Reliability and validity of the trunk position sense and modified functional reach tests in individuals after stroke

The psychometric qualities of the proprioception and dynamic trunk control tests have rarely been studied in individuals after stroke.

OBJECTIVE

To investigate the reliability and validity of the Trunk Position Sense Test (TPS) and Modified Functional Reach Test (MFRT) in persons after stroke.

METHODS

Thirty-two participants were included. The TPS and MFRT were assessed by two physiotherapists during a first session. After resting, a second session was conducted. The intraclass correlation coefficient (ICC) was calculated to assess the test-retest (ICC3,k) and inter-rater reliability (ICC2,k). Pearson correlations coefficients were calculated between TPS/MFRT performances and clinical tests (trunk strength, Timed Up and Go and Balance Assessment in Sitting and Standing Positions - BASSP).

RESULTS

The TPS inter-rater reliability was good for vertical error (ICC = 0.75 [0.50-0.88]) while it was moderate for horizontal error (ICC = 0.48 [0.10-0.75]) as well as for test-retest reliability (0.39 ≤ ICC ≤ 0.59). As for the MFRT, inter-rater (0.76 ≤ ICC ≤ 0.90) and test-retest reliability (0.71 ≤ ICC ≤ 0.91) were good to excellent for anterior, paretic et non-paretic displacements. Horizontal errors for the TPS (-0.26 ≤ r ≤ -0.36) and anterior MFRT (0.38 ≤ r ≤ 0.64) values correlated moderately with trunk strength.

CONCLUSION

The MFRT is a reliable test for persons after stroke with trunk control impairments. The TPS does not appear to be relevant for post-stroke individuals. This can be explained by the fact that its procedure is not easily applied for individuals after stroke - who may have significant motor and cognitive impairments.

Dance after stroke improves motor recovery in the subacute phase: A randomized controlled trial

Purpose

The objective of this study was to investigate the effects of a dance program, combined with conventional treatments, on the motor recovery and quality of life of stroke survivors in comparison with conventional treatments alone.

Materials and methods

A total of 16 subacute stroke survivors were randomized into two groups: a dance group (DG) and a conventional treatments group (CG). Stroke severity, cognitive abilities, and motor capacities were assessed at baseline. For six weeks, all participants underwent standard rehabilitation. However, in the DG, participants attended an additional weekly dance class. In both groups, the Mini-BESTest, Functional Independence Measure (FIM), ABC-Scale, Lower Extremity Motor Coordination Test (LEMOCOT), quadriceps strength, and Stroke-Specific Quality of Life Scale (SS-QOL) were measured at weeks 4 and 6. Nonparametric statistical tests were applied.

Results

Compared to the CG, the DG significantly improved recovery of balance, coordination, and FIM after four or six weeks. No differences were observed for quadriceps strength, SS-QOL, or cognition. Participants were completely satisfied with the dance class, and no adverse effects were observed.

Conclusions

This study was discontinued following the COVID-19 health crisis. However, the analysis revealed numerous beneficial effects of dance practice for subacute stroke survivors. The results contribute significantly to the advancement of artistic practices in stroke rehabilitation.

Feasibility, criterion and construct convergent validity of the 2-minute walk test and the 10-meter walk test in an oncological context

Objective

To examine the feasibility, the criterion, and the construct convergent validity of the 2-Minute Walk Test (2MWT) and the 10-Meter Walk Test (10MeWT) against the 6-Minute Walk Test (6MWT) to assess walking capacity in people with cancer. The criterion concurrent validity of a self-test version of the 10MeWT (10MeWTself-test) was also evaluated against the 10MeWT.

Methods

Fifty-six people with cancer performed the 2MWT, the 10MeWT at comfortable and fast speeds, the 6MWT, and the 10MeWTself-test. The feasibility of the tests was assessed using safety, adverse events, space requirements, time taken to administer and interpret the tool, equipment or training required, cost, and portability as criteria. Validity was assessed using Pearson correlation coefficients and Bland Altman plots.

Results

The 2MWT, 6MWT, 10MeWT, and 10MeWTself-test were feasible for people with cancer. The 2MWT and the 10MeWT results were moderately to strongly correlated with the 6MWT results (0.61 < r < 0.84, p < 0.001). The 10MeWTself-test results were strongly correlated with the 10MeWT results at comfortable and fast speeds (r = 0.99, p < 0.001).

Conclusions

The 2MWT, 10MeWT, and 10MeWTself-test are simple, rapid, and feasible tests for use in people with cancer. The strong correlation between the 2MWT and 6MWT results indicates that the 2MWT can be used as an alternative walking capacity assessment tool. The 10MeWT results moderately correlated with those of the other two tests, suggesting that it partially measures the same construct of walking capacity in walking-independent outpatients with cancer. The 10MeWTself-test showed promising results but needs further investigations in ecological settings.

Does texting while walking affect spatiotemporal gait parameters in healthy adults, older people, and persons with motor or cognitive disorders? A systematic review and meta-analysis

BACKGROUND

Smartphone use during postural-locomotor tasks is an everyday activity for individuals of all ages in diverse environmental situations and with various health conditions. Nevertheless, the use of smartphones during walking is responsible for many accidents.

RESEARCH QUESTION

This systematic review and meta-analysis examined spatiotemporal gait parameters during the dual-task situation "texting + gait" versus isolated gait task (single task) in adult persons (>18 years).

METHODS

Electronic database searches were performed in PubMed, Embase, CINHAL, and LISSA. Two examiners assessed the eligibility and quality of appraisal with the Downs and Black checklist. The standardized mean difference (SMD) with 95 % confidence intervals was calculated to compare single- and dual-task situations. The pooled estimates of the overall effect were computed using a random or fixed effects method, and forest plots were generated.

RESULTS AND SIGNIFICANCE

A total of 25 studies were included. All studies included healthy adults, with four studies including older persons and three including people with pathological conditions. The walking task was with (N = 4) and without (N = 21) obstacles and in laboratory (N = 21) or ecological conditions (N = 7). The quality scores were 6-8/16 for eight studies, 9-12/16 for seven studies, and more than 12/16 for three studies. During the "texting + gait" tasks, the meta-analysis highlighted a significant impairment of gait speed, step and stride length, cadence, and double and single support (p < 0.05). The spatiotemporal parameters of gait were systematically altered during the texting task regardless of the population and test conditions. However, the quality of the studies is moderate, and few studies have been conducted for people with motor deficiencies. The impact of texting on walking should be better considered to develop prevention actions.

Validity and reliability of center of pressure measures to quantify trunk control ability in individuals after stroke in subacute phase during unstable sitting test

Objective

The objective of this study was to assess, for individuals with hemiparesis after a stroke in subacute phase, the validity and reliability of center of pressure (CoP) parameters measured during sitting balance on an unstable support.

Materials and methods

Thirty-two individuals after stroke were included in this observational study for validity and reliability (mean age: 64.34 ± 9.30y, 23 men, mean post-stroke duration: 55.64 ± 27days). Intra-Class Correlation (ICC) and Bland Altman plot assessed intra-rater reliability and inter-rater reliability of CoP parameters during unstable sitting balance test (anteroposterior or mediolateral imbalance). Validity was established by correlating CoP parameters with the Modified Functional Reach Test, trunk strength, Balance Assessment in Sitting and Standing and Timed Up and Go tests.

Results

The findings highlighted significant correlations between CoP parameters and trunk strength for anteroposterior seated destabilization. Good to excellent intra and inter-rater reliability (0.87 ≤ ICC ≤ 0.95) was observed for all CoP length parameters and CoP mean velocity in both mediolateral and anteroposterior imbalance conditions. CoP parameters for mediolateral unstable sitting condition were more reliable than for anteroposterior instability.

Conclusion

Trunk control assessment during unstable sitting position on a seesaw is a reliable test for assessing trunk control ability in individuals after a stroke. CoP length and mean velocity are found to be the best parameters.

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Center of pressure values during anteroposterior perturbation is related to trunk strength.

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Center of pressure length parameters have excellent intra-rater and inter-rater reliability in individuals after a stroke in subacute phase.

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The reliability is better when the sitting instability is in mediolateral direction.

Influence of chemotherapy on postural control and quality of life in women with gynaecological cancer: a protocol of a prospective observational study

INTRODUCTION

Chemotherapy-induced peripheral neuropathy is a frequent side effect of some chemotherapies that can cause postural control disorders and has a serious impact on quality of life (QoL). An enhanced understanding of postural control dysfunction could help build a systematic and accurate assessment as well as specific exercises to limit the impact on QoL. This study aims to assess the influence of chemotherapy on postural control and the QoL for women with gynaecological cancer.

METHODS AND ANALYSIS

This prospective observational study will include 37 participants with cancer treated using neurotoxic chemotherapy. Their postural control in various conditions (rigid and foam surfaces, eyes open and closed, with and without tendon vibration, and dual tasks), limits of stability, QoL and modified Total Neuropathy Score will be assessed. A linear mixed model will compare postural control pre-chemotherapy and post-chemotherapy.

ETHICS AND DISSEMINATION

This study was approved by an ethical review board in Geneva (CCER-2020-01639). The study findings will be disseminated through conference presentations and publications in peer-reviewed journals.

TRIAL REGISTRATION NUMBER

NCT04692168.

Bariatric Surgery: Consequences on Functional Capacities in Patients With Obesity

INTRODUCTION

Bariatric surgery leads to loss of fat and fat-free mass (FFM). To preserve FFM it is recommended that weight loss interventions are accompanied by physical activity. However, it remains unknown if functional capacities spontaneously improve after a substantial weight loss. Study's aim was to assess the effect of bariatric surgery on strength, functional capacities and quality of life of participants with a body mass index (BMI) ≥ 35 kg/m².

METHOD

Anthropometric parameters (weight, BMI, waist circumference), physical functions (quadriceps strength, walking capacity, spatio-temporal gait parameters, dynamic balance, lower limb power) and quality of life were assessed before and at three months after the bariatric surgery in 33 individuals who did not follow any physical activity program.

RESULTS

The anthropometric parameters, quality of life and three functional abilities (walking capacity, normal gait speed and lower limb power) improved significantly three months post-surgery. In contrast, fast gait speed, absolute strength, normalized strength, and dynamic balance did not improve.

DISCUSSION

A massive weight loss should be accompanied by an exercise program aiming to maintain FFM and to enhance muscle strength and balance. Such a program might also enhance functional capacities and help to sustain the weight loss over time.