Effects of Robot-Aided Rehabilitation on Improving Ankle and Balance Performance of Stroke Survivors: A Randomized Controlled Trial

Abstract Background: Stroke survivors often experience abnormal posture control, which affects balance and locomotion. The ankle strategy is important in maintaining static balance. Prolonged spasticity may result in biomechanical changes at the ankle joint, which may cause balance disorders. The intelligent stretching device may decrease the stiffness of the ankle and improve balance. The purpose of this study was to investigate the effects of robot-aided ankle rehabilitation of stroke survivors with ankle spasticity and the correlations between biomechanical properties and balance in these patients. Methods: Twenty inpatients post stroke with ankle spasticity performed 20 minutes of stretching treatment for 2 weeks. The study group used a rehabilitation robot to stretch the spastic ankle plantar flexors under intelligent control and the control group received manual stretching. Outcome measures included biomechanical, clinical evaluations and Pro-Kin balance test. Results: After training, significant improvements were found in both groups in the active range of motion, muscle strength, Berg Balance Scale, Fugl-Meyer Motor Assessment of Lower Extremity, Postural Assessment Scale for Stroke Patients, 6-minute walk test, and Modified Barthel Index (P<0.05); significant decreases were found in the study group in dorsiflexion stiffness, Modified Ashworth Scale, trajectory lengths, elliptical trajectory, standard deviation medial/lateral, average speed forward/backward with eyes closed, and standard deviation forward/backward with eyes open (P=0.001, P=0.037, P=0.028, P=0.019, P=0.016, P=0.001, and P=0.033, respectively); dorsiflexion stiffness was positively correlated with the Pro-Kin balance test outcomes: ellipse area, trajectory length, average speed forward/backward, average speed medial/lateral with eyes open ( =0.352, P=0.026; =0.522, P=0.001; =0.045, P=0.004; =0.433, P=0.005, respectively); dorsiflexion stiffness was correlated with the Modified Ashworth Scale ( =0.265, P=0.041); the study group improved significantly more than the control group in the activities of daily living after training (P =0 .017). Conclusions: The results suggested that robot-aided ankle rehabilitation had a positive effect on the biomechanical properties of the spastic ankle, and it may be feasible to improve balance post-stroke. Ankle dorsiflexion stiffness affected balance poststroke significantly; it may be a sensitive indicator for evaluating balance. Trial registration: www.chictr.org.cn ChiCTR1900022128. Registered 21 February 2020. Retrospectively registered.

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Effects of Robot-Aided Rehabilitation on Improving Ankle and Balance Performance of Stroke Survivors: A Randomized Controlled Trial

10.21203/rs.3.rs-30969/v1 ◽

2020 ◽

Author(s):

Xiaoxue Zhai ◽

Qiong Wu ◽

Quan Xu ◽

Xin Li ◽

Yanlin Zhang ◽

...

Keyword(s):

Biomechanical Properties ◽

Control Group ◽

Study Group ◽

Stroke Survivors ◽

Balance Test ◽

Average Speed ◽

Modified Ashworth Scale ◽

Ankle Rehabilitation ◽

Eyes Open ◽

Ashworth Scale

Abstract Background: Stroke survivors often experience abnormal posture control, which affects balance and locomotion. The ankle strategy is important in maintaining static balance. Prolonged spasticity may result in biomechanical changes at the ankle joint, which may cause balance disorders. The intelligent stretching device may decrease the stiffness of the ankle and improve balance. The purpose of this study was to investigate the effects of robot-aided ankle rehabilitation of stroke survivors with ankle spasticity and the correlations between biomechanical properties and balance in these patients. Methods: Twenty inpatients post stroke with ankle spasticity performed 20 minutes of stretching treatment for 2 weeks. The study group used a rehabilitation robot to stretch the spastic ankle plantar flexors under intelligent control and the control group received manual stretching. Outcome measures included biomechanical, clinical evaluations and Pro-Kin balance test. Results: After training, significant improvements were found in both groups in the active range of motion, muscle strength, Berg Balance Scale, Fugl-Meyer Motor Assessment of Lower Extremity, Postural Assessment Scale for Stroke Patients, 6-minute walk test, and Modified Barthel Index (P<0.05); significant decreases were found in the study group in dorsiflexion stiffness, Modified Ashworth Scale, trajectory lengths, elliptical trajectory, standard deviation medial/lateral, average speed forward/backward with eyes closed, and standard deviation forward/backward with eyes open (P=0.001, P=0.037, P=0.028, P=0.019, P=0.016, P=0.001, and P=0.033, respectively); dorsiflexion stiffness was positively correlated with the Pro-Kin balance test outcomes: ellipse area, trajectory length, average speed forward/backward, average speed medial/lateral with eyes open ( =0.352, P=0.026; =0.522, P=0.001; =0.045, P=0.004; =0.433, P=0.005, respectively); dorsiflexion stiffness was correlated with the Modified Ashworth Scale ( =0.265, P=0.041); the study group improved significantly more than the control group in the activities of daily living after training (P =0 .017). Conclusions: The results suggested that robot-aided ankle rehabilitation had a positive effect on the biomechanical properties of the spastic ankle, and it may be feasible to improve balance post-stroke. Ankle dorsiflexion stiffness affected balance poststroke significantly; it may be a sensitive indicator for evaluating balance. Trial registration: www.chictr.org.cn ChiCTR1900022128. Registered 21 February 2020. Retrospectively registered.

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Effects of Robot-Aided Rehabilitation on the Ankle Joint Properties and Balance Function in Stroke Survivors: A Randomized Controlled Trial

Frontiers in Neurology ◽

10.3389/fneur.2021.719305 ◽

2021 ◽

Vol 12 ◽

Author(s):

Xiaoxue Zhai ◽

Qiong Wu ◽

Xin Li ◽

Quan Xu ◽

Yanlin Zhang ◽

...

Keyword(s):

Ankle Joint ◽

Outcome Measures ◽

Controlled Trial ◽

Control Group ◽

Stroke Survivors ◽

Balance Function ◽

Post Stroke ◽

Ankle Stiffness ◽

Eyes Open ◽

Experimental Group

Background: Stroke survivors with impaired control of the ankle due to stiff plantarflexors often experience abnormal posture control, which affects balance and locomotion. Forceful stretching may decrease ankle stiffness and improve balance. Recently, a robot-aided stretching device was developed to decrease ankle stiffness of patient post-stroke, however, their benefits compared to manual stretching exercises have not been done in a randomized controlled trial, and the correlations between the ankle joint biomechanical properties and balance are unclear.Objective: To compare the effects of robot-aided to manual ankle stretching training in stroke survivors with the spastic ankle on the ankle joint properties and balance function post-stroke, and further explore the correlations between the ankle stiffness and balance.Methods: Twenty inpatients post-stroke with ankle spasticity received 20 minutes of stretching training daily over two weeks. The experimental group used a robot-aided stretching device, and the control group received manual stretching. Outcome measures were evaluated before and after training. The primary outcome measure was ankle stiffness. The secondary outcome measures were passive dorsiflexion ranges of motion, dorsiflexor muscle strength, Modified Ashworth Scale (MAS), Fugl-Meyer Motor Assessment of Lower Extremity (FMA-LE), Berg Balance Scale (BBS), Modified Barthel Index (MBI), and the Pro-Kin balance test.Results: After training, two groups showed significantly within-group improvements in dorsiflexor muscle strength, FMA-LE, BBS, MBI (P < 0.05). The between-group comparison showed no significant differences in all outcome measures (P > 0.0025). The experimental group significantly improved in the stiffness and passive range of motion of dorsiflexion, MAS. In the Pro-Kin test, the experimental group improved significantly with eyes closed and open (P < 0.05), but significant improvements were found in the control group only with eyes open (P < 0.05). Dorsiflexion stiffness was positively correlated with the Pro-Kin test results with eyes open and the MAS (P < 0.05).Conclusions: The robot-aided and manual ankle stretching training provided similar significant improvements in the ankle properties and balance post-stroke. However, only the robot-aided stretching training improved spasticity and stiffness of dorsiflexion significantly. Ankle dorsiflexion stiffness was correlated with balance function.Clinical Trial Registration:www.chictr.org.cn ChiCTR2000030108.

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EEG Data Quality: Determinants and Impact in a Multicenter Study of Children, Adolescents, and Adults with Attention-Deficit/Hyperactivity Disorder (ADHD)

Brain Sciences ◽

10.3390/brainsci11020214 ◽

2021 ◽

Vol 11 (2) ◽

pp. 214

Author(s):

Anna Kaiser ◽

Pascal-M. Aggensteiner ◽

Martin Holtmann ◽

Andreas Fallgatter ◽

Marcel Romanos ◽

...

Keyword(s):

Data Quality ◽

Large Scale ◽

Linear Models ◽

Spectral Power ◽

Control Group ◽

Continuous Performance Task ◽

Related Data ◽

Eyes Closed ◽

Eeg Data ◽

Eyes Open

Electroencephalography (EEG) represents a widely established method for assessing altered and typically developing brain function. However, systematic studies on EEG data quality, its correlates, and consequences are scarce. To address this research gap, the current study focused on the percentage of artifact-free segments after standard EEG pre-processing as a data quality index. We analyzed participant-related and methodological influences, and validity by replicating landmark EEG effects. Further, effects of data quality on spectral power analyses beyond participant-related characteristics were explored. EEG data from a multicenter ADHD-cohort (age range 6 to 45 years), and a non-ADHD school-age control group were analyzed (ntotal = 305). Resting-state data during eyes open, and eyes closed conditions, and task-related data during a cued Continuous Performance Task (CPT) were collected. After pre-processing, general linear models, and stepwise regression models were fitted to the data. We found that EEG data quality was strongly related to demographic characteristics, but not to methodological factors. We were able to replicate maturational, task, and ADHD effects reported in the EEG literature, establishing a link with EEG-landmark effects. Furthermore, we showed that poor data quality significantly increases spectral power beyond effects of maturation and symptom severity. Taken together, the current results indicate that with a careful design and systematic quality control, informative large-scale multicenter trials characterizing neurophysiological mechanisms in neurodevelopmental disorders across the lifespan are feasible. Nevertheless, results are restricted to the limitations reported. Future work will clarify predictive value.

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Semi-Permanent Acupuncture Needles in the Prevention of Post-Operative Nausea and Vomiting

Acupuncture in Medicine ◽

10.1136/aim.14.2.68 ◽

1996 ◽

Vol 14 (2) ◽

pp. 68-70 ◽

Cited By ~ 8

Author(s):

J Andrzejowski ◽

D Woodward

Keyword(s):

Controlled Trial ◽

Total Abdominal Hysterectomy ◽

Abdominal Hysterectomy ◽

Nausea And Vomiting ◽

Control Group ◽

Study Group ◽

Median Score ◽

Severe Nausea ◽

Post Operative Nausea ◽

Trial Study Group

The efficacy of acupressure and acupuncture at the Pericardium 6 (PC.6) point in relieving post-operative nausea and vomiting (PONV) is well known. Lengthy manual stimulation of the needles, or electrostimulation, is inconvenient and incurs extra costs. The aim of this study was to test the effectiveness of the antiemetic action of semi-permanent acupuncture needles (SPANs), a cheap and convenient method of administering acupuncture, in the first 48 hours following gynaecological surgery. Patients (n = 36) having total abdominal hysterectomy were studied in a randomised, placebo controlled trial. Study group patients had SPANs inserted in PC.6 on both wrists. The control group had SPANs inserted into sham points on their forearms. There was no difference in the median nausea scores between the groups; however six patients suffered moderate or severe nausea during the second 24 hours in the control group, with none in the study group (p < 0.05). In addition, the nausea score between 8 and 24 hours in patients who had previously experienced PONV, was lower in the study group (median score 2) compared to the control group (median score 4) (p < 0.05). We conclude that the use of SPANs does not reduce the overall incidence of nausea and vomiting but does appear to reduce the severity of nausea in the second 24 hours, and has a greater effect on patients who had had nausea and vomiting after a previous anaesthetic.

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Effectiveness of Antipyretic with Tepid Sponging Versus Antipyretic Alone in Febrile Children: A Randomized Controlled Trial

Journal of Nepal Paediatric Society ◽

10.3126/jnps.v37i2.16879 ◽

2018 ◽

Vol 37 (2) ◽

pp. 129-133

Author(s):

Chetak Kadbasal Basavaraj ◽

Shyamala Gowri Pocha ◽

Ravi Mandyam Dhati

Keyword(s):

Randomized Controlled Trial ◽

Controlled Trial ◽

Control Group ◽

Study Group ◽

Axillary Temperature ◽

Medical College ◽

Randomized Controlled ◽

Significant Difference

Introduction: Fever is the most common presenting complain for which children are brought to the paediatrician.Physical methods are widely used in treating febrile children, tepid sponging being commonly practiced in hospitals along with antipyretics. The objectives of this study were to compare the effectiveness of tepid sponging and antipyretic drug versus antipyretic drug alone in febrile children.Material and Methods: This was a Randomized controlled trial done in JSS Medical College and Hospital. All children under the age of 6 months to 12 years, admitted with axillary temperature of >99oF were included in the study. A total of 500 children were included over two years study period. Children with recorded axillary temperature of >990F were randomized into control and study group by computer generated randomisation. Children in the control group received only paracetamol (15mg/kg) at 5 minutes and combined group received paracetamol and tepid sponging at five minutes. Axillary temperature was monitored every 15 minutes for a period of 2 hours in both the groups.Results: There is no significant difference in reduction of temperature between the two groups by the end of two hours. Children in combined group had a higher level of discomfort than those in only antipyretic group.Conclusion: Tepid sponging does not add to the efficacy of paracetamol in antipyresis and that addition of tepid sponging to antipyretic, results in additional discomfort for the child. This study, therefore, endorses the view that antipyretic alone without tepid sponging should be the modality of therapy in children with fever.

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Maximal stability limits in adolescents with Tourette syndrome

Journal of Advanced Pediatrics and Child Health ◽

10.29328/journal.japch.1001024 ◽

2021 ◽

Vol 4 (1) ◽

pp. 013-022

Author(s):

Blanchet Mariève ◽

Prince François ◽

Lemay Martin ◽

Chouinard Sylvain ◽

Messier Julie

Keyword(s):

Postural Control ◽

Tourette Syndrome ◽

Center Of Pressure ◽

Phase 1 ◽

Sensory Information ◽

Control Group ◽

Eyes Closed ◽

Highly Sensitive ◽

Eyes Open ◽

Stability Limits

We explored if adolescents with Gilles de la Tourette syndrome (GTS) had functional postural control impairments and how these deficits are linked to a disturbance in the processing and integration of sensory information. We evaluated the displacements of the center of pressure (COP) during maximal leaning in four directions (forward, backward, rightward, leftward) and under three sensory conditions (eyes open, eyes closed, eyes closed standing on foam). GTS adolescents showed deficits in postural stability and in lateral postural adjustments but they had similar maximal COP excursion than the control group. The postural performance of the GTS group was poorer in the eyes open condition (time to phase 1 onset, max-mean COP). Moreover, they displayed a poorer ability to maintain the maximum leaning position under the eyes open condition during mediolateral leaning tasks. By contrast, during forward leaning, they showed larger min-max ranges than control subjects while standing on the foam with the eyes closed. Together, these findings support the idea that GTS produces subclinical postural control deficits. Importantly, our results suggest that postural control disorders in GTS are highly sensitive to voluntary postural leaning tasks which have high demand for multimodal sensory integration.

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Sauna Yoga Superiorly Improves Flexibility, Strength, and Balance: A Two-Armed Randomized Controlled Trial in Healthy Older Adults

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16193721 ◽

2019 ◽

Vol 16 (19) ◽

pp. 3721 ◽

Cited By ~ 2

Author(s):

Bucht ◽

Donath

Keyword(s):

Large Scale ◽

Controlled Trial ◽

Pilot Trial ◽

Intervention Group ◽

Control Group ◽

Minimization Method ◽

Important Indicator ◽

Randomized Controlled ◽

Eyes Closed ◽

Healthy Elderly

Besides strength and balance, flexibility is an important indicator of health-related physical fitness. Thus, the aim of this two-armed randomized controlled pilot trial was to investigate whether sauna yoga at a moderate temperature (50 °C) beneficially affects flexibility, strength, balance, and quality of life (QOL) in healthy elderly community dwellers. Participants were randomly assigned to an intervention group (INT, n = 11, age: 68.7 ± 5.9) or control group (CON, n = 12, age: 69.3 ± 4.9), using the minimization method. Age, physical activity, gender, and the primary outcome flexibility were used as strata for group allocation. Both groups completed similar exercises in the sauna over eight weeks. Only the INT group was exposed to moderate temperatures of 50 °C. Large and statistically significant improvement in favor of the sauna group (INT) was observed for the chair sit-and-reach test (INT: +83%, CON +3%, p = 0.028, nр² = 0.24). The shoulder and lateral spine flexibility were not relevantly affected. Strength in the lower extremities merely showed a tendency to significant changes (INT: 16%, CON: 3%, p = 0.061, nр² = 0.181). Additionally, balance abilities, with eyes closed, improved (INT: 187%, CON +58%, p = 0.056, nр² = 0.189) in favor of the INT group. QOL only improved in favor of the INT for environmental dimension (INT: +7%, CON: 0%, p = 0.034, nр² = 0.227). These first but preliminary findings indicate that sauna yoga may serve as a promising and feasible means to improve flexibility in elderly people. Strength and balance do not meaningfully benefit from a sauna environment, although strength improved to a slightly higher extent in the sauna group. Future large-scale research is needed to elucidate underlying mechanisms and corroborate these findings

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Cryotherapy Reduced Postoperative Pain in Gynecologic Surgery: A Randomized Controlled Trial

Pain Research and Treatment ◽

10.1155/2019/2405159 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Apisada Chumkam ◽

Densak Pongrojpaw ◽

Athita Chanthasenanont ◽

Junya Pattaraarchachai ◽

Kornkarn Bhamarapravatana ◽

...

Keyword(s):

Postoperative Pain ◽

Statistical Difference ◽

Controlled Trial ◽

Exploratory Laparotomy ◽

Gynecologic Surgery ◽

Control Group ◽

Study Group ◽

Control Groups ◽

Vas Score ◽

And Control

Objective. To examine the effectiveness of cryotherapy for reducing postoperative pain in patients who underwent exploratory laparotomy for gynecologic surgery. Materials and Methods. Patients who had indication for an exploratory laparotomy gynecologic procedure were selected by attending physicians to undergo abdominal surgery via low transverse skin incision. The participants were randomized into study and control groups with simple random sampling methods. Cold packs were applied at two hours after operation for 6 hours. The visual analog scale (VAS) score was recorded at two, 6, and 12 hours after operation. Result. One hundred cases were recruited and then divided into study and control groups equally. The mean age of both groups was 43 years. There was no difference in demographics data of both groups. Half of the participants in both groups underwent hysterectomies. At two hours after surgery, both groups had similar VAS scores. The study group had a lower VAS score at 6 and 12 hours after surgery than the control group with statistical difference. Morphine consumption within 24 hours after surgery in both the study and control groups was 2.8±3.4 and 3.0±4.4 mg, respectively, with no statistical difference. However the registration time of the first morphine requirement in the study group was statistically more prolonged than that of the control group. The lengths of hospital stay in both groups were similar. There was no complication reported in this study. Conclusion. Cryotherapy can reduce postoperative pain. In this presented study the patients who underwent gynecologic surgery had improved pain relief and prolonged time for the first dose of the analgesic drug.

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Effect of cervical headgear on dental arch area, shape and interarch dimensions

Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie ◽

10.1007/s00056-020-00264-0 ◽

2020 ◽

Author(s):

Toni Heino ◽

Heta Kokko ◽

Ville Vuollo ◽

Pertti Pirttiniemi

Keyword(s):

Standard Deviation ◽

Early Phase ◽

Three Dimensional ◽

Polynomial Equation ◽

Control Group ◽

Dental Arch ◽

Study Group ◽

Class Ii Malocclusion ◽

Angle Class Ii

Abstract Purpose The goal was to study the effects of early cervical headgear treatment on maxillary and mandibular dental arch area, shape and interarch dimensions. Methods The total study group comprised 67 children aged 7.6 years (standard deviation 0.3) with Angle class II malocclusion collected between 1992 and 1996. The children were randomly divided into two groups of equal size. In the first group, cervical headgear treatment was started immediately and undertaken for 2 years. The remaining patients served as untreated controls. Dental casts were taken and scanned at the beginning of treatment (T0) and at the 2‑year (T1) and 4‑year follow-up (T2). Three-dimensional landmarks describing the positions of maxillary and mandibular incisors, canines, first and second premolars and first molars were used to calculate and visualize the maxillary and mandibular dental arch area and shape using the polynomial equation y = Ax6 + Bx2. Results Significant changes in the shape and area of both maxillary and mandibular dental arches were induced with cervical headgear. The headgear increased dental arch area, sagittal dimensions at the mid-sagittal line and transversal dimensions at all of the measured levels in both dental arches compared to the control group. Conclusions Cervical headgear is an effective treatment device to gain space in both dental arches. Furthermore, when used as an early phase treatment, relapse is relatively small compared to the gained space.

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