Effects of Functional Massage on Ankle Range of Motion and Muscle Tone in Post Stroke Patients

2021 ◽  
Vol 6 (4) ◽  
pp. 65-70
Author(s):  
Ji Sung Kim ◽  
Joo-Hyun Park
Keyword(s):  
Range Of Motion ◽  
Muscle Tone ◽  
Stroke Patients ◽  
Post Stroke

scholarly journals Evaluating the Effects of Botulinum Toxin Injection and Physiotherapy on Post-Stroke Patients During One Year Observation - a Pilot Study

2021 ◽  
Vol 25 (3) ◽  
Author(s):  
Zuzanna Olszewska ◽  
Elżbieta Mirek ◽  
Kinga Opoka-Kubica ◽  
Szymon Pasiut Szymon Pasiut ◽  
Magdalena Filip
Keyword(s):  
Botulinum Toxin ◽  
Pilot Study ◽  
Combination Therapy ◽  
Upper Limb ◽  
Muscle Tone ◽  
Statistical Significance ◽  
Botulinum Toxin Injection ◽  
Upper Limbs ◽  
Stroke Patients ◽  
Post Stroke

Introduction: Stroke is a serious health problem in the modern population. Spasticity is one of the consequences of stroke and affects about 30% of people. Increased muscle tone affects postural control disorders. Due to the specificity of spasticity, therapy in post-stroke patients is a challenge for neurological physiotherapy. Therefore, it requires the development of appropriate management standards . Study aim: The aim of the study was to evaluate the effectiveness of 3 combination therapy cycles based on botulinum toxin injection and physiotherapy for muscle tone, muscle strength and postural stability in post-stroke patients qualified for the spasticity treatment programme of the lower and upper limbs. Material and methods: The pilot study involved 12 patients (6 from the lower limb and 6 from the upper limb programme). The 1-year combination therapy programmes included 3 botulinum toxin injections and 3 weeks of physiotherapy after each injection. Clinical evaluation was conducted before and after the 1-year observation cycle. The results were evaluated using: MAS (Modified Ashworth Scale), MRC (Medical Research Council Scale) and posture stability test on a balance platform (BiodexSD). Results: A decrease was observed in muscle tone of the lower and upper limbs, as well as an increase in muscular strength of the upper limb. However, there were no noted statistical significance of the studied parameters. Conclusions: Physiotherapy in combination with the botulinum toxin is an important element of improvement in post-stroke patients. However, further research is needed to explicitly confirm its effectiveness.

scholarly journals Assessment of test-retest reliability and internal consistency of the Wisconsin Gait Scale in hemiparetic post-stroke patients

2016 ◽  
Vol 30 (3) ◽  
pp. 41-53 ◽  
Author(s):  
Agnieszka Guzik ◽  
Mariusz Drużbicki ◽  
Grzegorz Przysada ◽  
Andrzej Kwolek ◽  
Agnieszka Brzozowska-Magoń ◽  
...  
Keyword(s):  
Motor Control ◽  
Internal Consistency ◽  
Lower Limb ◽  
Barthel Index ◽  
Gait Speed ◽  
Muscle Tone ◽  
Stroke Patients ◽  
Retest Reliability ◽  
Post Stroke ◽  
Test Retest Reliability

Abstract Introduction: A proper assessment of gait pattern is a significant aspect in planning the process of teaching gait in hemiparetic post-stroke patients. The Wisconsin Gait Scale (WGS) is an observational tool for assessing post-stroke patients’ gait. The aim of the study was to assess test-retest reliability and internal consistency of the WGS and examine correlations between gait assessment made with the WGS and gait speed, Brunnström scale, Ashworth’s scale and the Barthel Index. Material and methods: The research included 36 post-stroke patients. The patients’ gait was assessed with the use of the Wisconsin Gait Scale, gait speed with the use of walk test, the level of motor control in a paretic lower limb – according to Brunnström recovery stages, muscle tone in a paretic lower limb – according to modified Ashworth’s scale and functional independence was assessed using the Barthel Index. Gait was assessed with the use of the WGS twice, with a 7-day interval, by three experienced physiotherapists. Results: The analysis of internal consistency of the WGS revealed that the Cronbach’s α coefficient was high in the case of all the three raters and ranged from 0.85 to 0.88. It was noted that the coefficient of variation for all the comparisons was below 10%. When assessing the repeatability of the results, it was revealed that correlations between both measurements made by particular raters were very strong and highly significant. The WGS results significantly correlated with Brunnström scale, Ashworth’s scale and gait speed. Conclusions: It was concluded that the WGS has a high internal consistency and test-retest reliability. Also, significant correlations were found between gait assessment made with the use of the WGS and gait speed, level of motor control and muscle tone of a paretic lower limb. The WGS constitutes a promising tool for a qualitative, observational analysis of gait in post-stroke patients and allows for proper planning, monitoring and assessing rehabilitation results.

Stationary walking performance of post-stroke patients and healthy individuals in real and virtual non-immersive environments

2021 ◽  
pp. 1-7
Author(s):  
Ailton Barbosa da Silva Júnior ◽  
Beatriz Cristina Medeiros de Lucena ◽  
Edson Meneses Silva-Filho ◽  
Aline Braga Galvão Silveira Fernandes
Keyword(s):  
Range Of Motion ◽  
Virtual Environment ◽  
Lower Limb ◽  
Healthy Individuals ◽  
Stroke Patients ◽  
Immersive Environments ◽  
The Real ◽  
Post Stroke ◽  
Real Environment ◽  
Immersive Virtual Environment

BACKGROUND: Several therapies are being used for the rehabilitation of stroke patients, such as Virtual Reality (VR) which has emerged as an interactive intervention to motivate and rehabilitate post-stroke patients. However, data comparison between the virtual and real environments is inconclusive. Thus, this study aimed to compare the kinematics and performance of the affected lower limb of post-stroke patients and healthy individuals during stationary walking activity between the real and virtual non-immersive environments. METHODS: A cross-sectional study was conducted with 10 stroke patients and 10 healthy individuals, matched for gender and age. The participants performed stationary walking in a real and non-immersive virtual environment (Wii Fit Plus® –Running mode) for 3 minutes in random order. The performance was measured in both environments using the number of steps, while the kinematics was assessed by calculating the mean maximum flexion and extension of each joint (hip, knee, and ankle) of the affected lower limb. RESULTS: Post-stroke patients performed a higher total number of steps (p = 0.042), mainly in the third minute (p = 0.011), less knee flexion (p = 0.001) and total knee range of motion (p = 0.001) in the virtual compared with the real environment. CONCLUSIONS: Post-stroke patients performed more steps, with a faster cadence and smaller knee range of motion on the affected side in non-immersive virtual environment compared with the real environment.

scholarly journals Walking robotic assistance: Assessment of the hip and knee range of motion among post stroke patients

2014 ◽  
Vol 57 ◽  
pp. e11
Author(s):  
S. Tasseel-Ponche ◽  
F. Haro ◽  
L. Damamme ◽  
J. Beaudreuil ◽  
T. Albert ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Robotic Assistance ◽  
Stroke Patients ◽  
Post Stroke

scholarly journals Is Dry Needling Effective for the Management of Spasticity, Pain, and Motor Function in Post-Stroke Patients? A Systematic Review and Meta-Analysis

Pain Medicine ◽  
2020 ◽  
Author(s):  
César Fernández-de-las-Peñas ◽  
Albert Pérez-Bellmunt ◽  
Luis Llurda-Almuzara ◽  
Gustavo Plaza-Manzano ◽  
Ana I De-la-Llave-Rincón ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Motor Function ◽  
Muscle Tone ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Dry Needling ◽  
Stroke Patients ◽  
Post Stroke ◽  
Mean Differences

Abstract Objective To evaluate the effects of muscle dry needling alone or combined with other interventions on post-stroke spasticity (muscle tone), related pain, motor function, and pressure sensitivity. Databases and Data Treatment Electronic databases were searched for randomized controlled trials including post-stroke patients where at least one group received dry needling and outcomes were collected on spasticity and related pain. Secondary outcomes included motor function and pressure pain sensitivity. Data were extracted by two reviewers. The risk of bias was assessed with the Cochrane Risk of Bias tool, methodological quality was assessed with the Physiotherapy Evidence Database score, and the quality of evidence was assessed by the Grading of Recommendations Assessment, Development, and Evaluation approach. Between-groups mean differences (MDs) and standardized mean differences (SMDs) were calculated. Results Seven studies (three within the lower extremity, four in the upper extremity) were included. The meta-analysis found significantly large effect sizes of dry needling for reducing spasticity (SMD: -1.01, 95%confidence interval [CI] -1.68 to -0.34), post-stroke pain (SMD -1.01, 95%CI -1.73 to -0.30), and pressure pain sensitivity (SMD 1.21, 95% CI: 0.62 to 1.80) as compared with a comparative group at short-term follow-up. The effect on spasticity was found mainly in the lower extremity (MD -1.05, 95% CI: -1.32 to -0.78) at short-term follow-up. No effect on spasticity was seen at 4 weeks. No significant effect on motor function (SMD 0.16, 95% CI: -0.13 to 0.44) was observed. The risk of bias was generally low, but the imprecision of the results downgraded the level of evidence. Conclusion Moderate evidence suggests a positive effect of dry needling on spasticity (muscle tone) in the lower extremity in post-stroke patients. The effects on related pain and motor function are inconclusive.

Post-Stroke Spasticity (PSS) Setting Up a PSS Clinic: Experience and Results

2018 ◽  
Vol 3 (5) ◽  
Keyword(s):  
Motor Neuron ◽  
Lower Limb ◽  
Muscle Tone ◽  
Plantar Flexion ◽  
Common Symptom ◽  
Functional Impairments ◽  
Ultrasound Guided ◽  
Stroke Patients ◽  
Post Stroke

Stroke is a leading cause of long-term disability. As a consequence of stroke and associated upper motor neuron (UMN) syndrome, stroke survivors are often left with muscle over activity, including spasticity. Spasticity is characterized by over- activity in muscles after injury to the central nervous system. When left untreated, post-stroke spasticity (PSS) can lead to contractures, pain and deformity, involuntary movement, and greater functional impairments (eg, reduced mobility, self-care and dressing). Spasticity is a common symptom after stroke, arising in about 30% of patients, and usually occurs within the first few days or weeks [1]. However, the onset of spasticity is highly variable and can occur in the short- medium or long-term post-stroke period [2]. Post-stroke hemiparesis, together with abnormal muscle tone, is a major cause of morbidity and disability. Patients with poststroke spasticity often demonstrate recognizable antigravity postural patterns (Fig 1) characterized by shoulder adduction, elbow and wrist flexion in the upper limb, hip adduction, knee extension and ankle plantar flexion in the lower limb. This “hemiplegic” posture, which is thought to result from increased motor neuron activity in antigravity muscles, significantly interferes with body image, balance and gait. BoNT-A, one of the most potent biologic toxins known to man acts by blocking neuromuscular transmission via inhibiting acetylcholine release [3]. BoNT-A treatment in post-stroke upper and lower limb spasticity is a safe and effective procedure to decrease muscle tone and increase the range of motion. More recent studies are demonstrating the importance for the rehabilitation therapist intervention to work alongside the physician to create more positive and significant effects on active function [4]. Daily stretching exercise is the key for the long-lasting benefits. BoNT-A Injections, Ultrasound guided technique, performed by a Physician in combination with physiotherapy and outcomes measurements are used to improve upper and lower limb function in stroke patients with spasticity in the clinical setting [5]. We would like to share our experience on the benefit of the ultrasound guided technique to target the muscles and our results in setting up a spasticity clinic for post-stroke patients.

Development of Supportive-Educative Range of Motion Exercise for Post-stroke Patients: A Pilot Study

2021 ◽  
pp. 108482232110357
Author(s):  
Elly Lilianty Sjattar ◽  
Irna Megawati ◽  
Andi Masyitha Irwan ◽  
Sintawati Majid
Keyword(s):  
Pilot Study ◽  
Muscle Strength ◽  
Range Of Motion ◽  
Intervention Group ◽  
Control Group ◽  
Willingness To Participate ◽  
Stroke Patients ◽  
Test Analysis ◽  
Post Stroke ◽  
A Value

The purpose of this pilot study was to assess of home care intervention on post-stroke related outcome of range of motion and muscle strength. Sample in 40 participants were divided into the intervention group and control group and included in this study according to the following criteria: post-stroke period of <12 months with hemiparesis, age of ≥18 years, and willingness to participate in the study. The intervention was carried out by nurses by providing education for 2 consecutive days and mentoring for 5 consecutive days, while the control group was given standard care and measured using a grip track, handheld dynamometer, and goniometer examination on June to September 2019. For the intervention group, paired t-test analysis confirmed a significant increase in the mean upper extremity muscle strength before (35.770 ± 46.063) and after (51.073 ± 50.866) the 7 day intervention ( p = .002), whereas the control group showed a value 36.570 ± 33.684 and then 31.400 ± 31.760 p = .256 and lower extremity strength before (3.627 ± 1.585) and after (4.365 ± 1.698) the 7-days intervention ( p = .000), whereas the control group showed a value 3.657 ± 1.671 and then 4.043 ± 1.849 p = .013. Almost all the items assessed from Range of Motion (ROM) in the upper and lower extremities showed a significant increase ( p < .05). Supportive-educative ROM exercise significantly contributed to an increase in the average muscle strength and ROM in post-stroke patients.

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

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