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Kim KH, Kim DH. Effects of ankle joint proprioceptive training and thermal approach on stroke patients' trunk, balance stability and gait parameter. J Back Musculoskelet Rehabil 2022; 35:1237-1246. [PMID: 35599465 DOI: 10.3233/bmr-210141] [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] [Indexed: 02/04/2023]
Abstract
BACKGROUND Numerous studies have investigated factors for trunk, balance stability and gait parameters of post-stroke patients. Evidence-based recommendations are required for the treatment of ankle proprioceptive exercise with thermal stimulation in post-stroke patients. OBJECTIVE We investigated the effects of ankle proprioceptive exercise with thermal stimulation on the trunk stability, balance, and gait ability of post-stroke patients. METHODS A total of 30 patients were randomly divided into the ankle proprioceptive training and thermal stimulation group (APT) and control group. The APT group performed ankle proprioceptive exercises with thermal stimulation for 60 min five times a week for eight weeks. The control group followed conservative treatment for 60 min five times a week for eight weeks. Trunk stability was measured with the trunk impairment scale (TIS) and balance tests were performed with the center of pressure (COP), limits of stability (LOS), Berg Balance Scale (BBS), and functional reach test (FRT) and gait ability was performed by OptoGait and 10 m WT. RESULTS There was a significant difference (p< 0.05) between before and after training in both groups. The APT group showed significant improvement in both groups. CONCLUSION This study can be used as intervention data for recovering trunk, balance stability and gait parameters in post-stroke patients.
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Affiliation(s)
- Kyung-Hun Kim
- Department of Physical Therapy, Graduate School, Gimcheon University, Gimcheon-si, Korea.,Gimcheon Institute of Rehabilitation Science, Gimcheon University, Gimcheon-si, Korea
| | - Dong-Hoon Kim
- Department of Physical Therapy, Graduate School, Gimcheon University, Gimcheon-si, Korea.,Gimcheon Institute of Rehabilitation Science, Gimcheon University, Gimcheon-si, Korea
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Ha SY, Han JH, Ko YJ, Sung YH. Ankle exercise with functional electrical stimulation affects spasticity and balance in stroke patients. J Exerc Rehabil 2020; 16:496-502. [PMID: 33457385 PMCID: PMC7788250 DOI: 10.12965/jer.2040780.390] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 11/22/2020] [Indexed: 11/22/2022] Open
Abstract
Stroke patients have limited motor function due to ankle spasticity, and various interventions are applied to solve this problem. The purpose of this study was to investigate the effects of functional electrical stimulation (FES) with ankle exercise on spinal cord motor neuron excitability and balance in stroke patients. Twenty-five stroke patients were divided into the three groups. For the intervention, the control group applied general physiotherapy, the experimental group I applied a sham FES with ankle exercise, and the experimental group II applied a FES with ankle exercise. All groups applied the intervention for 30 min per session, 5 times a week, for a total of 8 weeks. The functional reaching test (FRT), Timed Up and Go test was used to measure balance ability, and H-reflex was used to measure spinal motor neuron excitability. All tests were measured before and after the intervention. In the ankle exercise with FES group, spinal motor neuron excitability significantly decreased (P<0.05), and FRT was significantly increased (P<0.05). Therefore, FES with ankle exercise for stroke patients could be suggested as an effective intervention for improving motor function.
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Affiliation(s)
- Sun-Young Ha
- Department of Physical Therapy, Graduate School, Kyungnam University, Changwon, Korea
| | - Jun-Ho Han
- Department of Physical Therapy, Graduate School, Kyungnam University, Changwon, Korea
| | - Young Jun Ko
- Major in Sport Service Practice, College of Welfare Covergence, Kangnam University, Yongin, Korea
| | - Yun-Hee Sung
- Department of Physical Therapy, Graduate School, Kyungnam University, Changwon, Korea.,Department of Physical Therapy, College of Health Sciences, Kyungnam University, Changwon, Korea
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Chlebuś E, Wareńczak A, Miedzyblocki M, Lisiński P. The usefulness of isometric protocol for foot flexors and extensors in assessing the effects of 16-week rehabilitation regiment in poststroke patients. Biomed Eng Online 2019; 18:57. [PMID: 31088462 PMCID: PMC6518709 DOI: 10.1186/s12938-019-0678-6] [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: 02/20/2019] [Accepted: 04/30/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ankle joint function in a paretic limb has a fundamental impact on mobility. Return of joint function is a measure of early poststroke physical rehabilitation. This study aims to assess the suitability of using the isometric protocol for objective evaluation of flexor and extensor muscle strength in the paretic limb of poststroke patients. METHODS 34 patients (F: 9, M: 25) aged 51-79 years with hemiparesis following an acute ischemic stroke and 34 healthy controls were examined using the isometric protocol measured on the Biodex System®. The following parameters were analyzed: peak torque [PT], average torque [AVGT], average torque/body weight [AVGT/BW] for flexors and extensors, and AVGT flexor/AVGT extensor [agonist/antagonist ratio] of the paretic foot, the nonparetic foot and foot of healthy controls using three foot-shank positions (15°, 0°, and - 15°) prior to rehabilitation commencement and at its completion 16 weeks later. RESULTS Prior to rehabilitation commencement, nonparetic foot differed significantly (p < 0.05) from healthy foot controls in all parameters and all positions for flexors and in all positions for foot-shank positions of 0° and - 15° for extensors. At rehabilitation program completion the following parameters increased significantly for the paretic foot: PT, AVGT, and AVGT/BW for foot extensors in all tested positions, and PT for foot flexors in foot-shank position of - 15°. The nonparetic foot however, showed no significant difference following rehabilitation regardless parameter or foot position tested for flexors and extensors alike. Prior to rehabilitation agonist/antagonist ratio in the paretic foot differed significantly from corresponding parameter in the control group for the foot-shank positions of 15° and 0°, whereas at rehabilitation completion, the two groups showed significant difference only in foot-shank position of 0°. CONCLUSIONS In the early period following stroke, there is a significant strengthening of the paretic limb, but no improvement in the strength of nonparetic limb.
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Affiliation(s)
- Ewa Chlebuś
- Department of Rehabilitation and Physiotherapy Rehabilitation, University of Medical Sciences, 28 Czerwca 1956 Str., No 135/147, 60-545, Poznan, Poland.
| | - Agnieszka Wareńczak
- Department of Rehabilitation and Physiotherapy Rehabilitation, University of Medical Sciences, 28 Czerwca 1956 Str., No 135/147, 60-545, Poznan, Poland
| | - Margaret Miedzyblocki
- Department of Rehabilitation and Physiotherapy Rehabilitation, University of Medical Sciences, 28 Czerwca 1956 Str., No 135/147, 60-545, Poznan, Poland
| | - Przemysław Lisiński
- Department of Rehabilitation and Physiotherapy Rehabilitation, University of Medical Sciences, 28 Czerwca 1956 Str., No 135/147, 60-545, Poznan, Poland
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De Luca A, Vernetti H, Capra C, Pisu I, Cassiano C, Barone L, Gaito F, Danese F, Antonio Checchia G, Lentino C, Giannoni P, Casadio M. Recovery and compensation after robotic assisted gait training in chronic stroke survivors. Disabil Rehabil Assist Technol 2018; 14:826-838. [PMID: 29741134 DOI: 10.1080/17483107.2018.1466926] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Background: Gait re-education is a primary rehabilitation goal after stroke. In the last decades, robots with different mechanical structures have been extensively used in the clinical practice for gait training of stroke survivors. However, the effectiveness of robotic training is still controversial, especially for chronic subjects. In this study, we investigated the short-term effects of gait training assisted by an endpoint robot in a population of chronic stroke survivors.Methods: Subjects were evaluated before and after training with clinical scales and instrumented gait analysis. Our primary outcome indicator was the walking speed. Next, we investigated the changes in kinetic and kinematic gait patterns as well as the intersegmental coordination at the level of the lower limbs.Results: Most subjects improved their speed in over-ground walking, by modifying the temporal more than the spatial gait parameters. These changes led to an improvement in the ankle power for both sides and to a slight reduction of the inclination of the pelvis during the swing phase, mainly due to a decreased knee flexion and an increased hip extension on the unimpaired leg.Conclusions: These results indicate that the proposed training induced mainly a functional change rather than an improvement of the quality of gait.Implication for RehabilitationGait re-education is a primary goal in stroke rehabilitation.Nowadays several robotic devices for gait rehabilitation are used in the clinical practice, but their effectiveness is controversial, especially for chronic survivors.After a 20-session training with an endpoint robot the chronic stroke survivors showed an improvement in overground gait speed.The increased gait speed was mainly due to functional changes of the temporal parameters and of the kinetic variables at the level of both ankle joints, as well as to a reduction of compensatory strategies observable in the unimpaired side.
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Affiliation(s)
- Alice De Luca
- Department of Informatics, Bioengineering, Robotics and Systems Engineering, University of Genoa, Genoa, Italy.,Recovery and Functional Reeducation Unit, Rehabilitation Department, Santa Corona Hospital, Pietra Ligure, Savona, Italy
| | - Honoré Vernetti
- Recovery and Functional Reeducation Unit, Rehabilitation Department, Santa Corona Hospital, Pietra Ligure, Savona, Italy
| | - Cristina Capra
- Recovery and Functional Reeducation Unit, Rehabilitation Department, Santa Corona Hospital, Pietra Ligure, Savona, Italy
| | - Ivano Pisu
- Recovery and Functional Reeducation Unit, Rehabilitation Department, Santa Corona Hospital, Pietra Ligure, Savona, Italy
| | - Cinzia Cassiano
- Recovery and Functional Reeducation Unit, Rehabilitation Department, Santa Corona Hospital, Pietra Ligure, Savona, Italy
| | - Laura Barone
- Recovery and Functional Reeducation Unit, Rehabilitation Department, Santa Corona Hospital, Pietra Ligure, Savona, Italy
| | - Federica Gaito
- Recovery and Functional Reeducation Unit, Rehabilitation Department, Santa Corona Hospital, Pietra Ligure, Savona, Italy
| | - Federica Danese
- Department of Informatics, Bioengineering, Robotics and Systems Engineering, University of Genoa, Genoa, Italy
| | - Giovanni Antonio Checchia
- Recovery and Functional Reeducation Unit, Rehabilitation Department, Santa Corona Hospital, Pietra Ligure, Savona, Italy
| | - Carmelo Lentino
- Recovery and Functional Reeducation Unit, Rehabilitation Department, Santa Corona Hospital, Pietra Ligure, Savona, Italy
| | - Psiche Giannoni
- Department of Informatics, Bioengineering, Robotics and Systems Engineering, University of Genoa, Genoa, Italy
| | - Maura Casadio
- Department of Informatics, Bioengineering, Robotics and Systems Engineering, University of Genoa, Genoa, Italy
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