The Effect of Water-Based Therapy Compared to Land-Based Therapy on Balance and Gait Parameters of Patients with Stroke: A Systematic Review

2021 ◽  
pp. 1-9
Author(s):  
Nour Zughbor ◽  
Aisha Alwahshi ◽  
Rahaf Abdelrahman ◽  
Zeina Elnekiti ◽  
Hoda Elkareish ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Berg Balance Scale ◽  
Primary Outcome Measure ◽  
Balance System ◽  
Effect Of Water ◽  
Gait Parameters ◽  
Water Based ◽  
Biodex Balance System ◽  
Therapy Studies ◽  
The Brain

<b><i>Introduction:</i></b> Stroke is defined as the lack of blood supply to the brain, leading to rapid loss of brain function presenting with impairments such as muscle weakness, spasticity, lack of coordination, and proprioception loss. Both hydrotherapy and land-based therapy aim to target these aspects in the process of rehabilitation. The study aims to determine the effectiveness of water-based therapy on balance and gait of patients with stroke compared to land-based therapy. <b><i>Methods:</i></b> Data for this review were extracted from databases such as CINAHL, OTseeker, Ovid, PEDro, and PubMed (MEDLINE) and other sources such as Google Scholar. PRISMA guidelines were followed to exclude irrelevant studies. Only randomized controlled trials (RCTs) were included, and methodological quality was assessed using the PEDro scale. A meta-analysis of extracted data was conducted. <b><i>Results:</i></b> A total of 16 relevant RCTs were included for the review (<i>n</i> = 412 participants). All RCTs investigated the effect of water-based therapy compared to land-based therapy on balance and gait of patients with stroke. Meta-analysis of studies that used the Berg Balance Scale (BBS) as a primary outcome measure favored land-based therapy. Studies that used the Good Balance System (GBS) and the Biodex Balance System (BioBS) to measure the changes in anteroposterior sway and mediolateral sway favored water-based therapy. The overall pooled effect favored land-based therapy in improving gait parameters. <b><i>Conclusion:</i></b> Findings from meta-analysis support the effectiveness of land-based therapy in the improvement of balance and gait parameters of patients with stroke. However, the evidence for water-based therapy continues to be limited, and higher quality studies are required to determine the effectiveness of water-based therapy on patients with stroke, particularly on balance and gait.

scholarly journals The responsiveness of gait and balance outcomes to disease progression in Friedreich ataxia

2021 ◽  
Author(s):  
Sarah C Milne ◽  
Seok Hun Kim ◽  
Anna Murphy ◽  
Jane Larkindale ◽  
Jennifer Farmer ◽  
...  
Keyword(s):  
Effect Size ◽  
Rating Scale ◽  
Friedreich Ataxia ◽  
Correlation Coefficients ◽  
Berg Balance Scale ◽  
Therapeutic Effects ◽  
Balance System ◽  
Gait Parameters ◽  
Wide Range ◽  
Daily Step Count

Objective: To identify gait and balance measures that are responsive to change during the timeline of a clinical trial in Friedreich ataxia (FRDA) we administered a battery of potential measures three times over a 12-month period. Methods: Sixty-one ambulant individuals with FRDA underwent assessment of gait and balance at baseline, six months and 12 months. Outcomes included: GAITRite spatiotemporal gait parameters; Biodex Balance System Postural Stability Test (PST) and Limits of Stability; Berg Balance Scale (BBS); Timed 25 Foot Walk Test; Dynamic Gait Index (DGI); SenseWear MF Armband step and energy activity; and the Friedreich Ataxia Rating Scale Upright Stability Subscale (FARS USS). The standardised response mean (SRM) or correlation coefficients were reported as effect size indices for comparison of internal responsiveness. Internal responsiveness was also analysed in subgroups. Results: SenseWear Armband daily step count had the largest effect size of all the variables over six months (SRM=-0.615), while the PST medial-lateral index had the largest effect size (SRM=0.829) over 12 months. The FARS USS (SRM=0.824) and BBS (SRM=-0.720) were the only outcomes able to detect change over 12 months in all subgroups. The DGI was the most responsive outcome in children, detecting a mean change of -2.59 (95% CI -3.52 to -1.66, p<0.001, SRM=-1.429). Conclusions: The FARS USS and BBS are highly responsive and can detect change in a wide range of ambulant individuals with FRDA. However, therapeutic effects in children may be best measured by the DGI.

scholarly journals Effect of balance training with Biodex Balance System to improve balance in patients with diabetic neuropathy: A quasi experimental study

2021 ◽  
Vol 37 (2) ◽  
Author(s):  
Syeda Afsheen Hasnain Daud ◽  
Mujeeb Ur Rahman ◽  
Aatik Arsh ◽  
Muhammad Junaid
Keyword(s):  
Experimental Study ◽  
Diabetic Neuropathy ◽  
Balance Training ◽  
Berg Balance Scale ◽  
Post Treatment ◽  
Diabetes Mellitus Type Ii ◽  
Balance System ◽  
Treatment Data ◽  
Quasi Experimental ◽  
Biodex Balance System

Objective: To determine the effect of balance training with Biodex Balance System in improving balance function in patients with diabetic neuropathy. Methods: A quasi experimental study was conducted at physiotherapy department of Rehman Medical Institute Peshawar from January to June 2018. Thirty-eight Diabetes Mellitus Type-II patients with diagnosis of diabetic neuropathy participated in the study. Those patients were included who were able to stand independently and who scored moderate or severe neuropathy on Toronto Scale. Participants received 12 sessions (two sessions per week) of balance training on Biodex stability system in six weeks. Berg Balance Scale and Time Up and Go test were used to collect pre and post treatment data. Paired sample T-test was used to compare pre and post treatment data because data was normally distributed. Results: The mean age of the participants was 63.08 ± 3.3 years. Pretreatment Berg Balance Scale score was 42.68 ± 3.7 which improved to 48.89 ±3.7 after the treatment (P<0.001). Similarly, pretreatment Time Up and Go test score was 17.47 ± 2.0 while post treatment score was 13.57 ±1.5 (P<0.001). Conclusion: Balance training with Biodex Balance System can significantly improve balance function in Diabetes Mellitus Type-II patients with diabetic neuropathy. doi: https://doi.org/10.12669/pjms.37.2.2336 How to cite this:Daud SAH, Mujeeb-Ur-Rahman, Arsh A, Junaid M. Effect of balance training with Biodex Balance System to improve balance in patients with diabetic neuropathy: A quasi experimental study. Pak J Med Sci. 2021;37(2):---------.  doi: https://doi.org/10.12669/pjms.37.2.2336 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Morphological Changes in the Brain of Acutely Ill and Weight-Recovered Patients with Anorexia Nervosa

2014 ◽  
Vol 42 (1) ◽  
pp. 7-18 ◽  
Author(s):  
Jochen Seitz ◽  
Katharina Bühren ◽  
Georg G. von Polier ◽  
Nicole Heussen ◽  
Beate Herpertz-Dahlmann ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Cognitive Deficits ◽  
Time Course ◽  
Morphological Changes ◽  
Meta Analysis ◽  
Short Term ◽  
Clinical Prognosis ◽  
Qualitative Review ◽  
Brain Changes ◽  
The Brain

Objective: Acute anorexia nervosa (AN) leads to reduced gray (GM) and white matter (WM) volume in the brain, which however improves again upon restoration of weight. Yet little is known about the extent and clinical correlates of these brain changes, nor do we know much about the time-course and completeness of their recovery. Methods: We conducted a meta-analysis and a qualitative review of all magnetic resonance imaging studies involving volume analyses of the brain in both acute and recovered AN. Results: We identified structural neuroimaging studies with a total of 214 acute AN patients and 177 weight-recovered AN patients. In acute AN, GM was reduced by 5.6% and WM by 3.8% compared to healthy controls (HC). Short-term weight recovery 2–5 months after admission resulted in restitution of about half of the GM aberrations and almost full WM recovery. After 2–8 years of remission GM and WM were nearly normalized, and differences to HC (GM: –1.0%, WM: –0.7%) were no longer significant, although small residual changes could not be ruled out. In the qualitative review some studies found GM volume loss to be associated with cognitive deficits and clinical prognosis. Conclusions: GM and WM were strongly reduced in acute AN. The completeness of brain volume rehabilitation remained equivocal.

A systematic review and meta-analysis on efficacy of exercise on posture and balance in patients suffering from Diabetic Neuropathy

2020 ◽  
Vol 16 ◽  
Author(s):  
Neerja Thukral ◽  
Jaspreet Kaur ◽  
Manoj Malik
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Neuropathy ◽  
Meta Analysis ◽  
Berg Balance Scale ◽  
Risk Of Bias ◽  
Core Stability ◽  
Balance Scale ◽  
Eyes Closed ◽  
Significant Difference ◽  
Eyes Open

Background: Peripheral neuropathy is a major and chronic complication of diabetes mellitus affecting more than 50% of patients suffering from diabetes. There is involvement of both large and small diameter nerve fibres leading to altered somatosensory and motor sensations, thereby causing impaired balance and postural instability. Objective: To assess the effects of exercises on posture and balance in patients suffering from diabetes mellitus. Method: Mean changes in Timed Up and Go test(TUGT), Berg Balance Scale and Postural Sway with eyes open and eyes closed on Balance System were primary outcome measures. RevMan 5.3 software was used for the meta-analyses. Eighteen randomized controlled trials met the selection criteria and were included in the study. All the studies ranked high on PEDro Rating scale. Risk of bias was assessed by Cochrane collaboration tool of risk of bias. Included studies had low risk of bias. Sixteen RCT’s were included for the meta-analysis. Result: Results of meta-analysis showed that there was statistically significant improvement in TUGT with p≤ 0.05 and substantial heterogeneity (I 2 = 84%, p < 0.00001) in experimental group as compared to control group. There was statistically significant difference in Berg Balance Scale scores and heterogeneity of I 2 = 62%, p < 0.00001 and significant changes in postural stability (eyes open heterogeneity of I 2 = 100%, p =0.01 and eyes closed, heteogeneity I 2 = 0%, p =0.01). Sensitivity analysis causes change in heterogeneity. Conclusion: It can be concluded that various exercises like balance training, core stability, Tai-Chi, proprioceptive training etc. have a significant effect in improving balance and posture in diabetic neuropathy.

The Auditory Brainstem Implant

2019 ◽  
pp. 758-770
Author(s):  
Robert V. Shannon
Keyword(s):  
Surgical Technique ◽  
Cochlear Nucleus ◽  
Meta Analysis ◽  
Auditory Brainstem ◽  
Auditory Information ◽  
Speech Understanding ◽  
Auditory Neurons ◽  
Auditory Brainstem Implant ◽  
The Brain ◽  
Implanted Device

The auditory brainstem implant (ABI) is a surgically implanted device to electrically stimulate auditory neurons in the cochlear nucleus complex of the brainstem in humans to restore hearing sensations. The ABI is similar in function to a cochlear implant, but overall outcomes are poorer. However, recent applications of the ABI to new patient populations and improvements in surgical technique have led to significant improvements in outcomes. While the ABI provides hearing benefits to patients, the outcomes challenge our understanding of how the brain processes neural patterns of auditory information. The neural pattern of activation produced by an ABI is highly unnatural, yet some patients achieve high levels of speech understanding. Based on a meta-analysis of ABI surgeries and outcomes, a theory is proposed of a specialized sub-system of the cochlear nucleus that is critical for speech understanding.

Noninvasive brain stimulation for patients with a disorder of consciousness: a systematic review and meta-analysis

2020 ◽  
Vol 31 (8) ◽  
pp. 905-914 ◽  
Author(s):  
Yali Feng ◽  
Jiaqi Zhang ◽  
Yi Zhou ◽  
Zhongfei Bai ◽  
Ying Yin
Keyword(s):  
Brain Stimulation ◽  
Meta Analysis ◽  
Minimally Conscious State ◽  
Conscious State ◽  
Primary Outcome Measure ◽  
Noninvasive Brain Stimulation ◽  
Disorder Of Consciousness ◽  
Left Dlpfc ◽  
Dorsolateral Prefrontal ◽  
Minimally Conscious

AbstractNoninvasive brain stimulation (NIBS) techniques have been used to facilitate the recovery from prolonged unconsciousness as a result of brain injury. The aim of this study is to systematically assess the effects of NIBS in patients with a disorder of consciousness (DOC). We searched four databases for any randomized controlled trials on the effect of NIBS in patients with a DOC, which used the JFK Coma Recovery Scale-Revised (CRS-R) as the primary outcome measure. A random-effects meta-analysis was conducted to pool effect sizes. Fourteen studies with 273 participants were included in this review, of which 12 studies with sufficient data were included in the meta-analysis. Our meta-analysis showed a significant effect on increasing CRS-R scores in favor of real stimulation as compared to sham (Hedges’ g = 0.522; 95% confidence interval [CI], 0.318–0.726; P < 0.0001, I2 = 0.00%). Subgroup analysis demonstrated that only anodal transcranial direct current stimulation (tDCS) of the left dorsolateral prefrontal cortex (DLPFC) significantly enhances the CRS-R scores in patients with a DOC, as compared to sham (Hedges’ g = 0.703; 95% CI, 0.419–0.986; P < 0.001), and this effect was predominant in patients in a minimally conscious state (MCS) (Hedges’ g = 0.815; 95% CI, 0.429–1.200; P < 0.001). Anodal tDCS of the left DLPFC appears to be an effective approach for patients with MCS.

scholarly journals Validation of a Laser Ranged Scanner-Based Detection of Spatio-Temporal Gait Parameters Using the aTUG Chair

Sensors ◽  
2021 ◽  
Vol 21 (4) ◽  
pp. 1343
Author(s):  
Sebastian Fudickar ◽  
Jörn Kiselev ◽  
Christian Stolle ◽  
Thomas Frenken ◽  
Elisabeth Steinhagen-Thiessen ◽  
...  
Keyword(s):  
Correlation Coefficient ◽  
Measurement Accuracy ◽  
Dynamic Balance ◽  
Step Length ◽  
Berg Balance Scale ◽  
Walking Ability ◽  
Functional Requirements ◽  
Balance Confidence ◽  
Gait Parameters ◽  
Abc Scale

This article covers the suitability to measure gait-parameters via a Laser Range Scanner (LRS) that was placed below a chair during the walking phase of the Timed Up&Go Test in a cohort of 92 older adults (mean age 73.5). The results of our study demonstrated a high concordance of gait measurements using a LRS in comparison to the reference GAITRite walkway. Most of aTUG’s gait parameters demonstrate a strong correlation coefficient with the GAITRite, indicating high measurement accuracy for the spatial gait parameters. Measurements of velocity had a correlation coefficient of 99%, which can be interpreted as an excellent measurement accuracy. Cadence showed a slightly lower correlation coefficient of 96%, which is still an exceptionally good result, while step length demonstrated a correlation coefficient of 98% per leg and stride length with an accuracy of 99% per leg. In addition to confirming the technical validation of the aTUG regarding its ability to measure gait parameters, we compared results from the GAITRite and the aTUG for several parameters (cadence, velocity, and step length) with results from the Berg Balance Scale (BBS) and the Activities-Specific Balance Confidence-(ABC)-Scale assessments. With confidence coefficients for BBS and velocity, cadence and step length ranging from 0.595 to 0.798 and for ABC ranging from 0.395 to 0.541, both scales demonstrated only a medium-sized correlation. Thus, we found an association of better walking ability (represented by the measured gait parameters) with better balance (BBC) and balance confidence (ABC) overall scores via linear regression. This results from the fact that the BBS incorporates both static and dynamic balance measures and thus, only partly reflects functional requirements for walking. For the ABC score, this effect was even more pronounced. As this is to our best knowledge the first evaluation of the association between gait parameters and these balance scores, we will further investigate this phenomenon and aim to integrate further measures into the aTUG to achieve an increased sensitivity for balance ability.

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