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Vecchio M, Chiaramonte R, De Sire A, Buccheri E, Finocchiaro P, Scaturro D, Letizia Mauro G, Cioni M. Do proprioceptive training strategies with dual-task exercises positively influence gait parameters in chronic stroke? A systematic review. J Rehabil Med 2024; 56:jrm18396. [PMID: 39145519 PMCID: PMC11337222 DOI: 10.2340/jrm.v56.18396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 04/09/2024] [Indexed: 08/16/2024] Open
Abstract
OBJECTIVE This study aims to assess the impact of proprioceptive training strategies with dual-task exercises on gait in people with chronic stroke. STUDY DESIGN Systematic review. PATIENTS Chronic stroke. METHODS Searches were conducted in accordance with PRISMA guidelines and PICOS criteria. PubMed, Web of Science, and Scopus databases were systematically searched from November 2020 to February 2022, for eligible clinical trials. Two independent reviewers thoroughly screened potential articles for relevance and assessed the methodology quality. In accordance with the GRADE, PICOS criteria, and Cochrane risk of bias tools, the authors included articles concerning the effectiveness of dual-task in proprioceptive training on gait parameters in people with chronic stroke. RESULTS Of 3075 identified studies, 11 articles met the inclusion criteria: 7 were randomized clinical trials, 1 was not randomized, and 3 were observational studies. The overall quality of evidence, assessed using the GRADE framework, was high, indicating a high level of confidence in the systematic review's findings. The papers involved 393 stroke patients; 241 underwent dual-task in proprioceptive training, with 152 participants in other stroke rehabilitation; within the dual-task group, 71 engaged in cognitive tasks, and 170 participated in motor tasks. dual-task in proprioceptive training improved gait speed, cadence, stride time, stride length, and step length. The best effects were observed with training 3 times a week for 4 weeks, with each session lasting 30 minutes, on speed, cadence, stride length, and step length. CONCLUSION Current evidence suggests that proprioceptive training strategies with dual-task exercises improved walking abilities in people with chronic stroke. Specifically, it enhanced gait speed, a key indicator of clinical severity.
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Affiliation(s)
- Michele Vecchio
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy; Rehabilitation Unit, "AOU Policlinico G. Rodolico-San Marco", Catania, Italy
| | - Rita Chiaramonte
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy.
| | - Alessandro De Sire
- Physical and Rehabilitative Medicine, Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy; Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Enrico Buccheri
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Patrizia Finocchiaro
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Dalila Scaturro
- Department of Surgery, Oncology and Stomatology, University of Palermo, Palermo, Italy
| | - Giulia Letizia Mauro
- Department of Surgery, Oncology and Stomatology, University of Palermo, Palermo, Italy
| | - Matteo Cioni
- Laboratory of Neuro-Biomechanics, Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
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Prasomsri J, Sakai K, Ikeda Y. Effectiveness of Motor Imagery on Physical Function in Patients With Stroke: A Systematic Review. Motor Control 2024:1-22. [PMID: 39069292 DOI: 10.1123/mc.2023-0045] [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: 05/04/2023] [Revised: 04/23/2024] [Accepted: 04/30/2024] [Indexed: 07/30/2024]
Abstract
Over the past two decades, motor imagery (MI) has been used as a supplementary treatment approach to regain physical function in patients with stroke. However, the baseline treatment and the quality of study methodology for new treatment approaches have improved. This systematic review examined the evidence published in the past few decades on the effectiveness of MI on upper- and lower-extremity function and functional performance in patients with stroke. A total of 29 randomized controlled and crossover trials that compared MI with other interventions were analyzed. In addition, the outcomes were grouped into upper-, lower-extremity function, and functional performance for data analysis. More than half of the upper-extremity function studies reported improved performance in Fugl-Meyer assessment, Wolf motor function test, and box and block test in both acute and chronic stages. Lower-extremity function and functional performance were primarily investigated using Fugl-Meyer assessment, gait speed and parameters, activities of daily living, and balance ability. When considering only high-quality studies, six of 15 on upper extremity reported significant effects, whereas five of 15 reported nonsignificant effects. In addition, six of 14 studies on gait and balance reported significant effects. This systematic review suggests that both MI training and conventional rehabilitation programs effectively enhance upper limb functional abilities, including improvements in gait speed and balance, in individuals with acute and chronic stroke. Although the studies published during the past few decades showed heterogeneity in onset after stroke, research protocol, training intensity, and research methodology quality, none of them reported the long-term effects.
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Affiliation(s)
- Jaruwan Prasomsri
- Graduate School of Human Health Sciences, Department of Physical Therapy, Tokyo Metropolitan University, Tokyo, Japan
- Faculty of Medicine, Department of Physical Therapy, Prince of Songkla University, Songkhla, Thailand
| | - Katsuya Sakai
- Department of Physical Therapy, Faculty of Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
| | - Yumi Ikeda
- Graduate School of Human Health Sciences, Department of Physical Therapy, Tokyo Metropolitan University, Tokyo, Japan
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Yan T, Liang W, Chan CWH, Shen Y, Liu S, Li M. Effects of motor imagery training on gait performance in individuals after stroke: a systematic review and meta-analysis. Disabil Rehabil 2024:1-15. [PMID: 38638087 DOI: 10.1080/09638288.2024.2337091] [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: 11/14/2023] [Accepted: 03/09/2024] [Indexed: 04/20/2024]
Abstract
PURPOSE This review systematically explores and summarise the effects of motor imagery training (MIT) compared to conventional therapy on gait performance in individuals after stroke. MATERIALS AND METHODS Randomised controlled trials (RCTs) were systematically searched in five electronic databases (PubMed, EMBASE, PsycINFO, OVID Nursing and CINAHL) from inception to 30 December 2022. Studies investigating MITs, targeted at individuals after stroke were eligible. Data were extracted related to study and intervention characteristics. RESULTS Sixteen studies were included. Compared with 'routine methods of treatment or training', the meta-analyses showed that MIT was more effective in improving cadence immediately post intervention (SMD: 1.22, 95% CI: 0.59, 1.85, p = 0.0001, I2 = 25%) and at 1- or 2-months post intervention (SMD: 0.78, 95% CI: 0.35, 1.20, p = 0.0004, I2 = 46%). The results also showed that MIT improves the step length of the affected side and the unaffected side at 1- or 2-months post intervention. Separate meta-analyses were also conducted on different tests of walking endurance (assessed by the 6-Minute Walk Test) and functional mobility (assessed by the Timed-Up-and-Go test). CONCLUSIONS MIT effectively improved gait performance. The findings in individuals after stroke remain inconclusive due to significant heterogeneity in included studies.
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Affiliation(s)
- Tingting Yan
- School of Nursing, Peking University, Beijing, China
| | - Wei Liang
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Carmen W H Chan
- The Nethersole School of Nursing, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China
| | - Yao Shen
- The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Shuling Liu
- Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin, China
- Department of Neurosurgery, Tianjin Huanhu Hospital, Tianjin, China
| | - Mingzi Li
- School of Nursing, Peking University, Beijing, China
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Seok H, Choi YH. The Impact of Mental Practice on Motor Function in Patients With Stroke: A Systematic Review and Meta-analysis. BRAIN & NEUROREHABILITATION 2023; 16:e31. [PMID: 38047096 PMCID: PMC10689861 DOI: 10.12786/bn.2023.16.e31] [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: 07/12/2023] [Revised: 10/10/2023] [Accepted: 10/16/2023] [Indexed: 12/05/2023] Open
Abstract
Mental practice (MP), the cognitive rehearsal of physical activities without overt movements, has recently emerged as a promising rehabilitation method for patients with stroke. This paper presents a systematic review and meta-analysis critically evaluating the existing evidence to offer a comprehensive estimate of the overall effect of MP on motor function in stroke patients. A systematic search of 3 international databases (PubMed, Embase, and the Cochrane Library) was conducted for randomized controlled trials. We finally selected 31 randomized clinical trials and conducted meta-analysis to determine the effectiveness of MP on motor recovery of upper extremity, upper extremity function, activities of daily living, and gait velocity in stroke patients. The results of the systematic reviews showed that MP combined with conventional therapy has a positive impact on improving upper extremity motor function, with a moderate quality of evidence. However, the beneficial effect of MP on gait velocity was not demonstrated. It is recommended to treat with MP in addition to conventional rehabilitation therapy to improve the motor outcome of stroke depending on the patient's condition (Recommendation level: Conditional Recommend Evidence certainty: Moderate).
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Affiliation(s)
- Hyun Seok
- Department of Physical Medicine and Rehabilitation, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Yoon-Hee Choi
- Department of Physical Medicine and Rehabilitation, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
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Zhao LJ, Jiang LH, Zhang H, Li Y, Sun P, Liu Y, Qi R. Effects of Motor Imagery Training for Lower Limb Dysfunction in Patients With Stroke: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Am J Phys Med Rehabil 2023; 102:409-418. [PMID: 36170751 PMCID: PMC10125126 DOI: 10.1097/phm.0000000000002107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of the study is to determine the effects of motor imagery training associated with conventional rehabilitation therapies on lower limb motor function recovery in poststroke patients. DESIGN Comprehensive literature searches were performed to identify studies published before June 5, 2022. RevMan 5.3 software was used for meta-analysis. The quality of the included studies was assessed using the Cochrane risk-of-bias tool and the modified Jadad scale. The certainty of the evidence was evaluated with the Grading of Recommendations, Assessment, Development and Evaluations system. RESULT Twenty-three trials and/or 1109 participants with motor imagery training ability were included in this review. Motor imagery training combined with conventional rehabilitation therapies versus conventional rehabilitation therapies demonstrated significant benefits in motor function, balance function, temporospatial gait variables (walking speed, stride length, and cadence) and activities of daily living. Subgroup analysis demonstrated that motor imagery training-conventional rehabilitation therapies had a better effect on improvement in motor function and activities of daily living in the acute phase and had a greater benefit on walking speed in the chronic phase. In addition, motor imagery training-conventional rehabilitation therapies resulted in greater improvements in stride length, cadence, walking ability, and balance function in the subacute phase. CONCLUSIONS Motor imagery training-conventional rehabilitation therapies have better effects on the recovery of lower limb motor function in poststroke patients than conventional rehabilitation therapies, which may be most beneficial for lower extremity motor function recovery in the first 7 days to 6 mos.
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Hazelton C, Thomson K, Todhunter-Brown A, Campbell P, Chung CS, Dorris L, Gillespie DC, Hunter SM, McGill K, Nicolson DJ, Williams LJ, Brady MC. Interventions for perceptual disorders following stroke. Cochrane Database Syst Rev 2022; 11:CD007039. [PMID: 36326118 PMCID: PMC9631864 DOI: 10.1002/14651858.cd007039.pub3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Perception is the ability to understand information from our senses. It allows us to experience and meaningfully interact with our environment. A stroke may impair perception in up to 70% of stroke survivors, leading to distress, increased dependence on others, and poorer quality of life. Interventions to address perceptual disorders may include assessment and screening, rehabilitation, non-invasive brain stimulation, pharmacological and surgical approaches. OBJECTIVES To assess the effectiveness of interventions aimed at perceptual disorders after stroke compared to no intervention or control (placebo, standard care, attention control), on measures of performance in activities of daily living. SEARCH METHODS: We searched the trials registers of the Cochrane Stroke Group, CENTRAL, MEDLINE, Embase, and three other databases to August 2021. We also searched trials and research registers, reference lists of studies, handsearched journals, and contacted authors. SELECTION CRITERIA We included randomised controlled trials (RCTs) of adult stroke survivors with perceptual disorders. We defined perception as the specific mental functions of recognising and interpreting sensory stimuli and included hearing, taste, touch, smell, somatosensation, and vision. Our definition of perception excluded visual field deficits, neglect/inattention, and pain. DATA COLLECTION AND ANALYSIS One review author assessed titles, with two review authors independently screening abstracts and full-text articles for eligibility. One review author extracted, appraised, and entered data, which were checked by a second author. We assessed risk of bias (ROB) using the ROB-1 tool, and quality of evidence using GRADE. A stakeholder group, comprising stroke survivors, carers, and healthcare professionals, was involved in this review update. MAIN RESULTS We identified 18 eligible RCTs involving 541 participants. The trials addressed touch (three trials, 70 participants), somatosensory (seven trials, 196 participants) and visual perception disorders (seven trials, 225 participants), with one (50 participants) exploring mixed touch-somatosensory disorders. None addressed stroke-related hearing, taste, or smell perception disorders. All but one examined the effectiveness of rehabilitation interventions; the exception evaluated non-invasive brain stimulation. For our main comparison of active intervention versus no treatment or control, one trial reported our primary outcome of performance in activities of daily living (ADL): Somatosensory disorders: one trial (24 participants) compared an intervention with a control intervention and reported an ADL measure. Touch perception disorder: no trials measuring ADL compared an intervention with no treatment or with a control intervention. Visual perception disorders: no trials measuring ADL compared an intervention with no treatment or control. In addition, six trials reported ADL outcomes in a comparison of active intervention versus active intervention, relating to somatosensation (three trials), touch (one trial) and vision (two trials). AUTHORS' CONCLUSIONS: Following a detailed, systematic search, we identified limited RCT evidence of the effectiveness of interventions for perceptual disorders following stroke. There is insufficient evidence to support or refute the suggestion that perceptual interventions are effective. More high-quality trials of interventions for perceptual disorders in stroke are needed. They should recruit sufficient participant numbers, include a 'usual care' comparison, and measure longer-term functional outcomes, at time points beyond the initial intervention period. People with impaired perception following a stroke should continue to receive neurorehabilitation according to clinical guidelines.
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Affiliation(s)
- Christine Hazelton
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Katie Thomson
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
- Department of Occupational Therapy, Human Nutrition & Dietetics, Glasgow Caledonian University, Glasgow, UK
| | - Alex Todhunter-Brown
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Pauline Campbell
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Charlie Sy Chung
- Rehabilitation Services, Fife Health and Social Care Partnership, Dunfermline, UK
| | - Liam Dorris
- Paediatric Neurosciences, Royal Hospital for Children, NHS Greater Glasgow & Clyde, Glasgow, UK
| | - David C Gillespie
- Department of Clinical Neurosciences, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Susan M Hunter
- School of Allied Health Professions, Faculty of Medicine and Health Sciences, Keele University, Keele, UK
| | - Kris McGill
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | | | - Linda J Williams
- Usher Institute, College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, UK
| | - Marian C Brady
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
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Chiaramonte R, Bonfiglio M, Leonforte P, Coltraro GL, Guerrera CS, Vecchio M. Proprioceptive and Dual-Task Training: The Key of Stroke Rehabilitation, A Systematic Review. J Funct Morphol Kinesiol 2022; 7:jfmk7030053. [PMID: 35893327 PMCID: PMC9326539 DOI: 10.3390/jfmk7030053] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 06/29/2022] [Accepted: 07/05/2022] [Indexed: 12/03/2022] Open
Abstract
This systematic review aims to reveal the effectiveness of proprioceptive exercise combined with dual-task training in stroke patients. The research was conducted using PubMed, Cochrane Library, Web of Science, and Scopus databases to evaluate studies of rehabilitation interventions with proprioceptive and dual-task exercises in patients with stroke. The keywords for the search were: "stroke" AND "proprioception" OR "proprioceptive" AND "rehabilitation" OR "training" OR "exercises" AND "dual-task" OR "task-performance" with the following inclusion criteria: comparative studies of rehabilitation interventions with proprioceptive and dual-task exercises in stroke patients. Of the 104,014 studies identified, 23 were included according to the inclusion criteria. Proprioceptive and dual-task exercises stimulate and promote postural balance, gait, and quality of life and reduce the risk of falls in stroke patients compared with traditional rehabilitation programs. In conclusion, this systematic review suggests that proprioceptive exercise combined with dual-task training is needed to improve balance and recover gait. Moreover, it provides a comprehensive overview of the literature on the various proprioceptive treatments with contextual dual-task exercises for imbalance after stroke, providing a guide for choosing a complete rehabilitation protocol that combines these two techniques.
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Affiliation(s)
- Rita Chiaramonte
- Department of Biomedical and Biotechnological Sciences, Section of Pharmacology, University of Catania, 95123 Catania, Italy; (P.L.); (C.S.G.)
- Correspondence: or (R.C.); (M.V.); Tel.: +39-(0)3782703 (M.V.); Fax: +39-0957315384 (R.C.)
| | - Marco Bonfiglio
- Provincial Health Department of Siracusa, 96014 Sicily, Italy;
| | - Pierfrancesco Leonforte
- Department of Biomedical and Biotechnological Sciences, Section of Pharmacology, University of Catania, 95123 Catania, Italy; (P.L.); (C.S.G.)
| | | | - Claudia Savia Guerrera
- Department of Biomedical and Biotechnological Sciences, Section of Pharmacology, University of Catania, 95123 Catania, Italy; (P.L.); (C.S.G.)
| | - Michele Vecchio
- Department of Biomedical and Biotechnological Sciences, Section of Pharmacology, University of Catania, 95123 Catania, Italy; (P.L.); (C.S.G.)
- Rehabilitation Unit, AOU Policlinico Vittorio Emanuele, 95123 Catania, Italy;
- Correspondence: or (R.C.); (M.V.); Tel.: +39-(0)3782703 (M.V.); Fax: +39-0957315384 (R.C.)
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Winter L, Huang Q, Sertic JVL, Konczak J. The Effectiveness of Proprioceptive Training for Improving Motor Performance and Motor Dysfunction: A Systematic Review. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:830166. [PMID: 36188962 PMCID: PMC9397687 DOI: 10.3389/fresc.2022.830166] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 03/14/2022] [Indexed: 01/13/2023]
Abstract
Objective Proprioceptive training is any intervention aiming to improve proprioceptive function with the ultimate goal to enhance motor function and performance. It has been promoted as an approach to enhance athletic performance and as a tool for sensorimotor rehabilitation. Numerous studies sought to provide evidence on the effectiveness of the approach. However, many different training regimes claiming to train proprioception report a variety of sensorimotor measures that are not directly comparable. This, in turn, makes it difficult to assess effectiveness across approaches. It is the objective of this study to systematically review recent empirical evidence to gain an understanding of which outcome measures are most sensitive, which populations may benefit most from proprioceptive training, and what are the effects on proprioceptive and motor systems. Methods Four major databases were searched. The following inclusion criteria were applied: (1) A quantified pre- and post-treatment measure of proprioceptive function. (2) An intervention or training program believed to influence or enhance proprioceptive function. (3) Contained at least one form of treatment or outcome measure that is indicative of somatosensory function and not confounded by information from other sensory modalities. 4) The study reported of at least one quantified measure of motor performance. Results Of the 3,297 articles identified by the database search, 70 studies met the inclusion criteria and were included for further review. Across studies, proprioceptive training led to comparable gains in both proprioceptive (+46%) and motor performance (+45%). The majority of studies (50/70) applied active movement interventions. Interventions applying somatosensory stimulation were most successful in clinical populations. Joint position sense error (JPSE) was the most commonly used proprioceptive measure and presents a reliable and feasible measure for clinical use. Conclusion Proprioceptive training can lead to significant improvements in proprioceptive and motor function across a range healthy and clinical populations. Regimens requiring active movement of the trainee tended to be most successful in improving sensorimotor performance. Conclusive evidence on how long training gains are retained is still lacking. There is no solid evidence about the underlying long-term neuroplastic changes associated proprioceptive training.
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Affiliation(s)
- Leoni Winter
- Human Sensorimotor Control Laboratory, School of Kinesiology, University of Minnesota, Minneapolis, MN, United States
- Center for Clinical Movement Science, University of Minnesota, Minneapolis, MN, United States
- *Correspondence: Leoni Winter
| | - Qiyin Huang
- Human Sensorimotor Control Laboratory, School of Kinesiology, University of Minnesota, Minneapolis, MN, United States
- Center for Clinical Movement Science, University of Minnesota, Minneapolis, MN, United States
| | - Jacquelyn V. L. Sertic
- Human Sensorimotor Control Laboratory, School of Kinesiology, University of Minnesota, Minneapolis, MN, United States
- Center for Clinical Movement Science, University of Minnesota, Minneapolis, MN, United States
| | - Jürgen Konczak
- Human Sensorimotor Control Laboratory, School of Kinesiology, University of Minnesota, Minneapolis, MN, United States
- Center for Clinical Movement Science, University of Minnesota, Minneapolis, MN, United States
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Guerra ZF, Bellose LC, Ferreira AP, Faria CD, Paz CC, Lucchetti G. Effects of mental practice on mobility of individuals in the early subacute post-stroke phase: A randomized controlled clinical trial. J Bodyw Mov Ther 2022; 32:82-90. [DOI: 10.1016/j.jbmt.2022.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 04/04/2022] [Accepted: 04/24/2022] [Indexed: 10/18/2022]
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The effect of exercise on balance in patients with stroke, Parkinson, and multiple sclerosis: a systematic review and meta-analysis of clinical trials. Neurol Sci 2021; 43:167-185. [PMID: 34709478 DOI: 10.1007/s10072-021-05689-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 10/19/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Stroke, Parkinson, and multiple sclerosis are a range of diseases affecting the nervous system and show balance impairments due to damage of the balance control system. Many early articles have been published on the effect of exercise on balance in patients suffering from neuromuscular diseases. However, a comprehensive study showing a clear result of these three diseases was not found. Hence, the purpose of the present meta-analysis and systematic review is to determine the effect of exercise on balance in people with stroke, Parkinson, and multiple sclerosis. METHODS According to the PRISMA 2009 multi-step instructions, keywords related to the purpose of the research were browsed in the MeSH browser databases; IranDoc, MagIran, IranMedex, SID, ScienceDirect, Web of Science (WoS), ProQuest, Medline (PubMed), Scopus, and Google Scholar were searched to extract articles published in Persian and English language. The search process for retrieving the articles in the sources mentioned from January 01, 2000, to December 30, 2020, was done. The heterogeneity index of the studies was determined using the I2 test. Given the heterogeneity, the random-effects model was used to combine the articles and the results. RESULTS Initially, 7067 articles were found, but after removing duplicate and irrelevant articles, 96 clinical trials with a sample size of the intervention group of 1760 people were included in the study. As a result of the articles' composition, the mean balance score index after exercise in the intervention group showed a significant increase of 0.67 ± 0.12 of the unit (P˂0.01). The highest rate of increase in the balance score after the intervention was reported in patients with myelomeningocele with 1.66 ± 0.3 unit (P˂0.01). CONCLUSION Considering the positive effect of using exercise on increasing the balance in patients with stroke, Parkinson, and multiple sclerosis, it is recommended that health care providers implement a regular exercise program to improve the condition of these patients.
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Silva S, Borges LR, Santiago L, Lucena L, Lindquist AR, Ribeiro T. Motor imagery for gait rehabilitation after stroke. Cochrane Database Syst Rev 2020; 9:CD013019. [PMID: 32970328 PMCID: PMC8094749 DOI: 10.1002/14651858.cd013019.pub2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Motor imagery (MI) is defined as a mentally rehearsed task in which movement is imagined but is not performed. The approach includes repetitive imagined body movements or rehearsing imagined acts to improve motor performance. OBJECTIVES To assess the treatment effects of MI for enhancing ability to walk among people following stroke. SEARCH METHODS We searched the Cochrane Stroke Group registry, CENTRAL, MEDLINE, Embase and seven other databases. We also searched trial registries and reference lists. The last searches were conducted on 24 February 2020. SELECTION CRITERIA Randomized controlled trials (RCTs) using MI alone or associated with action observation or physical practice to improve gait in individuals after stroke. The critical outcome was the ability to walk, assessed using either a continuous variable (walking speed) or a dichotomous variable (dependence on personal assistance). Important outcomes included walking endurance, motor function, functional mobility, and adverse events. DATA COLLECTION AND ANALYSIS Two review authors independently selected the trials according to pre-defined inclusion criteria, extracted the data, assessed the risk of bias, and applied the GRADE approach to evaluate the certainty of the evidence. The review authors contacted the study authors for clarification and missing data. MAIN RESULTS We included 21 studies, involving a total of 762 participants. Participants were in the acute, subacute, or chronic stages of stroke, and had a mean age ranging from 50 to 78 years. All participants presented at least some gait deficit. All studies compared MI training versus other therapies. Most of the included studies used MI associated with physical practice in the experimental groups. The treatment time for the experimental groups ranged from two to eight weeks. There was a high risk of bias for at least one assessed domain in 20 of the 21 included studies. Regarding our critical outcome, there was very low-certainty evidence that MI was more beneficial for improving gait (walking speed) compared to other therapies at the end of the treatment (pooled standardized mean difference (SMD) 0.44; 95% confidence interval (CI) 0.06 to 0.81; P = 0.02; six studies; 191 participants; I² = 38%). We did not include the outcome of dependence on personal assistance in the meta-analysis, because only one study provided information regarding the number of participants that became dependent or independent after interventions. For our important outcomes, there was very low-certainty evidence that MI was no more beneficial than other interventions for improving motor function (pooled mean difference (MD) 2.24, 95% CI -1.20 to 5.69; P = 0.20; three studies; 130 participants; I² = 87%) and functional mobility at the end of the treatment (pooled SMD 0.55, 95% CI -0.45 to 1.56; P = 0.09; four studies; 116 participants; I² = 64.2%). No adverse events were observed in those studies that reported this outcome (seven studies). We were unable to pool data regarding walking endurance and all other outcomes at follow-up. AUTHORS' CONCLUSIONS We found very low-certainty evidence regarding the short-term benefits of MI on walking speed in individuals who have had a stroke, compared to other therapies. Evidence was insufficient to estimate the effect of MI on the dependence on personal assistance and walking endurance. Compared with other therapies, the evidence indicates that MI does not improve motor function and functional mobility after stroke (very low-certainty evidence). Evidence was also insufficient to estimate the effect of MI on gait, motor function, and functional mobility after stroke compared to placebo or no intervention. Motor Imagery and other therapies used for gait rehabilitation after stroke do not appear to cause significant adverse events.
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Affiliation(s)
- Stephano Silva
- Department of Physical Therapy, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Lorenna Rdm Borges
- Department of Physical Therapy, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Lorenna Santiago
- Department of Physical Therapy, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Larissa Lucena
- Department of Physical Therapy, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Ana R Lindquist
- Department of Physical Therapy, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Tatiana Ribeiro
- Department of Physical Therapy, Federal University of Rio Grande do Norte, Natal, Brazil
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12
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Chia FSF, Kuys S, Low Choy N. Sensory retraining of the leg after stroke: systematic review and meta-analysis. Clin Rehabil 2019; 33:964-979. [PMID: 30897960 PMCID: PMC6557007 DOI: 10.1177/0269215519836461] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 02/16/2019] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This systematic review aimed to investigate the effects of interventions intended for retraining leg somatosensory function on somatosensory impairment, and secondary outcomes of balance and gait, after stroke. DATA SOURCES Databases searched from inception to 16 January 2019 included Cochrane Library, PubMed, MEDLINE, CINAHL, EMBASE, PEDro, PsycINFO, and Scopus. Reference lists of relevant publications were also manually searched. REVIEW METHODS All types of quantitative studies incorporating interventions that intended to improve somatosensory function in the leg post stroke were retrieved. The Quality Assessment Tool for Quantitative Studies was used for quality appraisal. Standardised mean differences were calculated and meta-analyses were performed using preconstructed Microsoft Excel spreadsheets. RESULTS The search yielded 16 studies, comprising 430 participants, using a diverse range of interventions. In total, 10 of the included studies were rated weak in quality, 6 were rated moderate, and none was rated strong. Study quality was predominantly affected by high risk of selection bias, lack of blinding, and the use of somatosensory measures that have not been psychometrically evaluated. A significant heterogeneous positive summary effect size (SES) was found for somatosensory outcomes (SES: 0.52; 95% confidence interval (CI): 0.04 to 1.01; I2 = 74.48%), which included joint position sense, light touch, and two-point discrimination. There was also a significant heterogeneous positive SES for Berg Balance Scale scores (SES: 0.62; 95% CI: 0.10 to 1.14; I2 = 59.05%). Gait SES, mainly of gait velocity, was not significant. CONCLUSION This review suggests that interventions used for retraining leg somatosensory impairment after stroke significantly improved somatosensory function and balance but not gait.
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Affiliation(s)
- Fenny SF Chia
- School of Physiotherapy, Faculty of Health Sciences, Australian Catholic University, Brisbane, QLD, Australia
- Community Rehabilitation Unit, Tasmanian Health Service, Hobart, TAS, Australia
| | - Suzanne Kuys
- School of Physiotherapy, Faculty of Health Sciences, Australian Catholic University, Brisbane, QLD, Australia
| | - Nancy Low Choy
- School of Physiotherapy, Faculty of Health Sciences, Australian Catholic University, Brisbane, QLD, Australia
- Queensland Health Service, Brisbane, QLD, Australia
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13
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Paravlic AH, Slimani M, Tod D, Marusic U, Milanovic Z, Pisot R. Effects and Dose-Response Relationships of Motor Imagery Practice on Strength Development in Healthy Adult Populations: a Systematic Review and Meta-analysis. Sports Med 2018. [PMID: 29541965 DOI: 10.1007/s40279-018-0874-8] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Motor imagery (MI), a mental simulation of a movement without overt muscle contraction, has been largely used to improve general motor tasks. However, the effects of MI practice on maximal voluntary strength (MVS) remain equivocal. OBJECTIVES The aims of this meta-analysis were to (1) estimate whether MI practice intervention can meaningfully improve MVS in healthy adults; (2) compare the effects of MI practice on MVS with its combination with physical practice (MI-C), and with physical practice (PP) training alone; and (3) investigate the dose-response relationships of MI practice. DATA SOURCES AND STUDY ELIGIBILITY Seven electronic databases were searched up to April 2017. Initially 717 studies were identified; however, after evaluation of the study characteristics, data from 13 articles involving 370 participants were extracted. The meta-analysis was completed on MVS as the primary parameter. In addition, parameters associated with training volume, training intensity, and time spent training were used to investigate dose-response relationships. RESULTS MI practice moderately improved MVS. When compared to conventional PP, effects were of small benefit in favour of PP. MI-C when compared to PP showed unclear effects. MI practice produced moderate effects in both upper and lower extremities on MVS. The cortical representation area of the involved muscles did not modify the effects. Meta-regression analysis revealed that (a) a training period of 4 weeks, (b) a frequency of three times per week, (c) two to three sets per single session, (d) 25 repetitions per single set, and (e) single session duration of 15 min were associated with enhanced improvements in muscle strength following MI practice. Similar dose-response relationships were observed following MI and PP. CONCLUSIONS The present meta-analysis demonstrates that compared to a no-exercise control group of healthy adults, MI practice increases MVS, but less than PP. These findings suggest that MI practice could be considered as a substitute or additional training tool to preserve muscle function when athletes are not exposed to maximal training intensities.
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Affiliation(s)
- Armin H Paravlic
- Science and Research Centre, Institute for Kinesiology Research, University of Primorska, Garibaldijeva 1, 6000, Koper, Slovenia.
| | - Maamer Slimani
- Research Laboratory "Sports Performance Optimization", National Center of Medicine and Science in Sports (CNMSS), Tunis, Tunisia
| | - David Tod
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Uros Marusic
- Science and Research Centre, Institute for Kinesiology Research, University of Primorska, Garibaldijeva 1, 6000, Koper, Slovenia.,Department of Health Sciences, Alma Mater Europaea - ECM, Maribor, Slovenia
| | - Zoran Milanovic
- Science and Research Centre, Institute for Kinesiology Research, University of Primorska, Garibaldijeva 1, 6000, Koper, Slovenia.,Faculty of Sport and Physical Education, University of Niš, Čarnojevićeva 10a, Niš, 18000, Serbia
| | - Rado Pisot
- Science and Research Centre, Institute for Kinesiology Research, University of Primorska, Garibaldijeva 1, 6000, Koper, Slovenia
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14
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Elsner B, Schweder S, Mehrholz J. Immediate effects of rest periods on balance control in patients after stroke. A randomized controlled pilot trial. BMC Res Notes 2018; 11:338. [PMID: 29793516 PMCID: PMC5968623 DOI: 10.1186/s13104-018-3450-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 05/21/2018] [Indexed: 11/19/2022] Open
Abstract
Objectives This randomized controlled trial evaluates the effects of two different rest periods between as set of balance exercises after stroke during inpatient rehabilitation. Results Twenty patients after stroke [11 males; mean (SD) age 65.4 (11.5) years; duration of illness 5.3 (3.4) weeks; 16 (80%) left-sided strokes] were randomly allocated into two groups of either a full rest (FR) of 4 min (n = 10) or a short rest (SR) of 1 min between exercise sets (n = 10). Patients improved from baseline until immediately after exercises in one-leg standing time on the affected leg [SR: mean difference 5.1 s (SD 10.3) and FR: 2.0 s (2.4)] and tandem standing time (TST). [SR: 14.9 s (SD 24.6) and FR: 5.7 s (12.0)], but OLST and TST did not differ significantly between groups (p = 0.35 and p = 0.52, respectively). Trial registration The study was registered retrospectively in the German Register of Clinical Trials with the ID: DRKS00013979 Electronic supplementary material The online version of this article (10.1186/s13104-018-3450-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Bernhard Elsner
- Department of Public Health, Medical School, Technical University Dresden, Dresden, Germany.,SRH Hochschule Gera, Gera, Germany
| | | | - Jan Mehrholz
- Department of Public Health, Medical School, Technical University Dresden, Dresden, Germany. .,Wissenschaftliches Institut, Private Europäische Medizinische Akademie der Klinik Bavaria in Kreischa GmbH, An der Wolfsschlucht 1-2, 01731, Kreischa, Germany.
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15
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Karimi-AhmadAbadi A, Naghdi S, Ansari NN, Fakhari Z, Khalifeloo M. A clinical single blind study to investigate the immediate effects of plantar vibration on balance in patients after stroke. J Bodyw Mov Ther 2018; 22:242-246. [PMID: 29861214 DOI: 10.1016/j.jbmt.2017.04.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Revised: 04/20/2017] [Accepted: 04/25/2017] [Indexed: 02/05/2023]
Abstract
UNLABELLED Balance disorder is a very common cause of disability in patients after a stroke. Vibration therapy is one of the physiotherapeutic modalities used to improve balance. OBJECTIVE To investigate the immediate effects of plantar vibration on balance in patients with stroke. METHODS In this single blind comparative study, 22 patients with stroke (8 females, 14 males; age 55.82 ± 11.87 years old) participated. Patients underwent treatment, first with the placebo vibration and 1 week later with active vibration (frequency 100 HZ, 5 min). Mini-BESTest score, Modified Modified Ashworth Scale for plantar flexor spasticity, and ankle dorsiflexion passive range of motion (PROM) were evaluated before and immediately after the placebo or active vibration. RESULTS A significant clinical improvement in balance, ankle plantar flexor spasticity, and the ankle dorsiflexion PROM was observed following either placebo or active vibration. The improvements after active vibration were significantly greater for all outcome measures compared with placebo vibration. There was a large effect size (Cohen's d = 0.85) for balance after active vibration. CONCLUSION The vibration applied to the sole of the affected foot of patients after stroke was effective for improving balance, reducing ankle plantar flexor spasticity, and increasing ankle dorsiflexion PROM.
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Affiliation(s)
- Azam Karimi-AhmadAbadi
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Soofia Naghdi
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Noureddin Nakhostin Ansari
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Fakhari
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Maede Khalifeloo
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
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16
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Motor Imagery Training After Stroke: A Systematic Review and Meta-analysis of Randomized Controlled Trials. J Neurol Phys Ther 2017; 41:205-214. [DOI: 10.1097/npt.0000000000000200] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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17
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Real-time changes in corticospinal excitability related to motor imagery of a force control task. Behav Brain Res 2017; 335:185-190. [DOI: 10.1016/j.bbr.2017.08.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 08/08/2017] [Accepted: 08/12/2017] [Indexed: 12/31/2022]
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18
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Li RQ, Li ZM, Tan JY, Chen GL, Lin WY. Effects of motor imagery on walking function and balance in patients after stroke: A quantitative synthesis of randomized controlled trials. Complement Ther Clin Pract 2017; 28:75-84. [DOI: 10.1016/j.ctcp.2017.05.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 05/19/2017] [Accepted: 05/22/2017] [Indexed: 10/19/2022]
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19
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Saruco E, Di Rienzo F, Nunez-Nagy S, Rubio-Gonzalez MA, Jackson PL, Collet C, Saimpont A, Guillot A. Anodal tDCS over the primary motor cortex improves motor imagery benefits on postural control: A pilot study. Sci Rep 2017; 7:480. [PMID: 28352100 PMCID: PMC5428691 DOI: 10.1038/s41598-017-00509-w] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 02/28/2017] [Indexed: 11/09/2022] Open
Abstract
Performing everyday actions requires fine postural control, which is a major focus of functional rehabilitation programs. Among the various range of training methods likely to improve balance and postural stability, motor imagery practice (MIP) yielded promising results. Transcranial direct current stimulation (tDCS) applied over the primary motor cortex was also found to potentiate the benefits of MIP on upper-limb motor tasks. Yet, combining both techniques has not been tested for tasks requiring fine postural control. To determine the impact of MIP and the additional effects of tDCS, 14 participants performed a postural control task before and after two experimental (MIP + anodal or sham tDCS over the primary motor cortex) and one control (control task + sham tDCS) conditions, in a double blind randomized study. Data revealed a significant decrease of the time required to perform the postural task. Greater performance gains were recorded when MIP was paired with anodal tDCS and when the task involved the most complex postural adjustments. Altogether, findings highlight short-term effects of MIP on postural control and suggest that combining MIP with tDCS might also be effective in rehabilitation programs for regaining postural skills in easily fatigable persons and neurologic populations.
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Affiliation(s)
- Elodie Saruco
- Univ Lyon, Université Claude Bernard Lyon 1, Laboratoire Interuniversitaire de Biologie de la Motricité (EA 7424, LIBM), F-69622, Villeurbanne, France
| | - Franck Di Rienzo
- Univ Lyon, Université Claude Bernard Lyon 1, Laboratoire Interuniversitaire de Biologie de la Motricité (EA 7424, LIBM), F-69622, Villeurbanne, France
| | - Susana Nunez-Nagy
- Universidad de Alcalá, Unidad de Fisioterapia. Campus Universitario, Ctra. Madrid Barcelona, 28801, Alcalá de Henares, Madrid, Spain
| | - Miguel A Rubio-Gonzalez
- Facultad de Ciencias, UNED, Departamento Automática e Informática, Paseo Senda del Rey 9, 28040, Madrid, Spain
| | - Philip L Jackson
- Université Laval, École de Psychologie, Ville de Québec, Québec, Canada.,Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale, Québec, Canada
| | - Christian Collet
- Univ Lyon, Université Claude Bernard Lyon 1, Laboratoire Interuniversitaire de Biologie de la Motricité (EA 7424, LIBM), F-69622, Villeurbanne, France
| | - Arnaud Saimpont
- Univ Lyon, Université Claude Bernard Lyon 1, Laboratoire Interuniversitaire de Biologie de la Motricité (EA 7424, LIBM), F-69622, Villeurbanne, France
| | - Aymeric Guillot
- Univ Lyon, Université Claude Bernard Lyon 1, Laboratoire Interuniversitaire de Biologie de la Motricité (EA 7424, LIBM), F-69622, Villeurbanne, France. .,Institut Universitaire de France, Paris, France.
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20
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Patti A, Bianco A, Messina G, Paoli A, Bellafiore M, Battaglia G, Iovane A, Traina M, Palma A. The influence of the stomatognathic system on explosive strength: a pilot study. J Phys Ther Sci 2016; 28:72-5. [PMID: 26957731 PMCID: PMC4755977 DOI: 10.1589/jpts.28.72] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 10/09/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] Recent findings suggest there is an interesting interaction between the
stomatognathic system and the musculoskeletal system. The aim of this study was therefore
to examine the influence of the temporomandibular joint on the explosive strength of the
lower limbs. [Subjects and Methods] An observational study was carried out. The subjects
were 60 male football players who voluntarily participated in the investigation. After a
warm-up phase of 10 minutes, each participant performed three Squat Jumps (SJ) with
different mandible positions: mouth closed and mouth open. SJ heights were recorded using
a Sensor Medica force platform and the FreeMed system. [Results] Sixty participants were
enrolled in this study (age: 24 ± 7 yrs; height: 174 ± 4.6 cm; weight 63.7 ± 7.6 kg). The
SJ heights with the mouth closed, 38.50 ± 4.0 cm, were shorter than those with the mouth
open, 40.4 ± 4.1 cm. Statistical analysis showed there was a statistically significant
difference between the performances. [Conclusion] This pilot study highlighted that
occlusal factors can influence physical performance and this could have practical
applications in sports and exercise science. However, our results have to be confirmed in
studies with larger numbers of participants and supported by other investigations.
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Affiliation(s)
- Antonino Patti
- Sport and Exercise Sciences Research Unit, University of Palermo, Italy; Posturalab Italia, Italy
| | - Antonino Bianco
- Sport and Exercise Sciences Research Unit, University of Palermo, Italy
| | - Giuseppe Messina
- Sport and Exercise Sciences Research Unit, University of Palermo, Italy; Posturalab Italia, Italy
| | - Antonio Paoli
- Department of Biomedical Science, University of Padua, Italy
| | | | | | - Angelo Iovane
- Sport and Exercise Sciences Research Unit, University of Palermo, Italy
| | - Marcello Traina
- Sport and Exercise Sciences Research Unit, University of Palermo, Italy
| | - Antonio Palma
- Sport and Exercise Sciences Research Unit, University of Palermo, Italy
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21
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Fujita T, Nagayama H, Sato A, Yamamoto Y, Yamane K, Otsuki K, Tsuchiya K, Tozato F. Hierarchy of Dysfunction Related to Dressing Performance in Stroke Patients: A Path Analysis Study. PLoS One 2016; 11:e0151162. [PMID: 26954499 PMCID: PMC4783045 DOI: 10.1371/journal.pone.0151162] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Accepted: 02/24/2016] [Indexed: 11/30/2022] Open
Abstract
Previous reports indicated that various dysfunctions caused by stroke affect the level of independence in dressing. These dysfunctions can be hierarchical, and these effects on dressing performance can be complicated in stroke patients. However, there are no published reports focusing on the hierarchical structure of the relationships between the activities of daily living and balance function, motor and sensory functions of the affected lower limb, strength of the abdominal muscles and knee extension on the unaffected side, and visuospatial deficits. The purpose of this study was to elucidate the hierarchical and causal relationships between dressing performance and these dysfunctions in stroke patients. This retrospective study included 104 first-time stroke patients. The causal relationship between the dressing performance and age, time post stroke, balance function, motor and sensory functions of the affected lower limb, strength of the abdominal muscles and knee extension on the unaffected side, and visuospatial deficits were examined using path analysis. A hypothetical path model was created based on previous studies, and the goodness of fit between the data and model were verified. A modified path model was created that achieved an almost perfect fit to the data. Balance function and abdominal muscle strength have direct effects on dressing performance, with standardized direct effect estimates of 0.78 and 0.15, respectively. Age, motor and sensory functions of the affected lower limb, and strength of abdominal muscle and knee extension on the unaffected side have indirect effects on dressing by influencing balance function. Our results suggest that dressing performance depends strongly on balance function, and it is mainly influenced by the motor function of the affected lower limb.
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Affiliation(s)
- Takaaki Fujita
- Department of Rehabilitation, Faculty of Health Sciences, Tohoku Fukushi University, Sendai, Miyagi, Japan
- Department of Rehabilitation Sciences, Gunma University Graduate School of Health Sciences, Maebashi, Gunma, Japan
- * E-mail:
| | - Hirofumi Nagayama
- Department of Rehabilitation, Faculty of Health and Welfare, Kanagawa University of Human Services, Yokosuka, Kanagawa, Japan
| | - Atsushi Sato
- Department of Physical Therapy, Yachiyo Rehabilitation College, Yachiyo, Chiba, Japan
| | - Yuichi Yamamoto
- Department of Rehabilitation, Northern Fukushima Medical Center, Date, Fukushima, Japan
| | - Kazuhiro Yamane
- Department of Rehabilitation, Northern Fukushima Medical Center, Date, Fukushima, Japan
| | - Koji Otsuki
- Department of Rehabilitation, Northern Fukushima Medical Center, Date, Fukushima, Japan
| | - Kenji Tsuchiya
- Department of Rehabilitation Sciences, Gunma University Graduate School of Health Sciences, Maebashi, Gunma, Japan
- Department of Rehabilitation, Japan Community Healthcare Organization Gunma Chuo Hospital, Maebashi, Gunma, Japan
| | - Fusae Tozato
- Department of Rehabilitation Sciences, Gunma University Graduate School of Health Sciences, Maebashi, Gunma, Japan
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22
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Park KH, Lim JY, Kim TH. The effects of ankle strategy exercises on unstable surfaces on dynamic balance and changes in the COP. J Phys Ther Sci 2016; 28:456-9. [PMID: 27065530 PMCID: PMC4792990 DOI: 10.1589/jpts.28.456] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 10/31/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The objective of this study was to examine the effect of ankle strategy exercises on unstable surfaces on balance and walking ability in stroke patients. [Subjects and Methods] Among hospitalized stroke patients, 30 were selected based on the study criteria and were randomly divided into three groups: an ankle strategy group (n=10), balance exercise group (n=10), and control group (n=10). Patients in two groups (ankle strategy, balance exercise group) performed 15-minute exercise sessions three times a week for six weeks. To analyze the effect of the exercise, center of pressure, Berg balance Scale, Timed Up and Go test, and Functional Reach Test were assessed before and after the exercise. [Results] The ankle strategy exercise group showed more improvement in mediolateral center of pressure and Berg Balance Scale and Timed Up and Go test scores than the balance exercise group. [Conclusion] The results of this study suggest that ankle strategy exercises on unstable surfaces is feasible and efficacious for stroke patients.
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Affiliation(s)
- Ki-Hyeon Park
- Department of Physical Therapy, College of Rehabilitation
Science, Daegu University, Republic
of Korea
| | - Jin-Yong Lim
- Department of Physical Therapy, College of Rehabilitation
Science, Daegu University, Republic
of Korea
| | - Tae-Ho Kim
- Department of Physical Therapy, College of Rehabilitation
Science, Daegu University, Republic
of Korea
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23
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Bae YH, Ko Y, Ha H, Ahn SY, Lee W, Lee SM. An efficacy study on improving balance and gait in subacute stroke patients by balance training with additional motor imagery: a pilot study. J Phys Ther Sci 2015; 27:3245-8. [PMID: 26644684 PMCID: PMC4668175 DOI: 10.1589/jpts.27.3245] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 07/23/2015] [Indexed: 11/29/2022] Open
Abstract
[Purpose] The few studies conducted on subacute stroke patients have focused only on gait
function improvement. This study therefore aimed to confirm the effect of balance training
with additional motor imagery on balance and gait improvement in subacute stroke patients.
[Subjects and Methods] Participants were divided into an experimental or control group.
The experimental group received balance training for 20 minutes/day with mental imagery
for 10 minutes/day, three days/week, for four weeks. The control group received only
balance training for 30 minutes. Before and after the 12 sessions, balance and gait
ability were assessed by the researcher and a physical therapist. [Results] After
completion of the 4-week intervention, Berg Balance Scale, Timed Up and Go test,
Functional Reach Test, and Four Square Step test scores significantly increased in the
experimental group. In the control group, Berg Balance Scale and Functional Reach Test
scores significantly improved. Changes in the Timed Up and Go test, Functional Reach Test,
and Four Square Step Test scores after intervention were significantly higher in the
experimental than in the control group. [Conclusion] Specific balance training with
additional motor imagery may result in better rehabilitation outcomes of gait and balance
ability than balance training alone.
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Affiliation(s)
- Young-Hyeon Bae
- Department of Physical Medicine and Rehabilitation, Samsung Medical Center, Republic of Korea ; Department of Physical Therapy, Angelo State University, USA ; Department of Physical Therapy, Sahmyook University: 26-21 Gongneung 2-dong, Nowon-gu, Seoul, Republic of Korea
| | - YoungJun Ko
- Department of Physical Medicine and Rehabilitation, Samsung Medical Center, Republic of Korea ; Department of Physical Therapy, Sahmyook University: 26-21 Gongneung 2-dong, Nowon-gu, Seoul, Republic of Korea
| | - HyunGeun Ha
- Department of Physical Medicine and Rehabilitation, Samsung Medical Center, Republic of Korea ; Department of Physical Therapy, Sahmyook University: 26-21 Gongneung 2-dong, Nowon-gu, Seoul, Republic of Korea
| | - So Yeon Ahn
- Department of Physical Medicine and Rehabilitation, Samsung Medical Center, Republic of Korea
| | - WanHee Lee
- Department of Physical Therapy, Sahmyook University: 26-21 Gongneung 2-dong, Nowon-gu, Seoul, Republic of Korea
| | - Suk Min Lee
- Department of Physical Therapy, Sahmyook University: 26-21 Gongneung 2-dong, Nowon-gu, Seoul, Republic of Korea
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24
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Nagano K, Nagano Y. The improvement effect of limited mental practice in individuals with poststroke hemiparesis: the influence of mental imagery and mental concentration. J Phys Ther Sci 2015; 27:2641-4. [PMID: 26357451 PMCID: PMC4563333 DOI: 10.1589/jpts.27.2641] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 05/25/2015] [Indexed: 11/29/2022] Open
Abstract
[Purpose] This study examined whether limited mental practice improves the motor
performance of poststroke individuals with hemiparesis. [Subjects] Twenty-three
participants with poststroke hemiparesis (40–82 years of age) participated in this study.
[Methods] The subjects were divided into four groups with respect to a dart-throwing task:
the no-practice, physical practice only, mental practice only, and mental and physical
practice groups. The groups were compared in terms of gains in motor performance, mental
imagery vividness, and level of concentration during mental practice. [Results] No
statistically significant difference was found for gains in motor performance among
groups, and there was no correlation between imagery vividness and motor performance
gains. However, a correlation was found between gains in motor performance and mental
concentration during mental practice. [Conclusion] The results suggested that limited
mental practice for individuals with poststroke hemiparesis may not improve motor
performance. However, a higher degree of concentration during mental practice may improve
motor performance.
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Affiliation(s)
- Katsuhito Nagano
- Department of Physical Therapy, Faculty of Rehabilitation, Fukui College of Health Sciences: 56 Egami-cho 13-1, Fukui City, Fukui 910-3190, Japan
| | - Yumi Nagano
- Department of Nursing Care, Medical Care Co., Ltd., Japan
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