1
|
Han B, Lee J, Yim S, Kim D. Effects of rehabilitation exercise program types on dynamic balance in patients with stroke: a meta-analysis of randomized controlled trials. Top Stroke Rehabil 2024; 31:681-691. [PMID: 38598557 DOI: 10.1080/10749357.2024.2329849] [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: 11/29/2023] [Accepted: 02/29/2024] [Indexed: 04/12/2024]
Abstract
PURPOSE The purposes of meta-analysis are to evaluate evidence about the effects of Rehabilitation Exercise Program on the balance of post-stroke patients, evaluated by the Berg Balance Scale (BBS). METHODS The search was conducted 'stroke,' 'rehabilitation,' 'dynamic balance,' 'Berg Balance Scale,' 'exercise' and 'randomized controlled trial'using MEDLINE (accessed by PubMed), Web of Science (WoS), ProQuest, and Google Scholar for journal studies published from January 2018 to October 2022. Two independent reviewers performed the article selection, data extraction, and methodological quality assessment. The main outcome was dynamic balance assessed by the Berg Balance scale. RESULTS The review included 30 papers and a total of 540 patients. The overall effect size was 0.550, a medium effect size according to the Cohen's standard. It was observed that gender has moderate effect size in male (0.551), female (0.458) and higher in male. Exercise type results showed large effect sizes in balance training (0.966), and aquatic activities (0.830), moderate effect sizes in virtual reality (0.762), moderate effect sizes in physically active (0.581), gait training (0.541), dual-task (0.478), trunk control (0.284), and small effect sizes in resistance training (0.128). CONCLUSIONS Exercise programs are effective in improving dynamic balance in stroke patients. Especially, the meta-analysis showed higher Effect Size for balance training and virtual reality than for other programs making this relevant interventions for future head to head superiority studies that compare different balance interventions in stroke.
Collapse
Affiliation(s)
- Byumsuk Han
- Department of Sports Medicine, Kyunghee University, Yongin-si, South Korea
| | - Jaewon Lee
- Department of Special Physical Education, Yongin University, Yongin-si, South Korea
| | - Sanghun Yim
- Department of Special Physical Education, Yongin University, Yongin-si, South Korea
| | - Dongmin Kim
- Department of Special Physical Education, Yongin University, Yongin-si, South Korea
| |
Collapse
|
2
|
Deng Y, Tang Z, Yang Z, Chai Q, Lu W, Cai Y, Luo Y, Zhou Y. Comparing the effects of aquatic-based exercise and land-based exercise on balance in older adults: a systematic review and meta-analysis. Eur Rev Aging Phys Act 2024; 21:13. [PMID: 38764039 PMCID: PMC11102618 DOI: 10.1186/s11556-024-00349-4] [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: 10/10/2023] [Accepted: 05/10/2024] [Indexed: 05/21/2024] Open
Abstract
BACKGROUND Balance plays a crucial role in the daily activities of older adults. Aquatic-based exercises (AE) are widely conducted as an alternative to land-based exercises (LE). Previous studies have compared AE and LE as effective ways to improve balance and have yielded inconsistent results. Therefore, this review aimed to compare the effects of AE and LE on balance function in older adults. METHODS Electronic databases, including PubMed, Web of Science, Scopus, and Embase, were searched. Randomized controlled trials published from January 2003 to June 2023 were included following predetermined criteria. Data extraction was carried out by two independent reviewers. Data synthesis was conducted using RevMan 5.3 software. The fixed-effect model or random-effect model was chosen based on the results of the heterogeneity test. Meta-analysis for the effect sizes of balance outcomes was calculated as standardized mean difference (SMD) with 95% confidence intervals (CI). The quality of the included studies was evaluated using the Physiotherapy Evidence Database (PEDro) scale. This review was registered at PROSPERO CRD42023429557. RESULTS A total of 29 studies involving 1486 older adults (with an average age of 66.2 years) were included. Meta-analysis results indicated that AE could improve balance ability based on two tests: the Berg balance scale (BBS: SMD = 1.13, 95% CI 0.25 to 2.00, p = 0.01, I2 = 94%) and the 30-s chair stand test (30 CST: SMD = 2.02, 95% CI 0.50 to 3.54, p = 0.009, I2 = 96%). However, there were no significant differences between the AE group and the LE group in terms of the 6-min walking test (6 MWT: SMD = 0.13, 95% CI -0.16 to 0.43, p = 0.38, I2 = 62%) and time up to go test (TUGT: SMD = 0.44, 95% CI -0.44 to 0.91, p = 0.07, I2 = 85%). Older adults with different health conditions have different gains in different balance measurements after AE intervention and LE intervention. CONCLUSIONS Although this was influenced by participant health status, transfer effects, sample size, and other factors, AE offers better benefits than LE for improving balance function in older adults.
Collapse
Affiliation(s)
- Ying Deng
- Sichuan University, West China Hospital, Chengdu, 610041, Sichuan, China
| | - Zheng Tang
- Sichuan University, West China Hospital, Chengdu, 610041, Sichuan, China
| | - Zhengting Yang
- Sichuan University, West China Hospital, Chengdu, 610041, Sichuan, China
| | - Qi Chai
- Sichuan University, West China Hospital, Chengdu, 610041, Sichuan, China
| | - Wenting Lu
- Sichuan University, West China Hospital, Chengdu, 610041, Sichuan, China
| | - Yunshi Cai
- Sichuan University, West China Hospital, Chengdu, 610041, Sichuan, China
| | - Yiting Luo
- Sichuan University, West China Hospital, Chengdu, 610041, Sichuan, China
| | - Yongzhao Zhou
- Sichuan University, West China Hospital, Chengdu, 610041, Sichuan, China.
| |
Collapse
|
3
|
Leszczak J, Pyzińska J, Baran J, Baran R, Bylicki K, Pop T. Assessment of functional fitness impacted by hospital rehabilitation in post-stroke patients who additionally contracted COVID-19. PeerJ 2024; 12:e16710. [PMID: 38192599 PMCID: PMC10773450 DOI: 10.7717/peerj.16710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 12/01/2023] [Indexed: 01/10/2024] Open
Abstract
Background The aim of the study was to assess the effects of rehabilitation in post-stroke patients, or post-stroke patients with simultaneous COVID-19 infection, in relation to: improved locomotion efficiency, improved balance, reduced risk of falling as well as the patients' more effective performance in everyday activities. Methods The study involved 60 patients in the early period (2-3 months) after a stroke. Group I consisted of 18 patients (30.0%) who, in addition to a stroke, also contracted COVID-19. Group II consisted of 42 patients (70%) post-stroke, with no SARS-CoV2 infection. The effects were assessed on the basis of: Tinetti test, Timed Up & Go test and Barthel scale. Results Both groups achieved a statistically significant improvement in their Barthel score after therapy (p < 0.001). The Tinetti test, assessing gait and balance, showed that participants in Group I improved their score by an average of 4.22 points. ±4.35, and in Group II, on average, by 3.48 points ± 3.45 points. In the Timed Up & Go test over a distance of 3 m, significant improvement was achieved in both groups, as well but the effect was higher in Group I (p < 0.001). Conclusions Hospital rehabilitation in the early period after stroke improved locomotion efficiency and balance, and reduced the risk of falls in post-stroke patients, both with and without COVID-19 infection.
Collapse
Affiliation(s)
- Justyna Leszczak
- Institute of Health Sciences, Medical Faculty, University of Rzeszów, Rzeszów, Poland
| | - Joanna Pyzińska
- Institute of Health Sciences, Medical Faculty, University of Rzeszów, Rzeszów, Poland
| | - Joanna Baran
- Institute of Health Sciences, Medical Faculty, University of Rzeszów, Rzeszów, Poland
| | - Rafał Baran
- Institute of Health Sciences, Medical Faculty, University of Rzeszów, Rzeszów, Poland
| | - Krzysztof Bylicki
- Institute of Health Sciences, Medical Faculty, University of Rzeszów, Rzeszów, Poland
| | - Teresa Pop
- Institute of Health Sciences, Medical Faculty, University of Rzeszów, Rzeszów, Poland
| |
Collapse
|
4
|
Rodríguez-Huguet M, Ayala-Martínez C, Vinolo-Gil MJ, Góngora-Rodríguez P, Martín-Valero R, Góngora-Rodríguez J. Transcranial direct current stimulation in physical therapy treatment for adults after stroke: A systematic review. NeuroRehabilitation 2024; 54:171-183. [PMID: 38143386 DOI: 10.3233/nre-230213] [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: 12/26/2023]
Abstract
BACKGROUND Stroke is a clinical syndrome that can cause neurological disorders due to a reduction or interruption in the blood flow at the brain level. Transcranial direct current stimulation (TDCS) is a non-invasive electrotherapy technique with the ability to modulate the function of nervous tissue. OBJECTIVE The aim of this review is to analyze the effects derived from the application of the TDCS for post-stroke patients on functionality and mobility. METHODS The data search was conducted in PubMed, PEDro, Cochrane Library, Web of Science and Scopus between July and August 2023. The search focused on randomized clinical trials conducted in the period of 2019-2023, and according to the selection criteria, seven studies were obtained. RESULTS The results found are mainly focused on the analysis of the scales Fugl-Meyer Assessment for Upper Extremity and Wolf Motor Function Test. CONCLUSION The application of TDCS presents benefits in post-stroke individuals on functionality, mobility and other secondary studied variables.
Collapse
Affiliation(s)
| | | | - Maria Jesus Vinolo-Gil
- Department of Nursing and Physiotherapy, University of Cádiz, Cádiz, Spain
- Rehabilitation Clinical Management Unit, Interlevels-Intercenters Hospital Puerta del Mar, Hospital Puerto Real, Cádiz, Spain
- Biomedical Research and Innovation Institute of Cádiz (INiBICA), Research Unit, Puerta del Mar University Hospital, University of Cádiz, Cádiz, Spain
| | | | - Rocío Martín-Valero
- Department of Physiotherapy, Faculty of Health Science, CTS-1071 Research Group, University of Málaga, Málaga, Spain
| | | |
Collapse
|
5
|
Li D, Zha F, Wang Y. Association Between Falling and Activities of Daily Living Measured by the Longshi Scale in Patients Poststroke: A Cross-sectional Study. J Nurs Care Qual 2023; 38:E25-E31. [PMID: 36729956 DOI: 10.1097/ncq.0000000000000679] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Activities of daily living comprise an important risk factor for falls among patients who have suffered a stroke. PURPOSE To investigate the incidence of falls in patients with stroke, categorized by their Longshi grades (bedridden, domestic, community), and to explore their risk factors for falls. METHODS A cross-sectional descriptive design was used. Patients completed a survey during face-to-face interviews. RESULTS Of the 869 participants, 15.7% experienced a fall. Those in the domestic Longshi group had the highest rate of falls. Approximately 30% experienced either a moderate or severe injury as a result of falling. In addition, being older than 70 years was significantly correlated with fall risk. Intermediate Longshi grades, from moderately dependent to slightly dependent, were also positively correlated with falls. CONCLUSION Patients with stroke in the domestic Longshi group have a higher rate of falls. The risk of falling increased significantly in those with intermediate Longshi grades.
Collapse
Affiliation(s)
- Dongxia Li
- Department of Rehabilitation, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
| | | | | |
Collapse
|
6
|
Liu S, Yu H, Wang Z, Dai P. Correlation analysis of balance function with plantar pressure distribution and gait parameters in patients with cerebral infarction in the basal ganglia region. Front Neurosci 2023; 17:1099843. [PMID: 36908774 PMCID: PMC9998687 DOI: 10.3389/fnins.2023.1099843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 02/13/2023] [Indexed: 03/14/2023] Open
Abstract
Objective To analyze the correlation between balance function and gait parameters of patients with basal ganglia infarction. And to observe the influence of balance function on plantar pressure and hemiplegia gait based on the Berg Balance Scale (BBS) score. Methods One hundred and forty patients with cerebral infarction hemiplegia in the basal ganglia region (a study group, n = 140) and healthy people (a control group, n = 140) were enrolled. The study group was evaluated with the BBS, the 10 m walking test (10MWT), and the timed up-and-go test (TUGT). The gait parameters and the peak plantar pressure were measured in both groups while walking, and the differences between the groups were compared. In addition, the characteristics of the plantar pressure curve of the hemiplegic and non-hemiplegic sides during walking and the correlation between the 10MWT, the TUGT, the plantar pressure peak, the gait parameters,and the BBS score were analyzed in the study group. Results The peak plantar pressure of the forefoot and heel, stride length, lateral symmetry, stand phase, swing phase, and dual stand phase of both sides in the study group were significantly lower than those in the control group (P < 0.05). The BBS score negatively correlated with the 10MWT, the TUGT, the peak plantar pressure of the hemiplegic forefoot, midfoot, and the non-hemiplegic midfoot, the anterior to posterior position (ant/post position), hemiplegic stand phase, and the dual stand phase (P < 0.05). The BBS score positively correlated with the hemiplegic swing phase and stride length (P < 0.05). Conclusion A correlation was found between the forefoot plantar pressure and the stand phase of the hemiplegic limbs, the ant/post position, and the balance function after basal ganglion cerebral infarction. This association can be used in walking and balance assessment for stroke rehabilitation. Correcting forefoot pressure or the front and ant/post position can improve balance function.
Collapse
Affiliation(s)
| | - Huixian Yu
- Department of Rehabilitation Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | | | | |
Collapse
|
7
|
Mocanu GD. The influence of curricular physical activities on the values of body balance indices in university students. BALNEO AND PRM RESEARCH JOURNAL 2022. [DOI: 10.12680/balneo.2022.478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The investigation analyzes the effect of specific motor structures on the indicators of the static and dynamic balance of the students of Dunărea de Jos University in Galați (99 boys aged = 20.29 years, body weight = 84.17 kg, height = 180.08 cm, respectively 96 girls aged = 20.09 years, mass bodyweight = 60.88 kg, height = 164.73 cm. The members of the tested group have no concerns related to performance sports or physical activities as a lifestyle. The application of the experi-mental program was made during the 28 weeks of the academic year 2018-2019, with 3 distinct moments: T1 / initial at the beginning of the 1st semester, T2 / intermediate before the winter break, T3 / final at the end of the academic year. The battery of tests included 7 tests: One leg standing test with eyes closed (sec), Stork test (sec), Flamingo test (number of attempts), Bass test (points), Functional reach test (cm), Walk and turn field sobriety test (errors) and Fukuda test (degrees). The results of the Anova parametric test with repeated measurements revealed statis-tically significant values of F associated with critical thresholds (p <0.05), and the values of Parti-al eta squared (Ƞ2p) indicate strong influences of the proposed program on test performance in most cases, both at the level of the whole group and also for each gender. It should be noted that the performance improvements are greater in the first part of the study (differences between ini-tial and intermediate tests, with p <0.05), compared to those in semester 2 (differences between intermediate and final tests), which can be explained by the adaptation to the planned and ap-plied stimuli, so modifying or changing their dosage is necessary in order to have a better chan-ce of improving the results. Significant differences are confirmed for most tests of both genders (p <0.05), with exceptions being the Walk and turn field sobriety test for boys (at the level of the difference between intermediate and final testing) and the Fukuda test for both genders (for dif-ferences between initial and intermediate testing). However, the results should be viewed with caution, the low level of physical training and sedentary behavior of most students providing the premises for such progress, even with a single weekly physical activity.
Keywords: students, balance, postural stability, physical exercise, progress, motor skills
Collapse
Affiliation(s)
- George-Danut Mocanu
- “Dunărea de Jos” University, Faculty of Physical Education and Sports, Galați, România
| |
Collapse
|
8
|
Manning OJ, Rancourt S, Tomasone JR, Finlayson M, DePaul V. Water-based therapeutic exercise in stroke: a scoping review. Disabil Rehabil 2022; 45:1549-1562. [PMID: 35450495 DOI: 10.1080/09638288.2022.2063415] [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: 11/03/2022]
Abstract
PURPOSE To (1) describe the state of the literature on water-based therapeutic exercise (WBTE) for people living with stroke, (2) describe the content and structure of interventions, (3) summarize the effects of interventions described in the literature, and (4) identify gaps in the literature limiting application and implementation. MATERIALS AND METHODS Scoping review methodology described by Arksey and O'Malley (2005) and Levac et al. (2010). Electronic databases were searched for articles with eligibility criteria including: (1) adult stroke survivors (18 years or older) of any type (ischemic/hemorrhagic) or stage (acute/chronic) in any setting, and (2) the study intervention involved WBTE to address a post-stroke deficit. RESULTS 40 articles were included in this review. Five trials had a treatment control, 20 had an active comparison. Calculated intervention effect sizes demonstrated a strong effect of WBTE on balance and gait related outcomes in 80% of controlled and comparison trials. CONCLUSIONS This scoping review highlights common parameters of WBTE interventions and provides an inventory of the differences in the treatment approaches utilized in this population. Opportunities for future work include the development of a standardized treatment protocol, qualitative or mixed methodology research, and greater inclusion of more individuals with more severe stroke-related impairments. IMPLICATIONS FOR REHABILITATIONWater-based therapeutic exercise is an approach that may allow stroke survivors to carry out challenging activities in a safe and accessible environment.Water-based interventions for stroke survivors appear to have a beneficial impact on walking and balance.Given that an aquatic environment offers an opportunity for individuals with more significant physical impairments to carry out early practice of walking and balance related tasks, clinicians should explore the feasibility and effectiveness for this subset of stroke survivors.
Collapse
Affiliation(s)
- O J Manning
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada
| | - S Rancourt
- Providence Care Hospital, Kingston, Canada
| | - J R Tomasone
- School of Kinesiology and Health Studies, Queen's University, Kingston, Canada
| | - M Finlayson
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada
| | - V DePaul
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada
| |
Collapse
|
9
|
Zhao CG, Ju F, Sun W, Jiang S, Xi X, Wang H, Sun XL, Li M, Xie J, Zhang K, Xu GH, Zhang SC, Mou X, Yuan H. Effects of Training with a Brain-Computer Interface-Controlled Robot on Rehabilitation Outcome in Patients with Subacute Stroke: A Randomized Controlled Trial. Neurol Ther 2022; 11:679-695. [PMID: 35174449 PMCID: PMC9095806 DOI: 10.1007/s40120-022-00333-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 01/25/2022] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION Stroke is always associated with a difficult functional recovery process. A brain-computer interface (BCI) is a technology which provides a direct connection between the human brain and external devices. The primary aim of this study was to determine whether training with a BCI-controlled robot can improve functions in patients with subacute stroke. METHODS Subacute stroke patients aged 32-68 years with a course of 2 weeks to 3 months were randomly assigned to the BCI group or to the sham group for a 4-week course. The primary outcome measures were Loewenstein Occupational Therapy Cognitive Assessment (LOCTA) and Fugl-Meyer Assessment for Lower Extremity (FMA-LE). Secondary outcome measures included Fugl-Meyer Assessment for Balance (FMA-B), Functional Ambulation Category (FAC), Modified Barthel Index (MBI), serum brain-derived neurotrophic factor (BDNF) levels and motor-evoked potential (MEP). RESULTS A total of 28 patients completed the study. Both groups showed a significant increase in mean LOCTA (sham: P < 0.001, Cohen's d = - 2.972; BCI: P < 0.001, Cohen's d = - 4.266) and FMA-LE (sham: P < 0.001, Cohen's d = - 3.178; BCI: P < 0.001, Cohen's d = - 3.063) scores. The LOCTA scores in the BCI group were 14.89% higher than in the sham group (P = 0.049, Cohen's d = - 0.580). There were no significant differences between the two groups in terms of FMA-B (P = 0.363, Cohen's d = - 0.252), FAC (P = 0.363), or MBI (P = 0.493, Cohen's d = - 0.188) scores. The serum levels of BDNF were significantly higher within the BCI group (P < 0.001, Cohen's d = - 1.167), and the MEP latency decreased by 3.75% and 4.71% in the sham and BCI groups, respectively. CONCLUSION Training with a BCI-controlled robot combined with traditional physiotherapy promotes cognitive function recovery, and enhances motor functions of the lower extremity in patients with subacute stroke. These patients also showed increased secretion of BDNF. TRIAL REGISTRATION Chinese clinical trial registry: ChiCTR-INR-17012874.
Collapse
Affiliation(s)
- Chen-Guang Zhao
- Department of Rehabilitation Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Fen Ju
- Department of Rehabilitation Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Wei Sun
- Department of Rehabilitation Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Shan Jiang
- Department of Rehabilitation Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Xiao Xi
- Department of Rehabilitation Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Hong Wang
- Department of Rehabilitation Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Xiao-Long Sun
- Department of Rehabilitation Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Min Li
- School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, China
| | - Jun Xie
- School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, China
| | - Kai Zhang
- School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, China
| | - Guang-Hua Xu
- School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, China
| | - Si-Cong Zhang
- School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, China
| | - Xiang Mou
- Department of Rehabilitation Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Hua Yuan
- Department of Rehabilitation Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
| |
Collapse
|
10
|
Choi KB, Cho SH. Are Physical Therapeutics Important for Stroke Patients to Recover Their Cardiorespiratory Fitness? Medicina (B Aires) 2021; 57:medicina57111182. [PMID: 34833400 PMCID: PMC8619703 DOI: 10.3390/medicina57111182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 10/21/2021] [Accepted: 10/25/2021] [Indexed: 11/16/2022] Open
Abstract
Background and Objectives: Aspects of improving cardiorespiratory fitness should be factored into therapeutics for recovery of movement in stroke patients. This study aimed to recommend optimized cardiorespiratory fitness therapeutics that can be prescribed to stroke patients based on a literature review and an expert-modified Delphi technique. Materials and Methods: we searched PubMed, Embase, CINAHL, and Cochrane databases and yielded 13,498 articles published from 2010 to 2019 to support the development of drafts. After applying the exclusion criteria, 29 documents were analyzed (drafts, 17 articles; modified Delphi techniques, 12 articles). This literature was reviewed in combination with the results of a modified Delphi technique presented to experts in the physical medicine and rehabilitation field. Analysis of the literature and survey results was conducted at the participating university hospital. Results: the results of this analysis were as follows: first, 12 intervention items derived through a researcher’s literature review and a Delphi technique questionnaire were constructed using the Likert scale; second, we asked the experts to create two modified Delphi techniques by reconstructing the items after statistical analysis for each order comprising five categories, and 15 items were finally confirmed. Conclusions: the recommendations in this study may lead to the development of a standard decision-making process for physiotherapists to improve their patients’ cardiorespiratory fitness. Moreover, the study results can help prescribers document patient care to reduce prescription errors and improve safety. In the future, multidisciplinary studies could potentially provide better therapeutics alternatives for cardiorespiratory fitness.
Collapse
Affiliation(s)
- Ki-Bok Choi
- Team of Rehabilitation Treatment, Chosun University Hospital, 365, Pilmun-daero, Dong-gu, Gwangju 61453, Korea;
| | - Sung-Hyoun Cho
- Department of Physical Therapy, Nambu University, 23 Cheomdan Jungang-ro, Gwangsan-gu, Gwangju 62271, Korea
- Correspondence: ; Tel.: +82-10-3060-1330
| |
Collapse
|
11
|
Effects of Aquatic Exercise and Land-Based Exercise on Cardiorespiratory Fitness, Motor Function, Balance, and Functional Independence in Stroke Patients-A Meta-Analysis of Randomized Controlled Trials. Brain Sci 2021; 11:brainsci11081097. [PMID: 34439716 PMCID: PMC8394174 DOI: 10.3390/brainsci11081097] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 08/17/2021] [Accepted: 08/18/2021] [Indexed: 11/24/2022] Open
Abstract
The aim of this study was to evaluate the efficacy of aquatic exercise (AE) and land-based exercise (LE) on cardiorespiratory fitness, motor function, balance, and functional independence in stroke patients. Design: Through searching PubMed, Embase, Cochrane Library, Web of Science, CNKI, VIP and Wanfang Database, only randomized controlled trials (RCTs) were collected to study the effects of AE and LE on cardiorespiratory fitness, motor function, balance, and functional independence in patients with stroke. The included studies were evaluated for methodological quality by the Cochrane bias risk assessment tool, and statistical analysis was carried out by the Review Manage 5.3 and Stata 15.1 software. Results: The RCTs were collected between the earliest available date and April 2021. Eleven RCTs were included, including five studies with low risk and six studies with moderate risk. The total sample size used in the study was 369, which included 187 patients undertaking AE and 182 patients undertaking LE. The results of the meta-analysis showed that AE can significantly improve patients’ Berg Balance Scale (BBS) (MD = 5.19, 95% CI: 2.66 to 7.71, p < 0.0001), peak oxygen uptake (VO2peak) (MD = 3.49, 95% CI: 0.17 to 6.8, p = 0.04), Fugl–Meyer Assessment (FMA) (MD = 3.84, 95% CI: 1.64 to 6.04, p = 0.0006), and Functional Independence Measure (FIM) (MD = 6.1, 95% CI: 4.05 to 8.15, p < 0.00001). However, there was no statistically significant difference between the two exercise modes in the Timed Up and Go Test (TUGT) (MD = −2.52, 95% CI: −5.95 to 0.91, p = 0.15) or the Functional Ambulation Category scale (FAC) (MD = 0.28, 95% CI: −0.21 to 0.76, p = 0.26). Conclusion: Based on the improvement in the Berg Balance Scale, peak oxygen uptake, Fugl–Meyer Assessment, and Functional Independence Measure, we can state that aquatic exercise offers better advantages than land-based exercise for patients’ balance, motor function, cardiorespiratory fitness, and functional independence.
Collapse
|