scholarly journals Immediate Effects of Tibialis Anterior and Calf Muscle Taping on Center of Pressure Excursion in Chronic Stroke Patients: A Cross-Over Study

2020 ◽  
Vol 17 (11) ◽  
pp. 4109 ◽  
Author(s):  
Shin Jun Park ◽  
Tae-Hyun Kim ◽  
Seunghue Oh
Keyword(s):  
Repeated Measures ◽  
Tibialis Anterior ◽  
Center Of Pressure ◽  
Chronic Stroke ◽  
Stroke Survivors ◽  
Stroke Patients ◽  
Repeated Measures Design ◽  
Ankle Muscles ◽  
Kinesiology Tape ◽  
Forward Area

Stroke patients often have muscles spasticity, difficulty with posture control, and tend to fall. This study investigated the use of kinesiology tape for patients with spasticity of ankle muscles after stroke. This study had a randomized, repeated measures design, and evaluated the immediate effect of kinesiology tape on the center of pressure (COP) excursion when applied to the calf and tibialis anterior muscles in stroke survivors. We determined that the taping attachment direction affects the COP movement. Twenty subjects were randomly assigned to the tibialis anterior taping condition, calf taping condition, or nontaping condition. Condition excursion was assessed. The measured variables included the paretic side area, nonparetic side area, forward area, and backward area of COP. All evaluations were conducted immediately after taping. COP excursion for chronic stroke survivors improved after tibialis anterior and calf taping (p < 0.05). Calf taping conditions increased significantly in the forward area (p < 0.05), and tibialis anterior taping conditions increased significantly in the backward area (p < 0.05). Kinesiology tape immediately increased the forward and backward COP excursion for patients with stroke.

scholarly journals Mindfulness Meditation Effects on Poststroke Spasticity: A Feasibility Study

2019 ◽  
Vol 24 ◽  
pp. 2515690X1985594 ◽  
Author(s):  
Melanie Wathugala ◽  
David Saldana ◽  
Julia M. Juliano ◽  
Jennifer Chan ◽  
Sook-Lei Liew
Keyword(s):  
Quality Of Life ◽  
Feasibility Study ◽  
Repeated Measures ◽  
Mindfulness Meditation ◽  
Chronic Stroke ◽  
Future Research ◽  
Control Group ◽  
Stroke Survivors ◽  
Repeated Measures Design

This study examined the feasibility of an adapted 2-week mindfulness meditation protocol for chronic stroke survivors. In addition, preliminary effects of this adapted intervention on spasticity and quality of life in individuals after stroke were explored. Ten chronic stroke survivors with spasticity listened to 2 weeks of short mindfulness meditation recordings, adapted from Jon Kabat-Zinn’s Mindfulness-Based Stress Reduction course, in a pre/post repeated measures design. Measures of spasticity, quality of life, mindfulness, and anxiety, along with qualitative data from participants’ daily journals, were assessed. On average, participants reported meditating 12.5 days of the full 15 days (mean 12.5 days, SD 0.94, range 8-15 days). Seven of the 10 participants wrote comments in their journals. In addition, there were no adverse effects due to the intervention. Exploratory preliminary analyses also showed statistically significant improvements in spasticity in both the elbow ( P = .032) and wrist ( P = .023) after 2 weeks of meditation, along with improvements in quality of life measures for Energy ( P = .013), Personality ( P = .026), and Work/Productivity ( P = .032). This feasibility study suggests that individuals with spasticity following stroke are able to adhere to a 2-week home-based mindfulness meditation program. In addition, preliminary results also suggest that this adapted, short mindfulness meditation program might be a promising approach for individuals with spasticity following stroke. Future research should expand on these preliminary findings with a larger sample size and control group.

Influence of Foot Type and Orthotics on Static and Dynamic Postural Control

2004 ◽  
Vol 13 (1) ◽  
pp. 54-66 ◽  
Author(s):  
Lauren C. Olmsted ◽  
Jay Hertel
Keyword(s):  
Postural Control ◽  
Athletic Training ◽  
Outcome Measures ◽  
Repeated Measures ◽  
Center Of Pressure ◽  
Group Interaction ◽  
Force Plate ◽  
Balance Test ◽  
Repeated Measures Design ◽  
Plate Dynamic

Context:The effects of custom-molded foot orthotics on neuromuscular processes are not clearly understood.Objective:To examine these effects on postural control in subjects with different foot types.Design:Between-groups, repeated-measures design.Setting:Athletic training laboratory.Subjects:30 healthy subjects assigned to groups by foot type: planus (n = 11), rectus (n = 12), or cavus (n = 7).Interventions:Custom-fit semirigid orthotics.Main Outcome Measures:Static postural control was measured on a force plate. Dynamic postural control was measured using the Star Excursion Balance Test. Both measurements were assessed with and without orthotics at baseline and 2 weeks later.Results:For static postural control, a significant condition-by-group interaction was found. Subjects with cavus feet had a decreased center-of-pressure velocity while wearing orthotics. For dynamic postural control, a significant condition-by-direction-by-group interaction was found. Subjects with cavus feet had increased reach distances in 3 of 8 directions while wearing orthotics.Conclusions:Custom orthotics were associated with some improvements in static and dynamic postural control in subjects with cavus feet.

scholarly journals Effects of the Nursing Therapeutics Program for Facilitating Patient Transition (NTPFPT) on Subjective Well-Being, Role Mastery, and Relationships’ Well-Being among Adult Stroke Patients in Bandung, Indonesia

2018 ◽  
Vol 17 (5) ◽  
pp. 460-475
Author(s):  
Cecep Eli KOSASIH ◽  
Busakorn PUNTHMATHARITH ◽  
Umaporn BOONYASOPUN
Keyword(s):  
Repeated Measures ◽  
Well Being ◽  
Routine Care ◽  
Control Group ◽  
Subjective Well Being ◽  
Stroke Patients ◽  
Repeated Measures Design ◽  
The Mean ◽  
Role Mastery ◽  
Experimental Group

This quasi-experimental, repeated measures design was used to examine the effects of the nursing therapeutics program for facilitating patient transition (NTPFPT) on subjective well-being, role mastery, and relationships’ well-being among adult patients who suffered from stroke in Indonesia. Purposive sampling was used to recruit the sample. The control group (n = 42) received the routine care, while the experimental group (n = 42) received the NTPFPT and routine care. The data were collected using 1) the subjective well-being inventory, 2) the role function mode, and 3) the brief family relationship scale. The Chronbach’s alpha coefficients of questionnaires 1 - 3 were .89, .77 and .89, respectively. Descriptive statistics, repeated measures ANOVA, one-way ANOWA, and t-test were used to analyze the data. The results revealed that significant differences of the mean scores of subjective well-being, role mastery and relationships’ well-being were found between the control and experimental groups (p < .000) and between three times (e.g., Day 3 of hospitalization, T1; one day before discharge, T2; and one month after discharge, T3) within group (p < .000). Significant differences between all three pair wise comparisons of these three variables were found in the experimental group (p < .000) while, two pair wise comparisons showed significant differences in the control group. The mean scores of the three variables in the experimental group measured at T2 and T3 were significantly higher than those of the control group (p < .000) whereas those of measured at T1 showed no significant differences between two groups (p > .05). Thus, it is appropriate for nurses to provide the NTPFPT to stroke patients and families. The results revealed that significant differences of the mean scores of subjective well-being, role mastery and well-being of relationships were found between the control and experimental groups (p < .000) and between three times (e.g., Day 3 of hospitalization, T1; one day before discharge, T2; and one month after discharge, T3)within group (p < .000).Significant differences between all three pair wise comparisons of these three variables were found in the experimental group (p < .000) whereas in the control group, only two pair wise comparisons were significant differences. The mean scores of the three variables in the experimental group measured at T2 and T3 were significantly higher than those of the control group (p < .000) whereas those of measured at T1 were non significant differences between two groups (p > .05). Thus, it is appropriate for nurses to provide the NTPFPT to stroke patients and families.

An investigation into the validity and reliability of mHealth devices for counting steps in chronic stroke survivors

2019 ◽  
Vol 34 (3) ◽  
pp. 394-403
Author(s):  
Pollyana Helena Vieira Costa ◽  
Thainá Paula Dias de Jesus ◽  
Carolee Winstein ◽  
Camila Torriani-Pasin ◽  
Janaine Cunha Polese
Keyword(s):  
Repeated Measures ◽  
Chronic Stroke ◽  
Community Dwelling ◽  
The Body ◽  
Stroke Survivors ◽  
Validity And Reliability ◽  
Paretic Side ◽  
Body Location ◽  
Step Counting ◽  
Iphone Application

Objective: To investigate the validity and test–retest reliability of mHealth devices (Google Fit, Health, STEPZ, Pacer, and Fitbit Ultra) to estimate the number of steps in individuals after chronic stroke and to compare whether the measurement of the number of steps is affected by their location on the body (paretic and non-paretic side). Design: Observational study with repeated measures. Setting: University laboratory. Subjects: Fifty-five community-dwelling individuals with chronic stroke. Intervention: Not applicable. Main measures: The number of steps was measured using mHealth devices (Google Fit, Health, STEPZ, Pacer, and Fitbit Ultra), and compared against criterion-standard measure during the Two-Minute Walk Test using habitual speed. Results: Our sample was 54.5% men, mean age of 62.5 years (SD 14.9) with a chronicity after stroke of 66.8 months (SD 55.9). There was a statistically significant association between the actual number of steps and those estimated by the Google Fit, STEPZ Iphone and Android applications, Pacer iphone and Android, and Fitbit Ultra (0.30 ⩽  r ⩾ 0.80). The Pacer iphone application demonstrated the highest reliability coefficient (ICC(2,1) = 0.80; P < 0.001). There were no statistically significant differences in device measurements that depended on body location. Conclusions: mHealth devices (Pacer–iphone, Fitbit Ultra, Google Fit, and Pacer–Android) are valid and reliable for step counting in chronic stroke survivors. Body location (paretic or non-paretic side) does not affect validity or reliability of the step count metric.

Abstract WP205: Home-Based Virtual Reality Therapy for Hand Recovery After Stroke

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Adam MacLellan ◽  
Catherine Legault ◽  
Alay Parikh ◽  
Leonel Lugo ◽  
Stephanie Kemp ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Upper Extremity ◽  
Large Scale ◽  
Controlled Trial ◽  
Hand Function ◽  
Chronic Stroke ◽  
Stroke Survivors ◽  
Hand Rehabilitation ◽  
Stroke Patients ◽  
Home Based

Background: Stroke is the leading cause of disability worldwide, with many stroke survivors having persistent upper limb functional impairment. Aside from therapist-directed rehabilitation, few efficacious recovery tools are available for use by stroke survivors in their own home. Game-based virtual reality systems have already shown promising results in therapist-supervised settings and may be suitable for home-based use. Objective: We aimed to assess the feasibility of unsupervised home-based use of a virtual reality device for hand rehabilitation in stroke survivors. Methodology: Twenty subacute/chronic stroke patients with upper extremity impairment were enrolled in this prospective single-arm study. Participants were instructed to use the Neofect Smart Glove 5 days per week for 8 weeks, in single sessions of 50 minutes or two 25-minute sessions daily. We measured (1) compliance to prescribed rehabilitation dose, (2) patient impression of the intervention, and (3) efficacy measures including the upper extremity Fugl-Meyer (UE-FM), the Jebsen-Taylor hand function test (JTHFT) and the Stroke Impact Scale (SIS). Results: Seven subjects (35%) met target compliance of 40 days use, and 6 subjects (30%) used the device for 20-39 days; there were no age or gender differences in use. Subjective patient experience was favorable, with ninety percent of subjects reporting satisfaction with their overall experience, and 80% reporting perceived improvement in hand function (figure 1). There was a mean improvement of 26.6±48.8 seconds in the JTHFT ( p =0.03) and 16.1±15.3 points in the domain of the SIS that assesses hand function ( p <0.01). There was a trend towards improvement in the UE-FM (2.2±5.5 points, p =0.10). Conclusions: A novel virtual reality gaming device is suitable for unsupervised use in stroke patients and may improve hand/arm function in subacute/chronic stroke patients. A large-scale randomized controlled trial is needed to confirm these results.

scholarly journals Effect of home-based rehabilitation of purposeful activity-based electrical stimulation therapy for chronic stroke survivors: a crossover randomized controlled trial

2021 ◽  
pp. 1-8
Author(s):  
Seigo Minami ◽  
Yoshihiro Fykumoto ◽  
Ryuji Kobayashi ◽  
Hideaki Aoki ◽  
Tomoki Aoyama
Keyword(s):  
Upper Limb ◽  
Repeated Measures ◽  
Controlled Trial ◽  
Phase 1 ◽  
Chronic Stroke ◽  
Stroke Survivors ◽  
Electrical Stimulation Therapy ◽  
Home Based ◽  
Group A ◽  
Purposeful Activity

Background: In this trial we combined the effect of purposeful activity and electrical stimulation therapy (PA-EST) to promote transition of severely hemiparetic upper limb to auxiliary upper limb in chronic stroke survivors in a single-case study. Objective: The purpose of this study was to examine the effect of PA-EST on the upper limb motor function in a crossover randomized controlled trial. Methods: The study included eight stroke survivors (age: 63.1±10.9 years) who were receiving home-based visiting occupational therapy. The average time since stroke onset was 8.8±5.6 years. All participants had severely hemiparetic upper limb, with the Fugl–Meyer Assessment upper extremity (FMA-U) score of 21.3±8.5. Participants were randomly assigned to group A or B. Group A received PA-EST for 3 months (phase 1), followed by standard stretching and exercise for 3 months (phase 2), whereas group B had the inverse order of treatments. To avoid carry-over effect, 1-month washout period was provided between the phase 1 and 2. Two-way analysis of variance (ANOVA) with repeated measures was used for the analysis. The primary outcome was FMA-U, and the secondary outcomes were, Motor Activity Log (MAL; amount of use [AOU] and quality of movement [QOM]), and Goal attainment scale-light (GAS-light). Results: Repeated measures-ANOVA revealed a significant interaction between type of intervention and time for FMA-U (F = 16.303, P = 0.005), MAL AOU (F = 7.966, P = 0.026) and QOM (F = 6.408, P = 0.039), and GAS-light (F = 6.905, P = 0.034), where PA-EST was associated with significantly improved motor function and goal achievement compared with standard stretching. Conclusions: The PA-EST may have greater effects than stretch/exercise in the recovery of hand function as reflected in FMA-U, MAL, and GAS-light. Our results suggest that PA-EST is an important and useful home-based rehabilitation program for promoting the use of the severely hemiparetic upper limb in chronic stroke survivors.

scholarly journals Bilateral Contralaterally Controlled Functional Electrical Stimulation Reveals New Insights Into the Interhemispheric Competition Model in Chronic Stroke

2019 ◽  
Vol 33 (9) ◽  
pp. 707-717 ◽  
Author(s):  
David A. Cunningham ◽  
Jayme S. Knutson ◽  
Vishwanath Sankarasubramanian ◽  
Kelsey A. Potter-Baker ◽  
Andre G. Machado ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Upper Limb ◽  
Functional Electrical Stimulation ◽  
Repeated Measures ◽  
Neuromuscular Electrical Stimulation ◽  
Chronic Stroke ◽  
Motor Impairments ◽  
Repeated Measures Design ◽  
Interhemispheric Competition ◽  
Wide Range

Background. Upper-limb chronic stroke hemiplegia was once thought to persist because of disproportionate amounts of inhibition imposed from the contralesional on the ipsilesional hemisphere. Thus, one rehabilitation strategy involves discouraging engagement of the contralesional hemisphere by only engaging the impaired upper limb with intensive unilateral activities. However, this premise has recently been debated and has been shown to be task specific and/or apply only to a subset of the stroke population. Bilateral rehabilitation, conversely, engages both hemispheres and has been shown to benefit motor recovery. To determine what neurophysiological strategies bilateral therapies may engage, we compared the effects of a bilateral and unilateral based therapy using transcranial magnetic stimulation. Methods. We adopted a peripheral electrical stimulation paradigm where participants received 1 session of bilateral contralaterally controlled functional electrical stimulation (CCFES) and 1 session of unilateral cyclic neuromuscular electrical stimulation (cNMES) in a repeated-measures design. In all, 15 chronic stroke participants with a wide range of motor impairments (upper extremity Fugl-Meyer score: 15 [severe] to 63 [mild]) underwent single 1-hour sessions of CCFES and cNMES. We measured whether CCFES and cNMES produced different effects on interhemispheric inhibition (IHI) to the ipsilesional hemisphere, ipsilesional corticospinal output, and ipsilateral corticospinal output originating from the contralesional hemisphere. Results. CCFES reduced IHI and maintained ipsilesional output when compared with cNMES. We found no effect on ipsilateral output for either condition. Finally, the less-impaired participants demonstrated a greater increase in ipsilesional output following CCFES. Conclusions. Our results suggest that bilateral therapies are capable of alleviating inhibition on the ipsilesional hemisphere and enhancing output to the paretic limb.

scholarly journals Gait Training in Chronic Stroke Using Walk-Even Feedback Device: A Pilot Study

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
V. Krishnan ◽  
I. Khoo ◽  
P. Marayong ◽  
K. DeMars ◽  
J. Cormack
Keyword(s):  
Pilot Study ◽  
Center Of Pressure ◽  
Weight Bearing ◽  
Gait Training ◽  
Chronic Stroke ◽  
Common Finding ◽  
Controlled Study ◽  
Stroke Survivors ◽  
Temporal Asymmetry ◽  
Affected Side

Asymmetrical gait and a reduction in weight bearing on the affected side are a common finding in chronic stroke survivors. The purpose of this pilot study was to determine the effectiveness of a shoe insole device that we developed, called Walk-Even, in correcting asymmetric gait in chronic stroke survivors. Six individuals with chronic (>6 months) stroke underwent 8 weeks of intervention with 2 sessions/week, each consisting of 20 minutes of gait training and 20 minutes of lower-extremity strength training. The 2 control participants underwent conventional gait training, while 4 participants underwent gait training using the Walk-Even. Following intervention, all the participants improved on most of the gait measures: peak pressure of the foot, time of transfer of weight from heel-to-forefoot, center of pressure (COP) trajectory, COP velocity, asymmetry ratio of stance, mean-force-heel, mean-force-metatarsals, Timed “Up and Go,” and Activities-specific Balance Scale. The improvement was more pronounced in the 4 participants that underwent training with Walk-Even compared to the control participants. This pilot study suggests that a combination of strength and gait training with real-time feedback may reduce temporal asymmetry and enhance weight-bearing on the affected side in chronic stroke survivors. A large randomized controlled study is needed to confirm its efficacy.

scholarly journals Effects of Hinged versus Floor-Reaction Ankle-Foot Orthoses on Standing Stability and Sit-to-Stand Performance in Children with Spastic Diplegic Cerebral Palsy

2022 ◽  
Vol 19 (1) ◽  
pp. 542
Author(s):  
Yu-Lin Wang ◽  
Wen-Chou Chi ◽  
Chiung-Ling Chen ◽  
Cheng-Hsieh Yang ◽  
Ya-Ling Teng ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Repeated Measures ◽  
Center Of Pressure ◽  
Reaction Force ◽  
Vertical Direction ◽  
Foot Orthoses ◽  
Maximal Velocity ◽  
Repeated Measures Design ◽  
Sit To Stand ◽  
Ankle Foot Orthoses

Hinged ankle-foot orthoses (HAFOs) and floor reaction ankle-foot orthoses (FRAFOs) are frequently prescribed to improve gait performance in children with spastic diplegic cerebral palsy (CP). No study has investigated the effects of FRAFO on sit-to-stand (STS) performance nor scrutinized differences between the application of HAFOs and FRAFOs on postural control. This study compared the effects of HAFOs and FRAFOs on standing stability and STS performance in children with spastic diplegic CP. Nine children with spastic diplegic CP participated in this crossover repeated-measures design research. Kinematic and kinetic data were collected during static standing and STS performance using 3-D motion analysis and force plates. Wilcoxon signed ranks test was used to compare the differences in standing stability and STS performance between wearing HAFOs and FRAFOs. The results showed that during static standing, all center of pressure (COP) parameters (maximal anteroposterior/mediolateral displacement, maximal velocity, and sway area) were not significantly different between FRAFOs and HAFOs. During STS, the floor reaction force in the vertical direction was significantly higher with FRAFOs than with HAFOs (p = 0.018). There were no significant differences in the range of motion in the trunk, knee, and ankle, the maximal velocity of COP forward displacement, completion time, and the force of hip, knee, and ankle joints between the two orthoses. The results suggest both FRAFOs and HAFOs have a similar effect on standing stability, while FRAFOs may benefit STS performance more compared to HAFOs.

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