Paretic and nonparetic step tests are noninterchangeable in stroke: a prospective cohort study

2021 ◽  
Author(s):  
Shamala Thilarajah ◽  
Kelly J Bower ◽  
Gavin Williams ◽  
Ross A Clark ◽  
Dawn Tan ◽  
...  
Keyword(s):  
Physical Function ◽  
Gait Speed ◽  
Dynamic Balance ◽  
Knee Extensor ◽  
Inpatient Rehabilitation ◽  
Step Test ◽  
Timed Up And Go ◽  
Stroke Population ◽  
Knee Extensor Strength ◽  
Computerized Posturography

Abstract Objective The step test (ST) is a common clinical assessment of dynamic balance among survivors of stroke. The ST assesses a person’s ability to place their paretic (paretic ST) or nonparetic (nonparetic ST) foot rapidly and repeatedly on and off a standardized block while standing. No study has formally explored if the 2 tests are interchangeable. Our study aimed to (1) differentiate the correlates of paretic and nonparetic ST and (2) compare their associations with physical function and falls. Methods Eighty-one survivors of stroke were consecutively recruited from inpatient rehabilitation units (n = 4) and were assessed within 1 week prior to discharge. In addition to the ST, a handheld dynamometer and computerized posturography were used to measure lower limb muscle strength and standing balance, respectively. Self-selected gait speed and Timed “Up and Go” (TUG) test were also assessed as measures of physical function. Falls data were monitored for 12 months postdischarge using monthly calendars. Multivariable regression analyses were used to differentiate (1) the correlates of paretic and nonparetic STs and (2) their associations with physical function and falls. Results The median score for the paretic and nonparetic ST were 8 and 9 steps, respectively. Paretic ankle plantar-flexor and dorsiflexor strength were the strongest correlates of nonparetic ST, whereas both paretic ankle and knee extensor strength were the strongest correlates of paretic ST. In multivariable analyses adjusting for each other, both STs were independently associated with gait speed and TUG scores. Paretic ST (odds ratio [OR] = 0.37; 95% CI = 0.22 to 0.62) was a stronger predictor than nonparetic ST (OR = 0.51; 95% CI = 0.34 to 0.78) in predicting future falls. Conclusion This study confirmed that the paretic and nonparetic STs are noninterchangeable. ST scores should be assessed separately to achieve a more complete interpretation. Impact This study is the first to objectively evaluate the similarities and differences between the paretic and nonparetic STs. This information may refine the use and interpretation of the 2 STs in the stroke population.

scholarly journals Balance a few years after total hip replacement

2019 ◽  
Author(s):  
Agnieszka Wareńczak ◽  
Przemysław Lisiński
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Dynamic Balance ◽  
Berg Balance Scale ◽  
Step Test ◽  
Control Group ◽  
Timed Up And Go ◽  
Total Hip ◽  
Functional Reach ◽  
Functional Reach Test

Abstract Background: The aim of the study was to conduct a long-term evaluation of whether total hip replacement permanently affects the quality of postural reactions and body balance. Material and methods: The unilateral Total Hip Replacement (THR) group consisted of 30 subjects (mean age: 69.4). The control group consisted of 30 healthy subjects (mean age: 68.8). The force platform and functional tests such as Timed Up and Go, 3m walk test, Functional Reach Test, 30s Chair Stand Test, Step Test and Berg Balance Scale were used to assess dynamic balance. Results: Subjects from the study group exhibited significantly increased time (p=0.002) and distance (p=0.012) in the tests performed on the force platform compared to the control group. We also observed worse balance and functional test scores in the THR group: Timed Up and Go test (p<0.001), 3m walk test (p<0.001), Functional Reach Test (p=0.003), 30s Chair Stand Test (p=0.002) and Step Test (operated leg: p<0.001, non-operated leg: p=0.002). The results obtained in the Berg Balance Scale tests were not significantly different between the groups (p=0.597). Conclusions: Our research shows that total hip replacement permanently impairs patients’ dynamic balance and functionality in certain lower-extremity activities. Keywords: balance, total hip replacement, gait, muscle strength

scholarly journals The Effect of Pilates Training on the Balance of Elderly

2019 ◽  
Vol 1 (16) ◽  
Author(s):  
Kristina Zaičenkovienė ◽  
Renata Rakovaitė
Keyword(s):  
Dynamic Balance ◽  
Step Test ◽  
Control Group ◽  
Static Balance ◽  
Study Group ◽  
Timed Up And Go ◽  
Physically Active ◽  
Before And After ◽  
Four Square ◽  
And Control

Research background. Falling is one of the most important problems in the elderly’s mobility disorder, which is most often affected by the loss of balance. It is known that Pilates exercises could help to increase the deep muscle strength, improve posture and proprioception, which affects the improvement of the balance. Objective – to evaluate the effects of Pilates exercises on the elderly’s static and dynamic balance. Methodology. The study population consisted of 20 volunteers, men and women, who were divided into Pilates exercises (n = 10, age 65.1 ± 2.6) and control (n = 10, age 68.6 ± 4.9) groups. The study group participated in Pilates classes 2 times per week for six weeks (session duration 60 minutes). The control group did not participate in any physical activity, but they were physically active as usually in their daily life. The main outcome measures were assessed before and after the intervention. The static balance was assessed by measuring posturographic parameters using the force platform, dynamic balance was measured with the Timed up and Go Test (TUG) and the Four Square Step Test (FSST). Results. The results showed signifcant improvement in static balance of the experimental group after the Pilates exercises during standing tests when the feet were apart, eyes opened and closed and when the feet together with eyes opened, and when the foot was in front of the other foot. The results of the control group did not differ during both tests. The results of both groups did not differ in the static balance tests before and after the study, but after the Pilates exercises, the results of the Pilates group signifcantly differed from the control group test results when the feet were in shoulder line with open eyes. The results of the dynamic balance after Pilates exercises signifcantly improved in both tests in the study group. Before the study, there were not statistically signifcant differences in the dynamic balance results between the groups. Conclusions. Six-week Pilates exercises had a positive effect on the elderly’s static and dynamic balance.Keywords: Pilates training, static balance, dynamic balance.

scholarly journals Associations of knee extensor strength and standing balance with physical function in knee osteoarthritis

2011 ◽  
Vol 63 (12) ◽  
pp. 1706-1714 ◽  
Author(s):  
Yong-Hao Pua ◽  
Zhiqi Liang ◽  
Peck-Hoon Ong ◽  
Adam L. Bryant ◽  
Ngai-Nung Lo ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Physical Function ◽  
Knee Extensor ◽  
Standing Balance ◽  
Knee Extensor Strength

Comparison of Training between 2 Cycle Ergometers on Dynamic Balance for Middle-Aged Women

2009 ◽  
Vol 18 (2) ◽  
pp. 316-326 ◽  
Author(s):  
Lucinda E. Bouillon ◽  
Douglas K. Sklenka ◽  
Amy C. Driver
Keyword(s):  
Outcome Measures ◽  
Repeated Measures ◽  
Dynamic Balance ◽  
Step Test ◽  
Control Group ◽  
Middle Aged ◽  
Timed Up And Go ◽  
Balance Tests ◽  
Cycle Training ◽  
Cycle Group

Context:Interval cycle training could positively influence dynamic balance in middle-aged women.Objective:To compare training effects of a strength ergometer and a standard ergometer on 3 dynamic balance tests.Design:Repeated measures.Setting:Laboratory.Participants:Seventeen women were randomly assigned to standard (n = 10) or strength cycle ergometry (n = 7). A control group consisted of 7 women.Intervention:Ergometry interval training (3 sessions/wk for 4 wk).Main Outcome Measures:Three balance tests—the Star Excursion Balance Test (SEBT), timed up-and-go (TUG), and four-square step test (FSST)—were performed at pretraining and 4 wk posttraining.Results:Four SEBT directions improved and faster scores for FSST and TUG tests for the standard-cycle group were found, whereas the strength-cycle group only improved their TUG scores. No changes posttraining for the control group.Conclusions:Stationary cycle training should be included in the dynamic balance-rehabilitation protocol for middle-aged women.

scholarly journals Olfaction and Physical Function in Older Adults: Findings From Health ABC

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 530-531
Author(s):  
Yaqun Yuan ◽  
Zhehui Luo ◽  
Chenxi Li ◽  
Eleanor Simonsick ◽  
Eric Shiroma ◽  
...  
Keyword(s):  
Older Adults ◽  
Physical Function ◽  
Physical Performance ◽  
Physical Functioning ◽  
Knee Extensor ◽  
Community Dwelling ◽  
Potential Health ◽  
Knee Extensor Strength ◽  
Race Disparities

Abstract The present study aims to investigate poor olfaction in relation to physical functioning in community-dwelling older adults and potential sex and race disparities. The analysis included 2511 participants aged 71-82 years (51.7% women and 38.4% blacks) from the Health Aging, and Body Composition (Health ABC) study. Olfaction was tested with the 12-item Brief Smell Identification Test (BSIT). Physical function measures included the Short Physical Performance Battery (SPPB), the Health ABC Physical Performance Battery (HABCPPB), gait speed of 20-meter walk, fast 400-meter walking time, grip strength, and knee extensor strength, repeatedly assessed annually or biennially for a follow-up of seven years. We analyzed each of these physical function measures using mixed models, adjusting for demographics, lifestyle, and comorbidities. For all measures except grip and knee extensor strength, poor olfaction was clearly associated with poorer physical performance at baseline and a faster decline over time. For example, at baseline, the multivariate adjusted SPPB was 8.23 ± 0.09 for participants with poor olfaction and 8.55 ± 0.09 for those with good olfaction (P = 0.02), after seven years of follow-up, the corresponding scores decreased to 6.46 ± 0.12 and 7.36 ± 0.10 respectively (cross-sectional P&lt;0.001, and P for olfaction-by-year interaction &lt; 0.001). For grip and knee extensor strength, similar differences were suggested but didn’t reach statistical significance. The overall results were similar by sex and race. In summary, poor olfaction is clearly associated with faster decline in physical functioning in older adults and future studies should investigate its potential health implications.

Fall Risk Factors in Older Female Lawn Bowls Players and Controls

2008 ◽  
Vol 17 (1) ◽  
pp. 123-130 ◽  
Author(s):  
Katherine Brooke-Wavell ◽  
Victoria C. Cooling
Keyword(s):  
Risk Factors ◽  
Range Of Motion ◽  
Fall Risk ◽  
Ultrasonic Attenuation ◽  
Balance Training ◽  
Knee Extensor ◽  
Time Range ◽  
Timed Up And Go ◽  
Fall Risk Factors ◽  
Knee Extensor Strength

Fall-risk factors were compared between older women who regularly participate in lawn bowls and controls. Participants were 74 healthy women age 60–75 yr. Postural stability, timed up-and-go score, isometric knee-extensor strength, reaction time, range of motion, and calcaneal broadband ultrasonic attenuation (BUA) were assessed. Bowlers and controls were similar in regard to mean age, height, and weight. Regular bowlers had significantly lower timed up-and-go times, reaction times, and sway while standing on a compliant surface. They had significantly higher knee-extensor strength, range of motion at ankle and shoulder, and calcaneal BUA. Although targeted strength and balance training might be necessary in treatment of the physical frailty that can contribute to falls and fractures in older people, it is possible that long-term participation in activity such as lawn bowls could help prevent this frailty.

scholarly journals Step Test Scores Are Related to Measures of Activity and Participation in the First 6 Months After Stroke

2009 ◽  
Vol 89 (10) ◽  
pp. 1061-1071 ◽  
Author(s):  
Vicki Stemmons Mercer ◽  
Janet Kues Freburger ◽  
Shuo-Hsiu Chang ◽  
Jama L. Purser
Keyword(s):  
Motor Control ◽  
Lower Extremity ◽  
Physical Function ◽  
Gait Speed ◽  
Short Form ◽  
Small Sample Size ◽  
Small Sample ◽  
Stroke Recovery ◽  
Step Test ◽  
Additional Step

Background: The Step Test (ST) is a measure of dynamic standing balance and paretic–lower-extremity motor control in patients with stroke. Little is known about the extent to which impairments assessed by the ST relate to activity and participation during stroke recovery.Objective: The purpose of this study was to determine relationships between ST scores and measures of activity and participation during the first 6 months after stroke.Design: This was a prospective cohort study.Methods: Thirty-three individuals (18 men, 15 women) with a diagnosis of a single, unilateral stroke participated in the study. Participants were tested one time per month from 1 to 6 months poststroke. The ST was considered an impairment-level measure. Self-selected gait speed and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) Physical Function Index (PFI) were used to assess physical function. Three domains (mobility, basic and instrumental activities of daily living, participation) of the Stroke Impact Scale were used to assess self-reported disability. Regression analyses were conducted to examine the bivariate associations between ST scores and each physical function and disability measure at each time point (1–6 months).Results: The ST scores were positively associated with both physical function measures. The associations were stronger for self-selected gait speeds (R2=.60–.79) than for the PFI scores (R2=.32–.60). During the first 6 months after stroke, each additional step with the paretic lower extremity on the ST corresponded to a 0.07-m/s to 0.09-m/s increase in gait speed, and each additional step with the nonparetic lower extremity was associated with a 0.07-m/s to 0.08-m/s gait speed increase. The impairment-disability associations were weaker than the impairment-physical function associations.Limitations: Limitations of the study include a relatively small sample size and lack of examiner blinding with regard to participant characteristics.Conclusions: Impairments in balance and paretic–lower-extremity motor control, as measured by the ST, relate to physical function and disability during the first 6 months following stroke.

Muscle-Strength and Gait-Speed Changes after Bicycle Exercise in Participants with Unilateral CVA

2001 ◽  
Vol 9 (4) ◽  
pp. 386-397 ◽  
Author(s):  
Karen L. Perell ◽  
Robert J. Gregor ◽  
A.M. Erika Scremin
Keyword(s):  
Muscle Strength ◽  
Gait Speed ◽  
Knee Extensor ◽  
Eccentric Contraction ◽  
Knee Extensors ◽  
Bicycle Exercise ◽  
Contralateral Limb ◽  
Knee Extensor Strength ◽  
Walking Tests ◽  
Knee Muscle

The purpose of this study was to determine the effect of bicycle exercise on knee-muscle strength and gait speed in 8 male participants with cerebrovascular accident (CVA). Isokinetic knee-extensor and -flexor strength were measured in both concentric- and eccentric-contraction modes. Fifty-foot walking tests were used for gait speed. After only 4 weeks of stationary recumbent cycling (12 sessions), participants improved eccentric muscle strength of the knee extensors, bilaterally. Walking-speed improvements approached but did not achieve significance with training. Improvement in concentric muscle strength of the knee extensors was observed in the involved limb, although most participants demonstrated a nonsignificant increase in muscle strength in the contralateral limb, as well. No improvements were demonstrated in the knee-flexor muscles. Thus, bicycle exercise serves to improve knee-extensor strength. In addition, these strength improvements might have implications for better control of walking in terms of bilateral improvement of eccentric muscle strength.

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