Assessment of the Effects of Rehabilitation on Balance Impairment in Patients After Ischemic Stroke According to Selected Tests and Scales

Abstract Cerebral stroke is one of the most important issues for modern medicine. Despite the fact that numerous activities have been undertaken for the purpose of raising awareness and significance of prevention, this condition still remains one of the main reasons behind disability. The objective of the work was to assess the effects of the type of therapy, age and period from the incident occurrence, on the progress of rehabilitation of imbalance and body stability observed in a group of researched patients, on the basis of results obtained according to the Berg Balance Scale, tandem balance test, Kwolek’s loading symmetry index and Timed Up and Go test. The test group comprised of 55 post-stroke patients. The group consisted of 29 women (52.73%) and 26 men (47.27%). The average age of the subjects was 61.02 years (age range between 33-85 years). A number of the patients were subjected to rehabilitation with the use of classic kinesitherapy, whereas the remaining group underwent rehabilitation based on the proprioceptive neuromuscular facilitation method (PNF).

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Effectiveness of clinical and instrumental tools to predict falls In elderly patients neurological hospital

Journal of New Medical Technologies eJournal ◽

10.12737/7220 ◽

2014 ◽

Vol 8 (1) ◽

pp. 0-0

Author(s):

Робинсон ◽

K. Robinson ◽

Ахмадуллин ◽

F. Akhmadullin ◽

Харисова ◽

...

Keyword(s):

Elderly Patients ◽

Sagittal Plane ◽

Center Of Pressure ◽

Berg Balance Scale ◽

Timed Up And Go ◽

Balance Test ◽

Eyes Closed ◽

Medical University ◽

Reactive Balance ◽

Falls In Elderly

The purpose of this study was evaluation of the most effective clinical and paraclinical methods for prediction of falls in elderly patients of neurology ward. Мaterials and methods: the study included 251 patients (all retired by age) who admitted to neurology ward at the Hospital of Bashkir State Medical University (Ufa, Russia). The following tools were used: “Timed up and Go” (TUG), Berg Balance Scale (B), Duncan test (D), reactive balance test (T) and computerized stabilometric tests on force platform «STABILO-MBN» (Moscow). Results: Mean age of patients was 66.68 years (SD=8.79, median=64 года). The mean results of the clinical tests were the following: TUG=13.42 sec, SD=5.57 (normal reference time is less than 10 sec.), B= 45.90 (SD=7.70), which is interpreted as low risk for falling, D= 26.10 сm (SD=7.77), which is significantly less than normal results, T= 1.50 (SD=0.54), which is also worse than in healthy individuals. The best predictive power for prognosis of falls was calculated for reactive balance test values and root-mean-square deviation of center of pressure in frontal (CPF) or sagittal plane with the eyes closed. The authors present the predictive equations for prognosis of the number of falls. For instance, the predicted number of falls during 12 months =1.476 + 0.122TUG – 1.411T + 0.0161CPF. Conclusion: The tools evaluated in this study, have different effectiveness for prognosis of falls in patients and could be used in clinical practice as a part of predictive mathematical model.

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Neurometabolic Support for Post-stroke Patients with Movement Disorders during the Second Stage of Rehabilitation

Doctor Ru ◽

10.31550/1727-2378-2020-19-9-27-32 ◽

2020 ◽

Vol 19 (9) ◽

pp. 27-32

Author(s):

I.P. Yastrebtseva ◽

◽

V.A. Krivonogov ◽

N.N. Panueva ◽

V.V. Belova ◽

...

Keyword(s):

Movement Disorders ◽

Cognitive Assessment ◽

Montreal Cognitive Assessment ◽

Cerebral Stroke ◽

Stroke Patients ◽

Balance Test ◽

Second Stage ◽

Study Results ◽

Ethylmethylhydroxypyridine Succinate ◽

Group 1

Study Objective: To evaluate dose-dependent effects of adjunctive treatment with ethylmethylhydroxypyridine succinate within a comprehensive course of rehabilitation, in cerebral stroke patients with movement disorders in the second stage of rehabilitation. Study Design: This was a randomized study. Materials and Methods: Forty ischemic stroke patients were examined, and divided into three groups. Ethylmethylhydroxypyridine succinate was given intramuscularly to 18 patients: 250 mg/day (5 mL) in Group 1 (n = 9) and 100 mg/day (2 mL) in Group 2 (n = 9). In Group 3 (n = 22) patients did not receive this drug. All patients underwent a complete examination, including assessment of the following parameters: static and dynamic balance, as assessed by the Standing Balance Test and the Berg Balance Test; walking (Hauser Ambulation Index); and emotional (Hospital Anxiety and Depression Scale), cognitive (Montreal Cognitive Assessment), and sensory (Fugl-Meyer Assessment Scale) functions. Patients’ balance status was objectively assessed using stabilometric parameters. Study Results: Group 1 patients showed a significant increase in Berg Balance Test scores (from 44.00 [42.00; 47.00] to 46.00 [42.00; 49.00]) and a decrease in statokinesigram area (with eyes closed) (from 910.92 [36.20; 2,633.50] mm2 to 620.98 [213.40; 1,676.30] mm2 (p < 0.05). All groups exhibited trends toward improvement of static balance, quality of walking, and cognitive and sensory functions, but only the changes in the Montreal Cognitive Assessment in Group 1 were statistically significant (from 24.67 [19; 27] to 26.67 [22; 29]). Conclusion: Adjunctive ethylmethylhydroxypyridine succinate, 5 mL (250 mg/day), within a course of rehabilitation improved patients’ balance status and cognitive functions. Patients who received this medication at a dose of 2 mL (100 mg/day) and those who did not receive it showed no significant improvement during rehabilitation. Keywords: stroke, balance, neurometabolic therapy, ethylmethylhydroxypyridine succinate.

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Prevalence of falls among elderly participants of a health promotion group and comparison of balance tests to detect risk of falls

Fisioterapia em Movimento ◽

10.1590/1980-5918.030.003.ao10 ◽

2017 ◽

Vol 30 (3) ◽

pp. 519-525

Author(s):

Vanessa Lobo Carvalho ◽

Analita Alves Clementino ◽

Edel Quinn Ferreira Ferro de Magalhães ◽

Edlanne Morais Belo da Silva ◽

Jussara Almeida de Oliveira Baggio

Keyword(s):

Health Promotion ◽

Elderly Patients ◽

Public Health Problem ◽

Berg Balance Scale ◽

Cross Sectional Study ◽

Mean Value ◽

Timed Up And Go ◽

Balance Test ◽

Cross Sectional ◽

Risk Of Falls

Abstract Introduction: Falls of elderly people are common, representing a serious public health problem. The use of appropriate instruments in the assessment of elderly patients supports the early detection of individuals under risk of falls and its prevention. Objective: To verify the incidence of falls in a group of elderly patients and detect which balance test is the most appropriate for the studied sample. Methods: Quantitative, cross-sectional study with an observational approach. A total of 30 elderly patients aged over 60 years old participating in a health promotion group were included in the sample. The participants were initially interviewed and subsequently assessed by means of the following instruments: Berg Balance Scale (BBS), Timed Up and Go test (TUG), and the Dynamic Gait Index (DGI). Results: The mean age of the participants was 69.30 ± 7.47 years; 90% were women and 46.7% of the individuals reported falls. The participants obtained a mean value of 10.2 ± 2.5 seconds in the TUG, 51.4 ± 2.6 in the BBS, and 18.6 ± 4.2 in the DGI. The sensitivity of the scales was 0.71 in the TUG, 0.50 in the DGI, and 0.42 in the BBS; specificity was 0.44 in the TUG, 0.32 in the DGI and 0.63 in the BBS. Conclusion: A high prevalence of falls was observed in the sample. In addition, the TUG was the most sensitive test to assess balance in the assessed sample. However, its use alone requires caution in this sample.

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The Effects of Transcranial Direct Current Stimulation on Balance and Gait in Stroke Patients: A Systematic Review and Meta-Analysis

Frontiers in Neurology ◽

10.3389/fneur.2021.650925 ◽

2021 ◽

Vol 12 ◽

Author(s):

Ke Dong ◽

Shifeng Meng ◽

Ziqi Guo ◽

Rufang Zhang ◽

Panpan Xu ◽

...

Keyword(s):

Systematic Review ◽

Direct Current ◽

Transcranial Direct Current Stimulation ◽

Meta Analysis ◽

Functional Independence ◽

Berg Balance Scale ◽

Cochrane Central Register ◽

Stroke Patients ◽

Timed Up And Go ◽

Direct Current Stimulation

Objective: Balance dysfunction after stroke often results in individuals unable to maintain normal posture, limits the recovery of gait and functional independence. We explore the short-term effects of transcranial direct current stimulation (tDCS) on improving balance function and gait in stroke patients.Methods: We systematically searched on PubMed, Web of Science, EMBASE, Cochrane Central Register of Controlled Trials, and Google Scholar for studies that explored the effects of tDCS on balance after stroke until August 2020. All involved studies used at least one measurement of balance, gait, or postural control as the outcome.Results: A total of 145 studies were found, of which 10 (n = 246) met the inclusion criteria and included in our studies. The present meta-analysis showed that active tDCS have beneficial effects on timed up and go test (TUGT) [mean difference (MD): 0.35; 95% confidence interval (CI): 0.11 to 0.58] and Functional Ambulation Category (FAC) (MD: −2.54; 95% CI: −3.93 to −1.15) in stroke patients. However, the results were not significant on the berg balance scale (BBS) (MD: −0.20; 95% CI: −1.44 to 1.04), lower extremity subscale of Fugl-Meyer Assessment (FMA-LE) (MD: −0.43; 95% CI: −1.70 to 0.84), 10-m walk test (10 MWT) (MD: −0.93; 95% CI: −2.68 to 0.82) and 6-min walking test (6 MWT) (MD: −2.55; 95% CI: −18.34 to 13.23).Conclusions: In conclusion, we revealed that tDCS might be an effective option for restoring walking independence and functional ambulation for stroke patients in our systematic review and meta-analysis.Systematic Review Registration: CRD42020207565.

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Recovery of motor functions after a stroke

Neurology Bulletin ◽

10.17816/nb81051 ◽

2021 ◽

Vol XXX (3-4) ◽

pp. 50-51

Author(s):

A. S. Kadykov ◽

L. A. Chernikova

Keyword(s):

World Health Organization ◽

Rural Population ◽

Urban Population ◽

Developed Countries ◽

Modern Medicine ◽

World Health ◽

Cerebral Stroke ◽

Stroke Patients ◽

The World ◽

Health Organization

The problem of rehabilitation of stroke patients is being actively developed in modern medicine. According to the World Health Organization, 100-300 cases of stroke occur annually in developed countries for every 100 thousand people. In Russia, these numbers are 250-320 among the urban population (according to the registers of cerebral stroke in Moscow and Novosibirsk) and 170 among the rural population (according to the Stavropol Territory).

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The effects of golf training in patients with stroke: a pilot study

International Psychogeriatrics ◽

10.1017/s1041610214002452 ◽

2015 ◽

Vol 27 (5) ◽

pp. 865-873 ◽

Cited By ~ 8

Author(s):

Tobias Schachten ◽

Petra Jansen

Keyword(s):

Experimental Period ◽

Training Group ◽

Well Being ◽

Berg Balance Scale ◽

Control Group ◽

Stroke Patients ◽

Balance Test ◽

Assessment Tests ◽

Visual Spatial ◽

Before And After

ABSTRACTBackground:Stroke is the most common neurological disease and the primary cause of lifelong disability in industrialized countries. Because of this it is important to investigate any kind of successful therapy.Methods:From the 24 recruited stroke patients who were between 23 and 72 years old, 14 patients were separated either in a golf training group (EG), or a social communication meeting (CG). Both groups met for one hour sessions, twice a week, for ten weeks. All participants completed assessment tests before and after the experimental period: cognitive tests measuring attention (Go/No-Go task), visual-spatial memory (Block-Tapping test) and mental rotation performance (MRT); a balance test (Berg Balance Scale), and an emotional well-being test (CES-D-Scale).Results:The results show that both groups improved in the CES Scale, the block-tapping test and the balance test. In addition, stroke patients who received a golf training showed a significant improvement in the MRT comparing to the control group (CG).Conclusion:It is indicated that golf training can improve visual imagery ability in stroke patients, even late after stroke.

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Effect of an EMG–FES Interface on Ankle Joint Training Combined with Real-Time Feedback on Balance and Gait in Patients with Stroke Hemiparesis

Healthcare ◽

10.3390/healthcare8030292 ◽

2020 ◽

Vol 8 (3) ◽

pp. 292

Author(s):

Subeen Bae ◽

Jin Lee ◽

Byoung-Hee Lee

Keyword(s):

Real Time ◽

Ankle Joint ◽

Stride Length ◽

Muscle Tone ◽

Weight Bearing ◽

Step Length ◽

Berg Balance Scale ◽

Stroke Patients ◽

Timed Up And Go ◽

Joint Training

This study evaluated the effects of an electromyography–functional electrical stimulation interface (EMG–FES interface) combined with real-time balance and gait feedback on ankle joint training in patients with stroke hemiplegia. Twenty-six stroke patients participated in this study. All subjects were randomly assigned to either the EMG–FES interface combined with real-time feedback on ankle joint training (RFEF) group (n = 13) or the EMG–FES interface on ankle joint training (EF) group (n = 13). Subjects in both groups were trained for 20 min a day, 5 times a week, for 4 weeks. Similarly, all participants underwent a standard rehabilitation physical therapy for 60 min a day, 5 times a week, for 4 weeks. The RFEF group showed significant increases in weight-bearing lunge test (WBLT), Tardieu Scale (TS), Timed Up and Go Test (TUG), Berg Balance Scale (BBS), velocity, cadence, step length, stride length, stance per, and swing per (p < 0.05). Likewise, the EF group showed significant increases in WBLT, TUG, BBS, velocity, and cadence (p < 0.05). Moreover, the RFEF group showed significantly greater improvements than the EF group in terms of WBLT, Tardieu Scale, TUG, BBS, velocity, step length, stride length, stance per, and swing per (p < 0.05). Ankle joint training using an EMG–FES interface combined with real-time feedback improved ankle range of motion (ROM), muscle tone, balance, and gait in stroke patients. These results suggest that an EMG–FES interface combined with real-time feedback is feasible and suitable for ankle joint training in individuals with stroke.

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Development of mobile application to identify fall risk in the elderly

Revista Pesquisa em Fisioterapia ◽

10.17267/2238-2704rpf.v8i3.2047 ◽

2018 ◽

Vol 8 (3) ◽

pp. 354-360

Author(s):

Maria Consuelo D´Almeida Nuñez Filha ◽

Elen Beatriz Carneiro Pinto ◽

Handerson Jorge Dourado Leite

Keyword(s):

Software Development ◽

Health Professionals ◽

Test Performance ◽

The Elderly ◽

Berg Balance Scale ◽

Timed Up And Go ◽

Balance Test ◽

Mobility Assessment ◽

Risk Of Falls ◽

Dynamic Gait Index

INTRODUCTION: A fall can occur at any stage of one's life; however, it is more common in the elderly. The effects of falls are serious, in social and economic terms, in the country and worldwide. Today, the public health system extensively encourages scientific studies that help prevent these accidents effectively, reducing the demand for health services and its associated costs. OBJECTIVE: To develop an electronic mobile web tool (app) that helps health professionals to assess risk factors related to falls among elderly people, utilising validated instruments designed for this age group that are widely used in the literature and adapted to Brazilian Portuguese. METHOD: This is a project regarding the development of a prototype for use on the Android platform, programmed in JAVA. RESULTS: After analysing the criteria set out in the study, the selected tools for software development were the Dynamic Gait Index-DGI, the Berg Balance Scale, the Timed Up and Go (TUG) test and the Tinetti Balance test (Performance Oriented Mobility Assessment-POMA). The tests conducted after the software development phase showed the predetermined requirements were met 100%. CONCLUSION: The app that was developed during the process proved to be versatile, fast, includes the main instruments that are validated in the Brazilian literature, identifies the risk of falls in the elderly, is easy to use, which all are positive incentives for health professionals to use the device.

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Effect of Diagonal Pattern Training on Trunk Function, Balance, and Gait in Stroke Patients

Applied Sciences ◽

10.3390/app10134635 ◽

2020 ◽

Vol 10 (13) ◽

pp. 4635

Author(s):

Shin Jun Park ◽

Seunghue Oh

Keyword(s):

Scale Score ◽

Berg Balance Scale ◽

Control Group ◽

Stroke Patients ◽

Trunk Control ◽

Single Plane ◽

Walking Test ◽

Gait Performance ◽

Proprioceptive Neuromuscular Facilitation ◽

Test Result

Introduction: Trunk control disability commonly occurs after stroke. This study investigated the effect of diagonal pattern training in the sitting position to improve trunk control ability and gait performance. Method: 46 stroke patients were enrolled in this study. We used single plane training and diagonal pattern training. Additionally, the subjects were randomly assigned to the experiment group (diagonal pattern training) and the control group (single plane training). Diagonal pattern training was modified with proprioceptive neuromuscular facilitation technique’s chopping and lifting pattern to create 10 movements. Results: the trunk impairment scale score, Berg balance scale score, 10 m walking test result, and gait significantly increased in the experiment group compared to the control group. Conclusions: diagonal pattern training can be regarded as a promising method to improve postural control and increase balance and gait in stroke patients

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Ultrasound Imaging of the Trunk Muscles in Acute Stroke Patients and Relations With Balance Scales

Annals of Rehabilitation Medicine ◽

10.5535/arm.19125 ◽

2020 ◽

Vol 44 (4) ◽

pp. 273-283

Author(s):

Yunho Kim ◽

Jeeyoung Kim ◽

Heesung Nam ◽

Hyun Dong Kim ◽

Mi Ja Eom ◽

...

Keyword(s):

Acute Stroke ◽

Ultrasound Imaging ◽

Fall Risk ◽

Berg Balance Scale ◽

Erector Spinae ◽

Transversus Abdominis ◽

Trunk Muscles ◽

Stroke Patients ◽

Timed Up And Go ◽

Motor Test

Objective To examine the correlation between ultrasonographic trunk muscle parameters and balance scales in mild acute stroke patients.Methods A total of 55 stroke patients with hemiparesis and motor power grade ≥4 in the manual motor test were included. The Scale for the Assessment and Rating of Ataxia (SARA), Berg Balance Scale (BBS), Timed Up and Go Test (TUG), and Trunk Control Test (TCT) were used to evaluate patient balance function. Ultrasonographic parameters were measured on both non-paretic and paretic sides of the rectus abdominis, external oblique, internal oblique, transversus abdominis, and erector spinae muscles. Resting thickness and contraction thickness were measured in all muscles, and contractility and contractility ratio were calculated based on measured thicknesses. The differences between paretic and non-paretic muscle parameters, and the correlation between ultrasonographic parameters and balance scales were analyzed. Stroke patients were divided into two groups according to their fall risk. Ultrasonographic measurements between the two groups were compared.Results All muscles’ contraction thickness and contractility were significantly different between paretic and non-paretic sides (p<0.001). Contractility ratios of all trunk muscles showed a significant correlation with SARA, BBS, TUG, and TCT (p<0.05). Contractility ratios of all muscles were significantly different between high- and low-risk fall groups (p<0.05).Conclusion The contractility ratio in stroke patients reflects their balance disturbance and fall risk and it may serve as a new parameter for ultrasound imaging of trunk muscles.

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