Land-based and aquatic trunk exercise program improve trunk control, balance and activities of daily living ability in stroke: a randomized clinical trial

Author(s):  
Hye-Kang Park ◽  
Hwang-Jae Lee ◽  
Su-Jin Lee ◽  
Wan-Hee Lee
2021 ◽  
Vol 15 ◽  
Author(s):  
Thais Tavares Terranova ◽  
Marcel Simis ◽  
Artur César Aquino Santos ◽  
Fábio Marcon Alfieri ◽  
Marta Imamura ◽  
...  

Background: Stroke is one of the leading causes of adult disability, and up to 80% of stroke survivors undergo upper extremity motor dysfunction. Constraint-Induced Movement Therapy (CIMT) and Robot-Assisted Therapy (RT) are used for upper limb stroke rehabilitation. Although CIMT and RT are different techniques, both are beneficial; however, their results must be compared. The objective is to establish the difference between RT and CIMT after a rehabilitation program for chronic stroke patients.Method: This is a randomized clinical trial, registered at ClinicalTrials.gov (ID number NCT02700061), in which patients with stroke received sessions of RT or CIMT protocol, combined with a conventional rehabilitation program for 12 weeks. The primary outcome was measured by Wolf Motor Function Test (WMFT) and Fugl-Meyer Assessment—Upper Limb (FMA-UL). Activities of daily living were also assessed.Results: Fifty one patients with mild to moderate upper limb impairment were enrolled in this trial, 25 women and 26 men, mean age of 60,02 years old (SD 14,48), with 6 to 36 months after stroke onset. Function significantly improved regardless of the treatment group. However, no statistical difference was found between both groups as p-values of the median change of function measured by WMFT and FMA were 0.293 and 0.187, respectively.Conclusion: This study showed that Robotic Therapy (RT) was not different from Constraint-Induced Movement Therapy (CIMT) regardless of the analyzed variables. There was an overall upper limb function, motor recovery, functionality, and activities of daily living improvement regardless of the interventions. At last, the combination of both techniques should be considered in future studies.


2016 ◽  
Vol 25 (6) ◽  
pp. 1692-1696 ◽  
Author(s):  
Joicemar Tarouco Amaro ◽  
Gustavo Gonçalves Arliani ◽  
Diego Costa Astur ◽  
Pedro Debieux ◽  
Camila Cohen Kaleka ◽  
...  

2016 ◽  
Vol 64 (3) ◽  
pp. 477
Author(s):  
Maricel Garrido-Montenegro ◽  
Evelyn Álvarez-Espinoza ◽  
Sebastián Vergara-Ruiz

Introduction: Sequels in stroke patients include hemiparesis and dependency for performing basic activities of daily living (BADL). EMG biofeedback has yielded some benefits but has been limited to repetitive movement, therefore, it is insufficient for current task-oriented neurorehabilitation paradigms.Objective: To assess whether the application of EMG biofeedback in upper limbs during BADL training improves motor, occupational and satisfaction performances compared to BADL training without this feedback.Materials and methods: A pilot randomized clinical trial was conducted with stroke patients of more than six months of evolution, who showed hemiparesis and no cognitive deterioration. These patients were randomly classified into two groups: control group, who underwent conventional occupational therapy (COT), and experimental group, who underwent COT+EMG-BF. Patients were given 10 therapy sessions. Entry, evaluation and data analysis were masked.Results: Seven patients were included in each group, showing the same initial clinical and demographic characteristics (p>0.05). The group that underwent COT+EMG-BF showed a significantly better performance in all assessments. For example, the Barthel scale obtained a median of 100 points [85-100] for the COT+EMG-BF group versus 85 [80-90] for the control group (p<0.05), whereas ARAT score was 42 [40-47] points versus 20 [15-38] (p=0.03), respectively.Conclusion: The combination of COT+EMG-BF for BADL may be considered as an alternative for treatment of stroke patients.


2013 ◽  
Vol 131 (2) ◽  
pp. 80-87 ◽  
Author(s):  
Aline Mizusaki Imoto ◽  
Maria Stella Peccin ◽  
Lucas Emmanuel Pedro de Paiva Teixeira ◽  
Kelson Nonato Gomes da Silva ◽  
Marcelo Abrahão ◽  
...  

CONTEXT AND OBJECTIVE Neuromuscular electrical stimulation (NMES) has been used in rehabilitation protocols for patients suffering from muscle weakness resulting from knee osteoarthritis. The purpose of the present study was to assess the effectiveness of an eight-week treatment program of NMES combined with exercises, for improving pain and function among patients with knee osteoarthritis. DESIGN AND SETTING Randomized clinical trial at Interlagos Specialty Ambulatory Clinic, Sao Paulo, Brazil. METHODS One hundred were randomized into two groups: NMES group and control group. The following evaluation measurements were used: numerical pain scale from 0 to 10, timed up and go (TUG) test, Lequesne index and activities of daily living (ADL) scale. RESULTS Eighty-two patients completed the study. From intention-to-treat (ITT) analysis comparing the groups, the NMES group showed a statistically significant improvement in relation to the control group, regarding pain intensity (difference between means: 1.67 [0.31 to 3.02]; P = 0.01), Lequesne index (difference between means: 1.98 [0.15 to 3.79]; P = 0.03) and ADL scale (difference between means: -11.23 [-19.88 to -2.57]; P = 0.01). CONCLUSION NMES, within a rehabilitation protocol for patients with knee osteoarthritis, is effective for improving pain, function and activities of daily living, in comparison with a group that received an orientation program. CLINICAL TRIAL REGISTRATION ACTRN012607000357459.


2021 ◽  
pp. 1-10
Author(s):  
Douglas Rafael da Rosa Pinheiro ◽  
Maria Eduarda Parcianello Cabeleira ◽  
Luigi Antonio da Campo ◽  
Laís Andrielli Ferreira Gattino ◽  
Kellen Sábio de Souza ◽  
...  

BACKGROUND: Studies demonstrate the benefits of upper limbs cycle ergometer (ULCE) in subacute and chronic stroke subjects, but the literature still needs to explore the acute phase of the disease. OBJECTIVE: Verify the effects of ULCE on muscular strength, trunk control and independence of post-stroke subjects in hospital acute phase. METHODS: In this randomized clinical trial participants were allocated into two groups. The control group (CG) performed two daily sessions of conventional physiotherapy, while the intervention group (IG) had one daily session of conventional physiotherapy and one of ULCE. The interventions were carried out for 20 minutes for five days. Both groups were assessed before and after the treatment for upper limbs strength by manual dynamometer, trunk control by Trunk Impairment Scale and level of independence by the Modified Rankin Scale. RESULTS: Twenty subjects with mean ages of 63.5±4.5 were enrolled. There was a significant intra-group difference of palmar grip, shoulder abductors, elbow flexor and wrist extensor strength, trunk control and functional independence only in IG. Inter-group difference for all variables showed superiority in IG. CONCLUSIONS: ULCE is an effective device for increasing muscle strength, trunk control and consequently improving the independence of post-stroke subjects in the acute hospital phase.


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