1
|
Doctor K, Karnad SD, Krishnan S, Narayan A, Nayak A. Is functional mobility associated with quality of sitting in cerebral palsy? A cross-sectional study. J Neurosci Rural Pract 2024; 15:286-292. [PMID: 38746505 PMCID: PMC11090550 DOI: 10.25259/jnrp_516_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 01/22/2024] [Indexed: 05/16/2024] Open
Abstract
Objectives A group of neuromuscular system anomalies associated with non-progressive issues in the developing fetal or newborn brain are known as cerebral palsy (CP). These abnormalities are typified by poor posture and motor development, which limits the execution of functional activities. Consequently, to achieve the same goals as peers who are typically developing, children with CP employ a variety of compensatory postures and techniques. Given that both sitting and mobility are essential for functioning, assessing each skill alone and in relation to the other is necessary. This study aims to determine if a child's functional mobility affects their sitting ability. Materials and Methods Twenty CP (Gross Motor Function Classification System [GMFCS] levels I and II) children, aged 6-12, were enrolled in the research. The level of sitting scale (LSS) and the modified timed up and go (mTUG) test were utilized to evaluate sitting and functional mobility, respectively. Results The quality of sitting was shown to have a substantial effect on functional mobility, as a significant difference in mTUG durations was established between LSS levels (P < 0.001) and persisted when analyzed within the same GMFCS level (P = 0.007). Conclusion The importance of trunk control in functional mobility can be inferred from the link between sitting quality and mobility. To improve children with CP's functional mobility, this evidence may be utilized to design a well-informed and specific intervention program incorporating trunk control.
Collapse
Affiliation(s)
- Kaiorisa Doctor
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Shreekanth D. Karnad
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Shyam Krishnan
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Amitesh Narayan
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Akshatha Nayak
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| |
Collapse
|
2
|
Ha SY, Sung YH. Stimulus zones of Vojta method and trunk control in children with spastic-type cerebral palsy: A quasi-experimental pilot study. J Bodyw Mov Ther 2024; 38:150-154. [PMID: 38763554 DOI: 10.1016/j.jbmt.2024.01.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 11/21/2023] [Accepted: 01/13/2024] [Indexed: 05/21/2024]
Abstract
BACKGROUND Vojta method improves motor function by inducing a response by pressing the stimulus zones. PURPOSE To determine the effect of the stimulus zones on trunk muscle thickness, trunk control, trunk angle, and gross motor function in children with spastic-type cerebral palsy. METHODS A quasi-experimental pilot study was conducted with 19 children with spastic-type cerebral palsy divided into two groups: Vojta method group (n = 10) and general physical therapy group (n = 9). Each group underwent a 6-week intervention, and assessments were conducted to evaluate abdominal muscle thickness, trunk control, trunk angle, and gross motor function. RESULTS In the Vojta method group, the change rate in the thickness of the internal oblique and transversus abdominis increased significantly within the group (P < 0.05) and the difference (post-pre) of the transversus abdominis was higher (P < 0.05). The trunk angle increased significantly within the group when thoracic 7 and 11, lumbar 3, and sacrum 1 were supported (P < 0.05). There was a significant difference in trunk angle difference (post-pre) between groups when thoracic 11 and sacrum 1 were supported (P < 0.05). Segmental assessment of trunk control and gross motor function measure-88 scores were significantly increased within the group in all groups (P < 0.05). CONCLUSION The stimulus zones of the Vojta method could improve trunk control in children with spastic-type cerebral palsy through intra-abdominal pressure and anti-gravity movement.
Collapse
Affiliation(s)
- Sun-Young Ha
- The Basic Sciences Research Institute, Kyungnam University, Changwon, South Korea
| | - Yun-Hee Sung
- Department of Physical Therapy, College of Health Sciences, Kyungnam University, Changwon, South Korea.
| |
Collapse
|
3
|
Scheermesser M, Baumgartner D, Nast I, Bansi J, Kool J, Bischof P, Bauer CM. Therapists and patients perceptions of a mixed reality system designed to improve trunk control and upper extremity function. Sci Rep 2024; 14:6598. [PMID: 38503795 PMCID: PMC10951291 DOI: 10.1038/s41598-024-55692-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 02/27/2024] [Indexed: 03/21/2024] Open
Abstract
A prototype system aimed at improving arm function and trunk control after stroke has been developed that combines mixed-reality (MR) feedback with a mobile seat system (Holoreach). The purpose of this study was to assess the usability of Holoreach in a rehabilitation setting from both the patient and therapist perspective. Ten therapists (eight physiotherapists and two occupational therapists) used the device in their regular therapy programs for fifteen stroke patients with trunk control issues. Each patient received four individual therapy sessions with the device performed under the supervision of the therapist. Therapists and patients kept therapy diaries and used customized questionnaires. At the end of the study two focus groups were conducted to further assess usability. Generally, the prototype system is suitable for training trunk and arm control. The therapists expressed overall positive views on the impact of Holoreach. They characterized it as new, motivating, fresh, joyful, interesting, and exciting. All therapists and 80% of the patients agreed with the statement that training with Holoreach is beneficial for rehabilitation. Nonetheless, improvements are required in the hardware and software, and design. The prototype system contributes at various levels to the rapidly evolving advances in neurorehabilitation, particularly regarding the practical aspect of exercise delivery.
Collapse
Affiliation(s)
- M Scheermesser
- School of Health Sciences, Institute of Physiotherapy, Zurich University of Applied Sciences, Katharina-Sulzer-Platz 9, 8401, Winterthur, Switzerland.
| | - D Baumgartner
- School of Engineering, Institute of Mechanical Systems IMES, Zurich University of Applied Sciences, Technikumstrasse 71, 8400, Winterthur, Switzerland
| | - I Nast
- School of Health Sciences, Institute of Physiotherapy, Zurich University of Applied Sciences, Katharina-Sulzer-Platz 9, 8401, Winterthur, Switzerland
| | - J Bansi
- Kliniken-Valens, Research and Development, Rehabilitation Centre Valens, Taminaplatz 1, 7317, Valens, Switzerland
- Department of Health, Physiotherapy, OST-University of Applied Sciences Eastern Switzerland, Rosenbergstrasse 59, 9001, St. Gallen, Switzerland
| | - J Kool
- Kliniken-Valens, Research and Development, Rehabilitation Centre Valens, Taminaplatz 1, 7317, Valens, Switzerland
| | - P Bischof
- School of Engineering, Institute of Mechanical Systems IMES, Zurich University of Applied Sciences, Technikumstrasse 71, 8400, Winterthur, Switzerland
| | - C M Bauer
- School of Health Sciences, Institute of Physiotherapy, Zurich University of Applied Sciences, Katharina-Sulzer-Platz 9, 8401, Winterthur, Switzerland.
- Lake Lucerne Institute, Seestrasse 18, 6354, Vitznau, Switzerland.
- Faculty of Sport and Health Science, University of Jyväskylä, PO Box 35, 40014, Jyvaskyla, Finland.
| |
Collapse
|
4
|
Pellicciari L, Basagni B, Paperini A, Campagnini S, Sodero A, Hakiki B, Castagnoli C, Politi AM, Avila L, Barilli M, Romano E, Pancani S, Mannini A, Sensoli F, Salvadori E, Poggesi A, Grippo A, Macchi C, Baccini M, Carrozza MC, Cecchi F. Trunk Control Test as a Main Predictor of the Modified Barthel Index Score at Discharge From Intensive Post-acute Stroke Rehabilitation: Results From a Multicenter Italian Study. Arch Phys Med Rehabil 2024; 105:326-334. [PMID: 37625531 DOI: 10.1016/j.apmr.2023.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/05/2023] [Accepted: 08/06/2023] [Indexed: 08/27/2023]
Abstract
OBJECTIVES To verify whether trunk control test (TCT) upon admission to intensive inpatient post-stroke rehabilitation, combined with other confounding variables, is independently associated with discharge mBI. DESIGN Multicentric retrospective observational cohort study. SETTING Two Italian inpatient rehabilitation units. PARTICIPANTS A total of 220 post-stroke adult patients, within 30 days from the acute event, were consecutively enrolled. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURE The outcome measure considered was the modified Barthel Index (mBI), one of the most widely recommended tools for assessing stroke rehabilitation functional outcomes. RESULTS All variables collected at admission and significantly associated with mBI at discharge in the univariate analysis (TCT, mBI at admission, pre-stroke modified Rankin Scale [mRS], sex, age, communication ability, time from the event, Cumulative Illness Rating Scale, bladder catheter, and pressure ulcers) entered the multivariate analysis. TCT, mBI at admission, premorbid disability (mRS), communication ability and pressure ulcers (P<.001) independently predicted discharge mBI (adjusted R2=68.5%). Concerning the role of TCT, the model with all covariates and without TCT presented an R2 of 65.1%. On the other side, the model with the TCT only presented an R2 of 53.1%. Finally, with the inclusion of both TCT and all covariates, the model showed an R2 increase up to 68.5%. CONCLUSIONS TCT, with other features suggesting functional/clinical complexity, collected upon admission to post-acute intensive inpatient stroke rehabilitation, independently predicted discharge mBI.
Collapse
Affiliation(s)
| | | | - Anita Paperini
- IRCCS Fondazione Don Carlo Gnocchi onlus, Firenze, Italy
| | - Silvia Campagnini
- IRCCS Fondazione Don Carlo Gnocchi onlus, Firenze, Italy; The Biorobotics Institute, Scuola Superiore Sant'Anna, Pontedera (Pisa), Italy.
| | - Alessandro Sodero
- IRCCS Fondazione Don Carlo Gnocchi onlus, Firenze, Italy; Neurofarba Department, Neuroscience Section, University of Florence, Firenze, Italy
| | - Bahia Hakiki
- IRCCS Fondazione Don Carlo Gnocchi onlus, Firenze, Italy
| | | | | | - Lucia Avila
- Fondazione Don Carlo Gnocchi onlus, Marina di Massa, Italy
| | | | | | - Silvia Pancani
- IRCCS Fondazione Don Carlo Gnocchi onlus, Firenze, Italy
| | - Andrea Mannini
- IRCCS Fondazione Don Carlo Gnocchi onlus, Firenze, Italy
| | - Federico Sensoli
- The Biorobotics Institute, Scuola Superiore Sant'Anna, Pontedera (Pisa), Italy
| | | | - Anna Poggesi
- IRCCS Fondazione Don Carlo Gnocchi onlus, Firenze, Italy; Neurofarba Department, Neuroscience Section, University of Florence, Firenze, Italy
| | - Antonello Grippo
- IRCCS Fondazione Don Carlo Gnocchi onlus, Firenze, Italy; SOD Neurofisiopatologia, Dipartimento Neuromuscolo-Scheletrico e degli Organi di Senso, Azienda Ospedaliera Universitaria Careggi, Firenze, Italy
| | - Claudio Macchi
- IRCCS Fondazione Don Carlo Gnocchi onlus, Firenze, Italy; Department of Experimental and Clinical Medicine, University of Florence, Firenze, Italy
| | - Marco Baccini
- IRCCS Fondazione Don Carlo Gnocchi onlus, Firenze, Italy
| | | | - Francesca Cecchi
- IRCCS Fondazione Don Carlo Gnocchi onlus, Firenze, Italy; Department of Experimental and Clinical Medicine, University of Florence, Firenze, Italy
| |
Collapse
|
5
|
Ozkan T, Ataoglu NEE, Soke F, Karakoc S, Bora HAT. Investigation of the relationship between trunk control and balance, gait, functional mobility, and fear of falling in people with Alzheimer's disease. Ir J Med Sci 2023; 192:2401-2408. [PMID: 36656422 DOI: 10.1007/s11845-023-03279-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 12/19/2022] [Indexed: 01/20/2023]
Abstract
INTRODUCTION Optimal trunk control relies on adequate musculoskeletal, motor, and somatosensory systems that are often affected in people with Alzheimer's disease (AD). Therefore, the aim of this study was to compare trunk control between people with AD and healthy older adults, and investigate the relationship between trunk control and balance, gait, functional mobility, and fear of falling in people with AD. METHODS The study was completed with 35 people with AD and 33 healthy older adults with matching age and gender. Trunk control was evaluated with Trunk Impairment Scale (TIS); balance with Berg Balance Scale (BBS), Functional Reach Test (FRT), One-Leg Standing Test (OLST) and Five-Repeat Sit-and-Stand Test (5STS); gait with Dynamic Gait Index (DGI); functional mobility with Timed Up and Go (TUG) Test; fear of falling with Falls Efficacy Scale-International (FES-I). RESULTS BBS, FRT, OLST, and DGI scores were lower and 5STS and TUG Test scores were higher in people with AD compared to healthy older adults (p < 0.05). There was no difference in FES-I score between people with AD and healthy older adults (p > 0.05). TIS was associated with BBS, FRT, OLST, 5STS, DGI, TUG Test, and FES-I (r between - 0.341 and 0.738; p < 0.05 for all). CONCLUSION Trunk control is affected and related with balance, gait, functional mobility, and fear of falling in people with AD. For this reason, we think that trunk control should be evaluated in the early period, and applications for trunk control should be included in rehabilitation approaches in order to improve balance, gait, functional mobility, and reduce fear of falling.
Collapse
Affiliation(s)
- Taskin Ozkan
- Giresun University, Vocational School of Health Services, Therapy and Rehabilitation, Giresun, 28200, Turkey.
| | | | - Fatih Soke
- Gulhane Faculty of Physiotherapy and Rehabilitation, University of Health Sciences, Ankara, Turkey
| | - Selda Karakoc
- University of Health Sciences, Gulhane Institute of Health Sciences, Ankara, Turkey
| | | |
Collapse
|
6
|
Katırcı E, Adıgüzel H, Katırcı Kırmacı Zİ, Ergun N. The relationship between the backward walking and proprioception, trunk control, and muscle strength in children with cerebral palsy. Ir J Med Sci 2023; 192:2391-2399. [PMID: 36604372 DOI: 10.1007/s11845-022-03270-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 12/30/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVE This study was planned to determine the factors affecting backward walking in children with cerebral palsy (CP). METHODS The study included 30 children with CP, with a mean age of 10.43 ± 2.76 years. Backward walking abilities were evaluated with the 3-Meter Back Walk Test (3MBWT). A digital goniometer was used to evaluate proprioception, the Trunk Control Measurement Scale (TCMS) was used for trunk control, a digital muscle dynamometer was used for muscle strength, and the Gillette Functional Assessment Questionnaire (FAQ) was used for gait evaluation. RESULTS When the spasticity of children at levels I and II according to the Gross Motor Function Classification System (GMFCS) was compared, a significant difference was found in favor of level I in hamstring, gastro-soleus, and gastrocnemius spasticity (p < 0.05). When the results of the 3MBWT, TCMS, and FAQ were compared, a significant difference was found in favor of level I (p < 0.05). No significant relationship was revealed between the 3MBWT and lower extremity proprioception and TCMS (p > 0.05). A significant negative correlation was observed between the 3MBWT and FAQ (p < 0.05). No significant correlation was found between the 3MBWT and lower extremity muscle strengths (p > 0.05). A significant positive correlation was found only between hip extension proprioception and iliopsoas muscle strength (p = 0.023). There was no significant correlation between the FAQ and lower extremity muscle strength (p > 0.05). CONCLUSION It was revealed that the backward walking ability increased as the forward walking function improved in children with CP, but it was not affected by proprioception, trunk control, and muscle strength. CLINICAL TRIALS NCT05088629 (10/11/2021).
Collapse
Affiliation(s)
- Enver Katırcı
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, SANKO University, 27090, Gaziantep, Turkey
| | - Hatice Adıgüzel
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Kahramanmaras Sutcu Imam University, 46100, Kahramanmaras, Turkey
| | - Zekiye İpek Katırcı Kırmacı
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Kahramanmaras Sutcu Imam University, 46100, Kahramanmaras, Turkey.
| | - Nevin Ergun
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, SANKO University, 27090, Gaziantep, Turkey
| |
Collapse
|
7
|
Tutus N, Ozdemir F. The effects of gastrocnemius muscle spasticity on gait symmetry and trunk control in chronic stroke patients. Gait Posture 2023; 105:45-50. [PMID: 37480819 DOI: 10.1016/j.gaitpost.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 06/25/2023] [Accepted: 07/10/2023] [Indexed: 07/24/2023]
Abstract
BACKGROUND Although reduced gait asymmetry and trunk control are generally accepted outcomes in stroke patients after having a stroke, the number of studies examining the factors affecting gait symmetry and trunk control is limited in the literature. RESEARCH QUESTION What are the effects of gastrocnemius muscle spasticity on trunk control and gait symmetry in chronic stroke patients? METHOD The sample of the study included 29 individuals aged 40-70 who were diagnosed with stroke at least six months ago. The sociodemographic information of the patients was collected using a descriptive information form. Their gastrocnemius muscle spasticity levels were assessed using the Modified Ashworth Scale (MAS), their trunk control was assessed using the Trunk Impairment Scale (TIS), and their gait symmetry was assessed using software developed for the Kinect V2 camera. RESULTS There was a numerical difference between the gait symmetry results of the patients who had a MAS score lower than 2 and those who had a MAS score of 2 or higher, where MAS scores corresponded to gastrocnemius muscle spasticity levels, but this difference was not statistically significant (p > 0.05). There was a statistically significant difference between the total TIS scores and TIS coordination subscale scores of the patients who had a MAS score lower than 2 and those who had a MAS score of 2 or higher (p < 0.05). A negative significant relationship was determined between total TIS and TIS coordination subscale scores and the severity of gastrocnemius muscle spasticity. SIGNIFICANCE According to the results of our study, to improve trunk control and gait in stroke survivors, the management of gastrocnemius muscle spasticity should be included in rehabilitation programs. We believe that our study will be guiding for future interventional studies aiming to improve trunk control and gait in stroke patients.
Collapse
Affiliation(s)
- Nisanur Tutus
- Sureyyapasa Chest Diseases and Thoracic Surgery Teaching Hospital, Istanbul, Turkey.
| | - Filiz Ozdemir
- Inonu University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Malatya, Turkey
| |
Collapse
|
8
|
van Dellen F, Aurich-Schuler T, Hesse N, Labruyère R. Clustering trunk movements of children and adolescents with neurological gait disorders undergoing robot-assisted gait therapy: the functional ability determines if actuated pelvis movements are clinically useful. J Neuroeng Rehabil 2023; 20:71. [PMID: 37270537 DOI: 10.1186/s12984-023-01200-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 05/26/2023] [Indexed: 06/05/2023] Open
Abstract
INTRODUCTION Robot-assisted gait therapy is frequently used for gait therapy in children and adolescents but has been shown to limit the physiological excursions of the trunk and pelvis. Actuated pelvis movements might support more physiological trunk patterns during robot-assisted training. However, not every patient is expected to react identically to actuated pelvis movements. Therefore, the aim of the present study was to identify different trunk movement patterns with and without actuated pelvis movements and compare them based on their similarity to the physiological gait pattern. METHODS AND RESULTS A clustering algorithm was used to separate pediatric patients into three groups based on different kinematic reactions of the trunk to walking with and without actuated pelvis movements. The three clusters included 9, 11 and 15 patients and showed weak to strong correlations with physiological treadmill gait. The groups also statistically differed in clinical assessment scores, which were consistent with the strength of the correlations. Patients with a higher gait capacity reacted with more physiological trunk movements to actuated pelvis movements. CONCLUSION Actuated pelvis movements do not lead to physiological trunk movements in patients with a poor trunk control, while patients with better walking functions can show physiological trunk movements. Therapists should carefully consider for whom and why they decide to include actuated pelvis movements in their therapy plan.
Collapse
Affiliation(s)
- Florian van Dellen
- Swiss Children's Rehab, Children's University Hospital Zurich, Mühlebergstrasse 104, 8910, Affoltern Am Albis, Switzerland.
- Sensory-Motor Systems Lab, Department of Health Sciences and Technology, ETH Zurich, Tannenstrasse 1, 8092, Zurich, Switzerland.
- Children's Research Center, Children's University Hospital Zurich, University of Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland.
| | - Tabea Aurich-Schuler
- Swiss Children's Rehab, Children's University Hospital Zurich, Mühlebergstrasse 104, 8910, Affoltern Am Albis, Switzerland
- Children's Research Center, Children's University Hospital Zurich, University of Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland
| | - Nikolas Hesse
- Swiss Children's Rehab, Children's University Hospital Zurich, Mühlebergstrasse 104, 8910, Affoltern Am Albis, Switzerland
- Children's Research Center, Children's University Hospital Zurich, University of Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland
| | - Rob Labruyère
- Swiss Children's Rehab, Children's University Hospital Zurich, Mühlebergstrasse 104, 8910, Affoltern Am Albis, Switzerland
- Children's Research Center, Children's University Hospital Zurich, University of Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland
| |
Collapse
|
9
|
Pérez-Sanpablo AI, Quinzaños-Fresnedo J, Romero-Ixtla M, Aguirre-Güemez AV, Rodríguez-Reyes G, Pérez-Zavala R, Barrera-Ortiz A, Quijano-González Y. Validation of inertial measurement units for the assessment of trunk control in subjects with spinal cord injury. J Spinal Cord Med 2023; 46:154-163. [PMID: 34612796 PMCID: PMC9897781 DOI: 10.1080/10790268.2021.1975083] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Trunk control (TC) constitutes one of the main objectives in the rehabilitation of people with a spinal cord injury (SCI), but there are few clinically validated tests to assess it. Accelerometers have been proposed as sensitive and suitable procedures to assess TC. OBJECTIVE To evaluate test-retest reliability, construct and criterion validity of accelerometer parameters to assess TC in people with SCI. METHODS A cross-sectional study of simultaneous application of Clinical Trunk Control Test (CTCT) and accelerometer evaluation was conducted. Accelerometers were placed on the trunks of 27 people with SCI and 15 people without SCI. Reliability was assessed by three repeated measures in random order of selected static and dynamic TC tasks. Acceleration on three axes was analyzed using five metrics. Criterion validity was assessed by analyzing correlation of acceleration to CTCT scores. Construct validity was assessed by analyzing capacity of inertial measurement units (IMU) to differentiate individual's characteristics, ASIA Impairment scale, gait capacity, level of TC, and neurological level of injury. RESULTS Reliable IMU data were obtained in people with SCI and without SCI, of all accelerometer axes, metrics, and tested items of the CTCT. Reliability of acceleration decreases with the increasing demand for TC tasks. Ten acceleration parameters showed construct and criterion validity. CONCLUSION Accelerometer parameters are reliable, valid, and sensitive to evaluate TC in people with SCI. SIGNIFICANCE A set of IMU parameters were validated as reliable and valid measures to evaluate TC, which could be useful for the assessment of progression of people with SCI and clinical interventions.
Collapse
Affiliation(s)
- Alberto Isaac Pérez-Sanpablo
- Research Division, Human Motion Analysis Laboratory and Rehabilitation Engineering Department, National Institute of Rehabilitation Luis Guillermo Ibarra Ibarra, Mexico City, Mexico
| | - Jimena Quinzaños-Fresnedo
- Neurologic Rehabilitation Division, National Institute of Rehabilitation Luis Guillermo Ibarra Ibarra, Mexico City, Mexico,Correspondence to: Jimena Quinzaños-Fresnedo, Neurologic Rehabilitation Division, National Institute of Rehabilitation Luis Guillermo Ibarra Ibarra, Mexico-Xochimilco Av. 289, Research Tower 6th floor, 14389, Mexico City, Mexico; Ph: +52 (55) 5999 1000-13410.
| | - Marco Romero-Ixtla
- Health Education Direction, National Institute of Rehabilitation Luis Guillermo Ibarra Ibarra, Mexico City, Mexico
| | - Ana Valeria Aguirre-Güemez
- Neurologic Rehabilitation Division, Spinal Cord Injury Rehabilitation Service, National Institute of Rehabilitation Luis Guillermo Ibarra Ibarra, Mexico City, Mexico
| | - Gerardo Rodríguez-Reyes
- Orthotics and Prosthetics Laboratory, National Institute of Rehabilitation Luis Guillermo Ibarra Ibarra, Mexico City, Mexico
| | - Ramiro Pérez-Zavala
- Neurologic Rehabilitation Division, Spinal Cord Injury Rehabilitation Service, National Institute of Rehabilitation Luis Guillermo Ibarra Ibarra, Mexico City, Mexico
| | - Aida Barrera-Ortiz
- Neurologic Rehabilitation Division, Spinal Cord Injury Rehabilitation Service, National Institute of Rehabilitation Luis Guillermo Ibarra Ibarra, Mexico City, Mexico
| | - Yannick Quijano-González
- Research Division, Human Motion Analysis Laboratory and Rehabilitation Engineering Department, National Institute of Rehabilitation Luis Guillermo Ibarra Ibarra, Mexico City, Mexico
| |
Collapse
|
10
|
Kouwijzer I, van der Meer M, Janssen TWJ. Effects of trunk muscle activation on trunk stability, arm power, blood pressure and performance in wheelchair rugby players with a spinal cord injury. J Spinal Cord Med 2022; 45:605-13. [PMID: 33166206 DOI: 10.1080/10790268.2020.1830249] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective: In wheelchair rugby (WR) athletes with tetraplegia, wheelchair performance may be impaired due to (partial) loss of innervation of upper extremity and trunk muscles, and low blood pressure (BP). The objective was to assess the effects of electrical stimulation (ES)-induced co-contraction of trunk muscles on trunk stability, arm force/power, BP, and WR performance.Design: Cross-sectional study.Setting: Rehabilitation research laboratory and WR court.Participants: Eleven WR athletes with tetraplegia.Interventions: ES was applied to the rectus abdominis, obliquus externus abdominis and erector spinae muscles. For every test, the ES condition was compared to the non-ES condition.Outcome measures: Stability was assessed with reaching tasks, arm force/power with an isokinetic test on a dynamometer, BP during an ES protocol and WR skill performance with the USA Wheelchair Rugby Skill Assessment.Results: Overall reaching distance (ES 14.6 ± 7.5 cm, non-ES 13.4 ± 8.2 cm), and BP showed a significant increase with ES. Arm force (ES 154 ± 106 N, non-ES 148 ± 102 N) and power (ES 37 ± 26 W, non-ES 36 ± 25 W), and WR skills were not significantly improved.Conclusion: ES-induced trunk muscle activation positively affects trunk stability and BP, but not arm force/power. No effects were found in WR skill performance, probably due to abdominal strapping. More research is needed to assess different ES (training) protocols and longitudinal effects.
Collapse
|
11
|
Iso F, Mitsunaga W, Yamaguchi R, Shimizu N, Ito S, Honda Y, Okubo A, Honda S, Iso N, Higashi T, Tsujino A. Relationship among trunk control, activities of daily living, and upper extremity function during the first week after stroke in patients with acute cerebral infarction. J Phys Ther Sci 2022; 34:315-319. [PMID: 35400839 PMCID: PMC8989477 DOI: 10.1589/jpts.34.315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 01/25/2022] [Indexed: 11/24/2022] Open
Abstract
[Purpose] We aimed to identify the relationship among trunk control, activities of daily
living, and upper extremity function during the first week after stroke in patients with
acute cerebral infarction. [Participants and Methods] Ninety-five patients with first
cerebral infarction were included. Trunk control was assessed using the Postural
Assessment Scale for Stroke. Additionally, activities of daily living were evaluated using
the Functional Independence Measure, and upper extremity function was assessed using the
upper extremity component of the Fugl-Meyer Assessment. Correlation analysis was performed
to examine the relationships among these three measures. Furthermore, stepwise multiple
regression analysis was performed to investigate the factors affecting activities of daily
living. [Results] The total score and two subcategories of the Postural Assessment Scale
for Stroke were significantly correlated with the Functional Independence Measure motor
values. Stepwise multiple regression analysis revealed age and the Postural Assessment
Scale for Stroke as factors influencing the Functional Independence Measure. Moreover, the
Postural Assessment Scale for Stroke and upper extremity component of Fugl-Meyer
Assessment showed a high correlation. [Conclusion] The trunk control ability assessed
using the Postural Assessment Scale for Stroke is strongly correlated with activities of
daily living estimated using the Functional Independence Measure in the first week after
stroke in patients with acute cerebral infarction. The upper extremity component of
Fugl-Meyer Assessment was not identified as a factor affecting the Functional Independence
Measure.
Collapse
Affiliation(s)
- Fumiko Iso
- Unit of Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences: 1-7-1 Sakamoto, Nagasaki, Nagasaki 852-8520, Japan
| | - Wataru Mitsunaga
- Unit of Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences: 1-7-1 Sakamoto, Nagasaki, Nagasaki 852-8520, Japan.,Nagasaki University Hospital, Japan
| | | | | | | | | | | | - Sumihisa Honda
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Naoki Iso
- Department of Occupational Therapy, Tokyo Kasei University, Japan
| | - Toshio Higashi
- Unit of Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences: 1-7-1 Sakamoto, Nagasaki, Nagasaki 852-8520, Japan
| | - Akira Tsujino
- Unit of Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences: 1-7-1 Sakamoto, Nagasaki, Nagasaki 852-8520, Japan.,Nagasaki University Hospital, Japan
| |
Collapse
|
12
|
Ahmed U, Karimi H, Amir S, Ahmed A. Effects of intensive multiplanar trunk training coupled with dual-task exercises on balance, mobility, and fall risk in patients with stroke: a randomized controlled trial. J Int Med Res 2021; 49:3000605211059413. [PMID: 34812070 PMCID: PMC8647262 DOI: 10.1177/03000605211059413] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVE We determined whether an exercise regime comprising high-intensity training, multiplanar trunk movements, and dual-task practice could improve trunk control, balance, functional mobility, and reduce fall risk in patients with hemiplegic stroke. METHODS In this randomized controlled trial, 74 patients (mean age 61.71 years) were randomly assigned to the experimental and comparison groups. Primary outcome was trunk impairment scale (TIS) scores. Secondary outcomes were scores on the Berg balance scale, 10-meter walk test, Timed-up-and-go test, timed-Up-Go-cognitive, and Stroke Impact Scale-16 to measure between-group changes from baseline. We used linear mixed modeling to identify changes over time within and between groups on each scale and whether changes persisted at 6- and 12-month follow-ups. RESULTS We observed significantly increased mean TIS scores from baseline to 3 months post-treatment (7.74); the increased scores were maintained at 6- and 12-month follow-ups (8.60 and 8.43, respectively). In the experimental group, all secondary outcomes showed significant and clinically meaningful results. Fall risk between groups was significantly reduced at 6 and 12 months. CONCLUSIONS Intensive multiplanar trunk movements coupled with dual-task practice promoted trunk control, balance, and functional recovery in patients with stroke, reduced fall risk, and improved independent mobility.Trial registration: #IRCT20200127046275N1.
Collapse
Affiliation(s)
- Umair Ahmed
- University Institute of Physical Therapy, University of Lahore, Lahore, Pakistan
| | - Hossein Karimi
- University Institute of Physical Therapy, University of Lahore, Lahore, Pakistan.,Istanbul Gelisim University, Istanbul, Turkey
| | - Syed Amir
- Istanbul Gelisim University, Istanbul, Turkey
| | - Ashfaq Ahmed
- University Institute of Physical Therapy, University of Lahore, Lahore, Pakistan.,Allied Health Sciences, The University of Lahore, Lahore, Pakistan
| |
Collapse
|
13
|
Coelho TS, Bitencourt ACS, Bazan R, de Souza LAPS, Luvizutto GJ. Hip abduction with ankle dorsiflexion (HAAD) score and trunk seating control within 72 h after stroke predicts long-term disability: A cohort study. J Bodyw Mov Ther 2021; 27:710-716. [PMID: 34391311 DOI: 10.1016/j.jbmt.2021.05.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 04/20/2021] [Accepted: 05/14/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND The aim of this study was to determine whether muscle strength of the lower limb and trunk during the acute phase after stroke are predictors of motor function and disability 90 days after hospital discharge. METHODS This prospective study used a nonconcurrent design to evaluate stroke patients at two time points: a) first 72 h: hip abduction and ankle dorsiflexion (HAAD) score, trunk sitting control, clinical evaluation, demographic profile, and stroke severity using the National Institutes of Health Stroke Scale (NIHSS); b) 90 days after hospital discharge: modified Rankin scale (mRS). The participants were divided into two groups: good outcome (mRS 0-2) and worse outcome (mRS>2), and the differences between them were assessed statistically. Clinical and demographic variables were included in the multiple logistic regression analysis. The ROC curve was used to illustrate the clinical sensitivity and specificity of the HAAD score cutoff for the outcomes. RESULTS Thirty-seven patients were included: 16 with mRS≤2 and 21 with mRS>2. Patients in the worse outcome group were older (p = 0.02) and presented with higher NIHSS scores (p = 0.002), lower HAAD scores (p < 0.001), higher pain sensation (p = 0.04), greater altered perception (p = 0.008), and no trunk control in the sitting position (p = 0.004). A lower HAAD score (OR = 0.09; 95%CI: 0.14-0.53; p < 0.001) and the absence of trunk control in the sitting position (OR = 0.55; 95%CI:0.54-0.95; p < 0.001) were associated with unsatisfactory outcomes. CONCLUSION A HAAD score <6 and the absence of trunk control while sitting during the first 72 h are predictors of worse long-term disability in stroke patients.
Collapse
Affiliation(s)
| | | | - Rodrigo Bazan
- Botucatu Medical School (UNESP), Botucatu, São Paulo, Brazil
| | | | | |
Collapse
|
14
|
Shih HJS, Winstein CJ, Kulig K. Young adults with recurrent low back pain demonstrate altered trunk coordination during gait independent of pain status and attentional demands. Exp Brain Res 2021; 239:1937-1949. [PMID: 33871659 DOI: 10.1007/s00221-021-06106-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 04/02/2021] [Indexed: 11/25/2022]
Abstract
Pain influences both attention and motor behavior. We used a dual-task interference paradigm to investigate (1) alterations in attentional performance, (2) the ability to switch task prioritization, and (3) the effect of attentional demand on trunk coordination during narrow-based walking in and out of a painful episode in individuals with recurrent low back pain (LBP). We tested twenty young adults with LBP both in and out of a painful episode and compared them to twenty matched back-healthy individuals. Participants simultaneously performed a narrow step width matching task and an arithmetic task, with and without instructions to prioritize either task. A motion capture system was used to record kinematic data, and frontal plane trunk coordination was analyzed using vector coding on the thorax and pelvis angles. Single-task performance, dual-task effect, dual-task performance variability, task prioritization switch, and trunk coordination were analyzed using paired t tests or repeated measures two-way ANOVAs. Results indicated that active pain has a detrimental effect on attentional processes, indicated by poorer single-task performance and increased dual-task performance variability for individuals with recurrent LBP. Individuals with LBP, regardless of pain status, were able to switch task prioritization to a similar degree as their back-healthy counterparts. Compared to the control group, individuals with recurrent LBP exhibited a less in-phase, more pelvis-dominated trunk coordination during narrow-based walking, independent of pain status and regardless of attentional manipulations. Thus, altered trunk coordination in persons with LBP appears to be habitual, automatic, and persists beyond symptom duration.
Collapse
Affiliation(s)
- Hai-Jung Steffi Shih
- Division of Biokinesiology and Physical Therapy, University of Southern California, 1540 E. Alcazar St, CHP 155, Los Angeles, CA, 90033, USA.
| | - Carolee J Winstein
- Division of Biokinesiology and Physical Therapy, University of Southern California, 1540 E. Alcazar St, CHP 155, Los Angeles, CA, 90033, USA
| | - Kornelia Kulig
- Division of Biokinesiology and Physical Therapy, University of Southern California, 1540 E. Alcazar St, CHP 155, Los Angeles, CA, 90033, USA
| |
Collapse
|
15
|
Sato NTDS, Cunha AB, Antonio GLN, Tudella E. Does late preterm birth impact trunk control and early reaching behavior? Infant Behav Dev 2021; 63:101556. [PMID: 33819770 DOI: 10.1016/j.infbeh.2021.101556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 03/05/2021] [Accepted: 03/18/2021] [Indexed: 10/21/2022]
Abstract
The aims of the study were to 1) verify the level of trunk control longitudinally and reaching behavior while sitting in two positions in late preterm (LPT) and full-term (FT) infants, 2) determine whether the level of trunk control relates to reaching outcomes. Twenty LPT infants and 36 infants born FT were assessed via three in-lab visits: at 6, 7, and 8 months. At each visit, the Segmental Assessment of Trunk Control (SATCo) and reaching assessment were performed, where the infants were positioned sitting in the ring and at 90° of flexion of hips, knees, and ankles. Accurate manual support to the trunk was provided in each visit. LPT infants presented a lower level of trunk control over time. LPT infants presented a higher percentage of unimanual reaches and successful grasping at 7 months' visit, and a higher number of reaches at 8 months' visit compared to FT infants. The sitting positions did not influence reaching performance. The level of trunk control relates to functional reaching strategies only in FT infants. This study might provide insights for clinicians for understanding the level of trunk control, the importance of reaching behaviors for exploration, and considering these behaviors as strategies for intervention.
Collapse
Affiliation(s)
- Natalia Tiemi da Silva Sato
- Department of Physical Therapy, Federal University of Sao Carlos, Rodovia Washington Luís, km 235, Sao Carlos, SP, 13565-905, Brazil.
| | - Andréa Baraldi Cunha
- Department of Physical Therapy, University of Delaware (UD), 540 S College Ave, Newark, DE, 19713, USA
| | - Giovanna Laura Neves Antonio
- Department of Physical Therapy, Federal University of Sao Carlos, Rodovia Washington Luís, km 235, Sao Carlos, SP, 13565-905, Brazil
| | - Eloisa Tudella
- Department of Physical Therapy, Federal University of Sao Carlos, Rodovia Washington Luís, km 235, Sao Carlos, SP, 13565-905, Brazil
| |
Collapse
|
16
|
Norrud BC, Råheim M, Sudmann TT, Håkanson M. Facilitating new movement strategies: Equine assisted physiotherapy for children with cerebral palsy. J Bodyw Mov Ther 2021; 26:364-73. [PMID: 33992271 DOI: 10.1016/j.jbmt.2020.12.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 11/22/2020] [Accepted: 12/18/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Equine Assisted Physiotherapy (EAPT) offers children with cerebral palsy (CP) opportunities for new movement experiences, and may influence movement qualities. Descriptions of how, and to what extent EAPT affects trunk control is missing. The aim of this study was to explore if, and how changes in trunk control and changes in other movement aspects were observable in children with CP during EAPT, and if potential changes in trunk control could be measured. METHOD A multiple case study with a mixed methods design was completed. Two children with CP, GMFCS grade 1, were observed using video during a period of six months, and tested with Trunk Impairment Scale modified Norwegian Version. Skilled physiotherapists analyzed the videos qualitatively, and triangulated recurring changes in movement with the results from the test. RESULTS Riding bareback, improvements in trunk control were observed and measured. However, riding in a saddle led to reduced trunk control. Other observable movement changes were: from asymmetry to symmetry, adaptation to rhythm, mastery of riding skills, and reduced loss of postural control. Increased instances of adapting own movements in spontaneous dialogue with the horse, were observed. Instructions and feedback from the therapist influenced the dialogue with the horse both positively and negatively. CONCLUSION This study describes in detail how balance and symmetry can be stimulated during EAPT in a body characterized by imbalance and asymmetry. During EAPT, the children gained the possibility to explore new movement qualities. Equipment and feedback influenced movement qualities.
Collapse
|
17
|
Wee SK, Hughes AM, Warner MB, Burridge JH. Longitudinal analysis of the recovery of trunk control and upper extremity following stroke: An individual growth curve approach. Top Stroke Rehabil 2021; 29:58-73. [PMID: 33523777 DOI: 10.1080/10749357.2021.1878333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Background and Purpose: Trunk control is thought to contribute to upper extremity function. It is unclear whether recovery of trunk control has an impact on the recovery of the upper extremity in people with stroke. This longitudinal study monitored the recovery of trunk control and upper extremity in the first 6 months following stroke.Methods: Forty-five participants with stroke were assessed monthly for 6 months following stroke. Trunk control was assessed using the Trunk Impairment Scale (TIS); upper extremity impairment and function were assessed with the Fugl-Meyer (FMA) and Streamlined Wolf Motor Function Test (SWMFT) respectively. The SWMFT included the performance time (SWMFT-Time) and functional ability scale (SWMFT-FAS). The individual growth curve modeling was used to analyze the longitudinal data.Results: The recovery curve of TIS, FMA, SWMFT-Time and SWMFT-FAS followed a quadratic trend, with the rate of recovery decreasing from the first to sixth month. As TIS score improved over time, FMA, SWMFT-Time and SWMFT-FAS improved in parallel with the TIS score. TIS at each time point was found to be a significant predictor of FMA, SWMFT-Time and SWMFT-FAS at 6 months post stroke.Conclusion: Our work has provided, for the first time, substantial evidence that the pattern of recovery of trunk control is similar to that of the recovery of upper extremity following stroke. In addition, this study provides evidence on which to design a prospective study to evaluate whether improvement in trunk control early post-stroke results in better long-term upper extremity function.
Collapse
Affiliation(s)
- Seng Kwee Wee
- Rehabilitation and Health Technologies Research Group, Faculty of Health Sciences, University of Southampton, Southampton, UK.,Centre for Advanced Rehabilitation Therapeutics (CART), Tan Tock Seng Hospital, Singapore, Singapore.,Health and Social Sciences Cluster, Singapore Institute of Technology (SIT), Singapore, Singapore
| | - Ann-Marie Hughes
- Rehabilitation and Health Technologies Research Group, Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Martin B Warner
- Rehabilitation and Health Technologies Research Group, Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Jane H Burridge
- Rehabilitation and Health Technologies Research Group, Faculty of Health Sciences, University of Southampton, Southampton, UK
| |
Collapse
|
18
|
Rethwilm R, Böhm H, Haase M, Perchthaler D, Dussa CU, Federolf P. Dynamic stability in cerebral palsy during walking and running: Predictors and regulation strategies. Gait Posture 2021; 84:329-34. [PMID: 33445142 DOI: 10.1016/j.gaitpost.2020.12.031] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 12/10/2020] [Accepted: 12/28/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND The postural control in cerebral palsy (CP) is often deficient and manifests in a variety of impairments. Consequently, maintaining balance and controlling posture is impeded and results in an increased cost of locomotion and higher risk of falls. The margin of stability is an established measure to quantify dynamic stability during gait. It can be facilitated to analyze impaired control mechanisms, but it is unknown if and how people with CP manage to control the margin of stability during a more demanding motor task, such as running. RESEARCH QUESTION How do people with cerebral palsy regulate dynamic stability during walking and running? METHODS Children and adolescents with bilateral cerebral palsy (N = 117; 50 female, 67 male; age 11.0 ± 3.2) were retrospectively included. All underwent instrumented 3D gait analysis, walking and running barefoot at a self-selected gait speed. People with CP were compared to a control group of N = 25 typically developed (TD). Repeated measures ANOVAs were computed to analyze group differences and multiple linear regressions to identify predictors for the medio-lateral margin of stability. RESULTS The medio-lateral margin of stability was significantly higher in the CP group and was statistically unchanged during running. Different adaptions when running were particularly observed in the lateral trunk lean and step width, which remained high in CP, whereas the TD increased the trunk lean and reduced their step width. Step width was the main predictor for the medio-lateral margin of stability in both gait conditions. SIGNIFICANCE Young people with cerebral palsy manage to maintain their medio-lateral margin of stability during walking and running, however, with significantly higher safety margins compared to typically developed. This conservative strategy may reflect an adaption to motor and postural control impairments.
Collapse
|
19
|
Duchene Y, Mornieux G, Petel A, Perrin PP, Gauchard GC. The trunk's contribution to postural control under challenging balance conditions. Gait Posture 2021; 84:102-107. [PMID: 33290903 DOI: 10.1016/j.gaitpost.2020.11.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 11/03/2020] [Accepted: 11/16/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND The double inverted pendulum model is imprecise when applied to studies of postural control. Although multijoint analyses have improved our understanding of how balance is maintained, the exact role of the trunk remains unclear. RESEARCH QUESTIONS What is the trunk's contribution in postural control with respect to the other joints and how do trunk muscles control trunk kinematics? METHODS Thirty-six healthy athletes (handball, karate, long jump) performed a highly challenging balance task while the ground support was dynamically tilted in the sagittal plane. The center of force (CoF) as well as lower limb joint angles and the trunk-pelvis angle were respectively measured with a force platform and inertial measurement units. The amplitude, sway path and standard deviation of the CoF and the joint angles were then calculated. Electromyography was used to record the activity of the rectus abdominis, external obliquus, and erector spinae muscles. Multiple linear regressions were computed to determine the joints' and muscles' contributions (β-coefficients) in predicting CoF variables and trunk kinematics, respectively. RESULTS The linear combination of joint kinematic variables accounted for between 33 % and 75 % of the variance in the CoF. The ankle had the highestβ and was a significant predictor of all CoF variables. The trunk yielded the second highest β-coefficient and was a significant predictor of the CoF sway path. Electromyography variables accounted for no more than 35 % of the variance in the trunk kinematics, and erector spinae activity was the only significant predictor. SIGNIFICANCE The trunk appears to be the second most important element during this specific postural task, in the magnitude of body sway in particular. But neuromuscular control of these trunk processes is difficult to characterize with surface electromyography only. The trunk should be taken into account when seeking to improve overall postural control (e.g. during training, rehabilitation).
Collapse
Affiliation(s)
- Youri Duchene
- Université de Lorraine, DevAH, F-54000, Nancy, France; Université de Lorraine, Faculty of Sport Sciences, Nancy, France.
| | - Guillaume Mornieux
- Université de Lorraine, DevAH, F-54000, Nancy, France; Université de Lorraine, Faculty of Sport Sciences, Nancy, France
| | - Arthur Petel
- Université de Lorraine, DevAH, F-54000, Nancy, France
| | - Philippe P Perrin
- Université de Lorraine, DevAH, F-54000, Nancy, France; Université de Lorraine, Faculty of Sport Sciences, Nancy, France; Université de Lorraine, CHRU-Nancy, Laboratory for the Analysis of Posture, Equilibrium and Motor Function (LAPEM), F-54000, Nancy, France
| | - Gérome C Gauchard
- Université de Lorraine, DevAH, F-54000, Nancy, France; Université de Lorraine, Faculty of Sport Sciences, Nancy, France
| |
Collapse
|
20
|
van den Hoorn W, Cholewicki J, Coppieters MW, Klyne DM, Hodges PW. Trunk stiffness decreases and trunk damping increases with experimental low back pain. J Biomech 2020; 112:110053. [PMID: 33035844 DOI: 10.1016/j.jbiomech.2020.110053] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 09/06/2020] [Accepted: 09/17/2020] [Indexed: 11/28/2022]
Abstract
Movement adaptations to low back pain (LBP) are believed to protect the painful area. Increased trunk stiffness and decreased trunk damping have been shown in people with recurrent LBP. However, no study has examined these properties using external force perturbations to the trunk during acute LBP when protective adaptations might be expected to have most relevance. Adaptations to an acute painful stimulus via unilateral injection of hypertonic saline into the right longissimus muscle were assessed using a trunk force perturbation paradigm and a mass-spring-damper model to describe effective trunk dynamical properties. Equal weights (15% body weight) were connected to the front and back of the trunk via a cable. Either one was dropped at random to perturb the trunk. Effective trunk dynamical properties were estimated in fourteen males (mean (standard deviation) age 25 (6) years) assuming that trunk movement can be modelled as a second order linear system. Effective trunk dynamical properties were compared before, during and after the experimentally induced painful period. Estimates of effective trunk stiffness (K) decreased and damping (B) increased during pain compared to both before ([mean contrast, 95% CI] K: -403 [-651 to -155] Nm-1, B: 28 [9-50] Nms-1) and after (K: -324 [-58 to -591] Nm-1, B: 20 [4-33] Nms-1) the experimentally induced painful period. We interpret our results to show that, when challenged by a step force perturbation, a healthy system adapts to noxious input by controlling trunk velocity rather than trunk displacement, in contrast to observations during remission from recurrent clinical LBP.
Collapse
Affiliation(s)
- Wolbert van den Hoorn
- The University of Queensland, NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury & Health, School of Health and Rehabilitation Sciences, Australia.
| | - Jacek Cholewicki
- Center for Orthopedic Research, Department of Osteopathic Surgical Specialties, Michigan State University College of Osteopathic Medicine, MI, USA
| | - Michel W Coppieters
- Menzies Health Institute Queensland, Griffith University, Brisbane & Gold Coast, Australia; Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - David M Klyne
- The University of Queensland, NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury & Health, School of Health and Rehabilitation Sciences, Australia
| | - Paul W Hodges
- The University of Queensland, NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury & Health, School of Health and Rehabilitation Sciences, Australia
| |
Collapse
|
21
|
Bheemreddy A, Lombardo LM, Miller ME, Foglyano KM, Nogan-Bailey S, Triolo RJ, Audu ML. A closed-loop self-righting controller for seated balance in the coronal and diagonal planes following spinal cord injury. Med Eng Phys 2020; 86:47-56. [PMID: 33261733 DOI: 10.1016/j.medengphy.2020.10.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 10/06/2020] [Accepted: 10/12/2020] [Indexed: 11/22/2022]
Abstract
Spinal cord injury (SCI) often results in loss of the ability to keep the trunk erect and stable while seated. Functional neuromuscular stimulation (FNS) can cause muscles paralyzed by SCI to contract and assist with trunk stability. We have extended the results of a previously reported threshold-based controller for restoring upright posture using FNS in the sagittal plane to more challenging displacements of the trunk in the coronal plane. The system was applied to five individuals with mid-thoracic or higher SCI, and in all cases the control system successfully restored upright sitting. The potential of the control system to maintain posture in forward-sideways (diagonal) directions was also tested in three of the subjects. In all cases, the controller successfully restored posture to erect. Clinically, these results imply that a simple, threshold based control scheme can restore upright sitting from forward, lateral or diagonal leaning without a chest strap; and that removal of barriers to upper extremity interaction with the surrounding environment could potentially allow objects to be more readily retrieved from around the wheelchair. Technical performance of the system was assessed in terms of three variables: response time, recovery time and percent maximum deviation from erect. Overall response and recovery times varied widely among subjects in the coronal plane (415±213 ms and 1381±883 ms, respectively) and in the diagonal planes (530±230 ms and 1800±820 ms, respectively). Average response time was significantly lower (p < 0.05) than the recovery time in all cases. The percent maximum deviation from erect was of the order of 40% or less for 9 out of 10 cases in the coronal plane and 5 out of 6 cases in diagonal directions.
Collapse
|
22
|
Ha SY, Sung YH. Attentional concentration during physiotherapeutic intervention improves gait and trunk control in patients with stroke. Neurosci Lett 2020; 736:135291. [PMID: 32763360 DOI: 10.1016/j.neulet.2020.135291] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 07/28/2020] [Accepted: 07/31/2020] [Indexed: 11/16/2022]
Abstract
The restoration of motor function is important in daily life in patients with brain damage. Although attentional concentration can affect motor function, most physical therapists focus only on therapeutic exercise. Therefore, we investigated changes in motor function in patients with high attentional concentration during our intervention. A total of 21 subjects diagnosed with stroke participated in the study. They were divided into the high attentional concentration group and low attentional concentration group based on the self-programmed attention index. The subjects underwent trunk strengthening and gait training for 30 min per session, twice a day, 5 days a week, for a total of 4 weeks. All patients wore electroencephalogram (EEG) devices during the treatment to enable EEG examinations. Diagnostic ultrasound was used to measure muscles of the abdomen: external oblique abdominal, internal oblique abdominal, transversus abdominis, and rectus abdominal muscles. A trunk impairment scale was used to evaluate trunk control. We used Gaitrite to measure the spatial and temporal components during gait. The group with high attentional concentration showed significant differences in abdominal muscle strength and trunk control. In gait, there was a significant difference in swing cycle, stance cycle, single cycle, double support cycle, stance time, and double support time. Therefore, attentional concentration should be considered to improve motor function as a part of therapeutic exercises for stroke patients.
Collapse
Affiliation(s)
- Sun-Young Ha
- Department of Physical Therapy, Graduate School, Kyungnam University, Republic of Korea
| | - Yun-Hee Sung
- Department of Physical Therapy, Graduate School, Kyungnam University, Republic of Korea; Department of Physical Therapy, College of Health Sciences, Kyungnam University, Republic of Korea.
| |
Collapse
|
23
|
Karthikbabu S, Verheyden G. Relationship between trunk control, core muscle strength and balance confidence in community-dwelling patients with chronic stroke. Top Stroke Rehabil 2020; 28:88-95. [PMID: 32574524 DOI: 10.1080/10749357.2020.1783896] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND AND OBJECTIVE Impaired trunk control and core muscle weakness affect balance capacity after stroke, but confirmatory literature is lacking. The objective was to examine the relationship between trunk control, core muscle strength and self-confidence on balance efficacy in community-dwelling chronic stroke survivors and to identify trunk performance measures for determining balance confidence. METHODS Patients with a median post-stroke duration of 12 (IQR 7-18) months and independent walking ability participated in this cross-sectional study. Trunk control, core muscle strength and balance confidence were measured using trunk impairment scale 2.0 (TIS 2.0), handheld dynamometer and activity-specific balance confidence scale, respectively. Correlation among TIS 2.0, core muscle strength and balance confidence were tested by Pearson's correlation coefficient. Stepwise multivariate linear regression analysis was conducted to examine the most important trunk performance variables determining balance confidence. RESULTS Of 177 study participants, the median (IQR) score for TIS 2.0 was 10 (7-12) out of 16 and for balance confidence 41 (27-61) out of 100. Trunk control was highly correlated to overall core muscles strength (r = 0.61-0.70, p <.001) and balance confidence (r = 0.66, p <.001). The major trunk determinants of balance confidence were TIS 2.0 total score (partial R2 = 0.433) and dynamic sitting balance, i.e. trunk lateral flexion (partial R2 = 0.376) in chronic stroke. CONCLUSION A significant and strong positive association exists among trunk control, core muscles strength and balance confidence in community-dwelling patients with chronic stroke, warranting further investigation of the effect of targeted trunk rehabilitation strategies on functional balance.
Collapse
Affiliation(s)
- Suruliraj Karthikbabu
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal Hospital , Bangalore, India
| | - Geert Verheyden
- Department of Rehabilitation Sciences, KU Leuven University of Leuven , Leuven, Belgium
| |
Collapse
|
24
|
Vera-Garcia FJ, Irles-Vidal B, Prat-Luri A, García-Vaquero MP, Barbado D, Juan-Recio C. Progressions of core stabilization exercises based on postural control challenge assessment. Eur J Appl Physiol 2020; 120:567-577. [PMID: 32048007 DOI: 10.1007/s00421-020-04313-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 02/01/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE The intensity progression of core stabilization exercises (CSEs) is usually based on personal criteria rather than on objective parameters. To develop exercise progressions for four of the most common CSEs based on the postural control challenge imposed on the participants, and to analyze the effect of participants' sex and postural control level on these progressions. METHODS Seventy-six males and females performed five variations of front bridge, back bridge, side bridge and bird-dog exercises on two force platforms. The mean velocity of the center of pressure displacement was calculated to assess exercise intensity through the measurement of the participants' body sway (PBS). RESULTS In general, long bridges produced higher PBS than short bridges, bridging with single leg support produced higher PBS than bridging with double leg support and bridging on a hemisphere ball produced higher PBS than bridging on the floor. The most difficult bridging variations were those performed on a hemisphere ball with single leg support. Regarding the bird-dog, two-point positions produced higher PBS than three-point positions and the positions performed on a hemisphere ball produced higher PBS than those performed on the floor. CONCLUSION The CSE progressions obtained by males and females were very similar. However, the participants with high trunk control showed less significant differences between exercise variations than the participants with low trunk control, which shows the need to individualize the progressions according to the participants' training level. Overall, this study provides useful information to guide the prescription of CSE progressions in young physically active individuals.
Collapse
Affiliation(s)
- Francisco J Vera-Garcia
- Department of Sport Sciences, Sports Research Centre, Miguel Hernández University of Elche, Avda. de La Universidad s/n., 03202, Elche, Alicante, Spain
| | - Belen Irles-Vidal
- Department of Sport Sciences, Sports Research Centre, Miguel Hernández University of Elche, Avda. de La Universidad s/n., 03202, Elche, Alicante, Spain
| | - Amaya Prat-Luri
- Department of Sport Sciences, Sports Research Centre, Miguel Hernández University of Elche, Avda. de La Universidad s/n., 03202, Elche, Alicante, Spain
| | - María Pilar García-Vaquero
- Department of Sport Sciences, Sports Research Centre, Miguel Hernández University of Elche, Avda. de La Universidad s/n., 03202, Elche, Alicante, Spain
| | - David Barbado
- Department of Sport Sciences, Sports Research Centre, Miguel Hernández University of Elche, Avda. de La Universidad s/n., 03202, Elche, Alicante, Spain.
| | - Casto Juan-Recio
- Department of Sport Sciences, Sports Research Centre, Miguel Hernández University of Elche, Avda. de La Universidad s/n., 03202, Elche, Alicante, Spain
| |
Collapse
|
25
|
Näf OB, Bauer CM, Zange C, Rast FM. Validity and variability of center of pressure measures to quantify trunk control in stroke patients during quiet sitting and reaching tasks. Gait Posture 2020; 76:218-223. [PMID: 31864174 DOI: 10.1016/j.gaitpost.2019.12.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 08/19/2019] [Accepted: 12/05/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND In the immediate period following stroke, sitting balance is one of the most important predictors of functional recovery at discharge after rehabilitation. Thus, sitting balance determines the content of the early phase of stroke rehabilitation and an appropriate measurement tool is important. RESEARCH QUESTION The aim of this study is to investigate the concurrent validity of center of pressure (CoP) excursions of patients seated on a force plate, as well as to examine the daily variability of trunk control after stroke. METHODS Twenty stroke patients at an inpatient rehabilitation clinic underwent two assessment sessions, on average eight hours apart. Each session comprised two trials: quiet sitting for 30 s; extended reaching in forward, backward, left and right directions. The Trunk Impairment Scale (TIS) was measured during the first session. CoP excursions were measured to determine the outcomes of sway area and sway velocity during stable sitting and the maximal excursions in frontal and sagittal planes during the reaching tasks. RESULTS High Spearman's correlations (0.72, 0.79) were found between the TIS and the frontal and sagittal excursions. However, only low correlations between the TIS and the sway area and sway velocity were observed. Within sessions, all CoP outcomes showed high ICCs (0.73-1.00). Between sessions, high ICCs (0.86-0.93) were found except for sway velocity (ICC 0.51). Sway velocity increased significantly between sessions. SIGNIFICANCE Frontal and sagittal CoP excursions during reaching tasks appear to be valid measurement parameters to evaluate trunk control in patients after stroke. Only small variability was observed and no significant differences between consecutive days.
Collapse
Affiliation(s)
- Olivia Bernadette Näf
- ZHAW, Zurich University of Applied Sciences, School of Health Professions, Institute of Physiotherapy, Winterthur, Switzerland; Department of Physiotherapy, Rehabilitation Center Wald, Zurich, Switzerland
| | - Christoph Michael Bauer
- ZHAW, Zurich University of Applied Sciences, School of Health Professions, Institute of Physiotherapy, Winterthur, Switzerland.
| | | | - Fabian Marcel Rast
- ZHAW, Zurich University of Applied Sciences, School of Health Professions, Institute of Physiotherapy, Winterthur, Switzerland; Rehabilitation Center for Children and Adolescents, University Children's Hospital Zurich, Affoltern am Albis, Switzerland
| |
Collapse
|
26
|
Abstract
BACKGROUND Depression is the most common mood disorder following stroke. It can negatively affects different domains of patient's life. The present study aimed to explore demographic and clinical predictors of post stroke depression and determine discriminative cognitive, motor, and functional factors in stroke patients with and without depression. METHODS In a cross sectional study, 100 patients with stroke were investigated. Measurements consisted of Beck Depression Inventory-II, Trail Making Test A & B, Digit Span Subtest of Wechsler Memory Scale, Motricity Index (arm and leg motor), Trunk Control Test, Barthel Index, and Lawton Instrumental Activities of Daily Living. Demographics and clinical data including educational level, marital status, limb affected, cigarette smoking habits, diabetes mellitus, cardiac diseases, and blood pressure were also collected. RESULTS Multivariate logistic regression revealed that college level of education (OR = 8.78, 95% CI: 2.65-29.11, P < 0.001) and cardiac diseases (OR = 3.11, 95% CI: 1.19-8.13, P < 0.001) were significant demographic and clinical predictors of post stroke depression. Using stepwise discriminant function analysis, basic activities of daily living and trunk control with 88.0% classification accuracy, 81.1% sensitivity, and 95.7% specificity were as the best discriminators of post stroke depression. CONCLUSIONS Rehabilitation experts working with patients with stroke should pay special attention to trunk control and basic activities of daily living for preventing consequences of PSD particularly in those with higher educational level and cardiac diseases.
Collapse
Affiliation(s)
- Amin Ghaffari
- Department of Occupational therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
| | - Malahat Akbarfahimi
- Department of Occupational therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
| | - Hamid Reza Rostami
- Department of Occupational therapy, Musculoskeletal Research Center, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.
| |
Collapse
|
27
|
Bheemreddy A, Friederich A, Lombardo L, Triolo RJ, Audu ML. Estimating total maximum isometric force output of trunk and hip muscles after spinal cord injury. Med Biol Eng Comput 2020; 58:739-51. [PMID: 31974873 DOI: 10.1007/s11517-020-02120-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 01/03/2020] [Indexed: 10/25/2022]
Abstract
Functional neuromuscular stimulation (FNS) can be used to restore seated trunk function in individuals paralyzed due to spinal cord injury (SCI). Musculoskeletal models allow for the design and tuning of controllers for use with FNS; however, these models often use aggregated estimates for parameters of the musculotendon elements, the most significant of which is maximum isometric force (MIF). Stimulated MIF for individuals with SCI is typically assumed to be approximately 50% of the values exhibited by able-bodied muscles, which itself varies between studies and individuals. A method for estimating subject-specific MIF during dynamic motions in individuals with SCI produced by electrical stimulation has been developed to test this assumption and obtained more accurate estimates for biomechanical analysis and controller design. A simple on-off controller was applied to individuals with SCI seated in the workspace of a motion capture system to record joint angles of three types of trunk motions: forward flexion, left and right lateral bending followed by returning, un-aided, to upright posture via neural stimulation delivered to activate the muscles of the hips and trunk. System identification was used with a musculoskeletal model to find the optimal MIF values that reproduced the experimentally observed motions. Experiments with five volunteers with SCI indicate that an MIF of the 50% able-bodied values commonly used is significantly lower than the identified estimates in 33 of 44 muscle groups tested. This suggests that the strengths of paralyzed muscles when stimulated with FNS have been underestimated in many situations and their true force outputs may be higher than the values suggested for use in simulation studies with musculoskeletal models. These findings indicate that subject-specific musculoskeletal models can more closely mimic the motions of subjects by using individualized estimates of MIF, which may allow the design and tuning of controllers while reducing the time spent with subjects in the loop.
Collapse
|
28
|
Ozal C, Ari G, Gunel MK. Inter-intra observer reliability and validity of the Turkish version of Trunk Control Measurement Scale in children with cerebral palsy. Acta Orthop Traumatol Turc 2019; 53:381-384. [PMID: 31303422 PMCID: PMC6819824 DOI: 10.1016/j.aott.2019.04.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 02/19/2019] [Accepted: 04/28/2019] [Indexed: 12/04/2022]
Abstract
Objective The aim of this study was to demonstrate the inter and intra rater reliability and validity of the Turkish version of the Trunk Control Measurement Scale (TCMS) for children with CP. Methods Fifty children (21 girls and 29 boys; mean age 6.6 ± 2.3 years) with spastic, dyskinetic and ataxic types of CP were participated in the study. Children with Level I–II and III according to Gross Motor Function Classification System (GMFCS) were included into the study. All children were evaluated separately by two physiotherapists for interrater reliability and they re-evaluated for intra rater reliability. Gross Motor Function Measurement total score and B part were used for construct validity. Results The intraclass correlation coefficient (ICC) value of the inter-rater reliability for the Turkish TCMS was 95% CI (0.823–886), and the intra-rater reliability was 95% CI (0.986–0.992). The Spearman rank correlation coefficient between the Turkish TCMS and the Gross Motor Function Measure total score r: 0.827; p < 0.05 Part B was r: 0.863; p < 0.05. Conclusion The results of the study support that the Turkish TCMS has a high inter and intra rater reliability and validity similar to the original version. Thus, the Turkish TCMS appears to be a suitable evaluation tool to assess the qualitative performance of trunk control and sitting balance for children with CP and it gives opportunity to use clinically and research purposes. Level of Evidence Level III, Diagnostic Study.
Collapse
Affiliation(s)
- Cemil Ozal
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Ankara, Turkey.
| | - Gonca Ari
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Ankara, Turkey
| | - Mintaze Kerem Gunel
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Ankara, Turkey
| |
Collapse
|
29
|
Fryer C, Ithurburn MP, McNally MP, Thomas S, Paterno MV, Schmitt LC. The relationship between frontal plane trunk control during landing and lower extremity muscle strength in young athletes after anterior cruciate ligament reconstruction. Clin Biomech (Bristol, Avon) 2019; 62:58-65. [PMID: 30690410 PMCID: PMC6457265 DOI: 10.1016/j.clinbiomech.2018.11.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 10/18/2018] [Accepted: 11/28/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Lower extremity landing asymmetries are common and associated with strength deficits after anterior cruciate ligament reconstruction. However, less is known regarding trunk control during landing. This study's hypotheses were that frontal plane trunk excursion during single-leg landing would be greater in young athletes after anterior cruciate ligament reconstruction compared to controls and would be associated with strength deficits. METHODS Participants included 130 young athletes recently cleared for return-to-sport following anterior cruciate ligament reconstruction and 56 uninjured young athletes. Frontal plane trunk excursion was quantified using three-dimensional motion analysis during a single-leg landing task. Quadriceps and hip abduction strength were measured using an isokinetic dynamometer. Frontal plane trunk excursion was compared between the anterior cruciate ligament reconstruction and control groups and among quadriceps strength subgroups using independent t-tests and one-way analysis of variance. Linear regression examined the association between frontal plane trunk excursion and strength measures in the anterior cruciate ligament reconstruction group. FINDINGS The anterior cruciate ligament reconstruction group demonstrated greater frontal plane trunk excursion compared to controls. The low-quadriceps group demonstrated greater frontal plane trunk excursion compared to both the high-quadriceps and control groups. Additionally, the high-quadriceps group demonstrated greater frontal plane trunk excursion compared to controls. In the anterior cruciate ligament reconstruction group, lower quadriceps and hip abduction strength were weakly associated with greater frontal plane trunk excursion. INTERPRETATION Young athletes at time of return-to-sport after anterior cruciate ligament reconstruction demonstrated increased frontal plane trunk excursion during single-leg landing. Additionally, increased frontal plane trunk excursion was weakly associated with strength deficits.
Collapse
Affiliation(s)
- Conor Fryer
- College of Arts and Sciences, The Ohio State University, Columbus, OH, USA
| | - Matthew P. Ithurburn
- Department of Physical Therapy and Center for Exercise Medicine, School of Health Professions, The University of Alabama at Birmingham, Birmingham, AL, USA,School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA
| | - Michael P. McNally
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA,Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Staci Thomas
- Division of Sports Medicine, Cincinnati Children’s Hospital Medical Center; Cincinnati, OH, USA
| | - Mark V. Paterno
- Division of Sports Medicine, Cincinnati Children’s Hospital Medical Center; Cincinnati, OH, USA,Division of Occupational Therapy and Physical Therapy, Cincinnati Children’s Hospital Medical Center; Cincinnati, OH, USA,Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Laura C. Schmitt
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA,Sports Medicine Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA,Division of Physical Therapy, School of Health and Rehabilitation Sciences, The Ohio State University; Columbus, OH, USA
| |
Collapse
|
30
|
Quinzaños-Fresnedo J, Fratini-Escobar PC, Almaguer-Benavides KM, Aguirre-Güemez AV, Barrera-Ortíz A, Pérez-Zavala R, Villa-Romero AR. Prognostic validity of a clinical trunk control test for independence and walking in individuals with spinal cord injury. J Spinal Cord Med 2018; 43:331-338. [PMID: 30207875 PMCID: PMC7241519 DOI: 10.1080/10790268.2018.1518124] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
Objective: The objective of the present work was to determine the prognostic validity of the trunk control test for walking and independence in individuals with SCI.Design: A cohort, prospective study was carried out in all individuals with sub-acute SCI.Setting: All inpatients at the Mexico City based National Rehabilitation Institute (INR).Participants: Ninety individuals with a clinical diagnosis of sub-acute SCI, American Spinal Injury Association Impairment Scale (AIS) A-D, and that have not participated in a rehabilitation program were included. Thirty-five individuals had good initial trunk control and the remaining 55 had poor trunk control. All individuals participated in a standard rehabilitation program subsequently.Interventions: N/AOutcome Measures: The trunk control test was performed at baseline. At 1, 3, 6, 9 and 12 months after the first evaluation, walking and independence were assessed.Results: Survival Analysis revealed that 62.5% and 100% individuals with good trunk control at baseline assessment were respectively walking and independent in ADL at 12 months and 14% and 48% individuals with poor trunk control were walking and independent in ADL. Cox regression analysis revealed that individuals with good trunk control were 4.6 times more likely to walk independently at 12 months and 2.9 times more likely to be independent in activities of daily living.Conclusion: The present study revealed that the trunk control test is useful for providing a prognosis of independence and walking at 1 year in individuals with SCI, independently of the neurologic level and the severity of the injury.
Collapse
Affiliation(s)
- Jimena Quinzaños-Fresnedo
- División de Rehabilitación Neurológica, Instituto Nacional de Rehabilitación, Ciudad de México, México,Correspondence to: Jimena Quinzaños-Fresnedo, División de Rehabilitación Neurologica, Instituto Nacional de RehabilitaciónAvenida México- Xochimilco No. 289, Col. Arenal de Guadalupe, Delegación Tlalpan, CP, Mexico City 14389, Mexico.
| | | | | | | | - Aída Barrera-Ortíz
- División de Rehabilitación Neurológica, Instituto Nacional de Rehabilitación, Ciudad de México, México
| | - Ramiro Pérez-Zavala
- División de Rehabilitación Neurológica, Instituto Nacional de Rehabilitación, Ciudad de México, México
| | - Antonio Rafael Villa-Romero
- División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México
| |
Collapse
|
31
|
Sánchez MB, Loram I, Holmes P, Darby J, Butler PB. Working towards an objective segmental assessment of trunk control in children with cerebral palsy. Gait Posture 2018; 65:45-50. [PMID: 30558945 DOI: 10.1016/j.gaitpost.2018.06.176] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 06/06/2018] [Accepted: 06/28/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Physical therapy evaluations of motor control are currently based on subjective clinical assessments. Despite validation, these can still be inconsistent between therapists and between clinics, compromising the process of validating a therapeutic intervention and the subsequent generation of evidence-based practice (EBP) guidelines. EBP benefits from well-defined objective measurements that complement existing subjective assessments. RESEARCH QUESTION The aim of this study was to develop an objective measure of head/trunk control in children with Cerebral Palsy (CP) using previously developed video-based methods of head/trunk alignment and absence of external support and compare these with the existing subjective Segmental Assessment of Trunk Control (SATCo). METHODS Twelve children with CP were recruited and an average of 3 (±1.1) SATCo tests performed per child. The full SATCo was concurrently video-recorded from a sagittal view; markers were placed on specific landmarks of the head, trunk and pelvis to track and estimate head/trunk segment position. A simplified objective rule was created for control and used on videos showing no external support. This replicated the clinical parameters and enabled identification of the segmental-loss-of-control. The subjectively and objectively identified segmental-loss-of-control were compared using a Pearson Correlation Coefficient. RESULTS An angular-threshold of 17° from alignment showed the minimum bias between the subjectively and the objectively measured segmental-loss-of-control (mean error =-0.11 and RMSE = 1.5) and a significant correlation (r = 0.78, r2 = 0.61, p < .01). SIGNIFICANCE This study showed that simple objective video-based measurements can be used to reconstruct the subjective assessment of segmental head/trunk control. This suggests that a clinically-friendly video-based objective measure has future potential to complement subjective assessments and to assist in the generation of EBP guidelines. Further development will increase the information that can be extracted from video images and enable generation of a fully automated objective measure.
Collapse
Affiliation(s)
- María B Sánchez
- Research Centre for Musculoskeletal Science & Sports Medicine, Manchester Metropolitan University, Manchester, UK.
| | - Ian Loram
- Research Centre for Musculoskeletal Science & Sports Medicine, Manchester Metropolitan University, Manchester, UK
| | - Paul Holmes
- Research Centre for Musculoskeletal Science & Sports Medicine, Manchester Metropolitan University, Manchester, UK
| | - John Darby
- School of Computing Mathematics and Digital Technology, Manchester Metropolitan University, Manchester, UK
| | - Penelope B Butler
- Research Centre for Musculoskeletal Science & Sports Medicine, Manchester Metropolitan University, Manchester, UK
| |
Collapse
|
32
|
Rowley KM, Gordon J, Kulig K. Characterizing the balance-dexterity task as a concurrent bipedal task to investigate trunk control during dynamic balance. J Biomech 2018; 77:211-217. [PMID: 30037579 DOI: 10.1016/j.jbiomech.2018.07.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 06/18/2018] [Accepted: 07/04/2018] [Indexed: 11/29/2022]
Abstract
The purpose of the study was to characterize the Balance-Dexterity Task as a means to investigate a concurrent bipedal lower-extremity task and trunk control during dynamic balance. The task combines aspects of single-limb balance and the lower-extremity dexterity test by asking participants to stand on one limb while compressing an unstable spring with the contralateral limb to an individualized target force. Nineteen non-disabled participants completed the study, and performance measures for the demands of each limb - balance and dexterous force control - as well as kinematic and electromyographic measures of trunk control were collected. Given five practice trials, participants achieved compression forces ranging from 100 to 139 N (mean 121.2 ± 12.3 N), representing 14.4-23.0% of body weight (mean 18.7 ± 2.4%), which were then presented as target forces during test trials. Dexterous force control coefficient of variation and average magnitude of the center of pressure (COP) resultant velocity were associated such that greater variability in force control was accompanied by greater COP velocity (R = 0.598, p = 0.007). Trunk coupling, quantified as the coefficient of determination (R2) of a frontal plane thorax and pelvis angle-angle plot, varied independently of any measure of balance or dexterous force control. The Balance-Dexterity Task is a continuous, dynamic balance task where bipedal coordination and trunk coupling can be concurrently observed and studied.
Collapse
Affiliation(s)
- K Michael Rowley
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA.
| | - James Gordon
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA
| | - Kornelia Kulig
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA
| |
Collapse
|
33
|
Abstract
BACKGROUND Efficient trunk control is crucial in infant motor development when infants first learn how to move against gravity. Traditional assessments of trunk control commonly treat the trunk as one unit but the Segmental Assessment of Trunk Control (SATCo) assesses trunk control segment by segment. Good reliability and validity of the SATCo have been proved in children with neuro-disability but not yet validated in young infants. The present study was to examine if the SATCo was reliable, valid and responsive for infants aged 4 to 9 months. METHODS Infants born at full-term and at less than 30 weeks of gestation were recruited and assessed using the SATCo monthly from 4 to 9 months of age (corrected for prematurity). Intra-class correlation coefficients (ICC) were used to examine intra- and inter-rater reliability between 2 raters. The ability of the SATCo to demonstrate differences between the full-term and preterm infants was examined using the Mann Whitney U test. The responsiveness of the SATCo on the full-term infants was tested using the Friedman test. RESULTS Twenty full-term (mean gestation = 38.7 weeks; birthweight = 3019.9 g) and 20 preterm infants (mean gestation = 27.2 weeks; birthweight = 989.6 g) were recruited. The intra and inter-rater reliability of the SATCo levels on full-term infants was good (all ICC > 0.75), except inter-rater reliability at 6 months. The preterm infants scored significantly lower in reactive trunk control at 8 months (Mann Whitney U = 102.0, p = 0.016) but this was the only difference noted. A significant developmental trend was shown in the static, active and reactive trunk control of the full-term infants (Chi-square = 81.4, 75.6 and 79.5 respectively, all p < 0.001. CONCLUSIONS The SATCo was reliable and responsive in assessing trunk control in young infants aged from 4 to 9 months. Care should be exercised when testing infants aged 5 to 6 months, who are more likely to use subtle hand support, and for those who have already achieved independent sitting. The SATCo could differentiate the reactive trunk control between the full-term and preterm infants at 8 months but not earlier. Psychometric properties of the SATCo in infants with motor disorders requires further investigation.
Collapse
Affiliation(s)
- Tamis W. Pin
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Penelope B. Butler
- Health, Exercise and Active Living, Manchester Metropolitan University, Manchester, UK
| | - Hon-Ming Cheung
- Department of Paediatrics, Prince of Wales Hospital, Shatin, Hong Kong
| | | |
Collapse
|
34
|
Keles MN, Elbasan B, Apaydin U, Aribas Z, Bakirtas A, Kokturk N. Effects of inspiratory muscle training in children with cerebral palsy: a randomized controlled trial. Braz J Phys Ther 2018; 22:493-501. [PMID: 29636305 DOI: 10.1016/j.bjpt.2018.03.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 03/15/2018] [Accepted: 03/22/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Respiratory muscle weakness and its relation to other impairments in children with cerebral palsy (CP) have been shown in the latest studies. The effects of inspiratory muscle training (IMT) in this population have not been comprehensively investigated so far. OBJECTIVES To investigate the effects of IMT on trunk control, pulmonary functions, respiratory muscle strength, daily living activities, exercise capacity and quality of life in children with CP. METHODS This was a prospective-randomized controlled trial. Twenty-five children with CP were randomly assigned to the treatment (n=13) or the control group (n=12). The treatment group received IMT at 30% of maximal inspiratory pressure (MIP) and the control group received sham therapy (5% of MIP) for 6 weeks. Also, both groups received routine conventional physical therapy (stretching, strengthening, and functional exercises, etc.) for 6 weeks. The primary outcome measure was trunk control. Secondary outcome measures were pulmonary function, respiratory muscle strength, daily living activities, functional exercise capacity and quality of life. RESULTS The treatment group had better outcome for trunk control (3.87, 95% CI 3.72-4.02). Also, respiratory muscle strength, daily living activities, functional exercise capacity and quality of life were significantly improved in the treatment group compared with controls. No improvements were observed in the pulmonary function test scores between the groups. CONCLUSION Inspiratory muscle training improves trunk control, respiratory muscle strength, daily living activities, functional exercise capacity and quality of life in children with CP and it can be included in the physiotherapy and rehabilitation programs.
Collapse
Affiliation(s)
- Muserrefe Nur Keles
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey.
| | - Bulent Elbasan
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Umut Apaydin
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Zeynep Aribas
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Arzu Bakirtas
- Department of Pediatric Allergy and Asthma, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Nurdan Kokturk
- Department of Pulmonary Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey
| |
Collapse
|
35
|
Duncan K, Goodworth A, Da Costa CSN, Wininger M, Saavedra S. Parent handling of typical infants varies segmentally across development of postural control. Exp Brain Res 2018; 236:645-654. [PMID: 29285555 PMCID: PMC6190590 DOI: 10.1007/s00221-017-5156-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 12/14/2017] [Indexed: 12/13/2022]
Abstract
Although trunk muscles extend across multiple vertebral joints, recent motor control studies have shown that a top-down progression of trunk control in typical infants occurs incrementally, one segment at a time, until independent sitting. The current study merges this surprising developmental pattern with parent behavior by exploring the relationship between how parents hold their infant and the segmental level for which the infant exhibits postural control. We measured trunk control of 60 infants (1-8 months) via the segmental assessment of trunk control. Spontaneous parental hold and variability was recorded during repeated sitting and standing conditions. Parent hold correlated with infant level of control in both sitting and standing, providing evidence for a positive interaction between parent behavior and segmental trunk development.
Collapse
Affiliation(s)
- Kerian Duncan
- Department of Rehabilitation Sciences, University of Hartford, Dana Hall 410J, 200 Bloomfield Avenue, West Hartford, CT, 06117, USA
| | - Adam Goodworth
- Department of Rehabilitation Sciences, University of Hartford, Dana Hall 410J, 200 Bloomfield Avenue, West Hartford, CT, 06117, USA
| | | | - Michael Wininger
- Department of Rehabilitation Sciences, University of Hartford, Dana Hall 410J, 200 Bloomfield Avenue, West Hartford, CT, 06117, USA
- Department of Biostatistics, Yale School of Public Health, Yale University, New Haven, CT, 06510, USA
- Cooperative Studies Program, Department of Veterans Affairs, West Haven, CT, 06516, USA
| | - Sandra Saavedra
- Department of Rehabilitation Sciences, University of Hartford, Dana Hall 410J, 200 Bloomfield Avenue, West Hartford, CT, 06117, USA.
| |
Collapse
|
36
|
Pellegrino L, Giannoni P, Marinelli L, Casadio M. Effects of continuous visual feedback during sitting balance training in chronic stroke survivors. J Neuroeng Rehabil 2017; 14:107. [PMID: 29037206 PMCID: PMC5644142 DOI: 10.1186/s12984-017-0316-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 10/05/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Postural control deficits are common in stroke survivors and often the rehabilitation programs include balance training based on visual feedback to improve the control of body position or of the voluntary shift of body weight in space. In the present work, a group of chronic stroke survivors, while sitting on a force plate, exercised the ability to control their Center of Pressure with a training based on continuous visual feedback. The goal of this study was to test if and to what extent chronic stroke survivors were able to learn the task and transfer the learned ability to a condition without visual feedback and to directions and displacement amplitudes different from those experienced during training. METHODS Eleven chronic stroke survivors (5 Male - 6 Female, age: 59.72 ± 12.84 years) participated in this study. Subjects were seated on a stool positioned on top of a custom-built force platform. Their Center of Pressure positions were mapped to the coordinate of a cursor on a computer monitor. During training, the cursor position was always displayed and the subjects were to reach targets by shifting their Center of Pressure by moving their trunk. Pre and post-training subjects were required to reach without visual feedback of the cursor the training targets as well as other targets positioned in different directions and displacement amplitudes. RESULTS During training, most stroke survivors were able to perform the required task and to improve their performance in terms of duration, smoothness, and movement extent, although not in terms of movement direction. However, when we removed the visual feedback, most of them had no improvement with respect to their pre-training performance. CONCLUSIONS This study suggests that postural training based exclusively on continuous visual feedback can provide limited benefits for stroke survivors, if administered alone. However, the positive gains observed during training justify the integration of this technology-based protocol in a well-structured and personalized physiotherapy training, where the combination of the two approaches may lead to functional recovery.
Collapse
Affiliation(s)
- Laura Pellegrino
- Department Informatics, Bioengineering, Robotics and Systems Engineering, University of Genoa, Via Opera Pia, 16145, Genoa, Italy.
| | - Psiche Giannoni
- Department Informatics, Bioengineering, Robotics and Systems Engineering, University of Genoa, Via Opera Pia, 16145, Genoa, Italy
| | - Lucio Marinelli
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, L.go Daneo, Genoa, 16132, Italy.,Department of Neuroscience, Ospedale Policlinico San Martino, L.go R. Benzi, Genoa, 16132, Italy
| | - Maura Casadio
- Department Informatics, Bioengineering, Robotics and Systems Engineering, University of Genoa, Via Opera Pia, 16145, Genoa, Italy
| |
Collapse
|
37
|
Sánchez MB, Loram I, Darby J, Holmes P, Butler PB. The potential of an automated system to identify the upper limb component of a controlled sitting posture. Gait Posture 2017; 58:223-228. [PMID: 28806711 DOI: 10.1016/j.gaitpost.2017.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 07/06/2017] [Accepted: 08/01/2017] [Indexed: 02/02/2023]
Abstract
Full trunk control in sitting is demonstrated only when the head-trunk are aligned and upper limbs remain free of contact from mechanical support. These components represent a Controlled Kinetic Chain and can be evaluated in people with neuromotor disability using the Segmental Assessment of Trunk Control (SATCo) when a therapist provides manual trunk support at different segmental levels. However, the SATCo, as with other clinical assessments of control, is subjective. The SATCo was translated to objective rules relating the position of the hands and elbows to the head-trunk and then tested to determine the extent to which this automated objective method replicated the clinical judgement. Clinical evaluation used video to determine whether the upper limb was free of mechanical support while the objective evaluation used 3D motion capture of the trunk and upper limbs with a classification rule. The agreement between clinical and objective classification was calculated for three conditions of a distance-from-support-surface threshold parameter in five healthy adults and five children with cerebral palsy. The unfitted (zero-threshold values) method replicated the clinical judgement in part (68.26%±15.7, adults, 48.3%±33.9 children). The fitted (level-of-support determined) agreement showed that the process could be refined using trial specific parameters (88.32%±5.3 adults, 89.84%±10.2 children). The fixed-values agreement showed high values when using general group parameters (80.80%±3.1 adults, 74.31%±21.5 children). This objective classification of the upper limb component of trunk control largely captures the clinical evaluation. It provides the first stages in development of a clinically-friendly fully automated method.
Collapse
Affiliation(s)
- María B Sánchez
- School of Healthcare Science, Manchester Metropolitan University, Manchester, UK.
| | - Ian Loram
- School of Healthcare Science, Manchester Metropolitan University, Manchester, UK
| | - John Darby
- School of Computing Mathematics and Digital Technology, Manchester Metropolitan University, Manchester, UK
| | - Paul Holmes
- Health, Exercise and Active Living (HEAL), Manchester Metropolitan University, Cheshire, UK
| | - Penelope B Butler
- Health, Exercise and Active Living (HEAL), Manchester Metropolitan University, Cheshire, UK; The Movement Centre, Robert Jones and Agnes Hunt Hospital, Oswestry, Shropshire, UK
| |
Collapse
|
38
|
Kegelmeyer DA, Kostyk SK, Fritz NE, Fiumedora MM, Chaudhari A, Palettas M, Young G, Kloos AD. Quantitative biomechanical assessment of trunk control in Huntington's disease reveals more impairment in static than dynamic tasks. J Neurol Sci 2017; 376:29-34. [PMID: 28431622 DOI: 10.1016/j.jns.2017.02.054] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 02/03/2017] [Accepted: 02/23/2017] [Indexed: 10/20/2022]
Abstract
Postural instability is common in individuals with Huntington's disease (HD), yet little is known about control of the trunk during static and dynamic activities. We compared the trunk motion of 41 individuals with HD and 36 controls at thoracic and pelvic levels during sitting, standing, and walking using wearable iPod sensors. We also examined the ability of individuals with HD to respond to an auditory cue to modify trunk position when the pelvis moved >8° in sagittal or frontal planes during sitting using custom software. We found that amplitude of thoracic and pelvic trunk movements was significantly greater in participants with HD, and differences were more pronounced during static (i.e. sitting, standing) than dynamic (i.e. walking) tasks. In contrast to the slow, smooth sinusoidal trunk movements of controls, individuals with HD demonstrated rapid movements with varying amplitudes that continuously increased without stabilizing. Ninety-seven percent of participants with HD were able to modify their trunk position in response to auditory cues. Our results demonstrate that wearable iPod sensors are clinically useful for rehabilitation professionals to measure and monitor trunk stability in persons with HD. Additionally, auditory cueing holds potential as a useful training tool to improve trunk stability in HD.
Collapse
Affiliation(s)
- Deb A Kegelmeyer
- Physical Therapy Division, School of Health and Rehabilitation Sciences, The Ohio State University, 453 West 10th Ave, Columbus, OH 43210, United States.
| | - Sandra K Kostyk
- Movement Disorders Division, Department of Neurology, The Ohio State University, Columbus, OH, United States.
| | - Nora E Fritz
- Physical Therapy Division, School of Health and Rehabilitation Sciences, The Ohio State University, 453 West 10th Ave, Columbus, OH 43210, United States.
| | - Marianne M Fiumedora
- Physical Therapy Division, School of Health and Rehabilitation Sciences, The Ohio State University, 453 West 10th Ave, Columbus, OH 43210, United States.
| | - Ajit Chaudhari
- Physical Therapy Division, School of Health and Rehabilitation Sciences, The Ohio State University, 453 West 10th Ave, Columbus, OH 43210, United States.
| | - Marilly Palettas
- Center for Biostatistics, The Ohio State University, Columbus, OH, United States.
| | - Gregory Young
- Center for Biostatistics, The Ohio State University, Columbus, OH, United States.
| | - Anne D Kloos
- Physical Therapy Division, School of Health and Rehabilitation Sciences, The Ohio State University, 453 West 10th Ave, Columbus, OH 43210, United States.
| |
Collapse
|
39
|
Aoki O, Otani Y, Morishita S, Domen K. The effects of various visual conditions on trunk control during ambulation in chronic post stroke patients. Gait Posture 2017; 52:301-307. [PMID: 28033576 DOI: 10.1016/j.gaitpost.2016.12.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Revised: 12/03/2016] [Accepted: 12/18/2016] [Indexed: 02/02/2023]
Abstract
Downward gazing is commonly observed among patients after a stroke during standing or walking as they struggle to maintain equilibrium. In this study, we aimed to evaluate the effects of fixed gazing and downward gazing on trunk control ability during gait. Sixteen subjects after a stroke (age: 51.3±4.9years) and seven healthy subjects (age: 65.1±3.4years) participated in this study. Participants walked 10m at a comfortable speed while they faced forward (no gaze point), gazed forward (with a fixed gaze point), gazed downward, and gazed downward while concealing their legs. Trunk acceleration was measured using tri-axial accelerometers attached to the back of the upper (C7 spinous process) and lower (L3 spinous process) trunk. The coefficient of attenuation (CoA) of acceleration at the trunk was computed to assess trunk control ability. Results in the stroke group showed that the CoA during fixed-point and downward gazing was better than that while facing forward with no gaze point (p<0.001). In the stroke group, the CoA during gazing downward with their legs concealed was worse than that during downward gazing. Our findings indicate that patients after a stroke might use visual information for reducing their neck oscillation (C7) during fixed-point and downward gazing. Our results indicate that the visual information during downward gazing might work the same as during fixed-point gazing.
Collapse
Affiliation(s)
- Osamu Aoki
- Faculty of Rehabilitation, Shijonawate Gakuen University, 5-11-10 Houjo, Daito, Osaka, 574-0011, Japan.
| | - Yoshitaka Otani
- Faculty of Rehabilitation, Kobe International University, 9-1-6 Kouyocho-naka, Higashinada, Kobe, Hyogo, 658-0032, Japan.
| | - Shinichiro Morishita
- Faculty of Medical Technology, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata-shi, Niigata, 950-3198, Japan.
| | - Kazuhisa Domen
- Department of Physical Medicine and Rehabilitation, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan.
| |
Collapse
|
40
|
Bank J, Charles K, Morgan P. What is the effect of additional physiotherapy on sitting balance following stroke compared to standard physiotherapy treatment: a systematic review. Top Stroke Rehabil 2015; 23:15-25. [PMID: 26086177 DOI: 10.1179/1945511915y.0000000005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND Sitting balance dysfunction is commonly experienced following stroke. Physiotherapists utilize interventions to address this problem but it is unclear whether treatment type, target or practice intensity may affect outcomes. OBJECTIVE To compare the effects of standard physiotherapy to standard physiotherapy plus an additional physiotherapy treatment after stroke. DATA SOURCES The databases of Cochrane Library, CINAHL, Embase, Ovid Medline, AMED, and the Physiotherapy Evidence Database (PEDro) up to December 2014 were searched. STUDY SELECTION Randomized controlled trials in English reported in peer-reviewed journals regarding the effect of additional physiotherapy on sitting balance were retrieved. DATA EXTRACTION The PEDro scale was used to assess study quality. RESULTS Eleven studies met inclusion criteria. Nine targeted the ICF (International Classification of Function, Disability and Health) domain of Activity. The Trunk control test (TCT) was used as a primary outcome measure in five studies, and the Trunk Impairment Scale (TIS) was used in four. There was a significant effect (mean difference = 1.67, 95% CI = 0.54-2.80) favoring intervention, as measured by the TIS. There was no evidence to support the effect of additional treatment on sitting balance as measured by the TCT (mean difference = - 1.53, 95% CI = - 9.37 to 6.32). CONCLUSION The current evidence supports strategies that target deficits at the activity level and increase total treatment time. The TIS is most responsive as a measure of treatment efficacy. Further research is required using recommended outcome measures to facilitate generation of a minimum data set and data pooling.
Collapse
Affiliation(s)
- Jessica Bank
- Department of Physiotherapy, Monash University , Frankston, VIC, Australia
| | | | | |
Collapse
|
41
|
Milosevic M, Masani K, Kuipers MJ, Rahouni H, Verrier MC, McConville KMV, Popovic MR. Trunk control impairment is responsible for postural instability during quiet sitting in individuals with cervical spinal cord injury. Clin Biomech (Bristol, Avon) 2015; 30:507-12. [PMID: 25812727 DOI: 10.1016/j.clinbiomech.2015.03.002] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Revised: 02/04/2015] [Accepted: 03/02/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Individuals with cervical spinal cord injury usually sustain impairments to the trunk and upper and lower limbs, resulting in compromised sitting balance. The objectives of this study were to: 1) compare postural control of individuals with cervical spinal cord injury and able-bodied individuals; and 2) investigate the effects of foot support and trunk fluctuations on postural control during sitting balance. METHODS Ten able-bodied individuals and six individuals with cervical spinal cord injury were asked to sit quietly during two 60s trials. The forces exerted on the seat and the foot support surfaces were measured separately using two force plates. The global centre of pressure sway was obtained from the measurements on the two force plates, and the sway for each force plate was calculated individually. FINDINGS Individuals with spinal cord injury had at least twice as large global and seat sways compared to able-bodied individuals, while foot support sway was not significantly different between the two groups. Comparison between global and seat sways showed that anterior-posterior velocity of global sway was larger compared to the seat sway in both groups. INTERPRETATION Postural control of individuals with cervical spinal cord injury was worse than that of able-bodied individuals. The trunk swayed more in individuals with spinal cord injury, while the stabilization effect of the feet did not differ between the groups. Foot support affected anterior-posterior fluctuations in both groups equally. Thus, trunk control is the dominant mechanism contributing to sitting balance in both able-bodied and spinal cord injury individuals.
Collapse
Affiliation(s)
- Matija Milosevic
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, 164 College Street, Toronto M5S 3G9E, Ontario, Canada; Neural Engineering and Therapeutics Team, Lyndhurst Centre, Toronto Rehabilitation Institute,University Health Network, 520 Sutherland Drive, Toronto,M4G 3V9, Ontario, Canada.
| | - Kei Masani
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, 164 College Street, Toronto M5S 3G9E, Ontario, Canada; Neural Engineering and Therapeutics Team, Lyndhurst Centre, Toronto Rehabilitation Institute,University Health Network, 520 Sutherland Drive, Toronto,M4G 3V9, Ontario, Canada.
| | - Meredith J Kuipers
- Neural Engineering and Therapeutics Team, Lyndhurst Centre, Toronto Rehabilitation Institute,University Health Network, 520 Sutherland Drive, Toronto,M4G 3V9, Ontario, Canada; Department of Physiology, Faculty of Medicine, University of Toronto, 1 King's College Circle, TorontoM5S 1A8, Ontario, Canada.
| | - Hossein Rahouni
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, 164 College Street, Toronto M5S 3G9E, Ontario, Canada; Neural Engineering and Therapeutics Team, Lyndhurst Centre, Toronto Rehabilitation Institute,University Health Network, 520 Sutherland Drive, Toronto,M4G 3V9, Ontario, Canada.
| | - Mary C Verrier
- Neural Engineering and Therapeutics Team, Lyndhurst Centre, Toronto Rehabilitation Institute,University Health Network, 520 Sutherland Drive, Toronto,M4G 3V9, Ontario, Canada; Department of Physiology, Faculty of Medicine, University of Toronto, 1 King's College Circle, TorontoM5S 1A8, Ontario, Canada; Department of Physical Therapy, University of Toronto, 500 University Avenue, TorontoM5G 1V7, Ontario, Canada.
| | - Kristiina M V McConville
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, 164 College Street, Toronto M5S 3G9E, Ontario, Canada; Neural Engineering and Therapeutics Team, Lyndhurst Centre, Toronto Rehabilitation Institute,University Health Network, 520 Sutherland Drive, Toronto,M4G 3V9, Ontario, Canada; Department of Electrical and Computer Engineering, Ryerson University, 350 Victoria Street, TorontoM5B 2K3, Ontario, Canada.
| | - Milos R Popovic
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, 164 College Street, Toronto M5S 3G9E, Ontario, Canada; Neural Engineering and Therapeutics Team, Lyndhurst Centre, Toronto Rehabilitation Institute,University Health Network, 520 Sutherland Drive, Toronto,M4G 3V9, Ontario, Canada; Department of Physical Therapy, University of Toronto, 500 University Avenue, TorontoM5G 1V7, Ontario, Canada.
| |
Collapse
|
42
|
Gabison S, Verrier MC, Nadeau S, Gagnon DH, Roy A, Flett HM. Trunk strength and function using the multidirectional reach distance in individuals with non-traumatic spinal cord injury. J Spinal Cord Med 2014; 37:537-47. [PMID: 25229736 PMCID: PMC4166188 DOI: 10.1179/2045772314y.0000000246] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
CONTEXT Trunk control is essential to engage in activities of daily living. Measuring trunk strength and function in persons with spinal cord injury (SCI) is difficult. Trunk function has not been studied in non-traumatic SCI (NTSCI). OBJECTIVES To characterize changes in trunk strength and seated functional reach in individuals with NTSCI during inpatient rehabilitation. To determine if trunk strength and seated reach differ between walkers and wheelchair users. To explore relationships between trunk and hip strength and seated functional reach. DESIGN Observational study. SETTING Two SCI rehabilitation facilities. PARTICIPANTS 32 subacute inpatients (mean age 48.0 ± 15.4 years). OUTCOME MEASURES Isometric strength of trunk and hip and function (Multidirectional Reach Test: MDRT) were assessed at admission and within 2 weeks of discharge. Analysis of variance was conducted for admission measures (MDRT, hip and trunk strength) between walkers and wheelchair users. Changes in MDRT, hip and trunk strength were evaluated using parametric and non-parametric statistics. The level of association between changes in values of MRDT and strength was also examined. RESULTS Significant differences between walkers and wheelchair users were found for strength measures (P < 0.05) but not for MDRT. Left- and right-sided reaches increased in wheelchair users only (P < 0.05). Associations between changes in hip strength, trunk strength, and reach distance were found (R = 0.67-0.73). CONCLUSION In clinical settings, it is feasible and relevant to assess trunk, hip strength, and MRDT. Future studies require strategies to increase the number of participants assessed, in order to inform clinicians about relevant rehabilitation interventions.
Collapse
Affiliation(s)
- Sharon Gabison
- Correspondence to: Sharon Gabison, University Health Network – Toronto Rehabilitation Institute, SCI Mobility Laboratory, 520 Sutherland Drive, Toronto, ON, Canada M4G 3V9.
| | | | | | | | | | - Heather M. Flett
- Spinal Program, University Health Network – Toronto Rehabilitation Institute, Lyndhurst Centre Toronto, Ontario, Canada
| |
Collapse
|
43
|
Heyrman L, Feys H, Molenaers G, Jaspers E, Monari D, Nieuwenhuys A, Desloovere K. Altered trunk movements during gait in children with spastic diplegia: compensatory or underlying trunk control deficit? Res Dev Disabil 2014; 35:2044-2052. [PMID: 24864057 DOI: 10.1016/j.ridd.2014.04.031] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Revised: 04/30/2014] [Accepted: 04/30/2014] [Indexed: 06/03/2023]
Abstract
Altered trunk movements during gait in children with CP are considered compensatory due to lower limb impairments, although scientific evidence for this assumption has not yet been provided. This study aimed to study the functional relation between trunk and lower limb movement deficits during gait in children with spastic diplegia. Therefore, the relationship between trunk control in sitting, and trunk and lower limb movements during gait was explored in 20 children with spastic diplegia (age 9.2 ± 3 yrs; GMFCS level I n=10, level II n=10). Trunk control in sitting was assessed with the Trunk Control Measurement Scale (TCMS), a clinical measure that reflects the presence of an underlying trunk control deficit. Trunk movements during gait were measured with a recently developed trunk model including the pelvis, thorax, head, shoulder line and spine. Lower limb movements were assessed with the Plug-in-Gait model (Vicon(®)). Range of motion (ROM) of the different trunk segments was calculated, as well as the Trunk Profile Score (TPS) and Trunk Variable Scores (TVSs). Similarly, the Gait Profile Score (GPS) and Gait Variable Scores (GVSs) were calculated to describe altered lower limb movements during gait. Correlation analyses were performed between the presence of impaired trunk control in sitting (TCMS) and altered trunk movements during gait (ROM, TPS/TVSs) and between these altered trunk movements and lower limb movements (GPS/GVSs) during gait. A poorer performance on the TCMS correlated with increased ROM and TPS/TVSs, particularly for the thorax, indicating the presence of an underlying trunk control deficit. No significant correlation was found between the TPS and GPS, suggesting that overall trunk and lower limb movement deficits were not strongly associated. Only few correlations between specific lower limb deficits (GVSs for hip ab/adduction, knee flexion/extension and ankle flexion/extension) and TVSs for thorax lateral bending and rotation were found. This study provided first evidence that the altered trunk movements observed during gait should not be solely considered compensatory due to lower limb impairments, but that these may also partially reflect an underlying trunk control deficit. A better understanding of underlying trunk control deficits in children with CP may facilitate targeted therapy planning and ultimately can optimize a child's functionality.
Collapse
Affiliation(s)
- Lieve Heyrman
- KU Leuven, Faculty of Kinesiology and Rehabilitation Sciences, Department of Rehabilitation Sciences, Tervuursevest 101, 3001 Heverlee, Belgium.
| | - Hilde Feys
- KU Leuven, Faculty of Kinesiology and Rehabilitation Sciences, Department of Rehabilitation Sciences, Tervuursevest 101, 3001 Heverlee, Belgium.
| | - Guy Molenaers
- University Hospital of Pellenberg, Clinical Motion Analysis Laboratory, Weligerveld 1, 3212 Pellenberg, Belgium; KU Leuven, Faculty of Medicine, Department of Development and Regeneration, Herestraat 49, 3000 Leuven, Belgium.
| | - Ellen Jaspers
- ETH, Department of Health Sciences and Technology, Neural Control of Movement Lab, Rämistrasse 101, 8006 Zurich, Switzerland.
| | - Davide Monari
- KU Leuven, Science, Engineering and Technology Group, Department of Mechanical Engineering, Celestijnenlaan 300, 3001 Heverlee, Belgium.
| | - Angela Nieuwenhuys
- KU Leuven, Faculty of Kinesiology and Rehabilitation Sciences, Department of Rehabilitation Sciences, Tervuursevest 101, 3001 Heverlee, Belgium.
| | - Kaat Desloovere
- KU Leuven, Faculty of Kinesiology and Rehabilitation Sciences, Department of Rehabilitation Sciences, Tervuursevest 101, 3001 Heverlee, Belgium; University Hospital of Pellenberg, Clinical Motion Analysis Laboratory, Weligerveld 1, 3212 Pellenberg, Belgium.
| |
Collapse
|
44
|
Maaswinkel E, Veeger HEJ, Dieen JH. Interactions of touch feedback with muscle vibration and galvanic vestibular stimulation in the control of trunk posture. Gait Posture 2014; 39:745-9. [PMID: 24192277 DOI: 10.1016/j.gaitpost.2013.10.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Revised: 09/25/2013] [Accepted: 10/12/2013] [Indexed: 02/02/2023]
Abstract
This study investigated the effect of touch on trunk sway in a seated position. Two touch conditions were included: touching an object with the index finger of the right hand (hand-touch) and maintaining contact with an object at the level of the spine of T10 on the mid back (back-touch). In both touch conditions, the exerted force stayed below 2N. Furthermore, the interaction of touch with paraspinal muscle vibration and galvanic vestibular stimulation (GVS) was studied. Thirteen healthy subjects with no history of low-back pain participated in this study. Subjects sat on a stool and trunk sway was measured with a motion capture system tracking a cluster marker on the trunk. Subjects performed a total of 12 trials of 60-s duration in a randomized order, combining the experimental conditions of no-touch, hand-touch or back-touch with no sensory perturbation, paraspinal muscle vibration or GVS. The results showed that touch through hand or back decreased trunk sway and decreased the effects of muscle vibration and GVS. GVS led to a large increase in sway whereas the effect of muscle vibration was only observed as an increase of drift and not of sway. In the current experimental set-up, the stabilizing effect of touch was strong enough to mask any effects of perturbations of vestibular and paraspinal muscle spindle afference. In conclusion, tactile information, whenever available, seems to play a dominant role in seated postural sway and therefore has important implications for studying trunk control.
Collapse
Affiliation(s)
- E Maaswinkel
- Research Institute MOVE, Institute for Fundamental and Clinical Human Movement Sciences, Faculty of Human Movement Sciences, 'Vrije Universiteit Amsterdam', Van der Boechorststraat 9, NL-1081 BT Amsterdam, The Netherlands
| | - H E J Veeger
- Research Institute MOVE, Institute for Fundamental and Clinical Human Movement Sciences, Faculty of Human Movement Sciences, 'Vrije Universiteit Amsterdam', Van der Boechorststraat 9, NL-1081 BT Amsterdam, The Netherlands
| | - J Hv Dieen
- Research Institute MOVE, Institute for Fundamental and Clinical Human Movement Sciences, Faculty of Human Movement Sciences, 'Vrije Universiteit Amsterdam', Van der Boechorststraat 9, NL-1081 BT Amsterdam, The Netherlands.
| |
Collapse
|
45
|
Bae SH, Lee HG, Kim YE, Kim GY, Jung HW, Kim KY. Effects of Trunk Stabilization Exercises on Different Support Surfaces on the Cross-sectional Area of the Trunk Muscles and Balance Ability. J Phys Ther Sci 2013; 25:741-5. [PMID: 24259843 PMCID: PMC3805005 DOI: 10.1589/jpts.25.741] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Accepted: 02/15/2013] [Indexed: 12/02/2022] Open
Abstract
[Purpose] The purpose of this study was to examine the effects on stroke patients of
trunk stabilization exercise on different support surfaces. [Subjects and Methods] Sixteen
stroke patients with onset of stroke six months earlier or longer were randomly and
equally assigned to group I (exercise performed on a stable support surface) and group II
(exercise performed on an unstable support surface). The two groups conducted the trunk
stabilization exercises on the respective support surfaces, in addition to existing
rehabilitation exercises five times per week for 12 weeks. Changes in the cross-sectional
area (CSA) of the muscles were examined using computed tomography (CT), and changes in the
balance ability were assessed using a measuring system and the trunk impairment scale
(TIS). [Results] In group I, there was a significant increase in the CSA of the mulifidus
muscle on the side contralateral to the brain lesion and in the paravertebral and
multifidus muscles on the side ipsilateral to the brain lesion. In group II, there was a
significant increase in the CSA of the paravertebral and multifidus muscles on the side
contralateral to the brain lesion and on the side ipsilateral to the brain lesion. In
terms of changes in balance ability, the sway path (SP) and TIS significantly improved in
group I, and the SP, sway area (SA), and TIS significantly improved in group II .
[Conclusion] Exercise on the unstable support surface enhanced the size of the
cross-sectional area of the trunk muscles and balance ability significantly more than
exercise on the stable support surface.
Collapse
Affiliation(s)
- Sea Hyun Bae
- Department of Physical Therapy, Gwangju Heemang Hospital
| | | | | | | | | | | |
Collapse
|