scholarly journals Immediate Effects of Kinesio Taping of Tibialis Anterior and Ankle Joint on Mobility and Balance Ability for Chronic Hemiparesis: Randomized Controlled Cross-Sectional Design

2020 ◽  
Vol 30 (06) ◽  
pp. 350-357
Author(s):  
Kyung-Hun Kim ◽  
Yang-Jin Lee
Keyword(s):  
Ankle Joint ◽  
Tibialis Anterior ◽  
Timed Up And Go ◽  
Cross Sectional ◽  
Kinesio Taping ◽  
Tibialis Muscle ◽  
Before And After ◽  
Balance Ability ◽  
Hemiparetic Stroke ◽  
Chronic Hemiparetic Stroke

Abstract Background Stroke patients with hemiparesis are generally described as being slow and suffering a balance disability. Objective The purpose of this cross-sectional single-blind study was to evaluate the immediate effects of Kinesio taping of tibialis anterior and quadriceps on the mobility and balance ability in individuals with chronic hemiparetic stroke. Methods Thirty-three subjects participated in this study. Participants were divided into 3 groups: Ankle Kinesio taping (AKT) group, a placebo (PKT) group, and a control (NKT) group. The AKT group underwent Kinesio tapping of ankle joint and tibialis muscle, PKT group underwent placebo taping, and NKT group underwent no Kinesio taping. All participants were assessed before and after taping training using timed up and go test (TUG), timed up and down stairs test (TUDS), and balance ability. Results After taping training, the AKT group showed significant improvement in mobility and balance ability compared to the PKT group and NKT group (p < 0.05). The results of this study confirmed that Kinesio taping was effective to the balance and mobility abilities of patients with chronic hemiparetic stroke. Conclusions This study suggested Kinesio taping as an effective intervention to increase the mobility and balance abilities of patients with chronic hemiparetic stroke. Therefore, this study are believed to provide the baseline information to effectively improve the balance and mobility abilities of patients with chronic hemiparetic stroke during the rehabilitation treatment in the future.

scholarly journals Proprioceptive Neuromuscular Facilitation Kinesio Taping Improves Range of Motion of Ankle Dorsiflexion and Balance Ability in Chronic Stroke Patients

Healthcare ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1426
Author(s):  
Donghwan Park ◽  
Youngsook Bae
Keyword(s):  
Range Of Motion ◽  
Dynamic Balance ◽  
Chronic Stroke ◽  
Ankle Dorsiflexion ◽  
Muscle Synergy ◽  
Long Term Effects ◽  
Timed Up And Go ◽  
Kinesio Taping ◽  
Proprioceptive Neuromuscular Facilitation ◽  
Balance Ability

This study aimed to determine the effect of a proprioceptive neuromuscular facilitation (PNF) pattern Kinesio taping (KT) application on the ankle dorsiflexion range of motion (DF-ROM) and balance ability in patients with chronic stroke. This crossover study included 18 patients with stroke. The subjects were randomly assigned to three interventions: barefoot, ankle KT (A-KT), and PNF-KT. The A-KT was applied to the gastrocnemius and tibialis anterior (TA) muscles, and subtalar eversion. The PNF-KT was applied on the extensor hallucis, extensor digitorum, and TA muscles. DR-ROM was measured using the iSen™, a wearable sensor. Balance ability was assessed based on static balance, measured by the Biodex Balance System (BBS), and dynamic balance, measured by the timed up and go (TUG) test and dynamic gait index (DGI). Compared with the barefoot and A-KT interventions, PNF-KT showed significant improvements in the ankle DF-ROM and BBS scores, TUG, and DGI. PNF-KT, for functional muscle synergy, improved the ankle DF-ROM and balance ability in patients with chronic stroke. Therefore, the application of PNF-KT may be a feasible therapeutic method for improving ankle movement and balance in patients with chronic stroke. Additional research is recommended to identify the long-term effects of the PNF-KT.

Effects of Aerobic Treadmill Training on Gait Velocity, Cadence, and Gait Symmetry in Chronic Hemiparetic Stroke: A Preliminary Report

2000 ◽  
Vol 14 (1) ◽  
pp. 65-71 ◽  
Author(s):  
Kenneth H.C. Silver ◽  
Richard F. Macko ◽  
Larry W. Forrester ◽  
Andrew P. Goldberg ◽  
Gerald V. Smith
Keyword(s):  
Ischemic Stroke ◽  
Functional Mobility ◽  
Treadmill Training ◽  
Assistive Device ◽  
Gait Velocity ◽  
Gait Symmetry ◽  
Before And After ◽  
Hemiparetic Stroke ◽  
Temporal Measures ◽  
Chronic Hemiparetic Stroke

It is widely assumed that only limited improvement in functional mobility is pos sible beyond the subacute period following ischemic stroke. Contrary to this notion, we studied "neurologically plateaued" stroke patients with chronic hemiparesis to as sess whether a "task-oriented" treadmill-training regimen would improve walking speed, cadence, and gait cycle symmetry on a modified "Get-Up and Go" task. Five male patients with a mean age of 60.4 ± 2.7 years (mean ± S.D.) status post ischemic stroke (> 6 months prior) participated in this nonrandomized low-intensity tread mill exercise pilot study three times/week for 3 months. All patients had mild to mod erate gait asymmetries due to residual hemiparesis. Patients were videotaped before and after 3 months of treadmill aerobic exercise (AEX) while performing a functional task consisting of arising from a chair, walking 3.1 m without an assistive device as fast as safely possible, and returning to sit. Gait events were timed using a 2-D Peak Motus™ video analysis system. After 3 months AEX training, times for the overall "get-up and return-to-sit" (GURS) task and the "straight-away walk" (SAW) segment decreased from 8.2 ± 1.4 sec to 6.5 ± 0.8 sec (mean ± SEM) (p < 0.05), and from 3.7 ± 1 sec to 2.8 ± 0.7 sec (p < 0.05), respectively. These data represent improve ments of 21% and 24% for the GURS and 'SAW segments, respectively. Mean veloc ity increased from 0.9 ± 0.2 to 1.2 ± 0.21 m/sec, a 33% improvement (p < 0.01). Mean cadence (steps/min) increased from 89 ± 9 to 97 ± 8, a 9% increase (p < 0.05). Mean stance and swing duration diminished for both paretic (P) and nonparetic (NP) limbs, and the intralimb stance/swing ratio values moved toward normal for both the paretic and nonparetic limbs. However, these latter changes reached significance only for the P limb. Interlimb stance symmetry was unchanged. The more impaired subjects experienced the greatest gains in gait velocity and temporal measures. Collectively, these findings indicate that treadmill exercise improves functional overground mo bility in individuals with chronic, stable hemiparesis. Key Words: Cerebrovascular disease—Hemiplegia—Exercise—Gait.

scholarly journals Use of and confidence in administering outcome measures among clinical prosthetists: Results from a national survey and mixed-methods training program

2014 ◽  
Vol 39 (4) ◽  
pp. 314-321 ◽  
Author(s):  
Ignacio Gaunaurd ◽  
Susan E Spaulding ◽  
Dagmar Amtmann ◽  
Rana Salem ◽  
Robert Gailey ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Outcome Measures ◽  
Outcome Measure ◽  
Routine Practice ◽  
Timed Up And Go ◽  
Cross Sectional ◽  
Interactive Training ◽  
Study Results ◽  
Before And After ◽  
Formally Trained

Background: Outcome measures can be used in prosthetic practices to evaluate interventions, inform decision making, monitor progress, document outcomes, and justify services. Strategies to enhance prosthetists’ ability to use outcome measures are needed to facilitate their adoption in routine practice. Objective: To assess prosthetists’ use of outcome measures and evaluate the effects of training on their confidence in administering performance-based measures. Study design: Cross-sectional and single-group pretest–posttest survey. Methods: Seventy-nine certified prosthetists (mean of 16.0 years of clinical experience) were surveyed about their experiences with 20 standardized outcome measures. Prosthetists were formally trained by the investigators to administer the Timed Up and Go and Amputee Mobility Predictor. Prosthetists’ confidence in administering the Timed Up and Go and Amputee Mobility Predictor was measured before and after training. Results: The majority of prosthetists (62%) were classified as non-routine outcome measure users. Confidence administering the Timed Up and Go and Amputee Mobility Predictor prior to training was low-to-moderate across the study sample. Training significantly (p < 0.0001) improved prosthetists’ confidence in administering both instruments. Conclusion: Prosthetists in this study reported limited use of and confidence with standardized outcome measures. Interactive training resulted in a statistically significant increase of prosthetists’ confidence in administering the Timed Up and Go and Amputee Mobility Predictor and may facilitate use of outcome measures in clinical practice. Clinical relevance Frequency of outcome measure use in the care of persons with limb loss has not been studied. Study results suggest that prosthetists may not regularly use standardized outcome measures and report limited confidence in administering them. Training enhances confidence and may encourage use of outcome measures in clinical practice.

scholarly journals Serial sarcomere number is substantially decreased within the paretic biceps brachii in individuals with chronic hemiparetic stroke

2021 ◽  
Vol 118 (26) ◽  
pp. e2008597118
Author(s):  
Amy N. Adkins ◽  
Julius P. A. Dewald ◽  
Lindsay P. Garmirian ◽  
Christa M. Nelson ◽  
Wendy M. Murray
Keyword(s):  
Biceps Brachii ◽  
Second Harmonic ◽  
Motor Impairments ◽  
Fascicle Length ◽  
Cross Sectional ◽  
Passive Resistance ◽  
Hemiparetic Stroke ◽  
Chronic Hemiparetic Stroke ◽  
Sarcomere Number

A muscle’s structure, or architecture, is indicative of its function and is plastic; changes in input to or use of the muscle alter its architecture. Stroke-induced neural deficits substantially alter both input to and usage of individual muscles. We combined in vivo imaging methods (second-harmonic generation microendoscopy, extended field-of-view ultrasound, and fat-suppression MRI) to quantify functionally meaningful architecture parameters in the biceps brachii of both limbs of individuals with chronic hemiparetic stroke and in age-matched, unimpaired controls. Specifically, serial sarcomere number (SSN) and physiological cross-sectional area (PCSA) were calculated from data collected at three anatomical scales: sarcomere length, fascicle length, and muscle volume. The interlimb differences in SSN and PCSA were significantly larger for stroke participants than for participants without stroke (P = 0.0126 and P = 0.0042, respectively), suggesting we observed muscle adaptations associated with stroke rather than natural interlimb variability. The paretic biceps brachii had ∼8,200 fewer serial sarcomeres and ∼2 cm2 smaller PCSA on average than the contralateral limb (both P < 0.0001). This was manifested by substantially smaller muscle volumes (112 versus 163 cm3), significantly shorter fascicles (11.0 versus 14.0 cm; P < 0.0001), and comparable sarcomere lengths (3.55 versus 3.59 μm; P = 0.6151) between limbs. Most notably, this study provides direct evidence of the loss of serial sarcomeres in human muscle observed in a population with neural impairments that lead to disuse and chronically place the affected muscle at a shortened position. This adaptation is consistent with functional consequences (increased passive resistance to elbow extension) that would amplify already problematic, neurally driven motor impairments.

scholarly journals Serial sarcomere number is substantially decreased within the paretic biceps brachii in individuals with chronic hemiparetic stroke

2020 ◽  
Author(s):  
Amy N. Adkins ◽  
Julius P.A. Dewald ◽  
Lindsay Garmirian ◽  
Christa M. Nelson ◽  
Wendy M. Murray
Keyword(s):  
Biceps Brachii ◽  
Second Harmonic ◽  
Imaging Techniques ◽  
Muscle Length ◽  
Motor Impairments ◽  
Fascicle Length ◽  
Cross Sectional ◽  
Hemiparetic Stroke ◽  
Chronic Hemiparetic Stroke ◽  
Sarcomere Number

ABSTRACTA muscle’s structure, or architecture, is indicative of its function and is plastic; changes in input to or use of the muscle alter its architecture. Stroke-induced neural deficits substantially alter both input to and usage of individual muscles. Here, we combined novel in vivo imaging methods (second harmonic generation microendoscopy, extended field-of-view ultrasound, and fat-supression MRI) to quantify functionally meaningful muscle architecture parameters in the biceps brachii of both limbs of individuals with chronic hemiparetic stroke and in age-matched, unimpaired controls. Specifically, serial sarcomere number and physiological cross-sectional area were calculated from data collected at three anatomical scales: sarcomere length, fascicle length, and muscle volume. Our data indicate that the paretic biceps brachii had ~8,500 fewer serial sarcomeres compared to the contralateral limb (p=0.0044). In the single joint posture tested, the decreased serial sarcomere number was manifested by significantly shorter fascicles (10.7cm vs 13.6cm; p<0.0001) without significant differences in sarcomere lengths (3.58μm vs. 3.54μm; p=0.6787) in the paretic compared to the contralateral biceps. No interlimb differences were observed in unimpaired controls, suggesting we observed muscle adaptations associated with stroke rather than natural interlimb variability. This study provides the first direct evidence of the loss of serial sarcomeres in human muscle, observed in a population with neural impairments that lead to disuse and chronically place the affected muscle at a shortened position. This adaptation is consistent with functional consequences (increased passive resistance to elbow extension) that would amplify already problematic, neurally driven motor impairments.SIGNIFICANCE STATEMENTSerial sarcomere number determines a muscle’s length during maximum force production and its available length range for active force generation. Skeletal muscle length adapts to functional demands; for example, animal studies demonstrate that chronically shortened muscles decrease length by losing serial sarcomeres. This phenomenon has never been demonstrated in humans. Integrating multi-scale imaging techniques, including two photon microendoscopy, an innovative advance from traditional, invasive measurement methods at the sarcomere scale, we establish that chronic impairments that place a muscle in a shortened position are associated with the loss of serial sarcomeres in humans. Understanding how muscle adapts following impairment is critical to the design of more effective clinical interventions to mitigate such adaptations and to improve function following motor impairments.

scholarly journals Factors related to daily use of the paretic upper limb in patients with chronic hemiparetic stroke–A retrospective cross-sectional study

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0247998
Author(s):  
Syoichi Tashiro ◽  
Miho Kuroki ◽  
Kohei Okuyama ◽  
Osamu Oshima ◽  
Miho Ogura ◽  
...  
Keyword(s):  
Upper Extremity ◽  
Cross Sectional Study ◽  
Chronic Stroke ◽  
Sensory Function ◽  
Stroke Patients ◽  
Cross Sectional ◽  
Explanatory Variables ◽  
Hemiparetic Stroke ◽  
Upper Extremity Rehabilitation ◽  
Chronic Hemiparetic Stroke

Aims The present study aimed to determine factors associated with the frequency of paralyzed upper extremity (UE) use in chronic stroke patients with severe UE functional deficiency. Methods We retrospectively reviewed the medical records of 138 consecutive patients, and 117 was analyzed (median age, 55 [range, 18–85] years; median stroke duration, 24.5 [range, 7–302] months) with chronic hemiparetic stroke who were admitted to our hospital for intensive upper extremity rehabilitation. The mean Fugl-Meyer Assessment (FMA) UE score was 28.6. All of them are independent in their activity of daily living (ADL) and without remarkable cognitive deficits. Amount-of-use score of Motor Activity Log-14 (MAL-AOU) was applied as the index of daily use of affected UE. The following parameters were examined as the explanatory variables: demographics, proximal and distal sub-scores of FMA UE, Modified Ashworth Scale (MAS), and sensory function scores in the Stroke Impairment Assessment Set (SIAS). Results The median MAL-AOU score was 0.57 [range, 0.28–0.80]. Ordinal regression analysis revealed that FMA proximal, FMA distal, and SIAS sensory function (touch) were associated with AOU score of MAL-14 (Pseudo R-square = 0.460). Conclusion Not only motor but also sensory function, especially tactile sensation, play a crucial role in the daily use of affected UE in chronic stroke patients with severe UE hemiparesis.

SUBLINGUAL VITAMIN D3 DRUG THERAPY IN VITAMIN D DEFICIENCY PATIENTS AT PRAVARA RURAL HOSPITAL

2019 ◽  
pp. 18-20
Author(s):  
Sanjeeva Kumar Goud T ◽  
Rahul Kunkulol
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Vitamin D3 ◽  
Serum Vitamin ◽  
Cross Sectional ◽  
Serum Vitamin D ◽  
Significant Difference ◽  
Before And After

The present study was aimed to study the effect of Sublingual Vitamin D3 on Serum Vitamin D level in Vitamin D deficiency patients. This was a cross-sectional and interventional study. All the Vitamin D deficiency patients of age 18-60years and either gender, willing to participate in the study were included. Patients who had greater than 20 ng/ml were excluded from the study. The total number of participants in our study was 200, out of these 111 males and 89 females, the mean age in our study was 51.07 ± 7.39Yrs. All volunteers were given sublingual vitamin D3 (60,000IU) in six doses every fifteen days of follow up for 3 months. The subject’s serum 25(OH)D levels were estimated before and after the treatment of sublingual vitamin D3. There was a statistically significant difference in serum vitamin D3 level before 16.61±6.71 ng/ml and after 35.80±7.80 ng/ml after treatment with Sublingual Vitamin D3. Six doses of 60,000IU of Vitamin D3 sublingual route having improved the role of serum 25(OH)D levels in the treatment of Vitamin D3 deficiency patients.Keywords: Vitamin D3; Sublingual route

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