A treatment schedule of conventional physical therapy provided to enhance upper limb sensorimotor recovery after stroke: Expert criterion validity and intra-rater reliability

The aim: To assess the effect of the modified combined program of physical therapy and ergotherapy on the indicators of upper limb recovery in the patients with the left unilateral neglect. Materials and methods: The study involved 58 patients diagnosed with the right hemisphere stroke followed by neglect syndrome. Patients were randomly divided into main group (MG) and control group (CG) according to the ratio of 1:1. Physical therapy of CG patients included proprioceptive neuromuscular facilitation (PNF), balance training, ergotherapeutic intervention, and exercises improving fine motor skills. Specially developed intervention program of MG patients took into account patient’s individual capabilities and needs. It included PNF, balance training and upright posture correction, constraint-induced movement therapy, dual task activities, stimulation of the affected side in daily activities, targeted therapy. The length of intervention comprised 3 months in both groups. Results: According to the results of the primary examination, the groups had no differences in demographic variables, clinical history (NIHSS scale, the Glasgow Coma Scale and Albert’s Test) and Fugl-Meyer assessment of upper limb sensorimotor recovery. Statistical analysis of the final scores of the Fugl-Meyer scale confirmed that MG had statistical advantages in all measured items of the motor function domain, as well as in a number of proprioceptive sensitivity indicators. Conclusions: The obtained results confirm better efficacy of the modified program of physical therapy and ergotherapy, received by MG patients.

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Preliminary Study on the Effect of an Early Physical Therapy Intervention after Sentinel Lymph Node Biopsy: A Multicenter Non-Randomized Controlled Trial

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18031275 ◽

2021 ◽

Vol 18 (3) ◽

pp. 1275

Author(s):

María Jesús Muñoz-Fernández ◽

Esther M. Medrano-Sánchez ◽

Beatriz Ostos-Díaz ◽

Rocío Martín-Valero ◽

Carmen Suárez-Serrano ◽

...

Keyword(s):

Lymph Node ◽

Physical Therapy ◽

Sentinel Lymph Node ◽

Sentinel Lymph Node Biopsy ◽

Usual Care ◽

Upper Limb ◽

Lymph Node Biopsy ◽

Control Group ◽

Node Biopsy ◽

Early Physical Therapy

Selective sentinel lymph node biopsy (SLNB) represents a minimally invasive surgery in patients with breast cancer. The purpose of this study was to explore the possible effect of an early physiotherapy intervention for the recovery of the upper limb and the surgical scars after SLNB in comparison with usual care. A total of 40 patients were enrolled in either the control group (n = 20) or the experimental group (n = 20). The intervention group performed an early physiotherapy program based on functional exercises, scar manual therapy, and educational tips. The control group received usual care. Shoulder range of motion (ROM), grip strength, upper limb pain and disability (SPADI), scar recovery (POSAS), myofascial adhesions (MAP-BC), quality of life (EORTCQLA-BR-23) and the presence of axillary web syndrome (AWS) and lymphoedema were assessed at baseline and immediately after intervention. A follow-up period of 6 months was performed for lymphoedema surveillance. Between groups significant differences in favor of the intervention were found for ROM (r = 0.43), grip strength (r = 0.32), SPADI (d = 0.45), POSAS (d = 1.28), MAP-BC (d = 1.82) and EORTCQLQ-BR 23 general function subscale (d = 0.37) (p < 0.05 for all variables). Our results suggest that an early physical therapy program seems to be more effective than usual care in women after SLNB. However, results should be interpreted with caution and future randomized trial with a larger sample size is needed.

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Low frequency transcranial magnetic stimulation in subacute ischemic stroke: Number of sessions that altered cortical excitability

Neurorehabilitation ◽

10.3233/nre-203156 ◽

2020 ◽

Vol 47 (4) ◽

pp. 427-434

Author(s):

Mohammed S. El-Tamawy ◽

Moshera H. Darwish ◽

Saly H. Elkholy ◽

Engy BadrEldin S. Moustafa ◽

Shimaa T. Abulkassem ◽

...

Keyword(s):

Ischemic Stroke ◽

Transcranial Magnetic Stimulation ◽

Physical Therapy ◽

Upper Limb ◽

Magnetic Stimulation ◽

Cortical Excitability ◽

Low Frequency ◽

Cortical Reorganization ◽

Therapy Program ◽

Physical Therapy Program

BACKGROUND: Cortical reorganization between both cerebral hemispheres plays an important role in regaining the affected upper extremity motor function post-stroke. OBJECTIVES: The purpose of the current study was to investigate the recommended number of contra-lesion low frequency repetitive transcranial magnetic stimulation (LF-rTMS) sessions that could enhance cortical reorganization post-stroke. METHODS: Forty patients with right hemiparetic subacute ischemic stroke with an age range between 50–65 yrs were randomly assigned into two equal groups: control (GA) and study (GB) groups. Both groups were treated with a selected physical therapy program for the upper limb. Sham and real contra-lesion LF-rTMS was conducted for both groups daily for two consecutive weeks. Sequential changes of cortical excitability were calculated by the end of each session. RESULTS: The significant enhancement in the cortical excitability was observed at the fourth session in favor of the study group (GB). Sequential rate of change in cortical excitability was significant for the first eight sessions. From the ninth session onwards, no difference could be detected between groups. CONCLUSION: The pattern of recovery after stroke is extensive and not all factors could be controlled. Application of LF-rTMS in conjugation with a selected physical therapy program for the upper limb from four to eight sessions seems to be efficient.

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Development of an upper limb patient simulator for physical therapy exercise

2011 IEEE International Conference on Rehabilitation Robotics ◽

10.1109/icorr.2011.5975510 ◽

2011 ◽

Cited By ~ 9

Author(s):

Y. Takhashi ◽

T. Komeda ◽

H. Koyama ◽

S-I Yamamoto ◽

T. Arimatsu ◽

...

Keyword(s):

Physical Therapy ◽

Upper Limb ◽

Patient Simulator

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Using Robot Skin to Support Physical Therapy Routines with a Lightweight Upper-Limb Exoskeleton

10.1109/icar53236.2021.9659361 ◽

2021 ◽

Author(s):

Natalia Paredes-Acuna ◽

Nicolas Berberich ◽

Emmanuel Dean-Leon ◽

Gordon Cheng

Keyword(s):

Physical Therapy ◽

Upper Limb ◽

Upper Limb Exoskeleton ◽

Robot Skin

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Reliability of measuring the medial knee joint space using ultrasound imaging

10.36879/jcmi.18.000108 ◽

2018 ◽

pp. 1-4

Keyword(s):

Physical Therapy ◽

Knee Joint ◽

Ultrasound Imaging ◽

Mixed Model ◽

Glenohumeral Joint ◽

Joint Space ◽

Rater Reliability ◽

Medial Knee ◽

Operator Experience ◽

Bony Landmarks

Background: The use of ultrasound to perform quantitative musculoskeletal (MSK) measurements requires reliability among different providers with varied levels of experience and training. Recent studies have shown that physical therapists (PT) can reliably measure the glenohumeral joint space using ultrasound imaging (USI) and operator experience or well defined training protocols influences the reliability. Few studies have reported the reliability of medial knee gap measurements with USI. Objective: Evaluate inter- and intra-rater reliability of a novel approach to measuring knee gapping using experienced and trained novice clinicians. Design: Inter-rater and intra-rater reliability study Setting: Physical therapy program Participants: Novice researchers were three upper-year Doctor of Physical Therapy students. Experienced researchers were two PT certified in MSK USI with eight years of experience. Methods: A total of 166 images of two subject’s medial knee joint gaps were captured in resting by a single experience researcher. Three novice researchers, who underwent a three-hour training protocol and two experienced researchers measured the images individually. Measurements were taken using standardized bony landmarks and internal calipers. All researchers were blinded to the subjects and results. Main outcome measures: Data was analyzed using two-way ICC mixed-model single measurement, SEM run for all researchers compared with experienced researcher one. Results: An excellent degree of reliability was found for both intra-rater and inter-rater measurements for Novice One and a good degree of reliability was found between Experienced One and Novice Two and Three. Conclusion: Both experienced and novice researchers attained a clinically significant ICC when compared to Experienced One. An accurate and reliable measurement of the medial knee joint gap maybe useful for further studies and help with diagnosis of joint pathologies. Level of study: IIB

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Performance of the Upper Limb Module—A Reliable and Valid Evaluation for Chinese Patients with Duchenne Muscular Dystrophy

10.21203/rs.2.22633/v1 ◽

2020 ◽

Author(s):

Yuen Yee Alice Chiu ◽

Chun Wai Lo ◽

Chi Kuk Connie Hui ◽

Wai Chong Susanna Choi ◽

So Lun Lee ◽

...

Keyword(s):

Duchenne Muscular Dystrophy ◽

Muscular Dystrophy ◽

Upper Limb ◽

Forced Vital Capacity ◽

Motor Performance ◽

Vital Capacity ◽

High Reliability ◽

Reliability And Validity ◽

Chinese Patients ◽

Rater Reliability

Abstract Background Duchenne muscular dystrophy is a genetic disease leading to progressive muscle weakness and degeneration. Effective assessment tool is needed to allow monitoring of progress to guide the management. This study assessed the reliability and validity of the Performance of Upper Limb (PUL) Module when used in patients with Duchenne Muscular Dystrophy (DMD). MethodsTotal thirty-three Chinese DMD patients were included. Twenty-five video-recorded PUL Module version 1.3 assessments were performed for the recruited patients with three raters evaluated the same recorded video for inter-rater reliability and evaluated the same performance one month later for intra-rater reliability. Construct validity was assessed correlating the PUL Module scores with the patients’ age, their forced vital capacity (N=25) and their Hammersmith motor scale scores (N=25) performed on the same day. ResultsThe intra-rater and inter-rater reliability (ICC 0.92 - 0.99), internal consistency (Cronbach’s alpha 0.97 - 0.99) and known groups validity (AUC 0.97) of PUL module were excellent. PUL was negatively correlated with age (r = -0.912), and positively correlated with the forced vital capacity (r = 0.87) and the Hammersmith motor scale (r = 0.84). The findings confirm the high reliability and validity of PUL module, and its high clinical relevancy in monitoring the deteriorating upper limb motor performance that strongly correlated with the lung function and generalized motor performance as age increased in DMD. ConclusionThis first study of PUL module in Chinese patients with DMD confirmed that it is a reliable valid tool to monitor clinical progress and outcome for DMD.

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The upper limb Physiological Profile Assessment: Description, reliability, normative values and criterion validity

PLoS ONE ◽

10.1371/journal.pone.0218553 ◽

2019 ◽

Vol 14 (6) ◽

pp. e0218553 ◽

Cited By ~ 1

Author(s):

Lewis A. Ingram ◽

Annie A. Butler ◽

Lee D. Walsh ◽

Matthew A. Brodie ◽

Stephen R. Lord ◽

...

Keyword(s):

Upper Limb ◽

Criterion Validity ◽

Normative Values ◽

Physiological Profile ◽

Physiological Profile Assessment

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Upper limb robot-assisted rehabilitation versus physical therapy on subacute stroke patients: A follow-up study

Journal of Bodywork and Movement Therapies ◽

10.1016/j.jbmt.2019.03.016 ◽

2020 ◽

Vol 24 (1) ◽

pp. 194-198 ◽

Cited By ~ 3

Author(s):

Marco Franceschini ◽

Stefano Mazzoleni ◽

Michela Goffredo ◽

Sanaz Pournajaf ◽

Daniele Galafate ◽

...

Keyword(s):

Physical Therapy ◽

Upper Limb ◽

Stroke Patients ◽

Robot Assisted ◽

Follow Up Study ◽

Subacute Stroke

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Devices and Protocols for Upper Limb Robot-Assisted Rehabilitation of Children with Neuromotor Disorders

Applied Sciences ◽

10.3390/app9132689 ◽

2019 ◽

Vol 9 (13) ◽

pp. 2689 ◽

Cited By ~ 1

Author(s):

Valeria Falzarano ◽

Francesca Marini ◽

Pietro Morasso ◽

Jacopo Zenzeri

Keyword(s):

Upper Limb ◽

Pediatric Population ◽

Recovery Process ◽

Key Factors ◽

Robot Assisted ◽

Robotic Therapy ◽

Rehabilitation Protocols ◽

Potential Benefits ◽

Robotic Devices ◽

Sensorimotor Recovery

Neuromotor disorders negatively affect the sensorimotor system, limiting the ability to perform daily activities autonomously. Rehabilitation of upper limb impairments is therefore essential to improve independence and quality of life. In the last two decades, there has been a growing interest in robot-assisted rehabilitation as a beneficial way to promote children recovery process. However, a common understanding of the best drivers of an effective intervention has not been reached yet. With this aim, the current study reviewed the existing literature on robot-assisted rehabilitation protocols for upper extremities in children, with the goal of examining the effects of robotic therapy on their sensorimotor recovery process. A literature search was conducted in several electronic database to identify the studies related to the application of robotic therapy on upper limbs in the pediatric population. We analyzed three reviews and 35 studies that used 14 different robotic devices, and an overview of their characteristics, applications in the clinical setting and results is provided. Besides, the potential benefits of robot-assisted assessment and therapy are discussed to identify the key factors yielding positive outcomes in children. Finally, this review aim to lay the foundations for more effective neuroplasticity-enhancement protocols and elicit insights into robot-based approaches.

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