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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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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 2024:1-11. [PMID: 38598557 DOI: 10.1080/10749357.2024.2329849] [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: 11/29/2023] [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.
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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
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Kwon IH, Shin WS, Choi KS, Lee MS. Effects of Real-Time Feedback Methods on Static Balance Training in Stroke Patients: A Randomized Controlled Trial. Healthcare (Basel) 2024; 12:767. [PMID: 38610189 PMCID: PMC11011765 DOI: 10.3390/healthcare12070767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 03/25/2024] [Accepted: 03/29/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND The purpose of this study was to investigate the effects of real-time feedback methods on static balance training in stroke patients. There are two types of real-time feedback methods, as follows: one is Knowledge of Result (KR), and the other is Knowledge of Performance (KP). METHOD Thirty stroke patients participated in this study and were randomly assigned to the KR group (n = 15) or the KP group (n = 15). All of the groups underwent real-time feedback training for four weeks (30 min per session, five sessions per week). The primary outcomes were sway length, sway velocity, and area 95%, which were assessed before and after the intervention. The secondary outcomes included the Berg Balance Scale, the Fugl Meyer Assessment for Lower Extremity, the Postural Assessment Scale for Stroke Trunk Impairment Scale, and the Fall Efficacy Scale. A group × time interaction was assessed using two-way ANOVA with repeated measures. RESULT There was a significant increase over time in all outcomes (p < 0.05). Significant differences were observed for a group × time interaction in sway length and area 95% (p < 0.05). CONCLUSIONS Real-time feedback training for static balance enhanced stroke patients' static balance abilities, clinical outcome assessments, and promoted self-efficacy against falls.
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Affiliation(s)
- Il-Ho Kwon
- Department of Physical Therapy, Graduate School of Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon 34520, Republic of Korea;
| | - Won-Seob Shin
- Department of Physical Therapy, College of Health Medical Science, Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon 34520, Republic of Korea
| | - Kyu-Seong Choi
- Department of Physical Therapy, Graduate School of Health and Medicine, Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon 34520, Republic of Korea;
| | - Myung-Sun Lee
- Department of Beauty Design, College of Design and Art, Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon 34520, Republic of Korea;
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Chao X, Wang J, Dong Y, Fang Y, Yin D, Wen J, Wang P, Sun W. Neuroimaging of neuropsychological disturbances following ischaemic stroke (CONNECT): a prospective cohort study protocol. BMJ Open 2024; 14:e077799. [PMID: 38286706 PMCID: PMC10826587 DOI: 10.1136/bmjopen-2023-077799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 01/09/2024] [Indexed: 01/31/2024] Open
Abstract
INTRODUCTION Neuropsychiatric distubance is a common clinical manifestation in acute ischemic stroke. However, it is frequently overlooked by clinicians. This study aimed to explore the possible aetiology and pathogenesis of neuropsychiatric disturbances following ischaemic stroke (NDIS) from an anatomical and functional perspective with the help of neuroimaging methods. METHOD AND ANALYSIS CONNECT is a prospective cohort study of neuroimaging and its functional outcome in NDIS. We aim to enrol a minimum of 300 individuals with first-ever stroke. The neuropsychological disturbances involved in this study include depression, anxiety disorder, headache, apathy, insomnia, fatigue and cognitive impairment. Using scales that have been shown to be effective in assessing the above symptoms, the NDIS evaluation battery requires at least 2 hours at baseline. Moreover, all patients will be required to complete 2 years of follow-up, during which the NDIS will be re-evaluated at 3 months, 12 months and 24 months by telephone and 6 months by outpatient interview after the index stroke. The primary outcome of our study is the incidence of NDIS at the 6-month mark. Secondary outcomes are related to the severity of NDIS as well as functional rehabilitation of patients. Functional imaging evaluation will be performed at baseline and 6-month follow-up using specific sequences including resting-state functional MRI, diffusion tensor imaging, T1-weighted imaging, T2-weighted imaging, diffusion-weighted imaging, arterial spin labelling, quantitative susceptibility mapping and fluid-attenuated inversion recovery imaging. In addition, we collect haematological information from patients to explore potential biological and genetic markers of NDIS through histological analysis. ETHICS AND DISSEMINATION The CONNECT Study was approved by the Ethics Review Committee of the First Hospital of the University of Science and Technology of China (2021-ky012) and written informed consent will be obtained from all participants. Results will be disseminated via a peer-reviewed journal. TRIAL REGISTRATION NUMBER ChiCTR2100043886.
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Affiliation(s)
- Xian Chao
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Jinjing Wang
- Department of Neurology, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Yiran Dong
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Yirong Fang
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Dawei Yin
- Department of Radiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Jie Wen
- Department of Radiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Peng Wang
- Department of Radiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Wen Sun
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
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Lando A, Cacciante L, Mantineo A, Baldan F, Pillastrini P, Turolla A, Pregnolato G. Multi-Modal versus Uni-Modal Treatment for the Recovery of Lower Limb Motor Function in Patients after Stroke: A Systematic Review with Meta-Analysis. Healthcare (Basel) 2024; 12:189. [PMID: 38255077 PMCID: PMC10815740 DOI: 10.3390/healthcare12020189] [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: 12/19/2023] [Revised: 01/08/2024] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
The aim of this study is to evaluate whether the multimodal treatment based on both resistance and endurance training for the recovery of lower limb function in post-stroke patients is more effective than unimodal treatment. Six electronic databases were searched. The included articles were firstly analysed for methodological quality and then quantitatively analysed for the following outcomes: endurance, knee-extensor muscle strength, gait speed, and aerobic capacity. The treatment effect was analysed with the mean difference (MD) or standardised mean difference (SMD). From a total of 4439 records, 10 studies met the inclusion criteria for the qualitative analysis, whereas 7 studies were included in the quantitative analysis. There is a significant difference favourable to the group with multimodal treatment for knee-extensor muscle strength (SMD = 1.25; 95% CI 0.97, 1.53, I2 = 42%), both for the affected and the unaffected side. Multimodal treatments are a valid choice in the field of post-stroke rehabilitation. In particular, the combination of resistance and endurance training is useful to maximise the recovery of knee-extensor muscle strength, which in turn could be beneficial for achieving upright position and walking, allowing patients to improve independence levels in their activities of daily life.
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Affiliation(s)
- Alex Lando
- Rehabilitation Unit, Department of Neuroscience, General Hospital—University of Padova, 35128 Padova, Italy;
| | - Luisa Cacciante
- Laboratory of Healthcare Innovation Technology, IRCCS San Camillo Hospital, 30126 Venice, Italy; (A.M.); (G.P.)
| | - Alessio Mantineo
- Laboratory of Healthcare Innovation Technology, IRCCS San Camillo Hospital, 30126 Venice, Italy; (A.M.); (G.P.)
| | | | - Paolo Pillastrini
- Department of Biomedical and Neuromotor Sciences, Alma Mater University of Bologna, 40128 Bologna, Italy; (P.P.); (A.T.)
- Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Andrea Turolla
- Department of Biomedical and Neuromotor Sciences, Alma Mater University of Bologna, 40128 Bologna, Italy; (P.P.); (A.T.)
- Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Giorgia Pregnolato
- Laboratory of Healthcare Innovation Technology, IRCCS San Camillo Hospital, 30126 Venice, Italy; (A.M.); (G.P.)
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Xue A, Zeng Z, Wang H, Han J, Pang B. Kinematic characteristics of gait with different myopia: a cross-sectional study. Front Public Health 2023; 11:1256242. [PMID: 38179553 PMCID: PMC10765516 DOI: 10.3389/fpubh.2023.1256242] [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: 07/10/2023] [Accepted: 11/03/2023] [Indexed: 01/06/2024] Open
Abstract
Background Myopia, a condition affecting approximately one-quarter of the world' s population, has been projected to double in prevalence by the year 2050. It can have an impact on postural control during walking and can increase the risk of falls and injuries. Objective (1) To examine the abnormal performance of postural control during walking in male college students who used convex lenses for myopia intervention from a kinematic perspective; (2) to establish theoretical foundation for preventing falls and injuries in the myopic population. Methods A total of 22 male college students participated in this study. The center of gravity (COG), the percentage of gait cycle (PGC) and the joint angle(JT) were collected as indications of postural control during walking. A quantitative analysis was conducted using a One-Way Repeated Measures ANOVA to examine the variations among the three groups. Results During myopic interventions, (1) the range of vertical COG changes is significant to be greater compared with normal vision (P < 0.05). (2) there was an significant increase in the PGC in single-legged support, accompanied by a decrease in the PGC in double-legged support, compared with normal vision (P < 0.05). (3) The myopic intervention leads to increased variability in JT of the hip and the knee during the single-leg support and swing, as compared to individuals with normal vision (P < 0.05). Severe myopic interventions result in more changes in JT of ankle. Conclusion Myopia has been found to have a negative impact on postural control during walking, leading to changes in balance, increased instability, and an elevated risk of injury.
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Affiliation(s)
- Aochuan Xue
- College of Physical Education and Health, East China Normal University, Shanghai, China
- School of Sports and Health, Zunyi Medical University, Zunyi, Guizhou, China
| | - Zhaohong Zeng
- School of Sports and Health, Zunyi Medical University, Zunyi, Guizhou, China
| | - Huihui Wang
- School of Sports and Health, Zunyi Medical University, Zunyi, Guizhou, China
| | - Jinming Han
- School of Physical and Art Education, Beijing Institute of Education, Beijing, China
| | - Bo Pang
- School of Sports Science, Harbin Normal University, Harbin, China
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Sadiq AO, Awotidebe AW, Saeys W, Truijen S, Wong TWL, Ng SSM, Abdullahi A. Prevalence, associated factors and predictors of post stroke pneumonia in a Nigerian population: A retrospective study. J Stroke Cerebrovasc Dis 2023; 32:107404. [PMID: 37813084 DOI: 10.1016/j.jstrokecerebrovasdis.2023.107404] [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: 02/01/2023] [Revised: 09/20/2023] [Accepted: 09/30/2023] [Indexed: 10/11/2023] Open
Abstract
OBJECTIVES Stroke can trigger an immune response that can raise the risk of infection, alter tracheal epithelium, reduce pulmonary clearance and impair secretions drainage capacity. Infection, altered tracheal epithelium, reduced pulmonary clearance, impaired secretions drainage capacity and aspiration can cause pneumonia after stroke. The aim of this study is to find out the prevalence of post stroke pneumonia in a Nigerian population and factors that are associated with it. MATERIALS AND METHOD Study data was extracted from the case files of patients with stroke who were managed between 1st January, 2011 and 1st February, 2021 in the study setting. RESULTS The result showed that, there was a record of only 591 patients with stroke (mean age, 62.78 ± 14.86 years) who were managed in the two hospitals during the period of the study. Out of this number, only 102 (17.3 %) had pneumonia. Presence of the pneumonia was only significantly (p < 0.05) associated with sex, type of stroke, lower limb muscle power, and outcome (died or alive). However, only those with ischaemic stroke are less likely to have pneumonia (Odds ratio= 0.467; CI: 0.275 to 0.791, p= 0.005), and patients who survived the stroke and are alive are less likely to develop pneumonia (Odds ratio= 0.150; CI: 0.092 to 0.245, p < 0.001). CONCLUSIONS Pneumonia occurs to a large extent after stroke. Therefore, it is important measures are taken to prevent it or complications arising from it especially in those with a hemorrhagic stroke.
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Affiliation(s)
| | | | - Wim Saeys
- Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Belgium
| | - Steven Truijen
- Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Belgium
| | - Thomson W L Wong
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Shamay S M Ng
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Auwal Abdullahi
- Department of Physiotherapy, Bayero University Kano, Nigeria.
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Brown D, Simpkins C, Yang F. A systematic review of perturbation-based balance training on reducing fall risk among individuals with stroke. Clin Biomech (Bristol, Avon) 2023; 109:106078. [PMID: 37647717 DOI: 10.1016/j.clinbiomech.2023.106078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 08/17/2023] [Accepted: 08/21/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Perturbation-based balance training has been proven effective to reduce falls in older adults. However, it remains inconclusive if this training paradigm reduces falls in the stroke population. This review sought to summarize the existing literature to assess the effects of perturbation-based balance training on falls and some common fall risk factors in people with stroke. METHODS Seven databases were searched for studies, which included at least one perturbation-based balance training group and a control group. The primary outcome was the proportion of fallers, and the secondary outcomes encompassed commonly used fall risk factors: balance, balance confidence, reactive stepping characteristics, functional mobility, and muscle strength. FINDINGS This review included nine studies that enrolled 364 participants. The training protocols were significantly heterogeneous among studies, with variations in the training duration, number of sessions, session length, and type of devices used. The results indicated insufficient evidence supporting that perturbation-based balance training reduces falls in the laboratory and everyday living conditions for people with stroke. Furthermore, the effects of perturbation-based balance training on fall risk factors are also inconsistent between studies. INTERPRETATION The existing evidence does not conclusively support the reduction in falls and improvements in fall risk factors resulting from perturbation-based balance training among people with stroke. Such an inconsistent finding could be due to the small sample sizes and variations in perturbation-based balance training protocols across studies. More high-quality studies are needed to further determine the effects of perturbation-based balance training on reducing fall risk in people with stroke.
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Affiliation(s)
- Diané Brown
- Department of Kinesiology and Health, Georgia State University, Atlanta, GA 30303, USA
| | - Caroline Simpkins
- Department of Kinesiology and Health, Georgia State University, Atlanta, GA 30303, USA
| | - Feng Yang
- Department of Kinesiology and Health, Georgia State University, Atlanta, GA 30303, USA.
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Saraiva J, Rosa G, Fernandes S, Fernandes JB. Current Trends in Balance Rehabilitation for Stroke Survivors: A Scoping Review of Experimental Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6829. [PMID: 37835099 PMCID: PMC10572981 DOI: 10.3390/ijerph20196829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 09/15/2023] [Accepted: 09/23/2023] [Indexed: 10/15/2023]
Abstract
Balance impairment is a common consequence of a stroke, which can significantly hinder individuals' participation in daily activities, social interactions, and leisure pursuits and their ability to return to work. Rehabilitation is vital for minimizing post-stroke sequelae and facilitating the recovery of patients. This review aims to identify current trends in balance rehabilitation of stroke survivors. This Scoping review followed Arksey and O'Malley's methodological framework. The literature search was conducted in electronic databases, including CINAHL Complete, MEDLINE Complete, and Nursing & Allied Health Collection. The search was performed in March 2023, and the inclusion criteria were articles published in English or Portuguese between 2013 and 2023. A total of 446 articles were identified. After selecting and analyzing the reports, fourteen publications were included in this review. Seven distinct categories of balance rehabilitation interventions were identified, covering various approaches. These categories included conventional rehabilitation exercises, gym-based interventions, vibration therapy, rhythmic auditory stimulation training, boxing therapy, dual-task training, and technology-based rehabilitation interventions. Each of these methods presents unique benefits and can significantly impact the recovery of balance in stroke survivors, enhancing their overall well-being and functional capacity.
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Affiliation(s)
- Júlia Saraiva
- Department of Nursing, Hospital Garcia de Orta, 2805-267 Almada, Portugal;
- Nurs* Lab, Caparica, 2829-511 Almada, Portugal; (S.F.); (J.B.F.)
| | - Gonçalo Rosa
- Department of Nursing, Hospital Garcia de Orta, 2805-267 Almada, Portugal;
- Nurs* Lab, Caparica, 2829-511 Almada, Portugal; (S.F.); (J.B.F.)
| | - Sónia Fernandes
- Nurs* Lab, Caparica, 2829-511 Almada, Portugal; (S.F.); (J.B.F.)
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, Caparica, 2829-511 Almada, Portugal
| | - Júlio Belo Fernandes
- Nurs* Lab, Caparica, 2829-511 Almada, Portugal; (S.F.); (J.B.F.)
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, Caparica, 2829-511 Almada, Portugal
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Lizama-Pérez R, Chirosa-Ríos LJ, Contreras-Díaz G, Jerez-Mayorga D, Jiménez-Lupión D, Chirosa-Ríos IJ. Effect of sit-to-stand-based training on muscle quality in sedentary adults: a randomized controlled trial. PeerJ 2023; 11:e15665. [PMID: 37456889 PMCID: PMC10349562 DOI: 10.7717/peerj.15665] [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: 04/19/2023] [Accepted: 06/08/2023] [Indexed: 07/18/2023] Open
Abstract
The aim of this study was to compare the effects of sit-to-stand (STS) training programs with 5 vs. 10 repetitions on muscle architecture and muscle function in sedentary adults. Sixty participants were randomly assigned into three groups: five-repetition STS (5STS), 10-repetition STS (10STS), or a control group (CG). Participants performed three sets of five or 10 repetitions of the STS exercise three times per week for 8 weeks. Before and after 8 weeks, all groups performed ultrasound measures to evaluate muscle thickness (MT), pennation angle (PA), and fascicle length (FL), and the five-repetition STS test to estimate the relative STS power and muscle quality index (MQI). After 8 weeks, both experimental groups improved MQI (40-45%), relative STS power (29-38%), and MT (8-9%) (all p < 0.001; no differences between the 5STS vs. 10STS groups). These improvements in both groups resulted in differences regarding the CG, which did not present any change. In addition, only the 5STS group improved PA (15%; p = 0.008) without differences to the 10STS and CG.This suggests that STS training is time-effective and low-cost for improving muscle function and generating adaptations in muscle architecture.
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Affiliation(s)
- Rodrigo Lizama-Pérez
- Department of Physical Education and Sports, University of Granada, Granada, Spain
- Departamento de Ciencias Morfológicas, Facultad de Medicina y Ciencia, Universidad San Sebastián, Valdivia, Chile
| | | | | | - Daniel Jerez-Mayorga
- Department of Physical Education and Sports, University of Granada, Granada, Spain
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile
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Cabanas-Valdés R, García-Rueda L, Salgueiro C, Pérez-Bellmunt A, Rodríguez-Sanz J, López-de-Celis C. Assessment of the 4-meter walk test test-retest reliability and concurrent validity and its correlation with the five sit-to-stand test in chronic ambulatory stroke survivors. Gait Posture 2023; 101:8-13. [PMID: 36696822 DOI: 10.1016/j.gaitpost.2023.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 01/02/2023] [Accepted: 01/18/2023] [Indexed: 01/22/2023]
Abstract
BACKGROUND The 4-meter walk test (4-MWT) is a widely used measure to assess gait speed in the elderly but has not been validated for stroke survivors to date. OBJECTIVES To assess the test-retest reliability and concurrent validity of the 4-MWT compared to the 10-meter walk test (10-MWT) as a measure of gait speed in chronic post-stroke. SECONDARY OUTCOME MEASURE to assess the correlation of both gait measures with the 5 times sit-to-stand test (5TSTS). METHODS A cross-sectional observational study was conducted. Reliability was assessed by intraclass correlation coefficient (ICC2,1), standard error of measurement (SEM) and minimal detectable change (MDC-95%). Bland & Altman analysis was used to quantify agreement between the 4-MWT and the 10-MWT. Two consecutive walking trials of the 4-MWT and 10-MWT followed by 5TSTS were performed all on the same day. A single researcher made all measurements. RESULTS Thirty-six chronic ambulatory post-stroke (average age 58.56 ± 11.28 years) were analyzed at their self-selected walking speed with a dynamic start. The 4-MWT showed excellent concurrent validity and test-retest reliability: ICC2.1 = 0.991 (95% CI: 0.983, 0.996); SEM= 0.032 and MDC- 95% = 0.090 m/second) with a strong positive correlation with the 10-MWT (r = 0.957, p < 0.001). The Bland & Altman analysis showed a concordance of -0.05 m/second bias (p = 0.039) (95% limits of agreement: 0.20 to -0.29 m/second). The paired t-test showed no statistically significant difference in the mean of both walking tests (p < 0.091). However, there was only moderate correlation between the two gait assessments and the 5TSTS. CONCLUSIONS This study indicates excellent test-retest reliability concurrent validity and strong correlation between 4-MWT and 10-MWT with a dynamic start at comfortable speed. The 4-MWT could be used as a measure of gait speed in both outpatients and home settings in chronic ambulatory stroke survivors.
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Affiliation(s)
- Rosa Cabanas-Valdés
- Universitat Internacional de Catalunya, Physiotherapy Department, Faculty of Medicine and Health Sciences, Sant Cugat del Vallés, Barcelona, Spain.
| | - Laura García-Rueda
- Universitat Internacional de Catalunya, PhD Program, Sant Cugat del Vallés, Barcelona, Spain.
| | - Carina Salgueiro
- Universitat Internacional de Catalunya, Physiotherapy Department, Faculty of Medicine and Health Sciences, Sant Cugat del Vallés, Barcelona, Spain; Clínica de Neurorehabilitación, Sant Cugat del Vallés, Barcelona, Spain.
| | - Albert Pérez-Bellmunt
- Universitat Internacional de Catalunya, Campus Sant Cugat, Basic Sciences Department, Actium Functional Anatomy Research Group, Sant Cugat del Vallés, Barcelona, Spain.
| | - Jacobo Rodríguez-Sanz
- Universitat Internacional de Catalunya, Campus Sant Cugat, Basic Sciences Department, Actium Functional Anatomy Research Group, Sant Cugat del Vallés, Barcelona, Spain.
| | - Carlos López-de-Celis
- Universitat Internacional de Catalunya, Campus Sant Cugat, Basic Sciences Department, Actium Functional Anatomy Research Group, Sant Cugat del Vallés, Barcelona, Spain; Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain.
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Chen Y, Su W, Gui CF, Guo QF, Tan HX, He L, Jiang HH, Wei QC, Gao Q. Effectiveness of cerebellar vermis intermittent theta-burst stimulation in improving trunk control and balance function for patients with subacute stroke: a randomised controlled trial protocol. BMJ Open 2023; 13:e066356. [PMID: 36631236 PMCID: PMC9835952 DOI: 10.1136/bmjopen-2022-066356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION Balance impairments frequently occur after stroke. Achieving effective core trunk stability is the key to improving balance ability. However, there is still a lack of advanced well-defined rehabilitation protocols for balance improvement in patients with stroke. Intermittent theta-burst stimulation (iTBS) is a non-invasive brain activity modulation strategy that can produce long-term potentiation. The cerebellar vermis is a fundamental structure involved in balance and motor control. However, no study has demonstrated the therapeutic effect and potential mechanism of cerebellar vermis iTBS on balance after stroke. METHODS AND ANALYSIS This study will be a prospective single-centre double-blind randomised controlled clinical trial with a 3-week intervention and 3-week follow-up. Eligible participants will be randomly allocated to the experimental group or the control group in a 1:1 ratio. After routine conventional physical therapy, patients in the experimental group will receive cerebellar vermis iTBS, whereas patients in the control group will receive sham stimulation. The overall intervention period will be 5 days a week for 3 consecutive weeks. The outcomes will be measured at baseline (T0), 3 weeks postintervention (T1) and at the 3-week follow-up (T2). The primary outcomes are Berg Balance Scale and Trunk Impairment Scale scores. The secondary outcomes are balance test scores via the Balance Master system, muscle activation of the trunk and lower limbs via the surface electromyography recordings, cerebral cortex oxygen concentrations measured via the resting-state functional near-infrared spectroscopy, Fugl-Meyer Assessment of Lower Extremity and Barthel index scores. ETHICS AND DISSEMINATION This study was approved by the West China Hospital Clinical Trials and Biomedical Ethics Committee of Sichuan University. All participants will sign the informed consent form voluntarily. The results of this study will be published in peer-reviewed journals and disseminated at academic conferences. TRIAL REGISTRATION NUMBER ChiCTR2200065369.
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Affiliation(s)
- Yi Chen
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, People's Republic of China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, People's Republic of China
| | - Wei Su
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, People's Republic of China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, People's Republic of China
| | - Chen-Fan Gui
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, People's Republic of China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, People's Republic of China
| | - Qi-Fan Guo
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, People's Republic of China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, People's Republic of China
| | - Hui-Xin Tan
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, People's Republic of China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, People's Republic of China
| | - Lin He
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, People's Republic of China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, People's Republic of China
| | - Han-Hong Jiang
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, People's Republic of China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, People's Republic of China
| | - Qing-Chuan Wei
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, People's Republic of China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, People's Republic of China
| | - Qiang Gao
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, People's Republic of China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, People's Republic of China
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Understanding the Experiences of People Living with Stroke Engaging in a Community-Based Physical-Activity Programme. Healthcare (Basel) 2023; 11:healthcare11020154. [PMID: 36673523 PMCID: PMC9858664 DOI: 10.3390/healthcare11020154] [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: 09/27/2022] [Revised: 12/20/2022] [Accepted: 12/22/2022] [Indexed: 01/06/2023] Open
Abstract
Research has evidenced that regular exercise can provide physical and physiological benefits for people living with stroke. Our study aims to explore the experiences of people living with stroke when participating in a community physical activity programme. This programme was created to offer targeted physical activity and education interventions following the discharge of patients from the healthcare pathway. This qualitative study involved semi-structured interviews with 16 participants living with stroke who were recruited from individuals who had engaged with the activity programme. A reflexive thematic analysis was conducted on the data, and four overarching themes were developed: (i) Feelings of appreciation, (ii) Interactions with other patients, (iii) Positive contributions of trained instructors, and iv) Personal progress. Generally, participants reported very positive perceptions of the exercise programme, and were very grateful for the opportunity that the exercise classes provided. We hope that these findings will offer practical suggestions for healthcare providers who might develop similar activity programmes for clinical populations.
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Kim KI, Im SC, Kim K. Effects of trunk stabilization exercises using laser pointer visual feedback in patients with chronic stroke: A randomized controlled study. Technol Health Care 2023; 31:471-483. [PMID: 36120797 DOI: 10.3233/thc-220100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Many previous studies have cited the importance of trunk stabilization exercises in patients with stroke. However, the evidence for optimal trunk stabilization exercises for patients with stroke is still lacking. OBJECTIVE To investigate the effects of laser pointer visual feedback in trunk stabilization exercises that are important for improving trunk dysfunction in patients with stroke. METHODS In total, 30 patients with chronic stroke were randomly assigned to experimental and control groups. The experimental group underwent a traditional stroke rehabilitation program and trunk stabilization exercises using laser pointer visual feedback. The control group underwent a traditional stroke rehabilitation program and trunk stabilization exercises without visual feedback. Pre- and postintervention results after 6 weeks were evaluated using the Berg Balance Scale, static and dynamic plantar pressure, 10-m walk test, and the Korean version of the Fall Efficacy Scale. The results were analyzed using a general linear repeated measurement model. RESULTS Both groups showed significant improvements in BBS scores, static plantar pressure, dynamic plantar pressure, 10 MWT, and K-FES scores after 6 weeks of intervention (P< 0.05). Compared to the control group, significant improvements were observed in the experimental group in the Berg Balance Scale scores, dynamic paretic posterior plantar pressure, 10-m walk test, and Korean version of the Fall Efficacy Scale scores (P< 0.025). CONCLUSION Our results demonstrated the effectiveness of visual feedback during trunk stabilization exercises for resolving trunk dysfunction in patients with stroke. Trunk stabilization exercises using laser pointer visual feedback have been found to be more effective in balance, walking, and fall efficacy in patients with stroke.
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The Association of Gender and Body Mass Index on the Values of Static and Dynamic Balance of University Students (A Cross-Sectional Design Study). APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12083770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The balance of the body conditions the quality and efficiency of the movements in daily and sports activities, its impairment generating problems in the manifestation of motor skills for all age groups. The aim of this study is to analyze how the gender and BMI values of university students influence the results of the static and dynamic balance tests applied. The investigated group consists of 195 undergraduate students, from various specializations of the Dunărea de Jos University in Galați (99 males and 96 females, ages = 20.16 ± 1.98, BMI = 24.15 ± 5.68). The independent variables gender and BMI levels (underweight, normal weight and overweight/obese) were defined. The participants were evaluated in May 2019 using a series of 7 tests: one leg standing test with eyes closed, stork test, flamingo test, Bass test, functional reach test, walk and turn field sobriety test and Fukuda test. The results provided using multivariate analysis (MANOVA) indicate balanced performance for the gender variable, but with significantly better values for women in the one leg standing test, flamingo test and functional reach test (F values are associated with thresholds p < 0.05). Men obtain slightly better, but statistically insignificant (p > 0.05), performances on the stork test, Bass test and Fukuda test. The BMI step comparison confirms the difficulties of the overweight group in assessing balance, with the lowest scores in maintaining static positions and the most errors in dynamic balance tests, with significant differences from normal and underweight in most tests (p < 0.05). An interesting aspect is the slightly superior performance of the underweight compared to the normal weight group, for the one leg standing test, flamingo test and walk and turn field sobriety test. The analysis of Spearman correlation coefficients indicates a number of significant associations between elevated BMI values and decreased performance on balance tests.
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