Role of spasticity severity on the balance of post-stroke patients (Preprint)

2021 ◽  
Author(s):  
Ashraf Mahmoudzadeh ◽  
Noureddin Nakhostin Ansari ◽  
Soofia Naghdi ◽  
Ehsan Ghasemi ◽  
Brandon S Shaw ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Ankle Joint ◽  
Postural Sway ◽  
Dynamic Balance ◽  
Ankle Dorsiflexion ◽  
Plantar Flexor ◽  
Stroke Patients ◽  
Timed Up And Go ◽  
Balance Confidence ◽  
Post Stroke

BACKGROUND Lower limb spasticity, as is common following a cerebrovascular attack (CVA) or stroke, can affect the balance and gait of patients. This then not only affects independence, and quality of life, but also increases the risk for other concerns, such as falling and an increased sedentariness, which could further affect health outcomes. OBJECTIVE We aimed to evaluate the effect of ankle plantar flexor spasticity severity on balance and to determine the relationship between the spasticity severity with ankle proprioception, passive range of motion (ROM), and balance confidence in post-stroke patients. METHODS Twenty-eight post-stroke patients were divided into two groups based on the level of ankle plantar flexor spasticity according to the Modified Modified Ashworth Scale (MMAS) as a High Spasticity Group (HSG) (MMAS>2) (n=14) or a Low Spasticity Group (LSG) (MMAS≤2) (n=14). The MMAS scores, Activities-Specific Balance Confidence Questionnaire, postural sway in the open and closed eyes conditions, timed up and go (TUG) test, ankle dorsiflexion passive range of motion (ROM), and ankle joint proprioception were measured. RESULTS No significant (p>0.05) differences were found between the LSG and HSG in terms of balance confidence, dynamic balance, and ankle dorsiflexion ROM. In addition, postural sway in the open and closed eye conditions was not significantly different in both the LSG and HSG for both the less affected and affected limbs. Similarly, posturography indicators in the open and closed eye conditions were not significantly different in both the LSG and HSG for both the less affected and affected limbs. However, ankle joint proprioception in terms of repositioning error angle was significantly (p≤0.05) better in the LSG compared to the HSG (p=0.01). There was also a significant relationship between TUG scores and balance confidence in the HSG(r=-0.55, p=0.04) CONCLUSIONS Our data suggests that several aspects of balance needs to be considered in the assessment and rehabilitation of post-stroke patients and there is a need to monitor entire patterns of activities to support wider engagement in rehabilitation activities. INTERNATIONAL REGISTERED REPORT RR2-10.2196/16045

scholarly journals Role of Spasticity Severity on the Balance of Post-stroke Patients

2021 ◽  
Vol 15 ◽  
Author(s):  
Ashraf Mahmoudzadeh ◽  
Noureddin Nakhostin Ansari ◽  
Soofia Naghdi ◽  
Ehsan Ghasemi ◽  
Omid Motamedzadeh ◽  
...  
Keyword(s):  
Ankle Joint ◽  
Postural Sway ◽  
Ankle Dorsiflexion ◽  
Plantar Flexor ◽  
Plantar Flexors ◽  
Timed Up And Go ◽  
Balance Confidence ◽  
Eyes Closed ◽  
Eyes Open ◽  
Ankle Proprioception

Background: Lower limb spasticity after stroke is common that can affect the balance, increase the risk of falling, and reduces the quality of life.Objective: First, evaluate the effects of spasticity severity of ankle plantar flexors on balance of patients after stroke. Second, to determine the relationship between the spasticity severity with ankle proprioception, passive ankle dorsiflexion range of motion (ROM), and balance confidence.Methods: Twenty-eight patients with stroke based on the Modified Modified Ashworth Scale (MMAS) were divided into two groups: High Spasticity Group (HSG) (MMAS > 2) (n = 14) or a Low Spasticity Group (LSG) (MMAS ≤ 2) (n = 14). The MMAS scores, Activities-Specific Balance Confidence Questionnaire, postural sway of both affected and non-affected limbs under the eyes open and eyes closed conditions, timed up and go (TUG) test, passive ankle dorsiflexion ROM, and ankle joint proprioception were measured.Results: The ankle joint proprioception was significantly better in the LSG compared to the HSG (p = 0.01). No significant differences were found between the LSG and HSG on all other outcome measures. There were no significant relationships between the spasticity severity and passive ankle dorsiflexion ROM, and balance confidence.Conclusion: The severity of ankle plantar flexor spasticity had no effects on balance of patients with stroke. However, the ankle joint proprioception was better in patients with low spasticity. Our findings suggest that the balance is affected regardless of the severity of the ankle plantar flexor spasticity in this group of participants with stroke.

scholarly journals Proprioceptive Neuromuscular Facilitation Kinesio Taping Improves Range of Motion of Ankle Dorsiflexion and Balance Ability in Chronic Stroke Patients

Healthcare ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1426
Author(s):  
Donghwan Park ◽  
Youngsook Bae
Keyword(s):  
Range Of Motion ◽  
Dynamic Balance ◽  
Chronic Stroke ◽  
Ankle Dorsiflexion ◽  
Muscle Synergy ◽  
Long Term Effects ◽  
Timed Up And Go ◽  
Kinesio Taping ◽  
Proprioceptive Neuromuscular Facilitation ◽  
Balance Ability

This study aimed to determine the effect of a proprioceptive neuromuscular facilitation (PNF) pattern Kinesio taping (KT) application on the ankle dorsiflexion range of motion (DF-ROM) and balance ability in patients with chronic stroke. This crossover study included 18 patients with stroke. The subjects were randomly assigned to three interventions: barefoot, ankle KT (A-KT), and PNF-KT. The A-KT was applied to the gastrocnemius and tibialis anterior (TA) muscles, and subtalar eversion. The PNF-KT was applied on the extensor hallucis, extensor digitorum, and TA muscles. DR-ROM was measured using the iSen™, a wearable sensor. Balance ability was assessed based on static balance, measured by the Biodex Balance System (BBS), and dynamic balance, measured by the timed up and go (TUG) test and dynamic gait index (DGI). Compared with the barefoot and A-KT interventions, PNF-KT showed significant improvements in the ankle DF-ROM and BBS scores, TUG, and DGI. PNF-KT, for functional muscle synergy, improved the ankle DF-ROM and balance ability in patients with chronic stroke. Therefore, the application of PNF-KT may be a feasible therapeutic method for improving ankle movement and balance in patients with chronic stroke. Additional research is recommended to identify the long-term effects of the PNF-KT.

Effects Of A 8-week Pilates Exercise On Static And Dynamic Balance In Post Stroke Patients

2016 ◽  
Vol 48 ◽  
pp. 400 ◽  
Author(s):  
Sukhoon Yoon ◽  
Hee Sung Lim ◽  
Ji-sun Ryu ◽  
SangKyun Park ◽  
Sangheon Park ◽  
...  
Keyword(s):  
Dynamic Balance ◽  
Stroke Patients ◽  
Post Stroke

Effect of Plantar Flexor and Dorsiflexor Fatigue on Unilateral Postural Control

1993 ◽  
Vol 9 (3) ◽  
pp. 191-201 ◽  
Author(s):  
Thomas M. Lundin ◽  
Jon W. Feuerbach ◽  
Mark D. Grabiner
Keyword(s):  
Ankle Joint ◽  
Postural Sway ◽  
Plantar Flexor ◽  
Plantar Flexors ◽  
Joint Injury ◽  
Balance System ◽  
Fatigue Protocol ◽  
Before And After ◽  
Ankle Muscle ◽  
Male Subjects

The purpose of this study was to determine the effect of plantar flexor and dorsiflexor fatigue on postural sway amplitude during unilateral, or one-legged, stance. It was hypothesized that plantar flexor and dorsiflexor fatigue would increase unilateral postural sway amplitude. Eight uninjured male subjects participated in pre- and postfatigue unilateral stability tests. Selected parameters describing medial-lateral (ML) and anterior-posterior (AP) postural sway were measured on a Chattecx Balance System before and after an isokinetic fatigue protocol. The fatigue protocol resulted in a significant increase in ML postural sway amplitude (p< 0.05) and an increase in AP sway amplitude (p= 0.065). Previously, links have been established between increased postural sway amplitude and ankle joint injury. Thus, fatigue of the plantar flexors and dorsiflexors, which increased postural sway amplitude, may render the ankle joint susceptible to injury. Induced ankle muscle fatigue may represent a valid paradigm to study the causes of traumatic ankle joint injury.

CORRELATION OF ANKLE DORSIFLEXION RANGE OF MOTION WITH DYNAMIC BALANCE IN YOUNG NORMAL INDIVIDUALS

2015 ◽  
Vol 3 (4) ◽  
pp. 1184-1187 ◽  
Author(s):  
Pranali Suryavanshi ◽  
◽  
Ajay kumar ◽  
Parag Kulkarni ◽  
Prakash Patel ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Dynamic Balance ◽  
Ankle Dorsiflexion ◽  
Normal Individuals

Development of a Soft Pneumatic Sock for Robot-Assisted Ankle Exercise

2016 ◽  
Vol 10 (1) ◽  
Author(s):  
Fan-Zhe Low ◽  
Hong Han Tan ◽  
Jeong Hoon Lim ◽  
Chen-Hua Yeow
Keyword(s):  
Range Of Motion ◽  
Ankle Joint ◽  
Medical Condition ◽  
Joint Stiffness ◽  
Intermittent Pneumatic Compression ◽  
Ankle Dorsiflexion ◽  
Compression Stockings ◽  
Robot Assisted ◽  
Pneumatic Actuators ◽  
Prolonged Immobilization

Deep vein thrombosis (DVT) is a severe medical condition that affects many patients around the world, where one of the main causes is commonly associated with prolonged immobilization. Current mechanical prophylaxis systems, such as the compression stockings and intermittent pneumatic compression devices, have yet to show strong efficacy in preventing DVT. The current study aimed to develop a soft pneumatic sock prototype that uses soft extension pneumatic actuators to provide assisted ankle dorsiflexion–plantarflexion motion, so as to prevent the occurrence of DVT. The prototype was evaluated for its efficacy to provide the required dorsiflexion–plantarflexion motion by donning and actuating the prototype on simulated ankle–foot models with various ankle joint stiffness values. Our results showed that the soft extension actuators in the sock prototype provided controllable assisted ankle plantarflexion through actuator extension and ankle dorsiflexion through actuator contraction, where in our study, the actuations extended to 129.9–146.8% of its original length. Furthermore, the sock was able to achieve consistent range of motion at the simulated ankle joint across different joint stiffness values (range of motion: 27.5 ± 6.0 deg). This study demonstrated the feasibility of using soft extension pneumatic actuators to provide robot-assisted ankle dorsiflexion–plantarflexion motion, which will act as an adjunct to physiotherapists to optimize therapy time for bedridden patients and therefore may reduce the risk of developing DVT.

Effects of gait rehabilitation with a footpad-type locomotion interface in patients with chronic post-stroke hemiparesis: a pilot study

2012 ◽  
Vol 26 (8) ◽  
pp. 686-695 ◽  
Author(s):  
Naoki Tanaka ◽  
Hideyuki Saitou ◽  
Toshifumi Takao ◽  
Noboru Iizuka ◽  
Junko Okuno ◽  
...  
Keyword(s):  
Pilot Study ◽  
Sample Size ◽  
Gait Speed ◽  
Chronic Stroke ◽  
Gait Rehabilitation ◽  
Stroke Patients ◽  
Timed Up And Go ◽  
Intervention Phase ◽  
Post Stroke ◽  
Locomotion Interface

Objective: We developed a footpad-type locomotion interface called the GaitMaster. The purpose of this pilot study was to examine the effects of gait rehabilitation using the GaitMaster in chronic stroke patients. Design: Randomized cross-over design. Setting: An outpatient department. Subjects: Twelve patients with chronic post-stroke hemiparesis. Intervention: In group A, patients underwent an ‘intervention phase’ followed by a ‘non-intervention phase’, whereas in group B, patients underwent the non-intervention phase first, followed by the intervention phase. In the four- or six-week intervention phase, participants underwent twelve 20-minute sessions of gait rehabilitation using the GaitMaster4. Main outcome measures: We measured gait speed and timed up-and-go test. Results: No differences between the two groups were observed in the baseline clinical data. For the combined groups A and B, the maximum gait and timed up-and-go test speeds improved significantly only in the intervention phase ( P = 0.0001 and P = 0.003, respectively). The percentages of improvement from baseline at the end of GaitMaster training were 16.6% for the maximum gait speed and 8.3% for the timed up-and-go test. The effect size for GaitMaster4 training was 0.58 on the maximum gait speed and 0.43 on the timed up-and-go test. Conclusions: This pilot study showed that gait rehabilitation using the GaitMaster4 was a feasible training method for chronic stroke patients. Calculation of the sample size indicated that a sample size of 38 participants would be adequate to test a null hypothesis of nil benefit additional to routine rehabilitation for chronic stroke patients in a future randomized controlled trial.

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