Abstract TP162: The Therapeutic Effects of Peroneal Nerve Functional Electric Stimulation for Lower Extremity in Patients With Sub-Acute Post-Stroke Hemiplegia: A Randomized Controlled Study

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Shuji Matsumoto ◽  
Megumi Shimodozono
Keyword(s):  
Electrical Stimulation ◽  
Patient Satisfaction ◽  
Functional Recovery ◽  
Foot Drop ◽  
Controlled Study ◽  
Control Group ◽  
Therapeutic Effects ◽  
Walk Test ◽  
Stroke Patients ◽  
Orthotic Device

Background and Aims: The functional electrical stimulation (FES) is the electrical stimulation of a muscle deprived of nervous control for providing muscular contraction and thereby producing a functionally useful movement. FES is particularly effective for treating foot drop caused by stroke. The purpose of this study was to investigate the effect of WalkAide FES system on functional recovery and activities of daily living (ADL) in stroke patients with foot drop. Methods: Participants (n=203; 49 females and 154 males; time after stroke 61.6±31.5 days) were randomized to either FES group or the control group. All subjects participated in the same standard rehabilitation program. In addition, FES group participated in FES training for 40 mins per day, five times a week, for 8 weeks, and those in the control group participated in the usual physical therapy including gait re-education, gait training with an orthotic device, and muscle stretching. Functional recovery was assessed using 6-min walk test (6MWT), active range of motion of ankle dorsiflexion (A-ROM), and Timed Up and Go test (TUG). ADL was assessed using 10-m walk test (10MWT), Stroke Impact Scale (SIS), and patient satisfaction. Results: After intervention, there were significant improvements in 6MWT, TUG, 10MWT, SIS compared to baseline in both groups (p< 0.0001). The significant improvement in A-ROM was demonstrated only in FES group. At follow-up, AROM showed significant improvements in the FES group compared to the control group (p= 0.0011). However, when comparing average change scores from baseline to end of treatment, significant differences were noted only for the A-ROM scores. Stroke patients preferred the use of an electrical stimulation orthotic substitute device to an orthotic device, according to the questionnaire of patient satisfaction (p< 0.0001). Conclusions: The findings of the current study demonstrated the efficacy of FES on the functional recovery and ADL, and also showed the feasibility of applying FES for dropped foot during the convalescent phase of recovery after stroke. These results suggest that long-term FES use may lead to additional improvements in walking endurance and functional ambulation; further research is needed to confirm these findings.

scholarly journals Effect of Posterior Pelvic Tilt Taping on Pelvic Inclination, Muscle Strength, and Gait Ability in Stroke Patients: A Randomized Controlled Study

2021 ◽  
Vol 10 (11) ◽  
pp. 2381
Author(s):  
Tae-sung In ◽  
Jin-hwa Jung ◽  
May Kim ◽  
Kyoung-sim Jung ◽  
Hwi-young Cho
Keyword(s):  
Muscle Strength ◽  
Pelvic Tilt ◽  
Controlled Study ◽  
Control Group ◽  
Walk Test ◽  
Stroke Patients ◽  
Randomized Controlled ◽  
Pelvic Inclination ◽  
Stair Walking ◽  
10 Meter Walk Test

Objective: Pelvic alignment asymmetry in stroke patients negatively affects postural control ability. This study aimed to investigate the effect of posterior pelvic tilt taping on pelvic inclination, muscle strength, and gait ability in stroke patients. Methods: Forty stroke patients were recruited and randomly divided into the following two groups: the posterior pelvic tilt taping (PPTT) group (n = 20) and the control group (n = 20). All participants underwent sitting-to-standing, indoor walking, and stair walking training (30 min per day, 5 days per week, for 6 weeks). The PPTT group applied posterior pelvic tilt taping during the training period, while the control group did not receive a tape intervention. Pelvic inclination was measured using a palpation meter (PALM). A hand-held dynamometer and the 10-meter walk test were used to measure muscle strength and gait ability. Results: Significantly greater improvements in the pelvic anterior tilt were observed in the PPTT group than in the control group (p < 0.05). Muscle strength in the PPTT group was significantly increased compared to the control group (p < 0.05). Significantly greater improvements in gait speed were observed in the PPTT group than the control group. Conclusions: According to our results, posterior pelvic tilt taping may be used to improve the anterior pelvic inclination, muscle strength, and gait ability in stroke patients.

Clinical effectiveness of peroneal nerve functional electrical stimulation in chronic stroke patients with hemiplegia (PLEASURE): A multicentre, prospective, randomised controlled trial

2020 ◽  
pp. 026921552096670
Author(s):  
Kenji Hachisuka ◽  
Mitsuhiro Ochi ◽  
Takashi Kikuchi ◽  
Satoru Saeki
Keyword(s):  
Peroneal Nerve ◽  
Controlled Trial ◽  
Gait Training ◽  
Foot Drop ◽  
Control Group ◽  
Walk Test ◽  
Stroke Patients ◽  
Control Groups ◽  
Secondary Endpoints ◽  
And Control

Objective: To compare the effectiveness of gait training using a peroneal nerve stimulation device with the effectiveness of gait training without the device in improving gait ability and ankle-specific body functions. Design: Multicentre, prospective, randomised, open-label trial. Setting: Twenty-three hospitals. Subjects: In total, 119 stroke patients with foot drop were randomly assigned to the experimental (with the device) or control (without the device) group. Intervention: Subjects underwent 480-minute self-directed training over four weeks, followed by 260-minute physical therapist-assisted gait training with or without the device. Main measures: The primary endpoint was a change in the six-minute walk test (6MWT) without the device from baseline to after the four-week intervention. The secondary endpoints were changes in the 10-metre walk test (10MWT) without the device, Fugl-Meyer Assessment, range of motion, muscle strength, Modified Ashworth Scale, Stroke Impact Scale Japanese edition (J-SIS) and adverse events. Results: Fifty-six experimental and 59 control group participants, with an average age of 59 years (SD 12) completed the trial. The 6MWT distance changes (m) for the experimental and control groups were 14.7 (SD 37.6) and 22.2 (SD 49.3), respectively. The 10MWT speed changes (m/sec) for the experimental and control groups were 0.06 (SD 0.12) and 0.07 (SD 0.17), respectively. No significant differences were observed in these changes between both groups, and no differences were found in the other secondary endpoints, except for the J-SIS patient’s subjective assessment ( P = 0.048). Conclusion: The improvement in gait ability and body functions were equivalent with or without the use of the device.

scholarly journals Functional electrical stimulation reduces pain and shoulder subluxation in chronic post-stroke patients?

2020 ◽  
pp. 1-5
Author(s):  
Willian Vasconcellos da Silva ◽  
Gabriele Natane de Medeiros Cirne ◽  
Edson Meneses da Silva Filho ◽  
Enio Walker Azevedo Cacho ◽  
Johnnatas Mikael Lopes ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Functional Electrical Stimulation ◽  
Total Duration ◽  
Chronic Phase ◽  
Control Group ◽  
Mcgill Pain Questionnaire ◽  
Therapeutic Effects ◽  
Stroke Patients ◽  
Post Stroke ◽  
Scale Scores

Background: Shoulder subluxation is a common complication of cerebral vascular accident (stroke) and the use of Functional Electrical Stimulation (FES) within the rehabilitation process is extremely important. Objective: To analyze the therapeutic effects of FES in the treatment of chronic shoulder subluxation in post-stroke patients. Method: This is a case study of patients with radiologically subluxation confirmed, who were randomly divided into two groups: Control Group (CG) and Treatment Group (TG). Patients were assessed before and after treatment and at the 2-month follow-up. The assessment consisted of the modified Ashworth scale; passive goniometry; Fugl-Meyer scale; McGill pain questionnaire and evaluation of shoulder subluxation by radiography. The CG did not receive physiotherapeutic intervention; and TG underwent 20 sessions of motor kinesiotherapy and FES associated with functional exercises with a total duration of 1 hour, three times a week, for 7 weeks. The data were analyzed descriptively. Results: The mean age of CG participants was 82.5 ± 1.5 years and of the TG was 70.5 ± 13.5 years. All of them were retired, sedentary, non-smokers/alcoholics and had hemiparesis on the left side. There was an approximate increase of 10o for most joint movements of the shoulder, improvement in McGill scale scores and reduction of shoulder subluxation in TG patients. Conclusion: FES associated with functional movements was effective in reducing the degree of subluxation of the shoulder joint and decreased pain in subjectsin the chronic phase of the post-stroke.

scholarly journals Impact of Somatosensory Training on Neural and Functional Recovery of Lower Extremity in Patients with Chronic Stroke: A Single Blind Controlled Randomized Trial

2021 ◽  
Vol 18 (2) ◽  
pp. 583
Author(s):  
Reem M. Alwhaibi ◽  
Noha F. Mahmoud ◽  
Mye A. Basheer ◽  
Hoda M. Zakaria ◽  
Mahmoud Y. Elzanaty ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Lower Extremity ◽  
Functional Recovery ◽  
Intervention Group ◽  
Chronic Stroke ◽  
Post Treatment ◽  
Control Group ◽  
Stroke Patients ◽  
Significant Difference ◽  
Group Post

Recovery of lower extremity (LE) function in chronic stroke patients is considered a barrier to community reintegration. An adequate training program is required to improve neural and functional performance of the affected LE in chronic stroke patients. The current study aimed to evaluate the effect of somatosensory rehabilitation on neural and functional recovery of LE in stroke patients. Thirty male and female patients were recruited and randomized to equal groups: control group (GI) and intervention group (GII). All patients were matched for age, duration of stroke, and degree of motor impairment of the affected LE. Both groups received standard program of physical therapy in addition to somatosensory rehabilitation for GII. The duration of treatment for both groups was eight consecutive weeks. Outcome measures used were Functional Independent Measure (FIM) and Quantitative Electroencephalography (QEEG), obtained pre- and post-treatment. A significant improvement was found in the FIM scores of the intervention group (GII), as compared to the control group (GI) (p < 0.001). Additionally, QEEG scores improved within the intervention group post-treatment. QEEG scores did not improve within the control group post-treatment, except for “Cz-AR”, compared to pretreatment, with no significant difference between groups. Adding somatosensory training to standard physical therapy program results in better improvement of neuromuscular control of LE function in chronic stroke patients.

scholarly journals Intravesical dexmedetomidine instillation reduces postoperative catheter-related bladder discomfort in male patients under general anesthesia: a randomized controlled study

2020 ◽  
Author(s):  
Hong Chen ◽  
Bin Wang ◽  
Qin Li ◽  
Juan Zhou ◽  
Rui Li ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Patient Satisfaction ◽  
General Anesthesia ◽  
Normal Saline ◽  
Rating Scale ◽  
Intravesical Instillation ◽  
Controlled Study ◽  
Control Group ◽  
Post Operation ◽  
Male Patients

Abstract Background: The catheter-related bladder discomfort (CRBD) of male patients is a common clinical problem, albeit lacking effective solutions. The present study aimed to investigate whether intravesical dexmedetomidine instillation alleviates the postoperative urinary discomfort in male patients with catheter under general anesthesia.Methods: This single-blinded, prospective, randomized study included a total of 167 male patients American Society of Anesthesiologists (ASA) physical status I-II scheduled for surgery under general anesthesia were allocated to two groups: 84 in the dexmedetomidine group and 83 in the control group. Dexmedetomidine group patients received intravesical instillation of the drug 0.5 μg/kg and normal saline 20 mL, while the control group received intravesical instillation of 20 mL normal saline. The catheter was clamped for 30 min after intravesical instillation for all patients. CRBD scores and urethra pain numerical rating scale (NRS) scores were measured at admittance to post-anesthesia care unit (PACU) (T0), intravesical instillation (T1), 30 min (T2), 60 min (T3), 2 h (T4) after intravesical instillation, discharged from PACU (T5), and 6 h (T6) and 24 h (T7) after the operation. Patient satisfaction at discharge from PACU and 24 h post-operation were compared between the two groups. Results: CRBD scores and urethra pain NRS scores after 30 min of intravesical dexmedetomidine instillation to 24 h post-operation were significantly lower than the control group (p<0.001), and patient satisfaction was higher at discharge from PACU and 24 h post-operation (p<0.001). No differences were detected in Steward score out of PACU (p=0.213) and from the time of the end of operation to fully awake (p=0.417).Conclusion: Intravesical dexmedetomidine instillation reduces postoperative urinary discomfort and urethra pain and improves satisfaction in male patients under general anesthesia.Clinical Trial Registration: Chinese Clinical Trial Registry (No. ChiCTR1800016429), date of registration 1st June 2018

scholarly journals Effect of Ketorolac on the Prevention of Postoperative Catheter-Related Bladder Discomfort in Patients Undergoing Robot-Assisted Laparoscopic Radical Prostatectomy: A Randomized, Double-Blinded, Placebo-Controlled Study

2019 ◽  
Vol 8 (6) ◽  
pp. 759
Author(s):  
Jun-Young Park ◽  
Jun Hyuk Hong ◽  
Jihion Yu ◽  
Doo-Hwan Kim ◽  
Gi-Ho Koh ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Radical Prostatectomy ◽  
Primary Outcome ◽  
Laparoscopic Radical Prostatectomy ◽  
Controlled Study ◽  
Control Group ◽  
Robot Assisted ◽  
Pain Scores ◽  
Patient Satisfaction Scores ◽  
Double Blinded

Urinary catheterization can cause catheter-related bladder discomfort (CRBD). Ketorolac is widely used for pain control. Therefore, we evaluated the effect of ketorolac on the prevention of CRBD in patients undergoing robot-assisted laparoscopic radical prostatectomy (RALP). All patients were randomly allocated to the ketorolac group or the control group. The primary outcome was CRBD above a moderate grade at 0 h postoperatively. CRBD above a moderate grade at 1, 2, and 6 h was also assessed. Postoperative pain, opioid requirement, ketorolac-related complications, patient satisfaction, and hospitalization duration were also assessed. The incidence of CRBD above a moderate grade at 0 h postoperatively was significantly lower in the ketorolac group (21.5% vs. 50.8%, p = 0.001) as were those at 1, 2, and 6 h. Pain scores at 0 and 1 h and opioid requirement over 24 h were significantly lower in the ketorolac group, while patient satisfaction scores were significantly higher in the ketorolac group. Ketorolac-related complications and hospitalization duration were not significantly different between the two groups. This study shows ketorolac can reduce postoperative CRBD above a moderate grade and increase patient satisfaction in patients undergoing RALP, suggesting it is a useful option to prevent postoperative CRBD.

scholarly journals Effects of Training for Finger Perception on Functional Recovery of Hemiplegic Upper Limbs in Acute Stroke Patients

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Naho Umeki ◽  
Jun Murata ◽  
Misako Higashijima
Keyword(s):  
Training Program ◽  
Functional Recovery ◽  
Repeated Measures ◽  
Controlled Trial ◽  
Sensory Function ◽  
Control Group ◽  
Stroke Patients ◽  
Pressure Threshold ◽  
Sensory Training ◽  
Experimental Group

Background. Stroke causes severe disability, including motor and sensory impairments. We hypothesized that upper limb functional recovery after stroke may be augmented by combining treatments for motor and sensory functions. In order to examine this hypothesis, we conducted a controlled trial on rehabilitation for sensory function to the plegic hand. Methods. The sensory training program consisted of several types of discrimination tasks performed under blind conditions. The sensory training program was performed for 20 min per day, 5 days a week. An experimental group of 31 patients followed this sensory program, while a control group of 25 patients underwent standard rehabilitation. The efficacy of the intervention was evaluated by the tactile-pressure threshold, handgrip strength, and the completion time of manipulating objects. A two-way repeated measures analysis of variance was used to assess interactions between group and time. Moreover, to provide a meaningful analysis for comparisons, effect sizes were calculated using Cohen’s d. Results. The mean change in the tactile pressure threshold was significantly larger in the experimental group than in the control group (p<0.05, d=0.59). Moreover, the completion times to manipulate a middle-sized ball (d=0.53) and small ball (d=0.80) and a small metal disc (d=0.81) in the experimental group were significantly different from those in the control group (p<0.05). Conclusion. The present results suggest that the sensory training program to enhance finger discrimination ability contributes to improvements in not only sensory function but also manual function in stroke patients. The trial is registered with the UMIN Clinical Trials Registry (UMIN000032025).

scholarly journals Intravesical dexmedetomidine instillation reduces postoperative catheter-related bladder discomfort in male patients under general anesthesia: a randomized controlled study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Hong Chen ◽  
Bin Wang ◽  
Qin Li ◽  
Juan Zhou ◽  
Rui Li ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
General Anesthesia ◽  
Normal Saline ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Intravesical Instillation ◽  
Controlled Study ◽  
Control Group ◽  
Post Operation ◽  
Male Patients

Abstract Background The catheter-related bladder discomfort (CRBD) of male patients is a common clinical problem, albeit lacking effective solutions. The present study aimed to investigate whether intravesical dexmedetomidine instillation alleviates the postoperative urinary discomfort in male patients with catheter under general anesthesia. Methods This single-blinded, prospective, randomized study included a total of 167 male patients American Society of Anesthesiologists (ASA) physical status I-II scheduled for surgery under general anesthesia were allocated to two groups: 84 in the dexmedetomidine group and 83 in the control group. Dexmedetomidine group patients received intravesical instillation of the drug 0.5 μg/kg and normal saline 20 mL, while the control group received intravesical instillation of 20 mL normal saline. The catheter was clamped for 30 min after intravesical instillation for all patients. CRBD scores and urethra pain numerical rating scale (NRS) scores were measured at admittance to post-anesthesia care unit (PACU) (T0), intravesical instillation (T1), 30 min (T2), 60 min (T3), 2 h (T4) after intravesical instillation, discharged from PACU (T5), and 6 h (T6) and 24 h (T7) after the operation. Patient satisfaction at discharge from PACU and 24 h post-operation were compared between the two groups. Results CRBD scores and urethra pain NRS scores after 30 min of intravesical dexmedetomidine instillation to 24 h post-operation were significantly lower than the control group (p < 0.001), and patient satisfaction was higher at discharge from PACU and 24 h post-operation (p < 0.001). No differences were detected in Steward score out of PACU (p = 0.213) and from the time of the end of operation to fully awake (p = 0.417). Conclusion Intravesical dexmedetomidine instillation reduces postoperative urinary discomfort and urethra pain and improves satisfaction in male patients under general anesthesia. Trial registration Chinese Clinical Trial Registry (No. ChiCTR1800016429), date of registration 1st June 2018.

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