Comparison of Gait Parameters Across Three Attentional Loading Conditions During Timed Up and Go Test in Stroke Survivors

2014 ◽  
Vol 21 (2) ◽  
pp. 128-136 ◽  
Author(s):  
Haidzir Manaf ◽  
Maria Justine ◽  
Goh Hui Ting ◽  
Lydia Abd Latiff
2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Haidzir Manaf ◽  
Maria Justine ◽  
Mazlifah Omar

The aim of this study was to determine whether stroke survivor’s gait performance during dual-task Timed Up and Go (TUG) test is correlated with the level of functional balance and motor impairment. Thirty stroke survivors (22 men, 8 women) were recruited for this study. The level of functional balance (Berg Balance Scale) and motor impairment (Fugl-Meyer assessment lower extremity) were assessed prior to the TUG test. TUG test was conducted under three attentional loading conditions (single, dual motor, and dual-cognitive). The time and number of steps were used to quantify gait parameters. The Spearmen’s rank correlation coefficient was used to evaluate the relationship between these variables. There was moderate to strong negative correlation between functional balance and gait parameters (range −0.53 to −0.73,P<0.05). There was a weak negative correlation observed between the time taken to complete the single task and motor impairment (rs=-0.43;P=0.02) dual motor task and motor impairment (rs=-0.41;P=0.02). However, there were no significant correlations between lower limb motor impairment and the number of steps in all conditions. These findings suggest that functional balance may be an influential domain of successful dual-task TUG in stroke.


2021 ◽  
Vol 28 (2) ◽  
pp. 63-71
Author(s):  
Kamaruzaman Tajuddin ◽  
Maria Justine ◽  
Nadia Mohd Mustafah ◽  
Lydia Latif ◽  
Haidzir Manaf

Background: Stroke survivors depend on the unaffected leg during walking and standing. The presence of diabetic peripheral neuropathy (DPN) affecting both legs may further affect the postural balance and gait instability and increase the risk for falls in such patients. Thus, this study was conducted to investigate the effect of dual taskings on the gait and turning performance of stroke survivors with DPN. Methods: Forty stroke survivors were recruited (20 with DPN and 20 without DPN) in this cross-sectional study design. Instrumented timed up and go (iTUG) tests were conducted in three different tasking conditions (single task, dual motor and dual cognitive). APDM® Mobility Lab system was used to capture the gait parameters during the iTUG tests. A two-way mixed analysis of variance was used to determine the main effects of gait performance on three taskings during the iTUG test. Results: Spatiotemporal gait parameters and turning performance (turning time and turning step times) were more affected by the tasking conditions in stroke survivors with DPN compared to those without DPN (P < 0.05). Conclusion: Stroke survivors with DPN had difficulty walking while turning and performing a secondary task simultaneously.


2021 ◽  
pp. 251660852098287
Author(s):  
Hariharasudhan Ravichandran ◽  
Balamurugan Janakiraman

Background: Ankle dorsiflexion movement restriction is a common presentation in most of the chronic stroke survivors. Spasticity and connective tissue changes around ankle, limits dorsiflexion, and interferes with balance and gait performances. Improving functional range of dorsiflexion is essential in post-stroke rehabilitation. Objectives: This meta-analysis analyzed the effects of ankle mobilization techniques in improving dorsiflexion range and gait parameters among chronic stroke survivors. Method: Articles published up to July 2020 were searched in CINAHL, PubMed, Embase, PsyINFO, and OpenGrey. English version of randomized controlled trials (RCTs) assessing the effects of ankle joint mobilization among chronic stroke subjects, with dorsiflexion range of motion (ROM) and gait parameters as outcome, were included. Characteristics of participants, interventions, outcome measure, and measures of variability were extracted. Methodological quality of included trials was assessed using PEDro scale and Cochrane Collaboration tool for the risk of bias. Pooled standardized mean difference was calculated using random effects model for dorsiflexion ROM, gait velocity, step length, cadence, and timed up and go (TUG). Results: Eight RCTs including 226 stroke patients, with mean methodological score of 6 out of 10 in PEDro, were eligible for this meta-analysis. Ankle joint mobilization demonstrated statistically significant improvement on passive dorsiflexion ROM, gait velocity, step length (affected side), and cadence outcomes. Nonsignificance was found in step length (unaffected side) and in TUG. Conclusion: The ankle mobilization techniques are effective in improving passive dorsiflexion ROM, gait velocity, and cadence in chronic stroke survivors. However, the retention effect of ankle mobilization among stroke subjects is not known.


2004 ◽  
Vol 36 (1) ◽  
pp. 42-45 ◽  
Author(s):  
Toshiaki Takahashi ◽  
Kenji Ishida ◽  
Daisuke Hirose ◽  
Yasunori Nagano ◽  
Kiyoto Okumiya ◽  
...  

Author(s):  
Simone S. Fricke ◽  
Hilde J. G. Smits ◽  
Cristina Bayón ◽  
Jaap H. Buurke ◽  
Herman van der Kooij ◽  
...  

Abstract Background Recently developed controllers for robot-assisted gait training allow for the adjustment of assistance for specific subtasks (i.e. specific joints and intervals of the gait cycle that are related to common impairments after stroke). However, not much is known about possible interactions between subtasks and a better understanding of this can help to optimize (manual or automatic) assistance tuning in the future. In this study, we assessed the effect of separately assisting three commonly impaired subtasks after stroke: foot clearance (FC, knee flexion/extension during swing), stability during stance (SS, knee flexion/extension during stance) and weight shift (WS, lateral pelvis movement). For each of the assisted subtasks, we determined the influence on the performance of the respective subtask, and possible effects on other subtasks of walking and spatiotemporal gait parameters. Methods The robotic assistance for the FC, SS and WS subtasks was assessed in nine mildly impaired chronic stroke survivors while walking in the LOPES II gait trainer. Seven trials were performed for each participant in a randomized order: six trials in which either 20% or 80% of assistance was provided for each of the selected subtasks, and one baseline trial where the participant did not receive subtask-specific assistance. The influence of the assistance on performances (errors compared to reference trajectories) for the assisted subtasks and other subtasks of walking as well as spatiotemporal parameters (step length, width and height, swing and stance time) was analyzed. Results Performances for the impaired subtasks (FC, SS and WS) improved significantly when assistance was applied for the respective subtask. Although WS performance improved when assisting this subtask, participants were not shifting their weight well towards the paretic leg. On a group level, not many effects on other subtasks and spatiotemporal parameters were found. Still, performance for the leading limb angle subtask improved significantly resulting in a larger step length when applying FC assistance. Conclusion FC and SS assistance leads to clear improvements in performance for the respective subtask, while our WS assistance needs further improvement. As effects of the assistance were mainly confined to the assisted subtasks, tuning of FC, SS and WS can be done simultaneously. Our findings suggest that there may be no need for specific, time-intensive tuning protocols (e.g. tuning subtasks after each other) in mildly impaired stroke survivors.


2018 ◽  
Vol 34 (5) ◽  
Author(s):  
Qurat Ul Ain ◽  
Arshad Nawaz Malik ◽  
Umama Haq ◽  
Sehrish Ali

2020 ◽  
Vol 20 (3) ◽  
pp. 134-139
Author(s):  
Deepak Thazhakkattu Vasu ◽  
Nor Azlin Mohd Nordin ◽  
See Xiao Xu ◽  
Shazli Ezzat Ghazali ◽  
Siti Norfadilah Abu Zarim

A significant percentage of stroke survivors are reported to have anxiety and depression.  Autogenic Relaxation Training (ART), a psychophysiological self-control therapy which aims to induce relaxation proved to be effective in reducing the anxiety and depression in some health conditions. However, there is lack of studies which evaluated the effects of ART in the rehabilitation of stroke survivors. The aim of this experimental pilot study is to evaluate the feasibility and outcomes of ART in addition to usual physiotherapy for stroke survivors. A total of 14 sub-acute stroke survivors from a teaching hospital were enrolled in this study. All participants received 20 minutes ART followed by 40 minutes usual physiotherapy once a week and they were requested to carry out the intervention at home for twice per week, for six weeks. Intervention outcomes were assessed using Hospital Anxiety and Depression Scale (HADS-A and HADS-D), Barthel Index (BI), Timed Up and Go (TUG) and EuroQol 5-Dimension 5 Levels (EQ5D5L). Changes in all outcome measures were analysed using paired t-test and Wilcoxon signed rank test, with level of significance set at p<0.05. Post-intervention, there is statistically significant reduction of the HADS-A (p=0.04), HADS-D (p=0.02), TUG (p=0.004) and EQ5D5L (p=0.03) scores of the participants. Although not statistically significant, the mean score ± SD of BI increased from 95 ± 12.5 to 100 ± 6.25. The intervention is feasible and acceptable by the stroke survivors with no adverse events reported. In conclusion, ART in addition to usual physiotherapy is feasible and beneficial in reducing anxiety and depression, and improving functional ability, mobility and quality of life among stroke survivors.


2021 ◽  
Author(s):  
Obianuju Nwaedozie ◽  
Caleb Gbiri ◽  
Olajide Olawale ◽  
Ukamaka Mgbeojedo ◽  
Caleb Adeagbo

Abstract Background Post-stroke hemiplegic gait is a mixture of deviations and compensatory motion dictated by residual function. To improve stroke survivors' walking ability, it is necessary to evaluate different rehabilitation approaches and identify those that have a greater effect on locomotor recovery of stroke patients. Objectives This study was designed to compare the effect of open-chain kinematics (bicycle ergometry) and closed-chain kinematics (treadmill) on walking proficiency in post-stroke individuals and their societal integration. Methods This was a pretest- posttest- experimental study involving 35 ambulatory hemiplegic stroke survivors (18males and 17 females) with a mean age of 53.77±10.95 undergoing rehabilitation at the two Teaching Hospitals in Lagos. Patients went through a 10-week rehabilitation and were randomly assigned to two intervention groups. Spatio-temporal gait parameters were measured by the six-metre walkway and community integrated questionnaire was used to examine home integration, social integration and productive activities. Data were subjected to inferential and descriptive statistics. The level of significance was set at p<0.05. Results Results showed significant difference between baseline and post intervention scores for all the gait parameters in the bicycle ergometer group except for stride length (p = 0.078). There was also a significant difference in the mean change in cadence between the treadmill and bicycle ergometer group (p = 0.04). Conclusions Both open-chain and closed-chain kinematics are effective, but closed- chain is most effective in re-educating ambulation and re-gaining spatio-temporal gait parameters after stroke and should be structured into the patients’ treatment regimen to effectively improve functional capability in post-stroke individuals.


2018 ◽  
Vol 2018 ◽  
pp. 1-7
Author(s):  
Rabiatul Adawiah Abdul Rahman ◽  
Fazira Rafi ◽  
Fazah Akhtar Hanapiah ◽  
Azlina Wati Nikmat ◽  
Nor Azira Ismail ◽  
...  

Background. Tasks requiring simultaneous mobility and cognition (dual tasks) have been associated with incidence of falls. Although these deficits have been documented in individuals with neurologic disorder, the effect of dual task in children with traumatic brain injury has not been fully explored. Objective. To investigate the effect of dual-task (dual-motor and dual-cognitive task) conditions on spatiotemporal gait parameters during timed up and go test in children with traumatic brain injury. Methods and Material. A total of 14 children with traumatic brain injury and 21 typically developing children participated in this case-control study. Functional balance was assessed before the actual testing to predict the risk of falls. Timed up and go test was performed under single-task and dual-task (dual-motor and dual-cognitive task) conditions. Spatiotemporal gait parameters were determined using the APDM Mobility Lab system. The descriptive statistics and t-test were used to analyze demographic characteristics and repeated measure ANOVA test was used to analyze the gait parameters. Results. Under dual-task (dual-motor and dual-cognitive task) conditions during the timed up and go test, gait performance significantly deteriorated. Furthermore, the total time to complete the timed up and go test, stride velocity, cadence, and step time during turning were significantly different between children with traumatic brain injury and typically developing children. Conclusions. These findings suggest that gait parameters were compromised under dual-task conditions in children with traumatic brain injury. Dual-task conditions may become a component of gait training to ensure a complete and comprehensive rehabilitation program.


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