scholarly journals Application of Quantitative CT Imaging in Rehabilitation Nursing of Cerebral Apoplexy Patients

2021 ◽  
Vol 37 (6-WIT) ◽  
Author(s):  
Bing Yan ◽  
Huanhuan Zhang ◽  
Jie Liu
Keyword(s):  
Upper Limb ◽  
Nursing Intervention ◽  
Ct Imaging ◽  
Early Rehabilitation ◽  
Control Group ◽  
Observation Group ◽  
Quantitative Ct ◽  
Limb Function ◽  
Ct Examination ◽  
Upper Limb Function

Objectives: Electronic computed tomography (CT) is an important imaging method for the diagnosis of cerebral infarction. This paper explores the preventive effects of quantitative CT imaging and early rehabilitation nursing on patients with cerebral apoplexy and shoulder-hand syndrome. Methods: Sixty cerebral apoplexy patients treated were included as control group and given routine care from September 2018 to May 2020. Sixty cerebral apoplexy patients were included as observation group, and early rehabilitation nursing intervention was given based on control group. The incidence of shoulder-hand syndrome and upper limb function were compared between the two groups, to explore the effectiveness of the CT examination in promoting the physical function restoration. Results: The incidence of shoulder-hand syndrome in observation group after three months of intervention was lower than that in control group, and the severity was less than that in control group (P<0.05); The Ashworth score of muscle tension in observation group after three months of intervention was lower than that in control group, and the simplified FMA score of the upper limbs was higher than that in control group. Conclusion: Early rehabilitation nursing intervention after CT examination can prevent the occurrence of cerebral apoplexy and shoulder-hand syndrome and improve upper limb function, which is worthy of promotion. doi: https://doi.org/10.12669/pjms.37.6-WIT.4840 How to cite this:Yan B, Zhang H, Liu J. Application of Quantitative CT Imaging in Rehabilitation Nursing of Cerebral Apoplexy Patients. Pak J Med Sci. 2021;37(6):1574-1579. doi: https://doi.org/10.12669/pjms.37.6-WIT.4840 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.

scholarly journals Effectiveness of ultrasound guided ethanol motor points block in reduction of spasticity and improvement of upper limb function in hemiplegic patients: a randomized controlled study

2020 ◽  
Vol 7 (9) ◽  
pp. 1409
Author(s):  
Sreejith C. ◽  
Akoijam Joy Singh ◽  
Longjam Nilachandra Singh ◽  
Kanti Rajkumari ◽  
Margaret Chabungbam ◽  
...  
Keyword(s):  
Upper Limb ◽  
Randomized Controlled Study ◽  
Controlled Study ◽  
Control Group ◽  
Ultrasound Guided ◽  
Limb Function ◽  
Ethanol Injection ◽  
Randomized Controlled ◽  
Upper Limb Function ◽  
Group A

Background: Stroke is the third leading cause of disability in general population commonly causing upper motor neuron syndrome complications like spasticity, which is more common in upper limb. Ethanol injection into spastic muscle is an emerging effective treatment in the spasticity management. Ethanol causes selective destruction of nerve fibers through denaturation of protein.Methods: A randomized controlled study was conducted for a period of 2 years from March 2018 on sixty-eight hemiplegic patients to assess the effectiveness of ethanol muscle block in reduction of spasticity and improvement in functional ability. The patients were allocated into two groups (Group A and B). Group A received ultrasound guided intramuscular ethanol injection along with range of motion (ROM) exercises and wrist hand orthosis (WHO) and Group B received ROM exercises and WHO. The outcomes were measured by modified ashworth scale (MAS) for spasticity and modified version of motor assessment scale for functional improvement.Results: Intervention group showed significant improvement in spasticity shown by reduction of MAS of elbow flexors from 3 at baseline to 1.15±0.3 at 12 weeks as compared to control group with 3 at baseline to 1.76±0.5 at 12 weeks (p<0.05). Upper limb function scale of study group improved from 1.5±0.8 to 3.0±0.6 at 12 weeks compared to control group 1.3±0.8 to 2.8±0.6 (p<0.05).Conclusions: It can thus be concluded that intramuscular injection of ethanol accompanied by wrist hand orthosis have beneficial effect on improvement of spasticity and upper limb function.

scholarly journals Effect of Self-care Training on Upper Limb Function and Pain After Breast Cancer Surgery

2021 ◽  
Vol 10 (2) ◽  
Author(s):  
Somyye Noura ◽  
Fatemeh Kiani ◽  
Nezarali Moulaei ◽  
Mojtaba Tasbandi ◽  
Ebrahim Ebrahimi Tabas
Keyword(s):  
Breast Cancer ◽  
Upper Limb ◽  
Intervention Group ◽  
Self Care ◽  
Control Group ◽  
Limb Function ◽  
Upper Limb Function ◽  
Care Training ◽  
The Mean ◽  
And Control

Background: Breast cancer patients who undergo mastectomy encounter numerous problems, the most annoying of which is lymphedema followed by pain and decreased function in the affected limb. Objectives: This study examined the effect of self-care training on upper limb function and pain after breast surgery. Methods: This quasi-experimental study was performed on two groups of 60 patients with breast cancer in the Oncology Ward of Zahedan University of Medical Sciences in 2021. The patients were selected based on the inclusion criteria and through convenience sampling and were then randomly divided into intervention and control groups. The patients in the intervention group attended self-care training and exercise programs implemented in five sessions in addition to the routine care. One and three months after the intervention, upper limb function and pain were measured with DASH and McGill pain questionnaires. The repeated measures analysis of variance (ANOVA) and Bonferroni test were used to compare the pre-, and post-intervention mean scores and mean differences in the two groups. Results: The mean scores of upper limb function one and three months after the training program in the intervention group were lower than the mean scores of the control group. In other words, the quality of upper limb function was not significantly different despite the changes in the first month, but upper limb function significantly improved three months after the intervention (P < 0.001 vs. P = 0.06). The mean pain scores before, one month, and three months after the intervention in the intervention group were 10.4, 35.7, and 6.26, respectively, and the corresponding values in the control group were 10.8, 41.7, and 21.1, respectively, showing significant differences between the two groups, with the intervention group having lower pain scores than the control group (P = 0.001). Conclusions: Since lymphedema and its consequences, including decreased upper limb function and pain, are very serious issues, medical staff can give priority to this training program and implement it to prevent and control these complications.

scholarly journals Effectiveness of the Virtual Reality System Toyra on Upper Limb Function in People with Tetraplegia: A Pilot Randomized Clinical Trial

2016 ◽  
Vol 2016 ◽  
pp. 1-12 ◽  
Author(s):  
I. Dimbwadyo-Terrer ◽  
A. Gil-Agudo ◽  
A. Segura-Fragoso ◽  
A. de los Reyes-Guzmán ◽  
F. Trincado-Alonso ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Upper Limb ◽  
Conventional Therapy ◽  
Control Group ◽  
Virtual Reality System ◽  
Limb Function ◽  
Upper Limb Function ◽  
Level Of Satisfaction ◽  
High Level

The aim of this study was to investigate the effects of a virtual reality program combined with conventional therapy in upper limb function in people with tetraplegia and to provide data about patients’ satisfaction with the virtual reality system. Thirty-one people with subacute complete cervical tetraplegia participated in the study. Experimental group received 15 sessions with Toyra®virtual reality system for 5 weeks, 30 minutes/day, 3 days/week in addition to conventional therapy, while control group only received conventional therapy. All patients were assessed at baseline, after intervention, and at three-month follow-up with a battery of clinical, functional, and satisfaction scales. Control group showed significant improvements in the manual muscle test (p= 0,043, partialη2= 0,22) in the follow-up evaluation. Both groups demonstrated clinical, but nonsignificant, changes to their arm function in 4 of the 5 scales used. All patients showed a high level of satisfaction with the virtual reality system. This study showed that virtual reality added to conventional therapy produces similar results in upper limb function compared to only conventional therapy. Moreover, the gaming aspects incorporated in conventional rehabilitation appear to produce high motivation during execution of the assigned tasks. This trial is registered with EudraCT number2015-002157-35.

scholarly journals The effect of virtual reality on motor anticipation and hand function in patients with subacute stroke: A randomised trial on movement-related potential.

2020 ◽  
Author(s):  
Ling Chen ◽  
Yi Chen ◽  
Wai Leung Ambrose Lo
Keyword(s):  
Virtual Reality ◽  
Reaction Time ◽  
Upper Limb ◽  
Cortical Excitability ◽  
Control Group ◽  
Post Intervention ◽  
Limb Function ◽  
Upper Limb Function ◽  
Subacute Stroke ◽  
Vr Training

Abstract Background: Impaired cognitive ability to anticipate the required control may affect functional recovery. The cortical excitability of task related motor anticipation for upper limb movement induced by virtual reality (VR) training is unknown. Aims: To investigate the changes of motor anticipation, cortical excitability and upper limb function induced by VR training in subacute stroke survivors. Methods: Upper limb hemiparesis resulting from the first occurrence of stroke within 1 to 6 months were recruited. Participants were randomly allocated to conventional therapy or VR intervention. Electroencephalogram (EEG) and electromyography (EMG) were simultaneously recorded during palmar grasp motion. Outcome measures of contingent negative variation (CNV) latency, mean peak amplitude, electromyography (EMG) reaction time, Upper Limb Fugl-Meyer Assessment (UL-FMA) and the Action Research Arm Test (ARAT) were recorded pre and post intervention. The EEG and EMG differences between the two groups were assessed by mixed model ANOVA (p=0.05). The differences in UL-FMA and ARAT were assessed Wilcoxon signed-rank test (p=0.05). Results: The reduction in EMG reaction time difference, CNV latency and mean peak amplitude were significantly lower in the VR group than the control group when executing movement with the paretic hand. ARAT and UL-FMA scores were significantly higher in the VR group than the control group post intervention. Conclusions: The findings indicated a reduction in brain computational demand during palmar grasp task. Improvements in clinical function in the VR group suggested that VR intervention may be more beneficial in improving upper limb function patients with subacute stroke. Improvement in upper limb function may be related to improvement of the neural anticipatory process. Trial registration: Chinese Clinical Trial Registry (Registration No.: ChiCTR-IOC-15006064). Registered on 11 May 2015. Retrospectively registered. http://www.chictr.org.cn/searchprojen.aspx

scholarly journals Virtual Reality Games as an Adjunct in Improving Upper Limb Function and General Health among Stroke Survivors

2019 ◽  
Vol 16 (24) ◽  
pp. 5144 ◽  
Author(s):  
Mohd Azzuan Ahmad ◽  
Devinder Kaur Ajit Singh ◽  
Nor Azlin Mohd Nordin ◽  
Khor Hooi Nee ◽  
Norliza Ibrahim
Keyword(s):  
Virtual Reality ◽  
Outcome Measures ◽  
Upper Limb ◽  
General Health ◽  
Sensory Function ◽  
Control Group ◽  
Stroke Survivors ◽  
Limb Function ◽  
Significant Time ◽  
Upper Limb Function

Virtual reality (VR) games has the potential to improve patient outcomes in stroke rehabilitation. However, there is limited information on VR games as an adjunct to standard physiotherapy in improving upper limb function. This study involved 36 participants in both experimental (n = 18) and control (n = 18) groups with a mean age (SD) of 57 (8.20) and 63 (10.54) years, respectively. Outcome measures were the Fugl-Meyer assessment for upper extremities (FMA-UE), Wolf motor function test (WMFT), intrinsic motivation inventory (IMI), Lawton of instrumental activities of daily living (IADL), and stroke impact scale (SIS) assessed at pre-post intervention. The experimental group had 0.5 h of upper limb (UL) VR games with 1.5 h of standard physiotherapy, and the control group received 2 h of standard physiotherapy. The intervention for both groups was performed once a week for eight consecutive weeks. The results showed a significant time–group interaction effect for IMI (p = 0.001), Lawton IADL (p = 0.01) and SIS domain of communication (p = 0.03). A significant time effect was found in FMA-UE (p = 0.001), WMFT (p = 0.001), Lawton IADL (p = 0.01), and SIS domains; strength, ADL and stroke recovery (p < 0.05). These results indicated an improvement in UL motor ability, sensory function, instrumental ADL, and quality of life in both groups after eight weeks of intervention. However, no significant (p > 0.05) group effect on all the outcome measures was demonstrated. Thus, replacing a portion of standard physiotherapy time with VR games was equally effective in improving UL function and general health compared to receiving only standard physiotherapy among stroke survivors.

scholarly journals Musculoskeletal Ultrasonography Assessment of Functional Magnetic Stimulation on the Effect of Glenohumeral Subluxation in Acute Poststroke Hemiplegic Patients

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Chengyuan Yang ◽  
Ping Chen ◽  
Wenjie Du ◽  
Qingmei Chen ◽  
Huilin Yang ◽  
...  
Keyword(s):  
Upper Limb ◽  
Magnetic Stimulation ◽  
Contralateral Side ◽  
Control Group ◽  
Ipsilateral Side ◽  
Limb Function ◽  
Lesser Tuberosity ◽  
Upper Limb Function ◽  
The Difference ◽  
Musculoskeletal Ultrasonography

Background. Glenohumeral subluxation (GHS) is common in patients with acute hemiplegia caused by stroke. GHS and upper limb function are closely related. Objective. Using musculoskeletal ultrasonography (MSUS) to objectively evaluate the efficacy of functional magnetic stimulation (FMS) in the treatment of GHS in acute hemiplegic patients after stroke. Methods. The study used prospective case control study. Stroke patients with GHS were recruited and assigned to control group and FMS group. Control group received electrode stimulation at the supraspinatus and deltoid muscles of the hemiplegic side, while FMS group was stimulated at the same locations. Before and after treatment, the distances of the acromion-greater tuberosity (AGT), acromion-lesser tuberosity (ALT), acromiohumeral distance (AHD), supraspinatus thickness (SST), and deltoid muscle thickness (DMT) in patients’ bilateral shoulder joint were measured by MSUS, respectively. Meanwhile, Fugl-Meyer Assessment (FMA) was used to evaluate the improvement of upper limb function. Results. 30 patients were recruited. After FMS treatment, there was a significant decrease in the difference value between ipsilateral side and contralateral side of AGT [t=8.595, P<0.01], ALT [t=11.435, P<0.01], AHD [t=8.375, P<0.01], SST [t=15.394, P<0.01], and DMT [t=24.935, P<0.01], and FMA score increased [t=-13.315, P<0.01]. Compared with control group, FMS group decreased more significantly in the difference value between ipsilateral side and contralateral side of AGT [t=2.161, P<0.05], ALT [t=3.332, P<0.01], AHD [t=8.768, P<0.01], SST [t=6.244, P<0.01], and the DMT [t=3.238, P<0.01], and FMA score increased more significantly in FMS group [t=7.194, P<0.01]. Conclusion. The study preliminarily shows that the MSUS can objectively and dynamically evaluate the treatment effect of GHS in hemiplegic patients. Meanwhile, compared with control group, the FMS is more effective and has fewer side effects, and the long-term effect of FMS is worth further study. This trial is registered with ChiCTR1800015352.

scholarly journals Determining the Effects of a Horticultural Therapy Program for Improving the Upper Limb Function and Balance Ability of Stroke Patients

HortScience ◽  
2018 ◽  
Vol 53 (1) ◽  
pp. 110-119 ◽  
Author(s):  
A-Young Lee ◽  
Sin-Ae Park ◽  
Hye-Gyeong Park ◽  
Ki-Cheol Son
Keyword(s):  
Activities Of Daily Living ◽  
Upper Limb ◽  
Daily Living ◽  
Control Group ◽  
Stroke Patients ◽  
Horticultural Therapy ◽  
Limb Function ◽  
Rehabilitation Hospital ◽  
Upper Limb Function ◽  
Task Oriented

The objective of this study was to assess the physical and psychological effects of an 18-session horticultural therapy (HT) program based on task-oriented training in stroke patients and investigate patient satisfaction. The HT program consisted of horticultural activities including the motions such as reaching–grasping, squatting, stepping, and stooping. A total of 31 stroke inpatients (16 males, 15 females) at B rehabilitation hospital in Seongnam, South Korea, participated in this study. Fourteen stroke patients participated in a thrice weekly HT program (6 weeks, ≈60 minutes per session) between Aug. and Sept. 2016, whereas another 17 stoke patients comprised the control group. At the completion of the 18-session HT program, upper limb function [manual function test (MFT)], grip strength (hydraulic hand dynamometer), pinch force (hydraulic pinch gauge), fine motor skills (9-hole pegboard), balance [Berg Balance Scale (BBS)], and activities of daily living (Modified Barthel Index) were evaluated in both groups. In addition, depression [The Korean version of the short form of Geriatric Depression Scales (SGDS-K)], rehabilitation stress (Rehabilitation Stress Scales), rehabilitation motivation (Rehabilitation Motivation Scales), and fall efficacy (The Korean version of the Falls Efficacy Scale) were evaluated. Stroke patients in the HT group showed significantly improved upper limb function, hand force, balance, fall efficacy, activities of daily living, and decreased depression (P < 0.05). By contrast, no significant change was noted in the control group. In addition, 85.7% of the stroke patients in the HT group reported being very satisfied or satisfied with the HT program. In conclusion, the HT program based on task-oriented training improved the patients’ physical and psychological function after stroke rehabilitation. These study results suggest that implementing an HT program in a rehabilitation hospital will effectively contribute to functional recovery after stroke.

scholarly journals Effect of Scapular Stabilization Exercise during Standing on Upper Limb Function and Gait Ability of Stroke Patients

2017 ◽  
Vol 08 (04) ◽  
pp. 540-544 ◽  
Author(s):  
Kim JO ◽  
Lee BH ◽  
Keyword(s):  
Upper Limb ◽  
Repeated Measures ◽  
Hand Function ◽  
Control Group ◽  
Study Group ◽  
Stroke Patients ◽  
Limb Function ◽  
Stabilization Exercise ◽  
Upper Limb Function ◽  
Paretic Side

ABSTRACT Background: The purpose of this study was to determine the effect of scapular stabilization exercise during standing on a paretic side on upper limb function and gait ability of stroke patients. Methods: This study was a hospital-based, randomized controlled trial with a blinded assessor. A total of 17 patients with hemiplegic diagnosis after stroke were divided into two groups (9 patients in a study group and 8 patients in a control group). The study group received physical therapy and scapular stabilization exercise on a paretic side. Participants were subjected to initial evaluation before the treatment. Subjects were subsequently re-evaluated 4 and 8 weeks later to compare the changes. Measurements of hand function and gait ability were performed. Results: Based on multivariate analysis of variance for repeated-measures, there was a significant time effect for Timed Up and Go test (TUG) (F =13.816, P =0.000), Functional Gait Assessment (FGA) (F =18.613, P =0.000), and manual function test (MFT) (F =16.777, P =0.000). The group × time interaction effect was also significant for FGA (F =4.966, P =0.024) and MFT (F =6.946, P =0.003), but not for TUG test (F =3.343, P =0.069). Conclusion: Results of the present study indicated that scapular stabilization exercise during standing on a paretic side for 8 weeks had an effect on hand function and gait ability of hemiplegic patients after stroke. Further studies are needed to find the most proper exercise for stroke patients who have gait disability and upper limb dysfunction.

scholarly journals Can a pathological model improve the abilities of the paretic hand in hemiplegic children? The PAM-AOT study protocol of a randomised controlled trial

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e053910
Author(s):  
Jessica Verzelloni ◽  
Antonino Errante ◽  
Laura Beccani ◽  
Mariacristina Filippi ◽  
Barbara Bressi ◽  
...  
Keyword(s):  
Upper Limb ◽  
Mirror Neuron System ◽  
Action Observation ◽  
Controlled Trial ◽  
Secondary Outcome ◽  
Control Group ◽  
Limb Function ◽  
Upper Limb Function ◽  
Pathological Model ◽  
Randomised Controlled

IntroductionAction Observation Treatment (AOT) is an innovative therapeutic approach consisting in the observation of actions followed by subsequent repetition. In children with unilateral cerebral palsy (UCP), it improves upper limb function in daily activities. The standard paradigm of AOT requires the observation of healthy models; however, it has been demonstrated that the mirror neuron system of children with UCP is more activated by observation of pathological models, showing a similar motor repertoire, than by the healthy model, suggesting that AOT based on pathological models is superior to the standard paradigm of AOT in the functional rehabilitation of the affected upper limb of children with UCP.Methods and analysisThis protocol describes an active two-arm randomised controlled evaluator-blinded trial. Twenty-six children with UCP will participate in 3 weeks of intensive AOT: the experimental group will observe a pathological model, while the control group will observe a typically developed model. The primary outcome is the spontaneous use of the paretic hand, measured with the Assisting Hand Assessment. Secondary outcome measures are the Melbourne Assessment of Unilateral Upper Limb Function, the ABILHAND-Kids and the Activities Scale for Kids-performance. Assessments will be performed at baseline (T0), at the end of intensive AOT (T1), at 8–12 weeks (T2) and at 24–28 weeks (T3) after the end of intensive AOT.Ethics and disseminationThe trial was approved by the Area Vasta Emilia Nord Ethics Committee (AVEN prot. n. 133117, 29 November 2018), and it was prospectively registered on ClinicalTrials.gov. The results will be submitted for publication to a peer-reviewed journal, discussed with parents of children participating in the trial and disseminated at suitable conferences.Trial registration numberNCT04088994; Pre-results.

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