scholarly journals The relationship between energy expenditure and physical functions in patients hospitalised for stroke

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kota Hobo ◽  
Hideaki Kurita ◽  
Kimito Momose
Keyword(s):  
Energy Expenditure ◽  
Physical Function ◽  
Walking Speed ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Berg Balance Scale ◽  
Acceleration Sensor ◽  
Physical Ability ◽  
Physical Functions ◽  
The Relationship

AbstractWe assessed the relationship between energy expenditure (EE) and Functional Independence Measure motor items (FIM-M) score, Berg Balance Scale (BBS) score, and comfortable walking speed (CWS) in patients hospitalised for stroke. The total EE per day (TEE), EE during rehabilitation (REE), and EE during activities other than rehabilitation (OEE) were measured using a single-axis acceleration sensor in 36 patients hospitalised for the first stroke episode. In addition, the relationships between each type of EE and FIM-M, BBS, and CWS were investigated. In these patients (mean age 66.2 ± 10.6 years), the median values of TEE, REE, and OEE were 41.8 kcal, 18.5 kcal, and 16.6 kcal, respectively. Correlations were observed between each EE type and all physical function indices. Following the stratification of patients into two groups (high and low) based on the level of physical function, a significant correlation between EE type and physical function was observed only in the low BBS group. EE was correlated with overall physical function indices, but the trend differed depending on physical ability. When patients were stratified based on ability, there were several groups with no significant correlation. Therefore, several patients were unable to achieve an appropriate EE for their level of physical function.

scholarly journals The Relationship Between Energy Expenditure and Physical Functions in Patients Hospitalised For Stroke

2021 ◽  
Author(s):  
Kota Hobo ◽  
Hideaki Kurita ◽  
Kimito Momose
Keyword(s):  
Energy Expenditure ◽  
Physical Function ◽  
Walking Speed ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Berg Balance Scale ◽  
Acceleration Sensor ◽  
Physical Ability ◽  
Physical Functions ◽  
The Relationship

Abstract We assessed the relationship between energy expenditure (EE) and functional independence measure (FIM-M) score, Berg Balance Scale (BBS), and comfortable walking speed (CWS) in patients hospitalised for stroke. The total EE per day (TEE), EE during rehabilitation (REE), and EE during activities other than rehabilitation (OEE) were measured using a single-axis acceleration sensor in 36 patients hospitalised for a first stroke episode. In addition, the relationships between each type of EE and FIM-M, BBS, and CWS were investigated. In these patients (mean age 66.2±10.6 years), the median values of TEE, REE, and OEE were 41.8 kcal, 18.5 kcal, and 16.6 kcal, respectively. Correlations were observed between each EE type and all physical function indices. Following the stratification of patients into two groups (high and low) based on the level of physical function, a significant correlation between EE type and physical function was observed only in the low BBS group. EE was correlated with overall physical function indices, but the trend differed depending on physical ability. When patients were stratified based on ability, there were several groups with no significant correlation. Therefore, many patients were unable to achieve an appropriate EE for their level of physical function.

Predicting the Probability for Fall Incidence in Stroke Patients Using the Berg Balance Scale

2009 ◽  
Vol 37 (3) ◽  
pp. 697-704 ◽  
Author(s):  
N Maeda ◽  
J Kato ◽  
T Shimada
Keyword(s):  
Logistic Model ◽  
Functional Independence Measure ◽  
Length Of Hospital Stay ◽  
Functional Independence ◽  
Berg Balance Scale ◽  
Stroke Patients ◽  
Balance Scale ◽  
Patients At Risk ◽  
The Relationship ◽  
State Examination

This observational study investigated the relationship between balance, mobility and falls in 72 hemiplegic stroke inpatients, with the aim of developing a model for predicting fall risk. Fall history was recorded by interview, balance was assessed using the Berg Balance Scale (BBS) and activities of daily living were evaluated using the Functional Independence Measure (FIM). Variables differing between fallers and non-fallers were identified, and a stepwise regression analysis was performed to identify a combination of variables that effectively predicted fall status. Fallers (occasional and repeat; n = 27) had a shorter time from stroke onset, lower FIM scores on admission and discharge, lower BBS and Mini-Mental State Examination scores, a greater age and longer length of hospital stay compared with non-fallers (all differences were significant). A logistic model for predicting falls showed that BBS at admission was significantly related to falls, with fallers having lower BBS scores at admission (cut-off ≤ 29; sensitivity 80%; specificity 78%). These data suggest BBS is a sensitive and specific measure for identifying stroke patients at risk of falling.

ASSOCIATION BETWEEN BERG BALANCE, PHYSIOLOGICAL PROFILE ASSESSMENT AND PHYSICAL ACTIVITY, PHYSICAL FUNCTION AND BODY COMPOSITION: A CROSS-SECTIONAL STUDY

2015 ◽  
pp. 1-7
Author(s):  
D.J. SMEE ◽  
H.L. BERRY ◽  
G. WADDINGTON ◽  
J. ANSON
Keyword(s):  
Body Composition ◽  
Physical Function ◽  
Risk Measures ◽  
Berg Balance Scale ◽  
Cross Sectional ◽  
Physiological Profile ◽  
Falls Risk ◽  
Balance Scale ◽  
The Relationship ◽  
Physiological Profile Assessment

Background: Falls are of great concern to older adults and costly to the health system. In addition the relationship between falls risk and falls risk predictor characteristics is complex. Objective: This study aimed to explore the relationship between two objective fall-risk measures tools, the Physiological Profile Assessment and the Berg Balance Scale and to determine how an individual’s sex, level of physical function, health-related and body composition characteristics impact these objective falls risk measures. Design: A cross-sectional, observational study. Participants: 245 community-dwelling older adults (M age=68.12 years, SD=6.21; 69.8% female). Measurements: Participants were assessed for falls-risk (Physiological Profile Assessment and the Berg Balance Scale), physical activity, physical functional and body composition characteristics. Pearson product-moment correlation coefficients were calculated to examine bivariate relationships and hierarchical multiple linear regression modelling was used to estimate the contribution of each predictor in explaining variance in falls-risk. Results: In females, there was a weak association between the two objective falls-risk measures (r =-0.17 p <0.05). The number of falls in the previous 12 months explained 6% of variance in Physiological Profile Assessment scores, with bone density of the lumbar spine contributing a further 1%. In males and females, variance in the Berg Balance Scale showed that age (25%) and physical function (16% for females, 28% for males) contributed significantly to the explaining variance in the falls-risk measure. Conclusion: Sex differences are apparent and as such males and females should be assessed (and potentially treated) differently with regards to falls risk. Results indicate that both falls risk assessment tools measure aspects of balance but are not interchangeable. The Berg Balance Scale may be more discriminative in older, less functioning adults and the Physiological Profile Assessment is more useful in assessing falls risk in females.

scholarly journals Relationship between upper limb motor function and activities of daily living after removing the influence of lower limb motor function in subacute patients with stroke: A cross-sectional study

2020 ◽  
pp. 156918612092660
Author(s):  
Haruka Yamamoto ◽  
Kazuya Takeda ◽  
Soichiro Koyama ◽  
Keisuke Morishima ◽  
Yuichi Hirakawa ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Motor Function ◽  
Upper Limb ◽  
Lower Limb ◽  
Daily Living ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Motor Score ◽  
Cross Sectional ◽  
The Relationship

Background Previous studies have reported a relationship between upper limb motor function and activities of daily living. However, their relationship after removing the influence of lower limb motor function has not been clarified. Objective This study aimed to investigate the relationship between Fugl-Meyer assessment upper limb and total Functional Independence Measure motor score and between Fugl-Meyer assessment upper limb and each item contained in Functional Independence Measure motor score after eliminating the influence of the motor function of the affected lower limb. Methods This retrospective cross-sectional study included 58 subacute stroke patients. To investigate the relationship between the Fugl-Meyer assessment upper limb and total Functional Independence Measure motor score before and after removing the influence of Fugl-Meyer assessment lower limb, Spearman’s rank correlation coefficient and partial correlation analysis were used. Additionally, the relationship between Fugl-Meyer assessment upper limb and each item of Functional Independence Measure motor score after removing the influence was assessed. Results Before removing the influence of Fugl-Meyer assessment lower limb, Fugl-Meyer assessment upper limb was strongly correlated with total Functional Independence Measure motor score (r = 0.74, p < 0.001). However, it became weak after removing the influence (r = 0.27, p = 0.04). Regarding each item of Functional Independence Measure motor score, Fugl-Meyer assessment upper limb was correlated with grooming (r = 0.27, p = 0.04), bathing (r = 0.28, p = 0.03), dressing upper body (r = 0.33, p = 0.01), dressing lower body (r = 0.31, p = 0.02), and stair-climbing (r = 0.31, p = 0.02) after removing the influence. Conclusion These findings suggest that the relationship between the upper limb motor function and activities of daily living is strongly influenced by lower limb motor function.

Chronic Akinetic Mutism After Mesencephalic-Diencephalic Infarction: Remediated with Dopaminergic Medications

2001 ◽  
Vol 15 (2) ◽  
pp. 151-156 ◽  
Author(s):  
Michael P. Alexander
Keyword(s):  
Executive Functions ◽  
Key Words ◽  
Ventral Tegmental Area ◽  
Cognitive Functions ◽  
Neuropsychological Tests ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Akinetic Mutism ◽  
Rapid Improvement ◽  
The Relationship

Objective: Akinetic mutism (AKM) is an uncommon disorder with a complex neuropathology. There is no generally accepted treatment, and it is not known if late treatments are effective. The relationship between AKM and abulia is uncertain. Methods: The effects of dopaminergic treatment of a patient with chronic AKM after discrete bilateral infarctions of the mesencephalic ventral tegmental area and the lat eral hypothalamus were studied with motor measures, the Functional Independence Measure (FIM), and neuropsychological tests. Results: Treatment with a combination of carbidopa/levodopa and pergolide produced prompt amelioration of AKM with dra matic and rapid improvement in FIM. An apathetic, amotivational state persisted de spite resolution of akinesia and normal frontal executive functions. Conclusions: AKM may respond to dopaminergic treatment even after months of severe akinesia. The mechanism of abulia is more complex than simply a partial dopaminergic deficiency state and may persist even when AKM is treated and frontal cognitive functions are normal. Key Words: Akinetic mutism—Dopamine—Abulia.

Retraining selective trunk muscle activity: A key to more successful rehabilitation outcomes for hemiparetic stroke patients

2021 ◽  
pp. 1-8
Author(s):  
Matteo Bigoni ◽  
Veronica Cimolin ◽  
Luca Vismara ◽  
Andrea G. Tarantino ◽  
Silvia Baudo ◽  
...  
Keyword(s):  
Treatment Cycle ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Berg Balance Scale ◽  
Rehabilitation Program ◽  
Trunk Muscles ◽  
Single Subject ◽  
Rehabilitation Outcomes ◽  
Additional Improvement ◽  
Hemiparetic Stroke

BACKGROUND: Hemiparetic patients lose the ability to move their trunk selectively, abdominals are affected and neither voluntary nor reflex activity is present. OBJECTIVE: To investigate if the inclusion of specific exercises for the trunk muscles in a rehabilitation program for chronic hemiparetic patients could lead to an additional improvement. METHODS: A multiple-participant single-subject design was replicated in patients with hemiplegia. The study was conducted in two cycles: for the first cycle (A), patients received conventional rehabilitation program, then for the second cycle (B), six months later, the same subjects received conventional rehabilitation therapy plus an additional specific selective trunk muscles training. Trunk Impairment Scale (TIS), Berg Balance Scale (BBS), 10 meters distance walk test (10 MWT), Functional Independence Measure (FIM) and instrumental gait analysis were performed before and after both treatment cycles. RESULTS: Significant changes were observed in TIS and 10 MWT after the two treatment cycles. However, after treatment cycle B, BBS and FIM score showed an additional improvement. Whereas, after treatment cycle A gate analysis did not relevantly changed, but after cycle B a significant improvement was registered in velocity, cadence and percentage of stance in the gait cycle. CONCLUSIONS: In our patients, the training for selective activation of the trunk muscles had led to a consistent improvement of gate analysis parameters, and hemiparesis-related disability in stance and activities of daily living.

Abstract 2131: Prediction of Discharge Walking Ability from Initial Assessment in a Stroke IRF Population

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Margurhetta D Bland ◽  
Audra Sturmoski ◽  
Michelle Whitson ◽  
Lisa T Connor ◽  
Robert Fucetola ◽  
...  
Keyword(s):  
Logistic Model ◽  
Walking Speed ◽  
Local Population ◽  
Inpatient Rehabilitation ◽  
Functional Independence ◽  
Berg Balance Scale ◽  
Initial Assessment ◽  
Walking Ability ◽  
Balance Scale ◽  
Admission Variables

The purpose of this study was to investigate which physical therapy assessments administered at admission to an inpatient rehabilitation facility (IRF) could predict discharge walking ability in a local population of people with stroke. The sample consisted of 111 IRF participants with stroke who consented to have records stored in the Brain Recovery Core database between January 2010 and January 2011. Independent variables from the admission assessment included: lower extremity Motricity Index, somatosensation, Modified Ashworth Scale, Functional Independence Measure (FIM) locomotor item, Berg Balance Scale, walking speed, age, history of previous stroke, and time from stroke onset to IRF assessment. The dependent variable was discharge walking ability, defined as walking speed on the 10 m Walk Test. Correlational analyses examined relationships with and between the admission variables and discharge walking ability. Step-wise multiple regression was used to determine the most parsimonious combination of variables that could explain variance in discharge walking ability. Logistic regression was used to determine the likelihood of achieving household (< 0.4 m/s) versus community (≥ 0.4 - 0.8, > 0.8 m/s) ambulation categories. Results from the stepwise model indicated that 2 admission variables, Berg Balance score and FIM locomotor score, explained 80% of the variance in discharge walking ability. For the logistic model, the odds ratio of achieving only household ambulation at discharge was 20 (95%CI: 6-63) when the combination of having a Berg Balance < 20 and a FIM locomotor score of 1 or 2 was present. The logistic model correctly classified 92% of subjects achieving only household ambulation and 64% of subjects achieving better than household ambulation. These findings suggest that performance on the Berg Balance Scale and the FIM locomotor item at admission to an IRF can explain most of the variance in discharge walking ability. Having the combination of a Berg Balance score < 20 and a FIM locomotor score of 1 or 2 at admission indicates that a person is highly likely to be only a household ambulator at discharge from the IRF. Knowing at the time of IRF admission that a person with stroke is not likely to achieve limited community or community ambulation status will allow for earlier discharge planning with respect to needed assistance at home, durable-medical equipment, and home modifications.

scholarly journals Fear of Falling and Cognitive Impairments in Elderly People with Hip Fractures

2017 ◽  
Vol 7 (3) ◽  
pp. 386-394 ◽  
Author(s):  
Mari Kasai ◽  
Kenichi Meguro ◽  
Hiroshi Ozawa ◽  
Keiichi Kumai ◽  
Hideki Imaizumi ◽  
...  
Keyword(s):  
Hip Fractures ◽  
Daily Living ◽  
Fear Of Falling ◽  
Cognitive Impairments ◽  
Functional Independence ◽  
Covariate Effects ◽  
Physical Functions ◽  
And Gender ◽  
The Relationship ◽  
Prevalence Of Dementia

Background/Aim: The purpose of this study was to investigate the estimated prevalence of dementia and the relationship between cognitive impairment and fear of falling in patients with hip fractures. Methods: Analysis 1 included 100 patients with hip fractures. Analysis 2 included a subgroup of subjects with ≥75 years of functional independence: 46 patients with hip fractures and 46 control subjects without hip fractures, and presence or absence of dementia. We used an informant-rated questionnaire including the AD8 for screening for dementia, the Barthel Index for assessing activities of daily living, and the Short Falls Efficacy Scale-International (FES-I) for assessing fear of falling. Results: The estimated prevalence of dementia was 66% in patients with hip fractures. There were significant fracture and dementia effects, with significant covariate effects of age and gender on the Short FES-I scores. Conclusion: Our results suggested that more than two-thirds of patients with hip fractures had dementia. Fear of falling may reflect not only physical functions but also cognitive impairments.

scholarly journals Muscular efficiency during steady-rate exercise. II. Effects of walking speed and work rate

1977 ◽  
Vol 43 (3) ◽  
pp. 431-439 ◽  
Author(s):  
C. M. Donovan ◽  
G. A. Brooks
Keyword(s):  
Energy Expenditure ◽  
Walking Speed ◽  
Vertical Gradient ◽  
Work Rate ◽  
Baseline Correction ◽  
Energy Costs ◽  
Steady Rate ◽  
Work Level ◽  
The Relationship ◽  
Combined Work

A comparison of walking against vertical (gradient) and horizontal (trailing weight) forces was made during steady-rate exercise at 0.250, 500, and 750 kg-m/min with speeds of 3,0, 4.5, and 6.0 km/h. In all cases exponential relationships between energy expenditure (calculated from the steady-rate respiration) and increasing work rate and speed were observed which indicated that muscular efficiency during walking is inversely related to speed and work rate. “Work” (level, unloaded walking as the baseline correction), “delta” (measured work rate as the baseline correction), and “instantaneous” (derived from the equation describing the caloric cost of work) efficiencies were computed. All definitions yielded decreasing efficiencies with increasing work rates. At work rates above 250 kg-m/min the curves describing the relationship between energy expenditure and work rate were parallel for vertical and horizontal forces, indicating equivalent efficiencies in this range. Only the delta and instantaneous definitions accurately described these relationships for vertical and horizontal work. Determinations of combined work loads (gradient plus trailing weight) were made and the energy costs of both types of work found to be additive.

scholarly journals Postural control in blind subjects

2011 ◽  
Vol 9 (4) ◽  
pp. 470-476 ◽  
Author(s):  
Antonio Vinicius Soares ◽  
Cláudia Silva Remor de Oliveira ◽  
Rodrigo José Knabben ◽  
Susana Cristina Domenech ◽  
Noe Gomes Borges Junior
Keyword(s):  
Postural Control ◽  
Visual Loss ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Berg Balance Scale ◽  
Compensatory Mechanisms ◽  
Balance Scale ◽  
Brazilian Version ◽  
Congenitally Blind ◽  
The Mean

ABSTRACT Objective: To analyze postural control in acquired and congenitally blind adults. Methods: A total of 40 visually impaired adults participated in the research, divided into 2 groups, 20 with acquired blindness and 20 with congenital blindness − 21 males and 19 females, mean age 35.8 ± 10.8. The Brazilian version of Berg Balance Scale and the motor domain of functional independence measure were utilized. Results: On Berg Balance Scale the mean for acquired blindness was 54.0 ± 2.4 and 54.4 ± 2.5 for congenitally blind subjects; on functional independence measure the mean for acquired blind group was 87.1 ± 4.8 and 87.3 ± 2.3 for congenitally blind group. Conclusion: Based upon the scale used the results suggest the ability to control posture can be developed by compensatory mechanisms and it is not affected by visual loss in congenitally and acquired blindness.

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