(s)
- Liselot Thijs
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Eline Voets
- Department of Neurorehabilitation, KU Leuven, Leuven, Belgium
| | - Stijn Denissen
- AIMS lab, Center for Neurosciences, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium
- icometrix, Leuven, Belgium
| | - Jan Mehrholz
- Department of Public Health, Dresden Medical School, Technical University Dresden, Dresden, Germany
| | - Bernhard Elsner
- Department of Public Health, Dresden Medical School, Technical University Dresden, Dresden, Germany
| | - Robin Lemmens
- Department of Neurosciences, Experimental Neurology, KU Leuven, Leuven, Belgium
- Center for Brain & Disease Research, Laboratory of Neurobiology, VIB, Leuven, Belgium
- Department of Neurology, University Hospitals Leuven, Leuven, Belgium
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Aloraini SM, Abu Mismar AA, Aloqaily HF, Aldaihan MM. Balance assessment tools and their psychometric properties among individuals post-stroke: a systematic review. PHYSICAL THERAPY REVIEWS 2023. [DOI: 10.1080/10833196.2023.2168850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Saleh M. Aloraini
- Department of Physical Therapy, College of Medical Rehabilitation, Qassim University, Saudi Arabia
| | - Arwa A. Abu Mismar
- Department of Physical Therapy, College of Medical Rehabilitation, Qassim University, Saudi Arabia
| | - Haifa F. Aloqaily
- Department of Physical Therapy, College of Medical Rehabilitation, Qassim University, Saudi Arabia
| | - Mishal M. Aldaihan
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Saudi Arabia
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Kim KI, Im SC, Kim K. Effects of trunk stabilization exercises using laser pointer visual feedback in patients with chronic stroke: A randomized controlled study. Technol Health Care 2023; 31:471-483. [PMID: 36120797 DOI: 10.3233/thc-220100] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
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.
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Relationship Between Trunk Muscle Mass and Activities of Daily Living at Discharge in Acute Stroke Patients. Nutrition 2022; 103-104:111833. [DOI: 10.1016/j.nut.2022.111833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 08/01/2022] [Accepted: 08/12/2022] [Indexed: 11/24/2022]
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Sato Y, Yoshimura Y, Abe T, Nagano F, Matsumoto A. Impact of trunk and appendicular skeletal muscle mass on improving swallowing function in acute stroke patients. J Stroke Cerebrovasc Dis 2022; 31:106636. [PMID: 35914513 DOI: 10.1016/j.jstrokecerebrovasdis.2022.106636] [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: 05/19/2022] [Revised: 06/20/2022] [Accepted: 06/30/2022] [Indexed: 10/16/2022] Open
Abstract
OBJECTIVES To investigate the effect of trunk and appendicular skeletal muscle mass on the swallowing function at discharge in acute stroke patients. MATERIALS AND METHODS This retrospective cohort study included patients hospitalized after acute strokes. Skeletal muscle mass was measured by bioelectrical impedance analysis within 5 days of admission. The primary outcome was swallowing function at acute hospital discharge, assessed using the Functional Oral Intake Scale (FOIS). Secondary outcomes were Functional Independence Measure-eating (FIM-eating) scores and length of hospital stay. RESULTS Data from 231 patients (age 72.2 years; 151 men) were included in the analysis. The median trunk muscle mass index (TMI) was 8.2 and 6.8 kg/m2 in men and women, respectively. The median appendicular skeletal muscle mass index (ASMI) was 7.7 and 5.7 kg/m2 in men and women, respectively. The high TMI group had higher FIM-eating scores at discharge in each sex (p < 0.001). The high ASMI group had higher FOIS (p = 0.039 and 0.048) and FIM-eating scores at discharge (p = 0.046 and 0.047) in men and women, respectively. On multivariate analysis, TMI was independently associated with FIM-eating scores (β = 0.330, p < 0.001); ASMI was independently associated with FOIS (β = 0.229, p = 0.039) and FIM-eating scores (β = 0.111, p = 0.032). CONCLUSIONS Skeletal muscle mass had site-specific impacts on swallowing function and eating activities. This finding may contribute to the design of more individualized rehabilitation programs.
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Affiliation(s)
- Yoichi Sato
- Department of Rehabilitation, Uonuma Kikan Hospital, Minamiuonuma, Japan
| | - Yoshihiro Yoshimura
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, 760 Magate, Kikuyo-machi, Kikuchi-gun, Kumamoto 869-1106, Japan.
| | - Takafumi Abe
- Department of Rehabilitation, Uonuma Kikan Hospital, Minamiuonuma, Japan
| | - Fumihiko Nagano
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, 760 Magate, Kikuyo-machi, Kikuchi-gun, Kumamoto 869-1106, Japan
| | - Ayaka Matsumoto
- Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, 760 Magate, Kikuyo-machi, Kikuchi-gun, Kumamoto 869-1106, Japan
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Moreno-Segura N, Martín-San Agustín R, García-Bafalluy S, Escriche-Escuder A. Effects of core training on trunk function, balance, and gait in stroke patients: A systematic review and meta-analysis of randomised controlled trials. Clin Rehabil 2022; 36:1635-1654. [PMID: 35892183 DOI: 10.1177/02692155221117220] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The aim of this systematic review and meta-analysis of randomised controlled trials (RCTs) includes determining the effects of core training alone or combined with conventional therapy on trunk function, balance, and gait in stroke patients; analysing these effects considering the stroke stage and the core training type; establishing the methodological quality of the studies published to date; and knowing the best dosage and type of exercise these aspects. DATA SOURCE Cochrane Library, Medline, Web of Science, Scopus, and Science Direct were searched from inception to January 2022. REVIEW METHOD A review and meta-analysis of RCTs about core intervention effects on trunk function, balance, and gait in stroke patients was carried out following the Preferred Items for Reporting in Systematic Review and Meta-Analyses guidelines. The Cochrane Collaboration tool was used to assess the risk of bias and internal validity of the included studies. RESULTS Twenty-nine studies were included (1030 stroke patients). The mean age of the participants was 58.46 ± 9.89 years, and the average time since the stroke incident was 308.64 ± 175.52 days. The meta-analysis results showed significant improvements in core interventions for trunk function (P ≤ 0.008) and balance (P < 0.00001) but not for gait performance (P = 0.11 in chronic and P = 0.06 in pooled cases). In relation to the differential meta-analysis between training performed on stable and unstable surfaces, no significant differences were found in trunk function (P = 0.06) or balance measures (P = 0.05). CONCLUSION Core training improves trunk function and balance in acute and chronic patients, but no changes were found in gait performance.
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Affiliation(s)
| | | | | | - Adrián Escriche-Escuder
- Faculty of Health Sciences, Universidad Internacional de Valencia - VIU, Valencia, Spain.,Department of Physiotherapy, University of Malaga, Malaga, Spain
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Yoo YJ, Lim SH. Assessment of Lower Limb Motor Function, Ambulation, and Balance After Stroke. BRAIN & NEUROREHABILITATION 2022; 15:e17. [PMID: 36743203 PMCID: PMC9833471 DOI: 10.12786/bn.2022.15.e17] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/04/2022] [Accepted: 07/06/2022] [Indexed: 11/08/2022] Open
Abstract
Restoration of ambulation is important for stroke patients. Valid and reliable methods are required for the assessment of lower limb functional status. We reviewed the psychometric properties of methods employed to assess lower extremity motor function, ambulation, and balance, with a focus on stroke patients. We define "motor function" as the ability to produce bodily movements when the brain, motor neurons, and muscles interact. "Ambulation" is defined as the ability to walk with or without a personal assistive device, and "balance" as the ability to maintain stability (without falling) during various physical activities. The Motricity Index and Fugl-Meyer Assessment of Lower Extremities assess the motor function of the lower limbs. The Functional Ambulation Category, 10-m Walk Test, and 6-minute Walk Test assess ambulation. The Berg Balance Scale, Timed Up and Go Test, Functional Reach Test, and Trunk Impairment Scale explore balance. All these tests exhibit high-level validity and have good inter-rater and test-retest reliabilities. However, only 3 methods have been formally translated into Korean. The methods discussed here can be used for standardized assessment, personalized goal setting, rehabilitation planning, and estimation of therapeutic efficacy.
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Affiliation(s)
- Yeun Jie Yoo
- Department of Rehabilitation Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seong Hoon Lim
- Department of Rehabilitation Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Agostini LS, Rodrigues PSM, Bazan R, de Oliveira Baggio JA, de Souza LAPS, Luvizutto GJ. Analysis of Verticality Perception in Older Adults With and Without Acute Stroke in Half-Lying Versus Sitting Positions. Percept Mot Skills 2022; 129:591-605. [PMID: 35511924 DOI: 10.1177/00315125221091344] [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: 11/17/2022]
Abstract
Currently, there is no research consensus regarding the influence of body position on verticality perception in acute stroke. In this study, we aimed to compare the influence of half-lying and sitting positions on measurements of the subjective visual vertical (SVV) and the subjective haptic vertical (SHV) of individuals in the acute stroke phase. In this cross-sectional study, we compared these positional experiences in two groups of participants: adults in the acute stroke phase and elderly individuals without stroke. Independent variables were stroke versus no-stroke groups, in half-lying versus sitting positions. Analyzed variables of related interest were cognition (Mini-Mental State Examination or MMSE), stroke severity (National Institutes of Health Stroke Scale or NIHSS), and trunk control (Trunk Impairment Scale or TIS). Dependent variables were visual and haptic verticality, as evaluated by SVV and SHV. There were observed differences in absolute SVV in sitting position between groups (p = 0.021), absolute SVV in half-lying position between groups (p = 0.033), absolute SHV in sitting position between groups (p = 0.003), absolute SHV in half-lying position between groups (p = 0.002), and constant SVV in half-lying position between groups (p = 0.007). In the stroke group there was a higher coefficient of variation of SVV and SHV in the half-lying position compared to sitting position. In the sitting position, we observed a very strong correlation between the TIS and absolute SHV (p = 0.008). We concluded that individuals in the acute phase of stroke had greater misperceptions of visual and haptic verticality than older adults without strokes and that individuals in the acute phase of stroke showed less variability in visual and haptic vertical perception in the sitting position than in the half-lying position. By implication, we should encourage the sitting position in the acute stroke phase and develop early strategies to increase the verticality perception.
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Affiliation(s)
- Lívia S Agostini
- Department of Physical Therapy, 74348Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Priscila S M Rodrigues
- Department of Physical Therapy, 74348Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Rodrigo Bazan
- Department of Neurology Psychology and Psychiatry, Botucatu Medical School (UNESP), Botucatu, São Paulo, Brazil
| | | | - Luciane A P S de Souza
- Department of Physical Therapy, 74348Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Gustavo J Luvizutto
- Department of Physical Therapy, 74348Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
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Tedla JS, Rodrigues E, Ferreira AS, Vicente J, Reddy RS, Gular K, Sangadala DR, Kakaraparthi VN, Asiri F, Midde AK, Dixit S. Transcranial direct current stimulation combined with trunk-targeted, proprioceptive neuromuscular facilitation in subacute stroke: a randomized controlled trial. PeerJ 2022; 10:e13329. [PMID: 35505681 PMCID: PMC9057289 DOI: 10.7717/peerj.13329] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 04/04/2022] [Indexed: 01/13/2023] Open
Abstract
Background Stroke is the foremost cause of death and disability worldwide. Improving upper extremity function and quality of life are two paramount therapeutic targets during rehabilitation. Aim of the study To investigate the effects of transcranial direct current stimulation (tDCS) combined with trunk-targeted proprioceptive neuromuscular facilitation (PNF) on impairments, activity limitations, and participation restrictions of subjects with subacute stroke. Methodology Fifty-four subjects with subacute stroke were divided into three groups using block randomization. All three groups received rehabilitation sessions lasting 90 min in duration, four times per week, for 6 weeks. Group 1 (n = 18) received conventional physical therapy (CPT); group 2 (n = 18) received CPT, trunk-targeted PNF, and sham tDCS; and group 3 (n = 18) received CPT, trunk-targeted PNF, and bihemispheric motor cortex stimulation with tDCS. Changes in motor impairment, motor activity, and health-related quality of life assessments were outcome measures. Results A two-way linear mixed model analysis revealed interaction effects (group × time) for all outcome measurements (Trunk Impairment Scale, Fugl-Meyer Assessment of Motor Recovery after stroke upper extremity subsection, Wolf Motor Function Test, 10-Meter Walk Test, and the Stroke-Specific Quality of Life scale; all p < 0.01 or lower). Overall, post-pre mean differences demonstrate more substantial improvement in the active tDCS group, followed by sham stimulation associated with the PNF group and the group that received CPT alone. Conclusion Trunk-targeted PNF combined with bihemispheric tDCS along with CPT engender larger improvements in upper extremity and trunk impairment, upper limb function, gait speed, and quality of life in the subacute stroke population.
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Affiliation(s)
- Jaya Shanker Tedla
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Aseer, Saudi Arabia,Postgraduate Program in Rehabilitation Science, University Center Augusto Motta UNISUAM, Rio de Janeiro, Brazil
| | - Erika Rodrigues
- Postgraduate Program in Rehabilitation Science, University Center Augusto Motta UNISUAM, Rio de Janeiro, Brazil
| | - Arthur S. Ferreira
- Postgraduate Program in Rehabilitation Science, University Center Augusto Motta UNISUAM, Rio de Janeiro, Brazil
| | - Jose Vicente
- Professor of Neurological Physiotherapy, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ravi Shankar Reddy
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Aseer, Saudi Arabia
| | - Kumar Gular
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Aseer, Saudi Arabia
| | - Devika Rani Sangadala
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Aseer, Saudi Arabia
| | - Venkata Nagaraj Kakaraparthi
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Aseer, Saudi Arabia
| | - Faisal Asiri
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Aseer, Saudi Arabia
| | - Ajaya Kumar Midde
- Head of Neurorehabilitation, Department of Physiotherapy, Krishna Institute of Medical Sciences, Secunderabad, Telangana, India
| | - Snehil Dixit
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Aseer, Saudi Arabia
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12
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Iso F, Mitsunaga W, Yamaguchi R, Shimizu N, Ito S, Honda Y, Okubo A, Honda S, Iso N, Higashi T, Tsujino A. Relationship among trunk control, activities of daily living, and upper extremity function during the first week after stroke in patients with acute cerebral infarction. J Phys Ther Sci 2022; 34:315-319. [PMID: 35400839 PMCID: PMC8989477 DOI: 10.1589/jpts.34.315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 01/25/2022] [Indexed: 11/24/2022] Open
Abstract
[Purpose] We aimed to identify the relationship among trunk control, activities of daily
living, and upper extremity function during the first week after stroke in patients with
acute cerebral infarction. [Participants and Methods] Ninety-five patients with first
cerebral infarction were included. Trunk control was assessed using the Postural
Assessment Scale for Stroke. Additionally, activities of daily living were evaluated using
the Functional Independence Measure, and upper extremity function was assessed using the
upper extremity component of the Fugl-Meyer Assessment. Correlation analysis was performed
to examine the relationships among these three measures. Furthermore, stepwise multiple
regression analysis was performed to investigate the factors affecting activities of daily
living. [Results] The total score and two subcategories of the Postural Assessment Scale
for Stroke were significantly correlated with the Functional Independence Measure motor
values. Stepwise multiple regression analysis revealed age and the Postural Assessment
Scale for Stroke as factors influencing the Functional Independence Measure. Moreover, the
Postural Assessment Scale for Stroke and upper extremity component of Fugl-Meyer
Assessment showed a high correlation. [Conclusion] The trunk control ability assessed
using the Postural Assessment Scale for Stroke is strongly correlated with activities of
daily living estimated using the Functional Independence Measure in the first week after
stroke in patients with acute cerebral infarction. The upper extremity component of
Fugl-Meyer Assessment was not identified as a factor affecting the Functional Independence
Measure.
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Affiliation(s)
- Fumiko Iso
- Unit of Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences: 1-7-1 Sakamoto, Nagasaki, Nagasaki 852-8520, Japan
| | - Wataru Mitsunaga
- Unit of Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences: 1-7-1 Sakamoto, Nagasaki, Nagasaki 852-8520, Japan.,Nagasaki University Hospital, Japan
| | | | | | | | | | | | - Sumihisa Honda
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Naoki Iso
- Department of Occupational Therapy, Tokyo Kasei University, Japan
| | - Toshio Higashi
- Unit of Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences: 1-7-1 Sakamoto, Nagasaki, Nagasaki 852-8520, Japan
| | - Akira Tsujino
- Unit of Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences: 1-7-1 Sakamoto, Nagasaki, Nagasaki 852-8520, Japan.,Nagasaki University Hospital, Japan
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13
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Wang CY, Chen YC, Wang CH. Postural Maintenance Is Associated With Walking Ability in People Receiving Acute Rehabilitation After a Stroke. Phys Ther 2022; 102:6497837. [PMID: 35079798 DOI: 10.1093/ptj/pzab309] [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: 01/23/2021] [Revised: 09/02/2021] [Accepted: 12/03/2021] [Indexed: 11/13/2022]
Abstract
OBJECTIVES The Postural Assessment Scale for Stroke Patients (PASS) assesses the ability of people post stroke to maintain or change a given posture from lying to standing, and the items on which people with different walking status perform differently may suggest potential interventions. The purpose of this study was to (1) examine the association of PASS scores at admission for acute rehabilitation with walking status at admission and 3 months post stroke (3 M), and (2) identify PASS items that discriminate walking status. METHODS In this prospective observational study, 93 people post stroke were assessed with the PASS and a 2.44-m gait speed test at admission, with walking status assessed by telephone interview at 3 M. Those who could walk over a 2.44-m distance without the assistance of a walking aid or another person were considered to be independent in walking; others were considered to be dependent. Those who were dependent at admission were divided into the "regained independence" and "remained dependent" groups based on their status at 3 M. The association of the PASS at admission with 3 levels of walking status (independent at admission, regained independence, and remained dependent) was examined using the Kruskal-Wallis test. For those dependent at admission, the association of PASS score at admission with walking status at 3 M was examined using logistic regression and receiver operating curve analysis. RESULTS PASS scores at admission differed significantly across the 3 walking status groups and were significantly associated with walking status at 3 M (odds ratio = 0.864; 95% CI = 0.798-0.935) over and above length of stay. People post stroke who were dependent at admission and had PASS scores ≥22 were more likely to regain independence at 3 M. Nine PASS items differed among the 3 groups. CONCLUSIONS PASS score is significantly associated with walking status at admission and at 3 M. The identified 9 items suggest possible interventions for acute rehabilitation. IMPACT This study identified 9 PASS items that could guide clinicians in selecting interventions for acute rehabilitation.
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Affiliation(s)
- Ching-Yi Wang
- Department of Physical Therapy, Chung Shan Medical University, Taichung, Taiwan.,Physical Therapy Room, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Yueh-Chi Chen
- Department of Physical Therapy, Chung Shan Medical University, Taichung, Taiwan.,Physical Therapy Room, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Chun-Hou Wang
- Department of Physical Therapy, Chung Shan Medical University, Taichung, Taiwan.,Physical Therapy Room, Chung Shan Medical University Hospital, Taichung, Taiwan
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14
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Mihai EE, Mihai IV, Berteanu M. Effectiveness of Radial Extracorporeal Shock Wave Therapy and Visual Feedback Balance Training on Lower Limb Post-Stroke Spasticity, Trunk Performance, and Balance: A Randomized Controlled Trial. J Clin Med 2021; 11:jcm11010147. [PMID: 35011889 PMCID: PMC8745149 DOI: 10.3390/jcm11010147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/23/2021] [Accepted: 12/24/2021] [Indexed: 11/18/2022] Open
Abstract
Stroke remains one of the leading causes of disability in adults, and lower limb spasticity, affected stance, and balance impact everyday life and activities of such patients. Robotic therapy and assessment are becoming important tools to clinical evaluation for post-stroke rehabilitation. The aim of this study was to determine in a more objective manner the effects of visual feedback balance training through a balance trainer system and radial extracorporeal shock wave therapy (rESWT), along with conventional physiotherapy, on lower limb post-stroke spasticity, trunk control, and static and dynamic balance through clinical and stabilometric assessment. The study was designed as a randomized controlled trial. The experimental group underwent conventional physiotherapy, visual feedback balance training, and rESWT. The control group underwent conventional physiotherapy, visual feedback training and sham rESWT. The statistical analysis was performed using GraphPad Software and MATLAB. Primary clinical outcome measures were The Modified Ashworth Scale (MAS), passive range of motion (PROM), Visual Analogue Scale (VAS), and Clonus score. Secondary outcome measures were trunk performance, sensorimotor, and lower limb function. Stabilometric outcome measures were trunk control, static balance, and dynamic balance. Visual feedback training using the Prokin system and rESWT intervention, along with conventional physiotherapy, yielded statistically significant improvement both on clinical and stabilometric outcome measures, enhancing static and dynamic balance, trunk performance, sensorimotor outcome, and limb function and considerably diminishing lower limb spasticity, pain intensity, and clonus score in the experimental group.
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Affiliation(s)
- Emanuela Elena Mihai
- Physical and Rehabilitation Medicine Department, Carol Davila University of Medicine and Pharmacy Bucharest, 050451 Bucharest, Romania; (E.E.M.); (M.B.)
| | - Ilie Valentin Mihai
- Department of Telecommunications, University Politehnica of Bucharest, 060042 Bucharest, Romania
- Correspondence:
| | - Mihai Berteanu
- Physical and Rehabilitation Medicine Department, Carol Davila University of Medicine and Pharmacy Bucharest, 050451 Bucharest, Romania; (E.E.M.); (M.B.)
- Physical and Rehabilitation Medicine Department, Elias University Emergency Hospital, 011461 Bucharest, Romania
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15
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Ahmed U, Karimi H, Amir S, Ahmed A. Effects of intensive multiplanar trunk training coupled with dual-task exercises on balance, mobility, and fall risk in patients with stroke: a randomized controlled trial. J Int Med Res 2021; 49:3000605211059413. [PMID: 34812070 PMCID: PMC8647262 DOI: 10.1177/03000605211059413] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 10/22/2021] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVE We determined whether an exercise regime comprising high-intensity training, multiplanar trunk movements, and dual-task practice could improve trunk control, balance, functional mobility, and reduce fall risk in patients with hemiplegic stroke. METHODS In this randomized controlled trial, 74 patients (mean age 61.71 years) were randomly assigned to the experimental and comparison groups. Primary outcome was trunk impairment scale (TIS) scores. Secondary outcomes were scores on the Berg balance scale, 10-meter walk test, Timed-up-and-go test, timed-Up-Go-cognitive, and Stroke Impact Scale-16 to measure between-group changes from baseline. We used linear mixed modeling to identify changes over time within and between groups on each scale and whether changes persisted at 6- and 12-month follow-ups. RESULTS We observed significantly increased mean TIS scores from baseline to 3 months post-treatment (7.74); the increased scores were maintained at 6- and 12-month follow-ups (8.60 and 8.43, respectively). In the experimental group, all secondary outcomes showed significant and clinically meaningful results. Fall risk between groups was significantly reduced at 6 and 12 months. CONCLUSIONS Intensive multiplanar trunk movements coupled with dual-task practice promoted trunk control, balance, and functional recovery in patients with stroke, reduced fall risk, and improved independent mobility.Trial registration: #IRCT20200127046275N1.
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Affiliation(s)
- Umair Ahmed
- University Institute of Physical Therapy, University of Lahore,
Lahore, Pakistan
| | - Hossein Karimi
- University Institute of Physical Therapy, University of Lahore,
Lahore, Pakistan
- Istanbul Gelisim University, Istanbul, Turkey
| | - Syed Amir
- Istanbul Gelisim University, Istanbul, Turkey
| | - Ashfaq Ahmed
- University Institute of Physical Therapy, University of Lahore,
Lahore, Pakistan
- Allied Health Sciences, The University of Lahore, Lahore,
Pakistan
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16
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Ishiwatari M, Honaga K, Tanuma A, Takakura T, Hatori K, Kurosu A, Fujiwara T. Trunk Impairment as a Predictor of Activities of Daily Living in Acute Stroke. Front Neurol 2021; 12:665592. [PMID: 34220674 PMCID: PMC8247912 DOI: 10.3389/fneur.2021.665592] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 05/07/2021] [Indexed: 11/13/2022] Open
Abstract
Background and purpose: Trunk function plays a key role in performing activities of daily living (ADL) including locomotion and sitting. Sitting and ADL should be performed as early as possible especially during the acute phase of stroke rehabilitation. Therefore, this study aimed to assess trunk function among patients with acute stroke using the Trunk Impairment Scale (TIS) and to predict its functional outcomes. Methods: Overall, 67 patients with acute stroke (i.e., within 2 days of occurrence of the stroke) were included. The following clinical assessment items were obtained within 48 h after stroke onset and on the day before discharge from the hospital. Trunk function was examined using TIS and Trunk Control Test (TCT). The motor function of the upper and lower extremities was assessed using the stroke impairment assessment set motor (SIAS-M) score, and ADL was assessed using functional independence measure motor (FIM-M) items. Results: Multiple regression analysis was performed using the stepwise regression method, using the total FIM-M score following discharge as the dependent variable and age, TIS, TCT, SIAS-M, and FIM-M within 48 h after stroke onset as the independent variables. Age, TIS, and FIM-M within 48 h after stroke onset were selected as the input variables and showed a high-adjusted determination coefficient (R2 = 0.79; P < 0.001). Conclusion: TIS is a reliable method for evaluating trunk control function and is an early predictor of ADL among patients with acute stroke.
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Affiliation(s)
- Masahiro Ishiwatari
- Department of Rehabilitation Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Rehabilitation, Kiminomori Rehabilitation Hospital, Chiba, Japan
| | - Kaoru Honaga
- Department of Rehabilitation Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Akira Tanuma
- Department of Rehabilitation Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Tomokazu Takakura
- Department of Rehabilitation Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kozo Hatori
- Department of Rehabilitation Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Akihiro Kurosu
- Department of Rehabilitation Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Toshiyuki Fujiwara
- Department of Rehabilitation Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Physical Therapy, Juntendo University Faculty of Health Science, Tokyo, Japan
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17
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Liang PJ, Chiu VJ, Teng YC, Chiu HL, Lee SC. Turning difficulties after stroke and its relationship with trunk function. Eur J Phys Rehabil Med 2021; 57:859-865. [PMID: 34042411 DOI: 10.23736/s1973-9087.21.06841-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Turning difficulties has been reported in stroke patients, but most studies have indicated no differences in turning direction regarding turn time or steps. Recent evidence shows that turning difficulty may correlate with trunk control. Trunk flexibility and strength are considered essential to trunk control, but their association with turning performance has not been elucidated. AIM The study investigated the differences in turning direction in terms of turn duration and angular velocity and the relationship between turning performance and trunk function in patients with chronic stroke. DESIGN Cross-sectional study. SETTING Outpatient clinic at the Department of Physical Medicine and Rehabilitation. POPULATION Chronic stroke patients. METHODS Twenty-eight stroke patients were evaluated for turning performance and trunk function. Turn duration and angular velocity were assessed using three wearable sensors during 360° turning in place towards both sides. Trunk function, such as flexibility, strength, and control was measured using a tape measure, a microFET3 dynamometer, and the Trunk Impairment Scale. RESULTS Stroke patients showed significantly longer turn durations (4.62 ± 2.08 vs 3.59 ± 1.93 s, p = 0.036) and lower angular velocity (118.67 ± 35.78 vs 135.26 ± 42.41 0/s, p = 0.009) during turning toward the paretic side than towards the nonparetic side. The turning parameters towards the paretic side associated with trunk flexion (r = -0.550, p = 0.003) and rotation (r = 0.409, p = 0.034), trunk flexor strength (r = -0.387, p = 0.046), dynamic sitting balance (r = -0.383, p = 0.049) and coordination of trunk movement (r = -0.494, p = 0.009). However, no relationship was observed between trunk function and turning towards the nonparetic side. CONCLUSIONS Stroke participants experienced greater difficulty turning towards the paretic side. Trunk flexibility, strength, and control may affect turning performance, especially when turning towards the paretic side, which could explain the occurrence of falls after a turn towards the paretic side. CLINICAL REHABILITATION IMPACT Stroke patients experience turning difficulties, particularly during turning towards the paretic side. Stroke patients with limited trunk function are more likely to experience turning dysfunction. Clinical therapists should develop effective strategies for enhancing turning ability through improvement of trunk flexibility, strength, and control for clinical rehabilitation practice.
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Affiliation(s)
- Pei-Jung Liang
- Department of Rehabilitation Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan
| | - Valeria J Chiu
- Department of Rehabilitation Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan
| | - Yann-Cherng Teng
- Department of Rehabilitation Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan
| | - Huei-Ling Chiu
- School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Shu-Chun Lee
- School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan -
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18
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Pascucci Sande de Souza LA, Ferreira LR, Silva Bitencourt AC, Bazan R, Luvizutto GJ. Visual and haptic verticality misperception and trunk control within 72 h after stroke. J Bodyw Mov Ther 2021; 27:676-681. [PMID: 34391306 DOI: 10.1016/j.jbmt.2021.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 03/29/2021] [Accepted: 05/07/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Stroke patients often exhibit an altered perception of verticality, but there are no studies evaluating verticality perception in the first 72 h after stroke and its relationship with trunk control. Therefore, this study aimed to analyze visual and haptic verticality in the acute phase of stroke. METHODS This was a cross-sectional study conducted with two groups: (a) 13 individuals with stroke and (b) 12 healthy participants. We assessed verticality via the subjective visual vertical (SVV) and the subjective haptic vertical (SHV); and we measured trunk control with the Trunk Impairment Scale (TIS). We performed t-tests to compare the SVV and SHV between groups. Pearson correlation was performed between verticality tests with National Institutes of Health Stroke Scale (NIHSS) and the TIS. RESULTS Participants with recent stroke presented higher true and absolute SVV deviation values than did the control group. There was significant negative correlation between absolute (r = -0.57; p = 0.02) and true SVV (r = -0.54; p = 0.01) with TIS scores There was also significant positive correlation between absolute (r = 0.63; p = 0.009) and true SVV (r = 0.61; p = 0.003) with NIHSS. A significant negative correlation between NIHSS and TIS scores also was found (r = -0.80; p = 0.005). CONCLUSION Individuals with acute stroke presented larger variability in their perceptions of visual verticality than did healthy controls, and verticality perceptions were positively correlated with trunk impairment.
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Affiliation(s)
| | - Luana Ribeiro Ferreira
- Master's Program in Physical Therapy, Universidade Federal do Triângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
| | - Ana Carolina Silva Bitencourt
- Master's Program in Physical Therapy, Universidade Federal do Triângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
| | - Rodrigo Bazan
- Department of Neurology, Botucatu Medical School (UNESP), Botucatu, São Paulo, Brazil
| | - Gustavo José Luvizutto
- Department of Applied Physical Therapy, Universidade Federal do Triângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil.
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19
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Coelho TS, Bitencourt ACS, Bazan R, de Souza LAPS, Luvizutto GJ. Hip abduction with ankle dorsiflexion (HAAD) score and trunk seating control within 72 h after stroke predicts long-term disability: A cohort study. J Bodyw Mov Ther 2021; 27:710-716. [PMID: 34391311 DOI: 10.1016/j.jbmt.2021.05.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 04/20/2021] [Accepted: 05/14/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND The aim of this study was to determine whether muscle strength of the lower limb and trunk during the acute phase after stroke are predictors of motor function and disability 90 days after hospital discharge. METHODS This prospective study used a nonconcurrent design to evaluate stroke patients at two time points: a) first 72 h: hip abduction and ankle dorsiflexion (HAAD) score, trunk sitting control, clinical evaluation, demographic profile, and stroke severity using the National Institutes of Health Stroke Scale (NIHSS); b) 90 days after hospital discharge: modified Rankin scale (mRS). The participants were divided into two groups: good outcome (mRS 0-2) and worse outcome (mRS>2), and the differences between them were assessed statistically. Clinical and demographic variables were included in the multiple logistic regression analysis. The ROC curve was used to illustrate the clinical sensitivity and specificity of the HAAD score cutoff for the outcomes. RESULTS Thirty-seven patients were included: 16 with mRS≤2 and 21 with mRS>2. Patients in the worse outcome group were older (p = 0.02) and presented with higher NIHSS scores (p = 0.002), lower HAAD scores (p < 0.001), higher pain sensation (p = 0.04), greater altered perception (p = 0.008), and no trunk control in the sitting position (p = 0.004). A lower HAAD score (OR = 0.09; 95%CI: 0.14-0.53; p < 0.001) and the absence of trunk control in the sitting position (OR = 0.55; 95%CI:0.54-0.95; p < 0.001) were associated with unsatisfactory outcomes. CONCLUSION A HAAD score <6 and the absence of trunk control while sitting during the first 72 h are predictors of worse long-term disability in stroke patients.
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Affiliation(s)
| | | | - Rodrigo Bazan
- Botucatu Medical School (UNESP), Botucatu, São Paulo, Brazil
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20
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Sato K, Maeda K, Ogawa T, Shimizu A, Nagami S, Nagano A, Murotani K, Inoue T, Suenaga M. The functional assessment for control of trunk (FACT): An assessment tool for trunk function in stroke patients. NeuroRehabilitation 2021; 48:59-66. [PMID: 33386820 DOI: 10.3233/nre-201533] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The Functional Assessment for Control of Trunk (FACT) was developed to evaluate trunk function after stroke. However, only a few studies used FACT to show functional outcome. OBJECTIVE This study aimed to validate the FACT predictive ability for functional outcome following stroke and create an English version of the FACT. METHODS This retrospective, observational study was conducted with patients aged≥65 years with stroke. Patients were divided into two groups according to the median FACT score at admission: trunk impairment or high trunk function group. Multiple regression analysis was performed for Functional Independence Measure (FIM) gain and FIM efficiency to examine the relationship between trunk function assessed by FACT at admission and functional prognosis. RESULTS 105 participants (mean age, 80.2±7.6, 57.1%were men) were included. Of these, 48 (45.7%) and 57 (54.3%) were categorized to the trunk impairment group and high trunk function group, respectively. FACT score at admission was associated with FIM gain (coefficient = 0.875, P = 0.001) and FIM efficiency (coefficient = 0.015, P = 0.016) after adjusting for confounders. CONCLUSIONS Trunk impairment at admission assessed by FACT could predict functional prognosis. The English version of FACT was created and further demonstrated the validity of FACT.
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Affiliation(s)
- Keisuke Sato
- Okinawa Chuzan Clinical Research Center, Chuzan Hospital, Okinawa, Japan
| | - Keisuke Maeda
- Okinawa Chuzan Clinical Research Center, Chuzan Hospital, Okinawa, Japan.,Department of Geriatric Medicine, National Center for Geriatrics and Gerontology, Aichi, Japan.,Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, Aichi, Japan
| | - Takahiro Ogawa
- Department of Rehabilitation Medicine, Chuzan Hospital, Okinawa, Japan
| | - Akio Shimizu
- Department of Nutrition, Hamamatsu City Rehabilitation Hospital, Shizuoka, Japan
| | - Shinsuke Nagami
- Department of Speech Language Pathology and Audiology, Faculty of Rehabilitation, Kawasaki University of Medical Welfare, Kurashiki, Japan
| | - Ayano Nagano
- Department of Nursing Care, Nishinomiya Kyoritsu Neurosurgical Hospital, Nishinomiya, Japan
| | - Kenta Murotani
- Biostatistics Center, Kurume University, Asahimachi, Kurume, Japan
| | - Tatsuro Inoue
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Masaki Suenaga
- Department of Rehabilitation Medicine, Chuzan Hospital, Okinawa, Japan
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21
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Wee SK, Hughes AM, Warner MB, Burridge JH. Longitudinal analysis of the recovery of trunk control and upper extremity following stroke: An individual growth curve approach. Top Stroke Rehabil 2021; 29:58-73. [PMID: 33523777 DOI: 10.1080/10749357.2021.1878333] [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: 10/22/2022]
Abstract
Background and Purpose: Trunk control is thought to contribute to upper extremity function. It is unclear whether recovery of trunk control has an impact on the recovery of the upper extremity in people with stroke. This longitudinal study monitored the recovery of trunk control and upper extremity in the first 6 months following stroke.Methods: Forty-five participants with stroke were assessed monthly for 6 months following stroke. Trunk control was assessed using the Trunk Impairment Scale (TIS); upper extremity impairment and function were assessed with the Fugl-Meyer (FMA) and Streamlined Wolf Motor Function Test (SWMFT) respectively. The SWMFT included the performance time (SWMFT-Time) and functional ability scale (SWMFT-FAS). The individual growth curve modeling was used to analyze the longitudinal data.Results: The recovery curve of TIS, FMA, SWMFT-Time and SWMFT-FAS followed a quadratic trend, with the rate of recovery decreasing from the first to sixth month. As TIS score improved over time, FMA, SWMFT-Time and SWMFT-FAS improved in parallel with the TIS score. TIS at each time point was found to be a significant predictor of FMA, SWMFT-Time and SWMFT-FAS at 6 months post stroke.Conclusion: Our work has provided, for the first time, substantial evidence that the pattern of recovery of trunk control is similar to that of the recovery of upper extremity following stroke. In addition, this study provides evidence on which to design a prospective study to evaluate whether improvement in trunk control early post-stroke results in better long-term upper extremity function.
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Affiliation(s)
- Seng Kwee Wee
- Rehabilitation and Health Technologies Research Group, Faculty of Health Sciences, University of Southampton, Southampton, UK.,Centre for Advanced Rehabilitation Therapeutics (CART), Tan Tock Seng Hospital, Singapore, Singapore.,Health and Social Sciences Cluster, Singapore Institute of Technology (SIT), Singapore, Singapore
| | - Ann-Marie Hughes
- Rehabilitation and Health Technologies Research Group, Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Martin B Warner
- Rehabilitation and Health Technologies Research Group, Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Jane H Burridge
- Rehabilitation and Health Technologies Research Group, Faculty of Health Sciences, University of Southampton, Southampton, UK
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22
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Yakut H, Özalevli S, Birlik AM. Association between core stability and physical function, functional performance in patients with systemic sclerosis. Int J Rheum Dis 2021; 24:548-554. [PMID: 33463900 DOI: 10.1111/1756-185x.14067] [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: 10/16/2020] [Revised: 12/25/2020] [Accepted: 01/02/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To investigate the association of core stability with physical function and functional performance in patients with systemic sclerosis (SSc). METHODS Forty patients who met the American College of Rheumatology / European League Against Rheumatism 2013 classification criteria for SSc were included in the cross-sectional study. For evaluation of core stability, trunk muscle endurance and trunk muscle strength were assessed. Trunk extensor and trunk flexor endurance tests were used for assessment of trunk muscle endurance. Trunk muscle strength was measured with a hand-held dynamometer and modified sit-up test. To measure physical function the Health Assessment Questionnaire Disability Index (HAQ-DI) and to measure functional performance 6-minute walking test (6MWT) and sit-to-stand test (STS) were used. RESULTS Patients with SSc had lower mean trunk extensor and flexor endurance test times (49.87 ± 30.81 and 32.17 ± 15.42 seconds, respectively), modified sit-up test repetition (17.42 ± 7.81) and trunk extensor and flexor muscle strength (7.48 ± 2.29 kg and 6.20 ± 1.68 kg, respectively) when compared to the reference values in healthy individuals. All measurements were used to evaluate core stability associated with HAQ-DI score, 6DMWT walking distance and STS test duration (all P < .05). CONCLUSION Patients with SSc have markedly reduced core stability and this negatively affects the physical function and functional performance. Therefore, this study highlights the importance of trunk muscle in patients with SSc. We suggest that not only upper-lower extremity muscles, but also trunk muscle strength and endurance should be measured and core stability exercises can be added to the training programs to maintain and/or improve physical functions and functional performance in SSc patients.
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Affiliation(s)
- Hazal Yakut
- School of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
| | - Sevgi Özalevli
- School of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
| | - Ahmet Merih Birlik
- Division of Rheumatology, Department of Internal Medicine, School of Medicine, Dokuz Eylül University, Izmir, Turkey
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23
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Erol BN, Aydoğan Arslan S, Yaşar E, Keskin ED, Demirci CS. Reliability and validity of the Turkish version of Function in Sitting Test (FIST-T) in stroke. Top Stroke Rehabil 2021; 29:49-57. [PMID: 33438519 DOI: 10.1080/10749357.2020.1871284] [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: 10/22/2022]
Abstract
Background: Trunk control in sitting position after stroke is one of the most important determinants of independence in daily living activities and there is no gold standard assessment used to measure sitting postural control.Objectives: The aim of this study is to determine the reliability and validity of the Turkish version of Function in Sitting Test (FIST-T).Methods: After translation was conducted, Function in Sitting Test, Berg Balance Scale, Functional Independent Measure and Trunk Impairment Scale were applied to 72 stroke patients (mean age was 59.26 ± 16.38 years; post-stroke time was 95.93 ± 59.64 days). For reliability and validity analysis the spearman correlation analysis was used.Results: A positive, high correlation was found between the first application and repetition of Function in Sitting Test-T (ICC = 0.97, r = 0.95, p = .001). The internal consistency was high (Cronbach Alpha = 0.97), interrater correlation was high (Cronbach Alpha = 0.98) and a positive, high correlation was found with the scores obtained from the Berg Balance Scale (r = 0.82, p = .001), Functional Independent Measure (r = 0.84, p = .001) and Trunk Impairment Scale (r = 0.80, p = .001).Conclusions: It is concluded that the Turkish version of Function in Sitting Test is a valid and reliable scale for use in stroke patients, in clinical and scientific researches.
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Affiliation(s)
- Büşra Nur Erol
- Vocational School of Haymana, Physiotherapy Programme, Ankara University, Ankara, Turkey
| | - Saniye Aydoğan Arslan
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Kırıkkale University, Kırıkkale, Turkey
| | - Evren Yaşar
- Gülhane Faculty of Medicine, Department of Physical Medicine and Rehabilitation, University of Health Sciences, Ankara, Turkey
| | - Esra Dilek Keskin
- Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Kırıkkale University, Kırıkkale, Turkey
| | - Cevher Savcun Demirci
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Balıkesir University, Balıkesir, Turkey
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Wang CY, Chen YC, Wang CH. Early Rehabilitation in Acute Care Inpatient Wards May Be Crucial to Functional Recovery 3 Months After Ischemic Stroke. Phys Ther 2021; 101:5943766. [PMID: 33125475 DOI: 10.1093/ptj/pzaa197] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 02/10/2020] [Accepted: 09/15/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Early rehabilitation in acute care inpatient wards may maximize functional outcome at 3 months after stroke in survivors of stroke. It is unknown whether functional change during acute care hospitalization is significantly associated with functional recovery at 3 months in survivors of acute stroke. The purposes of this study were to examine the association of the Barthel Index (BI) at 3 months with functional change as measured with the Barthel Index (ΔBI) in an acute care inpatient ward and to identify the factors associated with ΔBI and who could benefit from an early rehabilitation program. METHODS In this prospective longitudinal study, 76 patients with ischemic stroke in an acute care inpatient ward received early rehabilitation of up to 2 sessions per day for 5 d/wk during their stay. Therapy density was calculated as the proportion of total therapy sessions completed. At admission and discharge, they were assessed with the BI and the Postural Assessment Scale for Stroke Patients (PASS). Demographic and health-related information was also collected. The Barthel Index (BI) was reassessed at 3 months. RESULTS ΔBI in the acute care inpatient ward significantly predicted the BI at 3 months, over and above the other significant variables; in addition, therapy density and change in PASS were significantly associated with ΔBI. Patients with moderate initial functional dependence had the largest ΔBI, followed by the group with a more severe condition. CONCLUSIONS ΔBI in acute care inpatient wards may be an important predictor of the BI at 3 months. Therapy density and change in PASS were significantly associated with ΔBI. IMPACT Survivors of acute stroke who receive up to 2 rehabilitation sessions per day for 5 d/wk early in their hospitalization have better functional recovery at 3 months after stroke.
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Affiliation(s)
- Ching-Yi Wang
- Department of Physical Therapy, Chung Shan Medical University, Taichung, Taiwan; Physical Therapy Room, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Yueh-Chi Chen
- Department of Physical Therapy, Chung Shan Medical University, Taichung, Taiwan; Physical Therapy Room, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Chun-Hou Wang
- Department of Physical Therapy, Chung Shan Medical University, Taichung, Taiwan; Physical Therapy Room, Chung Shan Medical University Hospital, Taichung, Taiwan
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25
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Gamble K, Chiu A, Peiris C. Core Stability Exercises in Addition to Usual Care Physiotherapy Improve Stability and Balance After Stroke: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil 2020; 102:762-775. [PMID: 33239203 DOI: 10.1016/j.apmr.2020.09.388] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 10/30/2019] [Accepted: 09/25/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To systematically review the effect of core stability exercises in addition to usual care physiotherapy on patient outcomes after stroke. DATA SOURCES Cumulative Index to Nursing and Allied Health, MEDLINE, Physiotherapy Evidence Database (PEDro), PubMed, and EMBASE were searched to November 2018. STUDY SELECTION Eleven randomized controlled trials that compared usual care physiotherapy with usual care physiotherapy with additional core stability exercises in people with stroke were included. The initial search yielded 1876 studies. DATA EXTRACTION Two independent reviewers applied inclusion and exclusion criteria and extracted data on methodological quality using the PEDro scale, participant characteristics, intervention details, outcome measures, and results. DATA SYNTHESIS Postintervention means and SDs were pooled to calculate either the standardized mean difference (SMD) or the mean difference (MD) and 95% CIs using a random-effects model and inverse variance methods. There was moderate quality evidence to suggest the addition of core stability exercises to usual care physiotherapy improved trunk control (SMD, 0.94; 95% CI, 0.44-1.44; I2=69%), functional dynamic balance (SMD, 1.23; 95% CI, 0.5-1.97; I2=71%), and walking speed (MD, 0.27m/s; 95% CI, 0.01-0.52; I2=40%) in people with acute and chronic stroke. No significant effect was found when assessing functional ambulation categories or the timed Up and Go test, and mixed results were found for global functioning. CONCLUSIONS The addition of core stability exercises to usual care physiotherapy after stroke may lead to improved trunk control and dynamic balance. Therefore, core stability exercises should be included in rehabilitation if improvements in these domains will help clients achieve their goals. Future trials should consider incorporating outcomes of body kinematics during functional tasks to assess movement quality and assess participation outcomes.
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Affiliation(s)
- Kate Gamble
- Department of Physiotherapy, Eastern Health, Victoria, Australia.
| | - April Chiu
- Department of Physiotherapy, Eastern Health, Victoria, Australia
| | - Casey Peiris
- Department of Physiotherapy, La Trobe University, College of Science, Health and Engineering, School of Allied Health
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26
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Exoskeleton use in post-stroke gait rehabilitation: a qualitative study of the perspectives of persons post-stroke and physiotherapists. J Neuroeng Rehabil 2020; 17:123. [PMID: 32912215 PMCID: PMC7488039 DOI: 10.1186/s12984-020-00750-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 08/24/2020] [Indexed: 01/06/2023] Open
Abstract
Background Wearable powered exoskeletons are a new and emerging technology developed to provide sensory-guided motorized lower limb assistance enabling intensive task specific locomotor training utilizing typical lower limb movement patterns for persons with gait impairments. To ensure that devices meet end-user needs it is important to understand and incorporate end-users perspectives, however research in this area is extremely limited in the post-stroke population. The purpose of this study was to explore in-depth, end-users perspectives, persons with stroke and physiotherapists, following a single-use session with a H2 exoskeleton. Methods We used a qualitative interpretive description approach utilizing semi-structured face to face interviews, with persons post-stroke and physiotherapists, following a 1.5 h session with a H2 exoskeleton. Results Five persons post-stroke and 6 physiotherapists volunteered to participate in the study. Both participant groups provided insightful comments on their experience with the exoskeleton. Four themes were developed from the persons with stroke participant data: (1) Adopting technology; (2) Device concerns; (3) Developing walking ability; and, (4) Integrating exoskeleton use. Five themes were developed from the physiotherapist participant data: (1) Developer-user collaboration; (2) Device specific concerns; (3) Device programming; (4) Patient characteristics requiring consideration; and, (5) Indications for use. Conclusions This study provides an interpretive understanding of end-users perspectives, persons with stroke and neurological physiotherapists, following a single-use experience with a H2 exoskeleton. The findings from both stakeholder groups overlap such that four over-arching concepts were identified including: (i) Stakeholder participation; (ii) Augmentation vs. autonomous robot; (iii) Exoskeleton usability; and (iv) Device specific concerns. The end users provided valuable perspectives on the use and design of the H2 exoskeleton, identifying needs specific to post-stroke gait rehabilitation, the need for a robust evidence base, whilst also highlighting that there is significant interest in this technology throughout the continuum of stroke rehabilitation.
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Kimura T. Interaction between locomotion and three subcategories for patients with stroke demonstrating fewer than 37 points on the total functional independence measure upon admission to the recovery ward. J Phys Ther Sci 2020; 32:516-523. [PMID: 32884173 PMCID: PMC7443547 DOI: 10.1589/jpts.32.516] [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: 03/25/2020] [Accepted: 05/13/2020] [Indexed: 12/02/2022] Open
Abstract
[Purpose] To investigate the interaction between locomotion and improvements in
performing self-care. [Participants and Methods] We retrospectively analyzed 930 patients
with stroke who were registered in the Japanese Rehabilitation Database. We performed a
correlation analysis to evaluate the relationships among all the collected data. Then,
hierarchical multiple regression analysis was performed using the self-care motor score of
the Functional Independent Measure (FIM) as the dependent variable. “Model 1” used two
independent variables (National Institute of Health Stroke and Rankin Scale), “model 2”
used two independent variables (locomotion gain and gain of an item with the closest
coefficient correlation added to model 1), and “model 3” used a mean-centering value,
which was added to model 2. R2 values were calculated using a simple slope
analysis. [Results] Locomotion showed an interaction with three self-care activities. The
R2 changes in models 1 and 2 (ΔR2) were significant for dressing
upper body (ΔR2=0.001), bowel management (ΔR2=0.006), and toileting
(ΔR2=0.006). The results of the simple slope analysis were significant.
[Conclusion] Locomotion demonstrated an interaction with various activities for improving
self-care. There were varying degrees of improvement in self-care despite a uniform
improvement in the degree of locomotion. Therefore, locomotion interaction should be
considered for each intervention that targets activities of daily living.
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Affiliation(s)
- Takashi Kimura
- Department of Physical Therapy, ASO Rehabilitation College: 3-2-1 Higashi-Hie, Hakata-ku, Fukuoka-Shi, Fukuoka 812-0007, Japan.,Department of Rehabilitation Medicine, Saga University Hospital, Japan
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Thijs L, Denissen S, Mehrholz J, Elsner B, Lemmens R, Verheyden GSAF. Trunk training for improving activities in people with stroke. Hippokratia 2020. [DOI: 10.1002/14651858.cd013712] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Liselot Thijs
- Department of Rehabilitation Sciences; KU Leuven; Leuven Belgium
| | - Stijn Denissen
- AIMS lab, Center for Neurosciences; UZ Brussel, Vrije Universiteit Brussel; Brussels Belgium
- icometrix; Leuven Belgium
| | - Jan Mehrholz
- Department of Public Health, Dresden Medical School; Technical University Dresden; Dresden Germany
| | - Bernhard Elsner
- Department of Public Health; Dresden Medical School, Technical University Dresden; Dresden Germany
| | - Robin Lemmens
- Department of Neurosciences, Laboratory for Neurobiology; UZ Leuven; Leuven Belgium
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Van Criekinge T, Hallemans A, Herssens N, Lafosse C, Claes D, De Hertogh W, Truijen S, Saeys W. SWEAT2 Study: Effectiveness of Trunk Training on Gait and Trunk Kinematics After Stroke: A Randomized Controlled Trial. Phys Ther 2020; 100:1568-1581. [PMID: 32542356 DOI: 10.1093/ptj/pzaa110] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/08/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Trunk training after stroke is an effective method for improving mobility, yet underlying associations leading to the observed mobility carryover effects are unknown. The purposes of this study were to investigate the effectiveness of trunk training for gait and trunk kinematics and to find explanatory variables for the mobility carryover effects. METHODS This study was an assessor-masked, randomized controlled trial. Participants received either additional trunk training (n = 19) or cognitive training (n = 20) after subacute stroke. Outcome measures were the Tinetti Performance-Oriented Mobility Assessment (POMA), the Trunk Impairment Scale, spatiotemporal gait parameters, center-of-mass excursions, and trunk and lower limb kinematics during walking. Multivariate analysis with post hoc analysis was performed to observe treatment effects. Correlation and an exploratory regression analysis were used to examine associations with the mobility carryover effects. RESULTS Significant improvements after trunk training, compared with the findings for the control group, were found for the Trunk Impairment Scale, Tinetti POMA, walking speed, step length, step width, horizontal/vertical center-of-mass excursions, and trunk kinematics. No significant differences were observed in lower limb kinematics. Anteroposterior excursions of the trunk were associated with 30% of the variability in the mobility carryover effects. CONCLUSIONS Carryover effects of trunk control were present during ambulation. Decreased anteroposterior movements of the thorax were the main variable explaining higher scores on the Tinetti POMA Gait subscale. However, the implementation and generalizability of this treatment approach in a clinical setting are laborious and limited, necessitating further research. IMPACT Trunk training is an effective strategy for improving mobility after stroke. Regaining trunk control should be considered an important treatment goal early after stroke to adequately prepare patients for walking.
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Affiliation(s)
- Tamaya Van Criekinge
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Science, University of Antwerp, MOVANT/REVAKI, Universiteitsplein 1, Wilrijk, 2610 Belgium; and Multidisciplinary Motor Centre Antwerp (M2OCEAN), University of Antwerp
| | - Ann Hallemans
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Science, University of Antwerp, MOVANT/REVAKI; and Multidisciplinary Motor Centre Antwerp (M2OCEAN), University of Antwerp
| | - Nolan Herssens
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Science, University of Antwerp, MOVANT/REVAKI; and Multidisciplinary Motor Centre Antwerp (M2OCEAN), University of Antwerp
| | - Christophe Lafosse
- RevArte Rehabilitation Hospital, Edegem, Antwerp, Belgium; and Department of Psychology, University of Leuven, Leuven, Belgium
| | | | - Willem De Hertogh
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Science, University of Antwerp, MOVANT/REVAKI; and Multidisciplinary Motor Centre Antwerp (M2OCEAN), University of Antwerp
| | - Steven Truijen
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Science, University of Antwerp, MOVANT/REVAKI; and Multidisciplinary Motor Centre Antwerp (M2OCEAN), University of Antwerp
| | - Wim Saeys
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Science, University of Antwerp, MOVANT/REVAKI; RevArte Rehabilitation Hospital; and Multidisciplinary Motor Centre Antwerp (M2OCEAN), University of Antwerp
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30
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Martins LG, Molle da Costa RD, Alvarez Sartor LC, Thomaz de Souza J, Winckler FC, Regina da Silva T, Modolo GP, Nunes HRDC, Bazan SGZ, Martin LC, Luvizutto GJ, Bazan R. Clinical factors associated with trunk control after stroke: A prospective study. Top Stroke Rehabil 2020; 28:181-189. [PMID: 32772828 DOI: 10.1080/10749357.2020.1805244] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Poor trunk control after stroke can impact recovery of global functional abilities. Therefore, the aim of this study was to evaluate whether clinical and functional data from stroke participants can be used to predict trunk control at 90 days. METHODS This is a prospective study of 37 participants with stroke. The variables evaluated at hospital discharge were stroke severity (National Institute of Health Stroke Scale - NIHSS); functional capacity (modified Rankin scale - mRS); handgrip; and cognitive function. At 90 days, the variables evaluated were autonomy (Functional Independence Measure - FIM, Barthel Index); gait mobility (Tinetti mobility test -TMT); quality of life (European Quality of Life Scale - EuroQol-5D) and trunk control (trunk impairment scale - TIS). The participants were considered to have satisfactory (TIS³14) or non-satisfactory trunk control (TIS≤13), and the differences between them were assessed by chi-square test (categorical variables) and Mann-Whitney/unpaired t-test (continuous variables). A ROC curve was used to show cut-off value of clinical variables to predict trunk control. RESULTS The unsatisfactory trunk control group presented ahigher NIHSS at discharge (p=0.01), higher mRS at discharge (p=0.00), lower Barthel Index at 90 days (p=0.03), lower FIM at 90 days (p=0.01) and lower TMT at 90 days (p=0.00) than the satisfactory trunk control group. The best cut-off points for the NIHSS and mRS scores at discharge for predicting unsatisfactory trunk control are ≥6 and ≥3, respectively. CONCLUSION Greater NIHSS and mRS scores at hospital discharge increase the chance of unsatisfactory trunk control at 90 days after stroke.
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Affiliation(s)
| | | | | | - Juli Thomaz de Souza
- Doctorate student in Physiopathology in Internal Medicine, Botucatu Medical School, Botucatu, Brazil
| | | | - Taís Regina da Silva
- Rehabilitation Department, Botucatu Medical School, Botucatu, Brazil.,Doctorate student in Physiopathology in Internal Medicine, Botucatu Medical School, Botucatu, Brazil
| | | | | | | | | | - Gustavo José Luvizutto
- Department of Applied Physical Therapy, Federal University of Triângulo Mineiro (UFTM), Uberaba, Brazil
| | - Rodrigo Bazan
- Department of Neurology, Psychology and Psychiatry, Botucatu Medical School, Botucatu, Brazil
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Bilek F, Deniz G, Ercan Z, Cetisli Korkmaz N, Alkan G. The effect of additional neuromuscular electrical stimulation applied to erector spinae muscles on functional capacity, balance and mobility in post-stroke patients. NeuroRehabilitation 2020; 47:181-189. [PMID: 32741788 DOI: 10.3233/nre-203114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the effects of neuromuscular electric stimulation applied to the erector spinae on balance, motor function and functional capacity in patients with stroke in a randomized controlled trial. METHODS Sixty patients with stroke were recruited and randomly distributed into two groups: control group and neuromuscular electric stimulation group. All participants underwent conventional physical therapy five times a week for six weeks. The neuromuscular electric stimulation group received additional electrical stimulation. Outcome measures were evaluated with Brunnel Balance Assessment, Stroke Rehabilitation Movement Assessment, Functional Ambulation Classification, Adapted Patient Evaluation and Conference System, Postural Assesment Scale for Stroke patients, Short Form-36, and Minimental State Examination scales. RESULTS Significant differences were observed in all scores at the end of the study in both groups. Postural Assesment Scale for Stroke patients and Stroke Rehabilitation Movement Assessment scores were higher in the neuromuscular electric stimulation group compared to the control group (p < 0.05). All the other scores were not statistically significant. CONCLUSION It is recommended to evaluate and treat trunk muscle, which is usually neglected in treatment, and to consider the combination of conventional treatment and neuromuscular electric stimulation when designing an ideal rehabilitation program.
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Affiliation(s)
- Furkan Bilek
- Department of Physiotherapy and Rehabilitation, Faculty of Health Science, University of Firat, Elazig, Turkey
| | - Gulnihal Deniz
- Department of Anatomy, Faculty of Medicine, University of Firat, Elazig, Turkey
| | - Zubeyde Ercan
- Department of Physiotherapy and Rehabilitation, Faculty of Health Science, University of Firat, Elazig, Turkey
| | | | - Gokhan Alkan
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, University of Firat, Elazig, Turkey
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32
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Ko H, Kim H, Kim Y, Sohn MK, Jee S. Dose-Response Effect of Daily Rehabilitation Time on Functional Gain in Stroke Patients. Ann Rehabil Med 2020; 44:101-108. [PMID: 32392648 PMCID: PMC7214137 DOI: 10.5535/arm.2020.44.2.101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 10/01/2019] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE To demonstrate the effect of daily treatment time on recovery of functional outcomes and how each type of rehabilitation treatment influences the improvement of subgroups of functional outcomes in stroke patients. METHODS We conducted a retrospective study in 168 patients who were admitted to the Department of Rehabilitation Medicine between 2015 and 2016. Patients who experienced their first-ever stroke and unilateral lesions were included. All patients underwent conventional rehabilitation treatment, and each treatment was administered one to two times a day depending on individual and treatment room schedules. Based on the mean daily treatment time, patients were divided into two groups: a high-amount group (n=54) and low-amount group (n=114). Outcomes were measured through the Korean version of Modified Barthel Index (MBI), FuglMeyer Assessment of the upper extremity, Trunk Impairment Scale (TIS), and Berg Balance Scale (BBS) scores on admission and at discharge. RESULTS The functional change and scores at discharge of MBI, TIS, and BBS were greater in the high-amount group than in the low-amount group. Among various types of rehabilitation treatments, occupational therapy training showed significant correlation with MBI, TIS, and BBS gain from admission to discharge. CONCLUSION The amount of daily mean treatment in post-stroke patients plays an important role in recovery. Mean daily rehabilitation treatment time seems to correlate with improved balance and basic activities of daily living after stroke.
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Affiliation(s)
- Hanbit Ko
- Department of Rehabilitation Medicine, Chungnam National University Hospital, Daejeon, Korea.,Daejeon-Chungcheong Regional Cardiocerebrovascular Center, Chungnam National University Hospital, Daejeon, Korea.,Daejeon-Chungcheong Regional Medical Rehabilitation Center, Chungnam National University Hospital, Daejeon, Korea
| | - Howook Kim
- Department of Rehabilitation Medicine, Chungnam National University Hospital, Daejeon, Korea.,Daejeon-Chungcheong Regional Cardiocerebrovascular Center, Chungnam National University Hospital, Daejeon, Korea.,Daejeon-Chungcheong Regional Medical Rehabilitation Center, Chungnam National University Hospital, Daejeon, Korea
| | - Yeongwook Kim
- Department of Rehabilitation Medicine, Chungnam National University Hospital, Daejeon, Korea.,Daejeon-Chungcheong Regional Cardiocerebrovascular Center, Chungnam National University Hospital, Daejeon, Korea.,Daejeon-Chungcheong Regional Medical Rehabilitation Center, Chungnam National University Hospital, Daejeon, Korea
| | - Min Kyun Sohn
- Department of Rehabilitation Medicine, Chungnam National University Hospital, Daejeon, Korea.,Daejeon-Chungcheong Regional Cardiocerebrovascular Center, Chungnam National University Hospital, Daejeon, Korea.,Daejeon-Chungcheong Regional Medical Rehabilitation Center, Chungnam National University Hospital, Daejeon, Korea
| | - Sungju Jee
- Department of Rehabilitation Medicine, Chungnam National University Hospital, Daejeon, Korea.,Daejeon-Chungcheong Regional Cardiocerebrovascular Center, Chungnam National University Hospital, Daejeon, Korea.,Daejeon-Chungcheong Regional Medical Rehabilitation Center, Chungnam National University Hospital, Daejeon, Korea
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Fukata K, Amimoto K, Inoue M, Sekine D, Inoue M, Fujino Y, Makita S, Takahashi H. Effects of diagonally aligned sitting training with a tilted surface on sitting balance for low sitting performance in the early phase after stroke: a randomised controlled trial. Disabil Rehabil 2019; 43:1973-1981. [PMID: 31714801 DOI: 10.1080/09638288.2019.1688873] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE To clarify the effects of diagonally aligned sitting training using a tilted surface on sitting balance for patients with low sitting performance in the early phase after stroke. MATERIALS AND METHODS This was an assessor-blinded randomised controlled trial. The experimental group used a surface tilted 10° backward and down toward the most affected side; the control group trained on a horizontal surface. Both groups were asked to move their trunk diagonally forward toward the least affected side. Participants performed the activity 40 times/session for seven sessions over 8 days. Sitting performances were assessed using the function in sitting test (FIST), subjective postural vertical (SPV) on the diagonal plane, and trunk impairment scale (TIS). RESULTS Thirty-three stroke patients were randomly allocated into two groups. Treatment effects differed significantly: mean differences between groups for FIST (total score, static, dynamic, scooting, and reactive) were 8.96, 2.35, 3.01, 1.27, and 1.72 points, for the mean SPV value was 1.82°, and for the TIS (total score and static) were 1.87 and 1.58 points, respectively. These results were more favourable in the experimental group. CONCLUSIONS Diagonally aligned sitting training on a tilted surface improves sitting balance and modulates the SPV compared with a horizontal surface.
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Affiliation(s)
- Kazuhiro Fukata
- Department of Rehabilitation Center, Saitama Medical University International Medical Center, Saitama, Japan.,Department of Physical Therapy, Tokyo Metropolitan University, Arakawaku, Japan
| | - Kazu Amimoto
- Department of Physical Therapy, Tokyo Metropolitan University, Arakawaku, Japan
| | - Masahide Inoue
- Department of Rehabilitation Center, Saitama Medical University International Medical Center, Saitama, Japan.,Department of Physical Therapy, Tokyo Metropolitan University, Arakawaku, Japan
| | - Daisuke Sekine
- Department of Rehabilitation Center, Saitama Medical University International Medical Center, Saitama, Japan.,Department of Physical Therapy, Tokyo Metropolitan University, Arakawaku, Japan
| | - Mamiko Inoue
- Department of Rehabilitation Center, Saitama Medical University International Medical Center, Saitama, Japan
| | - Yuji Fujino
- Department of Physical Therapy, Faculty of Health Science, Juntendo University, Bunkyo-Ku, Japan
| | - Shigeru Makita
- Department of Rehabilitation, Saitama Medical University International Medical Center, Hidaka, Japan
| | - Hidetoshi Takahashi
- Department of Rehabilitation, Saitama Medical University International Medical Center, Hidaka, Japan
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34
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Normann B, Arntzen EC, Sivertsen M. Comprehensive core stability intervention and coordination of care in acute and subacute stroke rehabilitation—a pilot study. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2019. [DOI: 10.1080/21679169.2018.1508497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Britt Normann
- Department of Health and Care Sciences, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
- Physiotherapy Department, Nordland Hospital Trust, Bodø, Norway
| | - Ellen Christin Arntzen
- Department of Health and Care Sciences, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
- Physiotherapy Department, Nordland Hospital Trust, Bodø, Norway
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Souza DCB, de Sales Santos M, da Silva Ribeiro NM, Maldonado IL. Inpatient trunk exercises after recent stroke: An update meta-analysis of randomized controlled trials. NeuroRehabilitation 2019; 44:369-377. [PMID: 31177237 DOI: 10.3233/nre-182585] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Although the role of trunk exercises in the chronic phase of stroke is acknowledged, the addition of specific inpatient training in the subacute stage is a matter of debate and varies among centers. Recent new evidence suggests the question should be revisited. OBJECTIVE To assess the impact of the addition of specific trunk training to inpatient rehabilitation protocols after a recent stroke. METHODS A systematic review was performed assessing the impact of inpatient trunk training. The search was performed in LILACS, SciELO, PEDro, Cochrane, and NCBI PubMed databases for clinical trials published up to December 31st, 2017. The initial bibliographic research identified 3202 articles. After analyzing the titles, 19 abstracts were selected for detailed analysis. After application of the eligibility criteria, the final selection included nine studies. Outcome measurements from the same evaluation instruments were submitted to a meta-analysis to improve homogeneity (7 studies). RESULTS All patients in the included studies were recruited less than three months after a stroke. Seven studies assessed trunk control using the Trunk Impairment Scale (TIS). There was a significant improvement in trunk control with a pooled increase in TIS score of 3.3 points from the baseline (CI95:2.54-4.06, p < 0.0001). Three studies assessed balance using the Brunel Balance Assessment (BBA) scale. There was also a significant improvement in balance with a pooled increase in BBA score of 2.7 points (CI95:1.5-4.03, p < 0.0001). The Berg Balance Scale was used for balance assessment in three studies. The meta-analysis of their results showed a pooled increase of 13.2 points (CI95:9.49-16.84, p < 0.0001). Weight transfer was evaluated in four studies using different methods. The addition of inpatient trunk exercises was associated with an improvement in the ability to transfer the trunk laterally in three studies. CONCLUSION The introduction of trunk-based inpatient training protocols brings short-term benefits in trunk performance and balance in stroke patients.
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Affiliation(s)
- Daniele Costa Borges Souza
- Programa de Pós-Graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil.,Divisão de Neurologia e Epidemiologia, Complexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil
| | - Matheus de Sales Santos
- Divisão de Neurologia e Epidemiologia, Complexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil.,Programa de Pós-Graduação em Processos Interativos dos Órgãos e Sistemas, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Brazil
| | - Nildo Manoel da Silva Ribeiro
- Divisão de Neurologia e Epidemiologia, Complexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil.,Programa de Pós-Graduação em Processos Interativos dos Órgãos e Sistemas, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Brazil.,Departamento de Fisioterapia, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Brazil.,Unidade de Reabilitação, Complexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil
| | - Igor Lima Maldonado
- Programa de Pós-Graduação em Medicina e Saúde, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil.,Divisão de Neurologia e Epidemiologia, Complexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil.,Unidade Neuro-Músculo-Esquelética, Complexo Hospitalar Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Brazil.,Departamento de Biomorfologia, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Brazil.,Le Studium Loire Valley Institute for Advanced Studies, Orléans, France.,UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
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Sheehy L, Taillon-Hobson A, Finestone H, Bilodeau M, Yang C, Hafizi D, Sveistrup H. Centre of pressure displacements produced in sitting during virtual reality training in younger and older adults and patients who have had a stroke. Disabil Rehabil Assist Technol 2019; 15:924-932. [PMID: 31219364 DOI: 10.1080/17483107.2019.1629118] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: Poor sitting balance is common after stroke and makes leaning and reaching while sitting difficult and dangerous. Virtual reality training (VRT) uses computer hardware and software to track a person's movements and allow him or her to interact with a virtual environment. VRT games are available to train sitting balance after stroke; however, it is unknown how challenging they are. The objectives of this study were to characterize the centre of pressure displacements generated during the performance of VRT in stroke patients (ST) and compare their performance to that of young (YA) and older adults (OA).Materials and Methods: Eight ST participants who could stand for at least four minutes were recruited from an inpatient stroke rehabilitation unit for this cross-sectional, observational pilot study. Eight YA and eight OA were recruited from the community. Participants sat on a pressure mat and played 17 VRT game/difficulty combinations. The area, range and average velocity of centre of pressure displacement were determined for each game/difficulty.Results: Virtually manoeuvring a motorcycle around barriers and leaning to move a ball down a maze produced the greatest displacement of the centre of pressure, particularly in the mediolateral direction. OA moved further and faster in the mediolateral direction than YA. ST's performance was more variable.Conclusions: Some VRT games were more likely to push participants to challenge their limits of stability. Others required less displacement but more trunk stability. These results can guide which VRT games are used for the rehabilitation of sitting balance after stroke.Implications for rehabilitationSome virtual reality training games produce greater displacements of the centre of pressure in sitting than others, suggesting that careful matching between game challenge and desired therapeutic outcome is necessary when selecting games.Virtual reality training performed in sitting with feet on the floor challenges sitting balance in the frontal plane more so than in the sagittal plane.Older adults tend to lean more than younger adults while individuals with stroke move more or less than others, depending on the game.
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Affiliation(s)
- Lisa Sheehy
- Bruyère Research Institute, Ottawa, Canada.,School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | | | - Hillel Finestone
- Bruyère Continuing Care, Ottawa, Canada.,Division of Physical Medicine and Rehabilitation, Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Martin Bilodeau
- Bruyère Research Institute, Ottawa, Canada.,School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada.,School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Christine Yang
- Bruyère Continuing Care, Ottawa, Canada.,Division of Physical Medicine and Rehabilitation, Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | | | - Heidi Sveistrup
- Bruyère Research Institute, Ottawa, Canada.,School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada.,School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
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Huzmeli ED, Korkmaz NC, Duman T, Gokcek O. Effects of sensory deficits on balance, functional status and trunk control in patients diagnosed with guillain-barre syndrome. ACTA ACUST UNITED AC 2018; 23:301-307. [PMID: 30351287 PMCID: PMC8015565 DOI: 10.17712/nsj.2018.4.20180098] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Objectives: To investigate the effects of sensory deficits on balance, functional status and trunk control in patients diagnosed with Guillain–Barré syndrome (GBS). Methods: Twenty patients who were diagnosed with GBS and who were in the neurology department of Mustafa Kemal University in 2017, participated in this descriptive study. There were 11 males and 9 females, and the average age was 41.55 ± 18.49 years. The trunk control of the GBS patients was assessed using the trunk impairment scale (TIS), reaching function was assessed using the functional reaching test (FRT) in the sitting position and body balance assessed using the Berg balance scale (BBS).Light touch was assessed using Semmes–Weinstein monofilament test, proprioception was assessed using the distal proprioception test and disability status was assessed using the Guillain–Barré syndrome disability scale (GBSDS). Results: We found a moderate, positive and significant correlation between proprioception scores and the BBS and between proprioception scores and the TIS. The correlation between proprioception and FRT in the sitting position and between proprioception and the GBSDS was not significant. We found a moderate and negative correlation between light touch and the FRT in the sitting position, TIS, BBS, but a moderate and positive correlation between light touch and the GBSDS. Conclusion: Neurologists and physiotherapists should both take sensory and motor function into consideration in the assessment and rehabilitation program of patients diagnosed with GBS.
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Affiliation(s)
- Esra-Dogru Huzmeli
- School of Physical Therapy and Rehabilitation, Hatay Mustafa Kemal University, Antakya, Turkey. E-mail:
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Dujović SD, Malešević J, Malešević N, Vidaković AS, Bijelić G, Keller T, Konstantinović L. Novel multi-pad functional electrical stimulation in stroke patients: A single-blind randomized study. NeuroRehabilitation 2018; 41:791-800. [PMID: 29254111 DOI: 10.3233/nre-172153] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Foot drop is common gait impairment after stroke. Functional electrical stimulation (FES) of the ankle dorsiflexor muscles during the swing phase of gait can help correcting foot drop. OBJECTIVE To evaluate efficacy of additional novel FES system to conventional therapy in facilitating motor recovery in the lower extremities and improving walking ability after stroke. METHODS Sixteen stroke patients were randomly allocated to the FES group (FES therapy plus conventional rehabilitation program) (n = 8), and control group (conventional rehabilitation program) n = 8. FES was delivered for 30 min during gait to induce ankle plantar and dorsiflexion. MAIN OUTCOME MEASURES gait speed using 10 Meter Walk Test (10 MWT), Fugl-Meyer Assessment (FMA), Berg Balance Scale (BBS) and modified Barthel Index (MBI). RESULTS Results showed a significant increase in gait speed in FES group (p < 0.001), higher than the minimal detected change. The FES group showed improvement in functional independence in the activities of daily living, motor recovery and gait performance. CONCLUSIONS The findings suggest that novel FES therapy combined with conventional rehabilitation is more effective on walking speed, mobility of the lower extremity, balance disability and activities of daily living compared to a conventional rehabilitation program only.
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Affiliation(s)
- Suzana Dedijer Dujović
- The University of Belgrade, Serbia and Clinic for rehabilitation "Dr M.Zotovic", Belgrade, Serbia
| | - Jovana Malešević
- The University of Belgrade and Tecnalia Serbia Ltd., Belgrade, Serbia
| | - Nebojša Malešević
- Department of Biomedical Engineering, Lund University, Belgrade, Serbia
| | - Aleksandra S Vidaković
- Faculty of Medicine, University of Belgrade and Clinic for rehabilitation "Dr M.Zotovic", Belgrade, Serbia
| | - Goran Bijelić
- Neurorehabilitation Area at the Health Division of TECNALIA, San Sebastian, Spain
| | - Thierry Keller
- Neurorehabilitation Area at the Health Division of TECNALIA, San Sebastian, Spain
| | - Ljubica Konstantinović
- Faculty of Medicine, University of Belgrade and Clinic for rehabilitation "Dr M.Zotovic", Belgrade, Serbia
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Lee MJ, Yoon S, Kang JJ, Kim J, Kim JM, Han JY. Efficacy and Safety of Caregiver-Mediated Exercise in Post-stroke Rehabilitation. Ann Rehabil Med 2018; 42:406-415. [PMID: 29961738 PMCID: PMC6058591 DOI: 10.5535/arm.2018.42.3.406] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 09/04/2017] [Indexed: 01/19/2023] Open
Abstract
Objective To assess the efficacy and safety of our 4-week caregiver-mediated exercise (CME) in improving trunk control capacity, gait, and balance and in decreasing concerns about post-stroke falls when there is an increase in its efficacy. Methods Acute or subacute stroke survivors were assigned to either the trial group (n=35) or the control group (n=37). Changes in Modified Barthel Index (MBI), Functional Ambulation Categories (FAC), Berg Balance Scale (BBS), and Trunk Impairment Scale (TIS) scores at 4 weeks from baseline served as primary outcome measures. Correlations of primary outcome measures with changes in Fall Efficacy Scale-International (FES-I) scores at 4 weeks from baseline in the trial group served as secondary outcome measures. Treatment-emergent adverse events (TEAEs) served as safety outcome measures. Results There were significant differences in changes in MBI, FAC, BBS, TIS-T, TIS-D, TIS-C, and FES-I scores at 4 weeks from baseline between the two groups (all p<0.0001). There were no significant (p=0.0755) differences in changes in TIS-S scores at 4 weeks from baseline between the two groups. MBI, FAC, BBS, and TIS scores showed significantly inverse correlations with FES-I scores in patients receiving CME. There were no TEAEs in our series. Conclusion CME was effective and safe in improving the degree of independence, ambulation status, dynamic and static balance, trunk function, and concerns about post-stroke falls in stroke survivors.
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Affiliation(s)
- Min Jun Lee
- Department of Rehabilitation Medicine, Konkuk University Chungju Hospital, Chungju, Korea
| | - Seihee Yoon
- Department of Rehabilitation Medicine, Konkuk University Chungju Hospital, Chungju, Korea
| | - Jung Joong Kang
- Department of Rehabilitation Medicine, Konkuk University Chungju Hospital, Chungju, Korea
| | - Jungin Kim
- Department of Rehabilitation Medicine, Konkuk University Chungju Hospital, Chungju, Korea
| | - Jong Moon Kim
- Department of Rehabilitation Medicine, Konkuk University Chungju Hospital, Chungju, Korea
| | - Jun Young Han
- Department of Rehabilitation Medicine, Konkuk University Chungju Hospital, Chungju, Korea
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Kawanabe E, Suzuki M, Tanaka S, Sasaki S, Hamaguchi T. Impairment in toileting behavior after a stroke. Geriatr Gerontol Int 2018; 18:1166-1172. [PMID: 29770543 DOI: 10.1111/ggi.13435] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 03/13/2018] [Accepted: 04/04/2018] [Indexed: 02/06/2023]
Abstract
AIM Dependence for toileting is the most problematic aspect for patients after a stroke. However, the relative difficulty of each component of toileting and the predictors for independent performance of these activities are unknown. We investigated these issues in stroke patients using Boltzmann sigmoid and generalized linear modeling. METHODS We carried out a cross-sectional correlation study, including 107 adult inpatients, hospitalized for a stroke. We assessed the activity components of toileting, as well as evaluated physical impairment using the Fugl-Meyer Assessment, impairments in balance using the Berg Balance Scale, cognitive impairments using the Mini-Mental State Examination and the presence or absence of unilateral spatial neglect or aphasia. RESULTS Boltzmann sigmoid modeling showed that the total scores required to obtain a response at 50% of the maximal value for the required components of toileting ranged between 2.691 and 34.962 points, for the components of "wearing pants" and "cutting the toilet paper," respectively. A generalized linear model showed that the Berg Balance Scale score was a significant predictor for independent performance on most component activities of toileting. CONCLUSIONS The component of toileting that was easiest to carry out was cutting the toilet paper, and the most difficult was wearing pants. Balance impairment was an independent predictor of independent toileting after stroke. This detailed toileting assessment enabled us to document the most difficult components of toileting, and to assess the motor and process skills required for independent toileting. Geriatr Gerontol Int 2018; 18: 1166-1172.
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Affiliation(s)
- Eri Kawanabe
- Department of Rehabilitation, Hamareha Home-visit Rehabilitation Station, Kanagawa, Japan
| | - Makoto Suzuki
- Faculty of Health Sciences, Tokyo Kasei University, Saitama, Japan
| | - Satoshi Tanaka
- Laboratory of Psychology, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Shotaro Sasaki
- Department of Rehabilitation, St. Marianna University, Yokohama City Seibu Hospital, Kanagawa, Japan
| | - Toyohiro Hamaguchi
- School of Health Sciences, Saitama Prefectural University, Saitama, Japan
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41
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Quintino LF, Franco J, Gusmão AFM, Silva PFDS, Faria CDCDM. Trunk flexor and extensor muscle performance in chronic stroke patients: a case-control study. Braz J Phys Ther 2018; 22:231-237. [PMID: 29258736 PMCID: PMC5993948 DOI: 10.1016/j.bjpt.2017.12.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 11/17/2017] [Accepted: 12/05/2017] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Although chronic stroke patients commonly show impairment of trunk muscle performance, this disability has only been analyzed in terms of peak torque. Therefore, other measures are needed for a more adequate description. OBJECTIVE This study aimed to compare concentric muscle performance of trunk flexor/extensor muscles between chronic stroke patients and matched-healthy subjects. METHODS 18 chronic stroke patients and 18 healthy subjects were matched according to their age, sex, body mass index and level of physical activity. After familiarization, trunk flexor/extensor concentric muscle strength was measured using an isokinetic dynamometer (Biodex Medical Systems Inc, Shirley, NY, USA) with 3 repetitions at a velocity of 60°/s and 5 repetitions at a velocity of 120°/s. Trunk muscular performance was characterized by peak torque, torque at 90°, total work, and total work normalized by trunk mass. Student's t-test was used for independent samples (α=0.05) for group comparisons. RESULTS All trunk muscle performance variables values investigated were significantly lower in chronic stroke patients when compared to matched-healthy subjects (p≤0.001). The obtained ratios of chronic stroke patients scores to that of the matched-healthy subjects at velocities of 60°/s and 120°/s were, respectively: flexor peak torque (60% & 53%)/extensor (54% & 53%); flexor torque at 90° (56.20% & 36.58%)/extensor (57.92% & 30.65%); flexor total muscular work (51.27% & 38.03%)/extensor (47.97% & 39.52%); and flexor total muscular work normalized by trunk mass (55.57% & 40%)/extensor (51.40% & 42%). CONCLUSIONS Chronic stroke patients showed decreased trunk muscle performance when compared to matched-healthy subjects in all variables investigated.
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Affiliation(s)
| | - Juliane Franco
- Universidade Federal de Minas Gerais (UFMG), Department of Physical Therapy, Belo Horizonte, MG, Brazil
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Sorrentino G, Sale P, Solaro C, Rabini A, Cerri CG, Ferriero G. Clinical measurement tools to assess trunk performance after stroke: a systematic review. Eur J Phys Rehabil Med 2018; 54:772-784. [PMID: 29684980 DOI: 10.23736/s1973-9087.18.05178-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Stroke may result in decreased trunk muscle strength and limited trunk coordination, frequently determining loss of autonomy due to the trunk impairment. Furthermore, sitting balance has been repeatedly identified as an important predictor of motor and functional recovery after stroke. Given the importance of the trunk, it is therefore mandatory that validated tools be available to assess its performance. A systematic review of the currently available clinical measurement tools to assess trunk performance after stroke has been carried out. EVIDENCE ACQUISITION We searched the PubMed database from January 2006 to April 2017 to select articles which reported or included a clinical measure of trunk performance used in an adult stroke population. The data collected were integrated with the results of a previous review published in 2006. A total of 302 articles were identified, of which 19 were eligible for inclusion. EVIDENCE SYNTHESIS Numerous clinical tools have been validated to assess trunk performance after stroke, including the Trunk Control Test, the Trunk Impairment Scale, the Postural Assessment Scale for Stroke, the Ottawa Sitting Scale, the Modified Functional Reach Test, the Function In Sitting Test, the Physical Ability Scale, the Trunk Recovery Scale, the Balance Assessment in Sitting and Standing Positions, and the and Sitting-Rising Test. CONCLUSIONS Several scales and tests have been demonstrated to be valid for assessing trunk performance in stroke. Some of these have already been refined by Rasch analysis to increase their psychometric characteristics. Further psychometric analysis of these tools in large and different samples is, however, still needed.
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Affiliation(s)
| | - Patrizio Sale
- Rehabilitation Unit, Department of Neuroscience, University of Padua, Padua, Italy
| | - Claudio Solaro
- Mons. Luigi Novarese Rehabilitation Center, Moncrivello, Vercelli, Italy
| | - Alessia Rabini
- Division of Physical Medicine and Rehabilitation, Department of Geriatrics, Neurosciences, and Orthopedics, Agostino Gemelli University Hospital, Sacred Heart Catholic University, Rome, Italy
| | - Cesare G Cerri
- School of Physical and Rehabilitation Medicine, Bicocca University of Milan, Milan, Italy
| | - Giorgio Ferriero
- Department of Physical Medicine and Rehabilitation, Scientific Institute for Research and Care of Lissone, Istituti Clinici Scientifici Maugeri, Lissone, Monza-Brianza, Italy -
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Vincent-Onabajo G, Joseph E, Musa HY. Impact of balance on functional independence after stroke: A cross-sectional study at rehabilitation settings in Nigeria. NeuroRehabilitation 2018; 42:499-504. [PMID: 29660950 DOI: 10.3233/nre-172305] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Functional independence is often compromised after stroke and its restoration is one of the goals of stroke rehabilitation. OBJECTIVE This study assessed the impact of balance on functional independence after stroke. METHODS Ninety-five stroke patients undergoing physical rehabilitation at two health institutions in Nigeria participated in the study. Balance and functional independence were respectively assessed with the Berg Balance Scale and the Barthel Index. Binary logistic regression analysis was conducted to examine the independent impact of balance on functional independence while controlling for participants' age, sex, side of hemiparesis and post-stroke duration. RESULTS Mean±SD age of the participants was 58.4±13.1 years and females were more (f = 48; % = 50.5). The regression model from the binary regression analysis explained 73.2% (Nagelkerke R2 = 0.732) of the variance in functional independence. Good balance function was found to independently and significantly (P < 0.01) increase the likelihood of being functionally independent after stroke (Odds ratio = 1.33; 95% CI = 1.11 to 1.58). CONCLUSION The goal of attaining functional independence after stroke may depend to a significant extent on good balance function irrespective of the stroke survivor's age, sex and post-stroke duration.
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Affiliation(s)
- Grace Vincent-Onabajo
- Department of Medical Rehabilitation (Physiotherapy), College of Medical Sciences, University of Maiduguri, Maiduguri, Borno State, Nigeria
| | - Emmanuel Joseph
- Department of Medical Rehabilitation (Physiotherapy), College of Medical Sciences, University of Maiduguri, Maiduguri, Borno State, Nigeria
| | - Hadiza Yakubu Musa
- Department of Medical Rehabilitation (Physiotherapy), College of Medical Sciences, University of Maiduguri, Maiduguri, Borno State, Nigeria
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Vaughan-Graham J, Patterson K, Zabjek K, Cott CA. Conceptualizing movement by expert Bobath instructors in neurological rehabilitation. J Eval Clin Pract 2017; 23:1153-1163. [PMID: 28425221 DOI: 10.1111/jep.12742] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 02/21/2017] [Accepted: 02/22/2017] [Indexed: 01/01/2023]
Abstract
RATIONALE, AIMS, AND OBJECTIVES Movement, a core aspect of physiotherapy practice, and integral to the clinical reasoning process has undergone limited theoretical development. Instead, research has focused on intervention effectiveness embedded within the positivist paradigm. The purpose of this study was to explore how expert neurorehabilitation therapists conceptualize movement as part of their clinical reasoning. METHOD A qualitative interpretive descriptive approach consisting of stimulated recall using video-recorded treatment sessions and in-depth interviews was used. Theoretical sampling was used to recruit members of the International Bobath Instructors Training Association (IBITA) who are recognized experts in neurorehabilitation. Interview transcripts were transcribed verbatim. Data analysis was progressive, iterative, and inductive. RESULTS Twenty-two IBITA instructors from 7 different countries volunteered to participate. They ranged in clinical experience from 12 to 40 years and instructor experience from 1 to 35 years. The conceptualization of movement by the IBITA instructors involves the following elements: (1) movement comprises the whole person and the whole body, not just individual body segments; (2) active alignment of body segments is integral to movement performance; and (3) efficient movement requires the relative integration of postural control/stability and selective movement/mobility. CONCLUSIONS The IBITA instructors conceptualize movement from a person-centred perspective. The integration of postural control and selective movement, with alignment and variability as key components, forms the foundation of their understanding of movement. Further investigation into the role of postural control in movement recovery post central nervous system lesion is required. Likewise, the dimensions of movement critical to the conceptualization of movement are not well understood from the perspective of the physiotherapist or persons with neurological impairments.
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Affiliation(s)
| | - Kara Patterson
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - Karl Zabjek
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - Cheryl A Cott
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
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Monticone M, Ambrosini E, Verheyden G, Brivio F, Brunati R, Longoni L, Mauri G, Molteni A, Nava C, Rocca B, Ferrante S. Development of the Italian version of the trunk impairment scale in subjects with acute and chronic stroke. Cross-cultural adaptation, reliability, validity and responsiveness. Disabil Rehabil 2017; 41:66-73. [PMID: 28891352 DOI: 10.1080/09638288.2017.1373409] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE To cross-culturally adapt and psychometrically analyse the Italian version of the Trunk Impairment Scale on acute (cohort 1) and chronic stroke patients (cohort 2). METHODS The Trunk Impairment Scale was culturally adapted in accordance with international standards. The psychometric testing included: internal consistency (Cronbach's alpha), inter- and intra-rater reliability (intraclass correlation coefficient; standard error of measurement and minimal detectable change), construct validity by comparing Trunk Impairment Scale score with Barthel Index, motor subscale of Functional Independence Measure, and Trunk Control Test (Pearson's correlation), and responsiveness (Effect Size, Effect Size with Guyatt approach, standardized response mean, and Receiver Operating Characteristics curves). RESULTS The Trunk Impairment Scale was administered to 125 and 116 acute and chronic stroke patients, respectively. Internal consistency was acceptable (α > 0.7), inter- and intra-rater reliability (ICC > 0.9, Minimal Detectable Change for total score < 1.6 in cohort 1 and < 1.1 in cohort 2) were excellent. The construct validity showed acceptable correlations (r > 0.4) with all scales but the motor Functional Independence Measure in cohort 2. Distribution-based methods showed large effects in cohort 1 and moderate to large effects in cohort 2. The Minimal Important Difference was 3.5 both from patient's and therapist's perspective in cohort 1 and 2.5 and 1.5 from patient's and therapist's perspective, respectively, in cohort 2. CONCLUSION The Trunk Impairment Scale was successfully translated into Italian and proved to be reliable, valid, and responsive. Its use is recommended for clinical and research purposes. Implications for Rehabilitation Trunk control is an essential part of balance and postural control, constituting an important prerequisite for daily activities and function. The TIS administered in subjects with subacute and chronic stroke was reliable, valid and responsive. The TIS is expected to help clinicians and researchers by identifying key functional processes related to disability in people with subacute and chronic stroke.
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Affiliation(s)
- Marco Monticone
- a Department of Medical Sciences and Public Health , University of Cagliari , Cagliari , Italy
| | - Emilia Ambrosini
- b Neuroengineering and Medical Robotics Laboratory, Department of Electronics Information and Bioengineering , Politecnico di Milano , Milan , Italy
| | - Geert Verheyden
- c Department of Rehabilitation Sciences , KU Leuven , Leuven , Belgium
| | - Flavia Brivio
- d Physical Medicine and Rehabilitation Unit , Scientific Institute of Lissone Clinical and Scientific Institutes Maugeri, Institute of Care and Research (IRCCS) , Lissone , Italy
| | - Roberto Brunati
- d Physical Medicine and Rehabilitation Unit , Scientific Institute of Lissone Clinical and Scientific Institutes Maugeri, Institute of Care and Research (IRCCS) , Lissone , Italy
| | - Luca Longoni
- d Physical Medicine and Rehabilitation Unit , Scientific Institute of Lissone Clinical and Scientific Institutes Maugeri, Institute of Care and Research (IRCCS) , Lissone , Italy
| | - Gaia Mauri
- d Physical Medicine and Rehabilitation Unit , Scientific Institute of Lissone Clinical and Scientific Institutes Maugeri, Institute of Care and Research (IRCCS) , Lissone , Italy
| | - Alessandro Molteni
- d Physical Medicine and Rehabilitation Unit , Scientific Institute of Lissone Clinical and Scientific Institutes Maugeri, Institute of Care and Research (IRCCS) , Lissone , Italy
| | - Claudia Nava
- d Physical Medicine and Rehabilitation Unit , Scientific Institute of Lissone Clinical and Scientific Institutes Maugeri, Institute of Care and Research (IRCCS) , Lissone , Italy
| | - Barbara Rocca
- d Physical Medicine and Rehabilitation Unit , Scientific Institute of Lissone Clinical and Scientific Institutes Maugeri, Institute of Care and Research (IRCCS) , Lissone , Italy
| | - Simona Ferrante
- b Neuroengineering and Medical Robotics Laboratory, Department of Electronics Information and Bioengineering , Politecnico di Milano , Milan , Italy
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Aaslund MK, Moe-Nilssen R, Gjelsvik BB, Bogen B, Næss H, Hofstad H, Skouen JS. A longitudinal study investigating how stroke severity, disability, and physical function the first week post-stroke are associated with walking speed six months post-stroke. Physiother Theory Pract 2017; 33:932-942. [DOI: 10.1080/09593985.2017.1360424] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Mona Kristin Aaslund
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Department of Physiotherapy, Haukeland University Hospital, Bergen, Norway
| | - Rolf Moe-Nilssen
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | | | - Bård Bogen
- Department of Occupational Therapy, Western Norway University of Applied Sciences, Bergen, Norway
| | - Halvor Næss
- Department of Neurology, Haukeland University Hospital, Bergen, Norway
- Centre for age-related medicine, Stavanger University Hospital, Stavanger, Norway
- Institute of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Håkon Hofstad
- Department of Physical Medicine and Rehabilitation, Haukeland University Hospital, Bergen, Norway
| | - Jan Sture Skouen
- Department of Physical Medicine and Rehabilitation, Haukeland University Hospital, Bergen, Norway
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Breistein K, Gjelsvik BEB, Jørgensen L. The Postural Assessment Scale for Stroke Patients: translation into Norwegian, cultural adaptation, and examination of reliability. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2017. [DOI: 10.1080/21679169.2017.1334817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Karen Breistein
- Department of Physiotherapy, Haukeland University Hospital, Bergen, Norway
| | | | - Lone Jørgensen
- Department of Health and Care Sciences, UiT-The Arctic University of Norway, Tromsø, Norway
- Department of Clinical Therapeutic Services, UiT-The Artic University of Norway, Tromsø, Norway
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Kinoshita S, Abo M, Okamoto T, Tanaka N. Utility of the Revised Version of the Ability for Basic Movement Scale in Predicting Ambulation during Rehabilitation in Poststroke Patients. J Stroke Cerebrovasc Dis 2017; 26:1663-1669. [PMID: 28579021 DOI: 10.1016/j.jstrokecerebrovasdis.2017.02.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 01/18/2017] [Accepted: 02/15/2017] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE This study aims to test the hypothesis that the Revised Version of the Ability for Basic Movement Scale (ABMSII) can predict ambulation during rehabilitation in poststroke patients. SUBJECTS AND METHODS The study included first-ever stroke patients who were admitted to the rehabilitation ward and were dependent in walking. ABMSII scores were assessed by physical therapists on admission to the hospital. Functional ambulation category (FAC) was assessed every 2 weeks during hospitalization. The primary outcome was independent ambulation, defined as 4 points or higher on the FAC. RESULTS After setting the inclusion criteria, data of 374 stroke patients (mean age: 70 years, 153 women) were eligible for the analysis. Of these, 193 patients achieved independent ambulation during hospitalization. The ABMSII score was significantly higher in the patients who regained independent walking ability than in those who required assistance in walking. Based on receiver operating characteristic curve analysis, an ABMSII score of 16 points or higher had a sensitivity of 93% and a specificity of 71%. Kaplan-Meier curve analysis after log-rank test demonstrated a significantly higher event rate in patients with an ABMSII score of 16 or higher compared to those with an ABMSII score lower than 16. Univariate and multivariate Cox regression analyses identified the ABMSII score as a significant and independent predictor of ambulation during rehabilitation. CONCLUSION Our results suggest that the ABMSII score is a potentially useful tool to predict ambulation during rehabilitation in poststroke patients.
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Affiliation(s)
- Shoji Kinoshita
- Department of Rehabilitation Medicine, Nishi-Hiroshima Rehabilitation Hospital, Hiroshima, Japan; Department of Rehabilitation Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Masahiro Abo
- Department of Rehabilitation Medicine, The Jikei University School of Medicine, Tokyo, Japan.
| | - Takatsugu Okamoto
- Department of Rehabilitation Medicine, Nishi-Hiroshima Rehabilitation Hospital, Hiroshima, Japan; Department of Rehabilitation Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Naojiro Tanaka
- Department of Rehabilitation Medicine, Nishi-Hiroshima Rehabilitation Hospital, Hiroshima, Japan
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Abstract
OBJECTIVE The present study aimed to determine the discriminant power of the modified Trunk Impairment Scale (mTIS) in stroke survivors versus healthy adults. DESIGN Cross-sectional. SETTING Inpatient rehabilitation center. PARTICIPANTS Fifty-five subjects with stroke and 29 healthy adults. METHODS Subjects were examined using the mTIS, Berg Balance Scale, and Timed Up and Go test for balance; 5-m Walk Test and Functional Ambulation Category for gait; Fugl-Meyer Assessment for motor function; Postural Assessment Scale for Stroke-Trunk Control and Trunk Control Test for trunk control; and Modified Barthel Index for activities of daily living performance. RESULTS The mTIS results differed significantly between stroke survivors and healthy adults (p < 0.001). In addition, mTIS scores were significantly correlated with the Berg Balance Scale (r = 0.82), Timed Up and Go test (r = -0.70), 5-m Walk Test (r = 0.73), Functional Ambulation Category (r = 0.54), Fugl-Meyer Assessment (r = 0.37-0.80), Postural Assessment Scale for Stroke-Trunk Control and Trunk Control Test (r = 0.55-0.63), and Modified Barthel Index score (r = 0.56) results (p < 0.05-0.01). The mTIS also showed 66% influence on the Berg Balance Scale, 49% on the Timed Up and Go test, 53% on the 5-m Walk Test, 28% on the Functional Ambulation Category, 12% on the Fugl-Meyer Assessment-upper extremity, 64% on the Fugl-Meyer Assessment-lower extremity, and 30% on the Modified Barthel Index. The cutoff value of the mTIS for the Modified Barthel Index classification was >10.5 points, while the area under the curve had a moderate accuracy of 73%. CONCLUSION The mTIS can be used to examine the degree of trunk control or the level of trunk impairment, which is seen as a prerequisite for balance, gait, motor function, and activities of daily living performance in stroke survivors. Implications for Rehabilitation The modified Trunk Impairment Scale can be used as an assessment tool to classify the degree of trunk control or its level of impairment in stroke survivors. The modified Trunk Impairment Scale may have a favorable correlation with assessing physical functions such as balance, gait, motor function, and ADL in stroke survivors.
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Affiliation(s)
- YunBok Lee
- a Department of Nurse , Dongseo University , Busan , Republic of Korea
| | - SeungHeon An
- b Department of Physical Therapy , National Rehabilitation Center , Seoul , Republic of Korea
| | - GyuChang Lee
- c Department of Physical Therapy , Kyungnam University , Changwon , Gyeongsangnam-do , Republic of Korea
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Lee KB, Lim SH. Prognosis and Recovery of Motor Function with Lesion–Symptom Mapping in Patients with Stroke. BRAIN & NEUROREHABILITATION 2017. [DOI: 10.12786/bn.2017.10.e5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Affiliation(s)
- Kyoung Bo Lee
- Department of Rehabilitation Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Seong Hoon Lim
- Department of Rehabilitation Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
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