scholarly journals 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 ◽  
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.

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

2015 ◽  
Vol 51 (2) ◽  
pp. 55-63 ◽  
Author(s):  
Magdalena Jaworska ◽  
Tomasz Tuzim ◽  
Małgorzata Starczyńska ◽  
Magdalena Wilk-Frańczuk ◽  
Agnieszka Pedrycz
Keyword(s):  
Test Group ◽  
Berg Balance Scale ◽  
Modern Medicine ◽  
Cerebral Stroke ◽  
Stroke Patients ◽  
Timed Up And Go ◽  
Balance Test ◽  
Raising Awareness ◽  
Proprioceptive Neuromuscular Facilitation ◽  
Age Range

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).

The Effects of a Divided-Attention Timed Stepping Accuracy Task on Balance, Strength, Endurance, and Functional Performance in Healthy Older Adults: A Pilot Study

2019 ◽  
Vol 27 (4) ◽  
pp. 521-528 ◽  
Author(s):  
Susan J. Leach ◽  
Joyce R. Maring ◽  
Ellen Costello
Keyword(s):  
Older Adults ◽  
Divided Attention ◽  
Functional Performance ◽  
Step Length ◽  
Berg Balance Scale ◽  
Primary Outcome Measure ◽  
Community Dwelling ◽  
Timed Up And Go ◽  
Healthy Older Adults ◽  
Stepping Accuracy

The aim of this study was to investigate whether a 6-week Divided-Attention Stepping Accuracy Task (DATSAT) intervention improved the primary outcome measure, maximal step length; other balance measures (Berg Balance scale and Timed Up and Go test); leg strength; endurance (6-min walk test); and functional tasks in 15 community-dwelling healthy older adults (age: 71.5 years, female: 46.7%) compared with 15 community-dwelling healthy older adults in a Bike and Strength (B&S) program (age: 73.8 years, female: 33.3%). Participants trained 3× per week, 30–60 min per session. Stepping-group differences were significant for all measures. B&S group improved in maximal step length (anterior and lateral), strength, and one functional task. Stepping group outperformed B&S group in Timed Up and Go and maximal step length posterior. B&S group outperformed stepping group in two strength measures. Exertion scores were lower for the stepping group. Overall, Divided-Attention Timed Stepping Accuracy Task training resulted in more within-group improvements and two between-group measures with less perceived effort and shorter intervention times.

scholarly journals An objective measure of gait using ink footprints

1999 ◽  
Vol 55 (2) ◽  
pp. 8-11 ◽  
Author(s):  
M. Riley ◽  
M. Goodman ◽  
V. U. Fritz
Keyword(s):  
Data Analysis ◽  
Data Collection ◽  
Lower Extremity ◽  
Stride Length ◽  
Objective Measure ◽  
Step Length ◽  
Temporal Distance ◽  
Length Ratio ◽  
Stroke Patients ◽  
Distance Measurements

A study was conducted to test the usefulness of seven temporal distance measurements (measurements of time and distance) in the assessment of functional ambulation in stroke patients. These measurements were obtained simply and inexpensively using a paper walkway and ink footprints.The gait of ten hemiparetic patients was initially assessed according to the Massachusetts Functional Ambulation Rating. Each patient was then instructed to walk at his/her most comfortable speed along a ten metre paper walkway while velocity and cadence were measured. Ink pads were then attached to the heel and toe of each shoe and the patients walked again along the walkway.Measurements of step length, stride length, stride length: lower extremity length ratio, foot angle and width of base were recorded and analysed.Velocity and cadence were found to correlate well with the functional ambulation rating. Step length was found to correlate with the functional ambulation rating, but the longer step was not always taken with the affected leg. Stride length and stride length: lower extremity length ratio correlated well with the functional ambulation rating. Foot angle and width of base did not correlate with function but all hemiparetic patients showed a greater foot angle with the affected leg.This method of data collection is inexpensive and easy to use in any physiotherapy department although the data analysis is time-consuming.

The Effects of Ankle Joint Mobilization on Dorsiflexion Range and Gait Parameters in Chronic Stroke Survivors: A Systematic Review and Meta-analysis

2021 ◽  
pp. 251660852098287
Author(s):  
Hariharasudhan Ravichandran ◽  
Balamurugan Janakiraman
Keyword(s):  
Ankle Joint ◽  
Meta Analysis ◽  
Step Length ◽  
Chronic Stroke ◽  
Gait Velocity ◽  
Stroke Survivors ◽  
Timed Up And Go ◽  
Unaffected Side ◽  
Joint Mobilization ◽  
Gait Parameters

Background: Ankle dorsiflexion movement restriction is a common presentation in most of the chronic stroke survivors. Spasticity and connective tissue changes around ankle, limits dorsiflexion, and interferes with balance and gait performances. Improving functional range of dorsiflexion is essential in post-stroke rehabilitation. Objectives: This meta-analysis analyzed the effects of ankle mobilization techniques in improving dorsiflexion range and gait parameters among chronic stroke survivors. Method: Articles published up to July 2020 were searched in CINAHL, PubMed, Embase, PsyINFO, and OpenGrey. English version of randomized controlled trials (RCTs) assessing the effects of ankle joint mobilization among chronic stroke subjects, with dorsiflexion range of motion (ROM) and gait parameters as outcome, were included. Characteristics of participants, interventions, outcome measure, and measures of variability were extracted. Methodological quality of included trials was assessed using PEDro scale and Cochrane Collaboration tool for the risk of bias. Pooled standardized mean difference was calculated using random effects model for dorsiflexion ROM, gait velocity, step length, cadence, and timed up and go (TUG). Results: Eight RCTs including 226 stroke patients, with mean methodological score of 6 out of 10 in PEDro, were eligible for this meta-analysis. Ankle joint mobilization demonstrated statistically significant improvement on passive dorsiflexion ROM, gait velocity, step length (affected side), and cadence outcomes. Nonsignificance was found in step length (unaffected side) and in TUG. Conclusion: The ankle mobilization techniques are effective in improving passive dorsiflexion ROM, gait velocity, and cadence in chronic stroke survivors. However, the retention effect of ankle mobilization among stroke subjects is not known.

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

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.

scholarly journals Comparison of Gait parameters among the adults (18-24) with and without flatfoot – A Cross sectional study

2021 ◽  
Vol 3 (2) ◽  
pp. 83-88
Author(s):  
Nayan Fulewale ◽  
Dr. Deepak Anap (PT)
Keyword(s):  
Stride Length ◽  
Weight Bearing ◽  
Step Length ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Flat Foot ◽  
Cross Sectional ◽  
Gait Parameters ◽  
Significant Difference ◽  
Length Step

Background: Flat foot is a common deformity in which the medial longitudinal arch is eliminated or reduced, subtalar joint is pronated and the calcaneus achieves valgus position under- weight bearing conditions. Any feet disorder can alter the biomechanics of the entire lower limb. The aim of the study was to compare the gait parameters (Cadence, stride length, step length and pace) among the adults (18-24) with and without flat foot. Methodology: It was a cross-sectional study with 3 months duration. Total 56 young adults (18-24) with and without flatfoot were recruited with purposive sampling method. the categorization of the type of arch using Arch-Height index. The Outcome measures were Gait parameters (cadence, distance walked in one minute, speed, step length, stride length) which were noted by pedometer of Smart watch and stride length, step length by using formula using cadence and distance findings. Result: Comparison analysis was done by using unpaired t-test. On comparison of various Gait parameters between normal and flat foot individuals such as cadence (p=0.7), distance walked in one minute (p= 0.96), speed (p=0.78), step length (p= 0.98), stride length (p= 0.92), there was no significant difference between two groups. Conclusion: The study concludes that there is no difference in gait parameters between flatfoot and normal foot.

scholarly journals The Effects of Posterior Talar Glide and Dorsiflexion of the Ankle Plus Mobilization with Movement on Balance and Gait Function in Patient with Chronic Stroke: A Randomized Controlled Trial

2018 ◽  
Vol 09 (01) ◽  
pp. 061-067 ◽  
Author(s):  
Sang-Lim Kim ◽  
Byoung-Hee Lee
Keyword(s):  
Postural Sway ◽  
Controlled Trial ◽  
Weight Bearing ◽  
Control Group ◽  
Static Balance ◽  
Stroke Patients ◽  
Timed Up And Go ◽  
Before And After ◽  
Eyes Open ◽  
Movement Group

ABSTRACT Background: This study was to evaluate the effects of weight-bearing-based mobilization with movement (WBBMWM) on balance and gait in stroke patients. Methods: Thirty stroke patients participated in this study. All individuals were randomly assigned to either WBMWM group (n = 15) or weight-bearing with placebo mobilization with movement group (control, n = 15). Individuals in the WBMWM group were trained for 10 glides of 5 sets a day, 5 times a week during 4 weeks. Furthermore, individuals in the control group were trained for 10 lunges of 5 sets a day, 5 times a week during 4 weeks. All individuals were measured weight-bearing lunge test (WBLT), static balance ability, timed up and go test (TUG), and dynamic gait index (DGI) in before and after intervention. Results: The result showed that WBBMWM group and control group had significantly increased in WBLT, postural sway speed, total postural sway path length with eyes open and closed, TUG and DGI (P < 0.05). In particular, the WBMWM group showed significantly greater improvement than control group in WBLT, static balance measures, TUG, and DGI (P < 0.05). Conclusion: Therefore, WBMWM improved ankle range of motion, balance, and gait in stroke patients. These results suggest that WBBMWM is feasible and suitable for individuals with a stroke.

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 Changes in Gait Performance in Stroke Patients after Taping with Scapular Setting Exercise

Healthcare ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 128
Author(s):  
Shin Jun Park ◽  
Seunghue Oh
Keyword(s):  
Group Intervention ◽  
Step Length ◽  
Measurement Unit ◽  
Stroke Patients ◽  
Timed Up And Go ◽  
Phase Duration ◽  
Gait Performance ◽  
Double Support ◽  
Gait Parameters ◽  
Length Step

The purpose of this study was to investigate the effects of combined taping with scapular setting exercise on the gait performance of stroke patients. Twenty stroke patients were randomly allocated to two groups: the taping with scapular setting exercise (TSSE) group (n = 10) and scapular setting exercise (SSE) group (n = 10). Intervention was performed for one week, and pre- and postintervention results for TSSE and SSE were compared. Outcomes were determined using the inertia measurement unit, which can measure spatiotemporal gait parameters, and using the timed up-and-go test. Two-way repeated analysis was used to compare pre- and postintervention results. In the TSSE group, intervention significantly improved cadence, gait speed, stride length, step length, gait cycle, swing phase duration, double support duration, and timed up-and-go test results more than in the SSE group. TSSE was found to improve all spatiotemporal gait parameters examined; thus, we recommend TSSE be considered as an intervention to improve gait parameters in stroke patients.

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