Impact of Somatosensory Training on Neural and Functional Recovery of Lower Extremity in Patients with Chronic Stroke: A Single Blind Controlled Randomized Trial

Recovery of lower extremity (LE) function in chronic stroke patients is considered a barrier to community reintegration. An adequate training program is required to improve neural and functional performance of the affected LE in chronic stroke patients. The current study aimed to evaluate the effect of somatosensory rehabilitation on neural and functional recovery of LE in stroke patients. Thirty male and female patients were recruited and randomized to equal groups: control group (GI) and intervention group (GII). All patients were matched for age, duration of stroke, and degree of motor impairment of the affected LE. Both groups received standard program of physical therapy in addition to somatosensory rehabilitation for GII. The duration of treatment for both groups was eight consecutive weeks. Outcome measures used were Functional Independent Measure (FIM) and Quantitative Electroencephalography (QEEG), obtained pre- and post-treatment. A significant improvement was found in the FIM scores of the intervention group (GII), as compared to the control group (GI) (p < 0.001). Additionally, QEEG scores improved within the intervention group post-treatment. QEEG scores did not improve within the control group post-treatment, except for “Cz-AR”, compared to pretreatment, with no significant difference between groups. Adding somatosensory training to standard physical therapy program results in better improvement of neuromuscular control of LE function in chronic stroke patients.

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Efficacy of repetitive peripheral magnetic stimulation on the functional recovery in stroke patients

QJM ◽

10.1093/qjmed/hcaa054.010 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

F F Kenawy ◽

S A Helal ◽

M M Moustafa ◽

N M Elnahas ◽

L M Elnabil ◽

...

Keyword(s):

Functional Recovery ◽

Lower Limb ◽

Rating Scale ◽

Chronic Stroke ◽

University Hospital ◽

Control Group ◽

Stroke Patients ◽

National Priority ◽

Significant Difference ◽

And Control

Abstract © 2018 Institute of Psychiatry, Ain Shams University Copyright r 2018 Institute of Psychiatry, Ain Shams University. Unauthorized reproduction of this article is prohibited. Background Optimizing the management of stroke is a national priority. In Egypt, the mean crude prevalence rate of stroke is 721.6/100,000 1of which almost 30 percent suffer from post stroke spasticity. Theta Burst Stimulation (TBS) is a new faster modality of the conventional rTMS that is used to improve functional recovery after stroke. Objective This work was carried out to assess the effects of peripheral TBS in improving the functional recovery of the lower limb after stroke. Patients and methods A case–control study was conducted to include 27 patients with chronic stroke, who were selected from the attendants of the neurology outpatient clinic in Ain Shams University Hospital, along with 19 participants of age-matched and sex-matched stroke patients as a control group. Case and control groups were subjected to neurological and functional assessment using gait assessment rating scale (GARS) at baseline and after the sessions. An informed written consent was taken from patients included in the study. All patients received 6 sessions of peripheral TBS on affected lower limb. Results There was a statistically significant difference between the two groups in the improvement of functional scale (GARS). Conclusion Peripheral TBS improves gait and functional recovery in chronic stroke patients.

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Effects of mental imagery technique in addition to conventional physical therapy to improve hand functions in chronic stroke patient

Journal of the Pakistan Medical Association ◽

10.47391/jpma.998 ◽

2021 ◽

pp. 1-15

Author(s):

Iqra Mubeen ◽

Ashfaq Ahmad ◽

Waqar Afzal

Keyword(s):

Physical Therapy ◽

Mental Imagery ◽

Hand Function ◽

Chronic Stroke ◽

P Value ◽

Stroke Patients ◽

Maximum Duration ◽

Significant Difference ◽

Group A ◽

Group B

Abstract Objective: To find the effect of mental imagery and conventional physical therapy for the treatment of hand function in chronic stroke patients. Methods: A randomized controlled trial was conducted at Rana and Alvi welfare society. A sample of 50 stroke patients was selected and divided in two groups; group A (experimental) and group B (control). Inclusion and exclusion criteria were established and patients meeting inclusion criteria were included in the study. P value was set as 0.05. Group A was treated with conventional physical therapy combined with mental imagery whereas Group B was treated with conventional physical therapy alone. Wolf motor function test and action research arm test was used as outcome measures. Results: Group A consisted of 68% of females and 32% of males and group B comprised of 44% females and 32% males. Mean age of group A and B were 59.68 + 2.37 and 58.52 + 2.46 respectively. Mean duration (in months) of stroke for group A was 16.32+3.77 (minimum and maximum duration 13 and 23 months respectively). The stroke mean duration of group B was 16.00 +2.34 (minimum and maximum duration 13 and 20 months respectively). Both groups did not show significant difference at 5th week (P=0.721) whereas a significant difference was observed at 10th week (P=0.000) Conclusion: It was concluded that mental imagery technique in combination with conventional physical therapy is significantly effective to improve hand function among chronic stroke patients in comparison to conventional physical therapy alone. Continuous...

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The effect of addition protein, phosphatidylcholine, phosphatidylserine, and inulin on GFAP levels of acute ischemic stroke patients at Dr. Kariadi Hospital, Semarang

JURNAL GIZI INDONESIA ◽

10.14710/jgi.9.2.184-197 ◽

2021 ◽

Vol 9 (2) ◽

pp. 184-197

Author(s):

Diah Retno Wahyuningrum ◽

Retnaningsih Retnaningsih ◽

Martha Irene Kartasurya

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

G Protein ◽

Intervention Group ◽

Circulatory System ◽

Enzyme Linked Immunosorbent Assay ◽

Control Group ◽

Stroke Patients ◽

Significant Difference ◽

Enteral Formula

Background: The occurrence of ischemia causes a loss of energy to switch to anaerobic processes resulting in acidosis due to reduced Adenosina Triphosphate (ATP). This condition makes neuron cells apoptotic. Apoptotic of several biochemical substrates in the brain, such as Glial Fibrillary Acidic Protein (GFAP) exit into the circulatory system which is associated with dysbiosis through immunological pathways.Objectives: To determine the effect of giving enteral formula containing protein, phosphatidylcholine, phosphatidylserine, and inulin on GFAP levels in patients with acute ischemic stroke Dr. Kariadi Hospital.Materials and Methods: This study was done in a single-blind RCT. Eighteen ischemic stroke patients were randomly divided into intervention (9 subjects) and control groups (9 subjects). The intervention group received 69 g of the powdered enteral formula three times a day for seven days. The formula contained protein (15 g), phosphatidylcholine (128 mg), phosphatidylserine (32 mg), and inulin (3 g). The subject who had diabetes mellitus received for 14 days at a dose of 34.5 g per day (7.5 g protein with additions 64mg phosphatidylcholine, 16mg phosphatidylserine, 1.5 g inulin). The control group received the standard enteral formula from the hospital, which contains (11.8 g protein without additions protein, phosphatidylcholine, phosphatidylserine, and inulin). GFAP levels by ELISA method (Enzyme-linked immunosorbent Assay) at pre and post-intervention.Results: There was a trend of decreasing GFAP levels before and after in the intervention group towards a better direction from 8.37±4.25 to 8.30±4.9 compared with the control group which experienced an increasing trend from 5.4±1.8 to 7.5±4. There was no significant difference in GFAP levels after intervention between groups (p = 0.7).Conclusions: The addition of protein, phosphatidylcholine, phosphatidylserine, and inulin had no significant effect on GFAP levels.

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Cerebellar Theta Burst Stimulation on Walking Function in Stroke Patients: A Randomized Clinical Trial

Frontiers in Neuroscience ◽

10.3389/fnins.2021.688569 ◽

2021 ◽

Vol 15 ◽

Author(s):

Yun-Juan Xie ◽

Qing-Chuan Wei ◽

Yi Chen ◽

Ling-Yi Liao ◽

Bao-Jin Li ◽

...

Keyword(s):

Physical Therapy ◽

Lower Extremity ◽

Significant Interaction ◽

Theta Burst Stimulation ◽

Burst Stimulation ◽

Stroke Patients ◽

Significant Difference ◽

Walking Performance ◽

Theta Burst ◽

Walking Time

Objectives: The objective of this study was to explore the efficacy of cerebellar intermittent theta burst stimulation (iTBS) on the walking function of stroke patients.Methods: Stroke patients with walking dysfunction aged 25–80 years who had suffered their first unilateral stroke were included. A total of 36 patients [mean (SD) age, 53 (7.93) years; 10 women (28%)] were enrolled in the study. All participants received the same conventional physical therapy, including transfer, balance, and ambulation training, during admission for 50 min per day during 2 weeks (10 sessions). Every session was preceded by 3 min procedure of cerebellar iTBS applyed over the contralesional cerebellum in the intervention group or by a similar sham iTBS in control group. The groups were formed randomly and the baseline characteristics showed no significant difference. The primary outcome measure was Fugl–Meyer Assessment–Lower Extremity scores. Secondary outcomes included walking performance and corticospinal excitability. Measures were performed before the intervention beginning (T0), after the first (T1) and the second (T2) weeks.Results: The Fugl–Meyer Assessment for lower extremity scores slightly improved with time in both groups with no significant difference between the groups and over the time. The walking performance significantly improved with time and between group. Two-way mixed measures ANOVA showed that there was significant interaction between time and group in comfortable walking time (F2,68 = 6.5242, P = 0.0080, η2partial = 0.276, ε = 0.641), between-group comparisons revealed significant differences at T1 (P = 0.0072) and T2 (P = 0.0133). The statistical analysis of maximum walking time showed that there was significant interaction between time and groups (F2,68 = 5.4354, P = 0.0115, η2partial = 0.198, ε = 0.734). Compared with T0, the differences of maximum walking time between the two groups at T1 (P = 0.0227) and T2 (P = 0.0127) were statistically significant. However, both the Timed up and go test and functional ambulation category scale did not yield significant differences between groups (P > 0.05).Conclusion: Our results revealed that applying iTBS over the contralesional cerebellum paired with physical therapy could improve walking performance in patients after stroke, implying that cerebellar iTBS intervention may be a noninvasive strategy to promote walking function in these patients. This study was registered at ChiCTR, number ChiCTR1900026450.

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PENGARUH SHAKER EXERCISE TERHADAP KEMAMPUAN MENELAN PADA PASIEN STROKE DENGAN DISFAGIA DI RUMAH SAKIT KOTA MEDAN

Indonesian Trust Health Journal ◽

10.37104/ithj.v1i2.14 ◽

2019 ◽

Vol 1 (2) ◽

pp. 61-67

Author(s):

Yusrial Tarihoran

Keyword(s):

Clinical Symptoms ◽

Intervention Group ◽

Nursing Intervention ◽

Control Group ◽

P Value ◽

Stroke Patients ◽

Control Group Design ◽

Consecutive Sampling ◽

Significant Difference ◽

Shaker Exercise

Stroke adalah kumpulan gejala klinis akibat hilangnya fungsi otak sebagian atau keseluruhan. Salah satu penyebab kematian pasien stroke adalah aspirasi pneumonia yang berhubungan dengan disfagia. Penelitian ini bertujuan mengidentifikasi pengaruh shaker exercise terhadap kemampuan menelan pada pasien stroke dengan disfagia di Rumah Sakit Kota Medan. Desain penelitian ini adalah quasy eksperiment, khususnya pretest-posttest design withtout control. Pengambilan sampel dengan metode consecutive sampling. Sampel berjumlah 24 orang, kelompok intervensi ini diberikan shaker exercise selama 6 hari berturut-turut dan dilakuan tiga kali sehari. Hasil penelitian dinyatakan ada perbedaan yang signifikan kemampuan menelan pada pasien stroke dengan disfagia setelah diberikan shaker exercise, dengan p value 0,000 (α =0,05). Manfaat penelitian ini nantinya dapat dijadikan sebagai salah satu intervensi mandiri keperawatan dalam menangani pasien stroke dengan disfagia sehingga meningkatkan mutu asuhan keperawatan, mempercepat penyembuhan, serta mencegah komplikasi. Stroke is a group of clinical symptoms due to partial or complete brain function loss. One of the causes of death of stroke patients is the aspiration of pneumonia associated with dysphagia. This study aims to identify the effect of shaker exercise on swallowing ability in stroke patients with dysphagia at Rumah Sakit Kota Medan. This research used Quasy experimental with pretest-posttest without control group design. As samples, there were 24 respondents for intervention group with consecutive sampling method. The intervention group was given shaker exercise for 3 times a day and it was done continued for 6 days. The results revealed that there was a significant difference in swallowing ability in stroke patients with dysphagia after being given shaker exercise, with p value 0,000 (α = 0.05). The research can be used as a nursing intervention in stroke patients with dysphagia that improve the quality of nursing care, promote healing, and prevent complications.

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A Novel Virtual Reality Training Strategy for Poststroke Patients: A Randomized Clinical Trial

Journal of Healthcare Engineering ◽

10.1155/2021/6598726 ◽

2021 ◽

Vol 2021 ◽

pp. 1-6

Author(s):

Naveed Anwar ◽

Hossein Karimi ◽

Ashfaq Ahmad ◽

Nazia Mumtaz ◽

Ghulam Saqulain ◽

...

Keyword(s):

Clinical Trial ◽

Virtual Reality ◽

Physical Therapy ◽

Lower Extremity ◽

Randomized Clinical Trial ◽

Virtual Reality Training ◽

Lower Extremity Function ◽

Stroke Patients ◽

Extremity Function ◽

Significant Difference

Stroke patients suffer impairments including sensory, motor, visual, and cognitive areas, as well as gait and balance manifestations making activities of daily living difficult. In such conditions, virtual reality training can be a potential rehabilitation tool in comparison to conventional physical therapy to cater to the burden of this disability; hence, this randomized clinical trial compared the effects of virtual reality training and conventional physical therapy on balance and lower extremity function in stroke patients. The sample of 68 poststroke participants from Kanaan Physical Therapy and Spine Clinic, Lahore, Pakistan, were divided into N = 34 cases each using the lottery method with one group given virtual reality training and the other received conventional physical therapy. Each group received 60 minutes intervention, 3 days per week for 6 weeks. The Berg balance scale and the Fugl-Meyer assessment-lower extremity scale were employed for data collection preintervention, immediate postintervention, and 6 weeks postintervention. The statistically significant differences between virtual reality and conventional physical therapy groups for the Berg Balance score ( p < 0.001 ), Fugl-Meyer assessment (FMA)-lower extremity domains of FMA-motor function ( p < 0.001 ), FMA-joint pain, and joint range ( p < 0.001 ); however, there is no significant difference p = 0.202 for time vs. group interaction and significant ( p < 0.001 ) for the time main effect for FMA sensation. Hence, virtual reality training is more effective to restore balance and lower extremity function compared to conventional physical therapy in stroke patients. The results of the study have significant implications for the clinicians with better case management enhancing quality of life of patients along with the dearth of local literature, thus providing base for future research from a developing country’s perspective.

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Effect of Aerobic Exercise in Positive and Negative Symptoms in Schizophrenia

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2021.6324 ◽

2021 ◽

Vol 9 (T3) ◽

pp. 178-181

Author(s):

Nazli Mahdinasari Nasution ◽

Elmeida Effendy ◽

Mustafa Mahmud Amin ◽

Ice Ratnalela Siregar

Keyword(s):

Mental Health ◽

Physical Therapy ◽

Aerobic Exercise ◽

Negative Symptoms ◽

Intervention Group ◽

Control Group ◽

Significant Difference ◽

Schizophrenic Patients ◽

And Control ◽

The Impact

BACKGROUND: Schizophrenia is a severe mental disorder that impacts on the individual and society. It is characterized by positive, negative, cognitive, affective, and aggressive symptoms. This condition has a detrimental influence on the ability of schizophrenic patients to work across all facets of everyday life, making it a significant clinical goal that cannot be handled with antipsychotics in a sufficient manner. The International Organization of Physical Therapy in Mental Health has confirmed that physical therapy helps to improve physical mental health and quality of life in multidisciplinary care for people with schizophrenia. AIM: The aim of this study is to see the impact of aerobic exercise on schizophrenic patients. PATIENTS AND METHODS: This study was conducted at Prof. Dr. M. Ildrem Mental Hospital in 2016. Methods: 34 female chronic schizophrenic patients included in this study. They divided into two groups: Intervention and control group. The intervention group was given aerobic exercise, 3 times a week for 8 weeks. RESULTS: We obtained a significant difference change in positive and negative scores of positive and negative syndrome scales between intervention group and control group (p < 0.001). CONCLUSION: There is a significant change in positive and negative score of PANSS between intervention group and control group.

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Effect of Elastic Abdominal Binder on Pain and Functional Recovery Following Gynecologic Cancer Surgery: A Randomized Controlled Trial

Medicina ◽

10.3390/medicina57050481 ◽

2021 ◽

Vol 57 (5) ◽

pp. 481

Author(s):

Nopwaree Chantawong ◽

Kittipat Charoenkwan

Keyword(s):

Postoperative Pain ◽

Abdominal Surgery ◽

Functional Recovery ◽

Gynecologic Cancer ◽

Intervention Group ◽

Cancer Surgery ◽

Walking Distance ◽

Control Group ◽

Pain Scores ◽

Significant Difference

Background and Objectives: Clinicians have been using elastic abdominal binder for stabilizing incision site after major abdominal surgery. However, the benefits of that practice have never been formally assessed. The aim of this study was to examine the effects of the use of elastic abdominal binder on postoperative pain and recovery of gynecologic cancer patients. Materials and Methods: One-hundred and nine women diagnosed with cervical, endometrial, or ovarian cancer, who underwent open abdominal surgery were assigned randomly into two groups: intervention (56 patients) and control (53 patients). The women in the intervention group applied abdominal binder from postoperative day 1. For the control group, the women did not wear the binder or similar devices. The primary outcomes were pain and functional recovery. Subgroup analysis on participants age ≥ 50 was also performed. Results: For the entire study cohort, the baseline, postoperative day 1, and postoperative day 2 pain scores in the intervention group were significantly lower than the control group. However, there was no significant difference between the groups for postoperative day 3 pain score and for the change in pain scores from the baseline value. Of note, the age ≥ 50 subgroup represented a more balanced cohort with comparable baseline pain scores between the study groups. For this population, the pain scores for postoperative day 1–3 were significantly lower in the intervention group. The intervention group had a longer six-minute walking distance on postoperative day 3 with a trend toward a smaller difference in the day 3 distance from the baseline. Conclusions: The potential benefits of abdominal binder use in reducing postoperative pain and improving functional recovery after open gynecologic cancer surgery could be demonstrated only in those age ≥ 50.

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Breastfeeding Training through Role-Play and Effects on Mother-infant Attachment Behaviours: A Randomised Controlled Trial

Africa Journal of Nursing and Midwifery ◽

10.25159/2520-5293/6232 ◽

2020 ◽

Vol 22 (1) ◽

Author(s):

Farokh Saljughi ◽

Mitra Savabi-Esfahani ◽

Shahnaz Kohan ◽

Soheila Ehsanpour

Keyword(s):

Pregnant Women ◽

Maternal Employment ◽

Controlled Trial ◽

Role Play ◽

Intervention Group ◽

Control Group ◽

Maternal Behaviour ◽

Infant Attachment ◽

Significant Difference ◽

History Of

Mother-infant attachment is an intimate, lasting and satisfying relationship that leads to better cognitive, emotional and social growth of the infant. The aim of this study was to determine the effects of breastfeeding training by role-play on mother-infant attachment behaviours. This research was a randomised clinical trial (parallel design). Inclusion criteria were: no history of mental disorders; ability to read and write the Persian language to complete the questionnaire; no history of drug and tobacco intake in primigravida women. The sample comprised 100 pregnant women (in 2 groups), selected through simple random sampling at healthcare centres. The researcher reviewed prenatal care registries of selected healthcare centres and extracted the names of pregnant women in their early third trimester. The data were imported into randomisation software. The control group received routine breastfeeding training, while the intervention group received routine training together with training through role-play. The data collection tool was the Maternal Behaviour Inventory Questionnaire. Consequently 75 samples were analysed in SPSS16. Independent t-tests and chi-square tests were used to examine the difference between the two groups. Results showed that the mean score of mother-infant attachment one week after delivery was significantly higher in the intervention group in comparison to that in the control group (p<0.001). No significant difference was observed between the two groups in maternal age, age of marriage, neonatal gender, maternal employment and education, number of parity, and number of abortions (P>0.05). Since breastfeeding training through role-play could affect mother-infant attachment, it is suggested that this type of training should be provided for pregnant women to promote mother-infant attachment and exclusive breastfeeding.

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TERAPI MUSIK DAN TINGKAT KECEMASAN PASIEN PREOPERASI

Media Ilmu Kesehatan ◽

10.30989/mik.v5i1.44 ◽

2016 ◽

Vol 5 (1) ◽

pp. 1-6

Author(s):

Wenny Savitri ◽

Nani Fidayanti ◽

Paulus Subiyanto

Keyword(s):

Music Therapy ◽

Intervention Group ◽

Complementary Therapy ◽

T Test ◽

Anxiety Level ◽

Preoperative Anxiety ◽

Control Group ◽

Music Intervention ◽

Significant Difference ◽

Anxiety Levels

Background: Surgery is one of medical interventions which can cause fear, anxiety, and stressed because of its effects toward the integrity of body and soul. Nurses have significant roles in any preoperative care which is helping patients to decrease preoperative anxiety by using complementary therapy. The use of music therapy as one of the complementary therapies is not common in Indonesia. Therefore, scientific studies to prove the role of this therapy to decrease the level of anxiety of pre-operative patients is needed. Objective: To investigate the effects of music therapy in reducing anxiety levels of preoperative patients. Methods: A quasy experimental study with pre-test and post-test design with control group was applied to 50 respondents from medical ward in Panembahan Senopati Hospital of Yogyakarta who met the inclusion criteria.Dara were then analyzed by using t-test statistical analysis. Results: The control group showed the increased value of anxiety level of0.8 without music intervention (t= - 1503, df = 24, p<.05), whereas the intervention group showed the decreased value of anxiety level of -5.52 (t=5.081, df=24, p<.05). Meanwhile the independent t-test results for both groups showed a significant difference between group (t= 3,373, df=48, p<.05). Conclusion: Music therapy has significant effect in reducing preoperative anxiety levels of patients. Keywords: anxiety, preoperative, music therapy

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