scholarly journals Post-Stroke Treatment with Neuromuscular Functional Electrostimulation of Antagonistic Muscles and Kinesiotherapy Evaluated with Electromyography and Clinical Studies in a Two-Month Follow-Up

2022 ◽  
Vol 19 (2) ◽  
pp. 964
Author(s):  
Juliusz Huber ◽  
Katarzyna Kaczmarek ◽  
Katarzyna Leszczyńska ◽  
Przemysław Daroszewski
Keyword(s):  
Large Population ◽  
Manual Muscle Testing ◽  
Stroke Patients ◽  
Positive Correlation ◽  
Post Stroke ◽  
Positive Effects ◽  
Muscle Testing ◽  
Neurophysiological Studies ◽  
Scale Scores ◽  
Ashworth Scale

The aim of this study was to determine the sustained influence of personalized neuromuscular functional electrical stimulation (NMFES) combined with kinesiotherapy (mainly, proprioceptive neuromuscular facilitation (PNF)) on the activity of muscle motor units acting antagonistically at the wrist and the ankle in a large population of post-stroke patients. Clinical evaluations of spasticity (Ashworth scale), manual muscle testing (Lovett scale), and surface electromyography recordings at rest (rEMG) and during attempts of maximal muscle contraction (mcEMG) were performed three times in 120 post-stroke patients (T0: up to 7 days after the incidence; T1: after 21 days of treatment; T2: after 60 days of treatment). Patients (N = 120) were divided into two subgroups—60 patients received personalized NMFES and PNF treatment (NMFES+K), and the other 60 received only PNF (K). The NMFES+K therapy resulted in a decrease in spasticity and an increase in muscle strength of mainly flexor muscles, in comparison with the K group. A positive correlation between the increase of rEMG amplitudes and high Ashworth scale scores and a positive correlation between low amplitudes of mcEMG and low Lovett scale scores were found in the wrist flexors and calf muscles on the paretic side. Negative correlations were found between the rEMG and mcEMG amplitudes in the recordings. The five-grade alternate activity score of the antagonists’ actions improved in the NMFES+K group. These improvements in the results of controlled NMFES treatment combined with PNF in patients having experienced an ischemic stroke, in comparison to the use of kinesiotherapy alone, might justify the application of conjoined rehabilitation procedures based on neurophysiological approaches. Considering the results of clinical and neurophysiological studies, we suppose that NMFES of the antagonistic muscle groups acting at the wrist and the ankle may evoke its positive effects in post-stroke patients by the modulation of the activity more in the spinal motor centers, including the level of Ia inhibitory neurons, than only at the muscular level.

scholarly journals THERAPEUTIC EFFECTS OF ANKLE JOINT TAPING COMBINED WITH FUNCTIONAL ELECTRICAL STIMULATION FOR THE CORRECTION OF POST STROKE FOOT DROP

2015 ◽  
Vol 4 (2) ◽  
pp. 15-20
Author(s):  
Amna Aamir Khan ◽  
Hassan Abbas ◽  
Rabbia Naseer Ahmed ◽  
Maria Salman
Keyword(s):  
Electrical Stimulation ◽  
Ankle Joint ◽  
Functional Electrical Stimulation ◽  
Ankle Dorsiflexion ◽  
Foot Drop ◽  
Manual Muscle Testing ◽  
Therapeutic Effects ◽  
Post Stroke ◽  
Muscle Testing ◽  
Significant Difference

OBJECTIVE Post stroke foot is inability to lift foot at ankle joint due to paralysis of ankle dorsiflexor muscles. It is a common problem faced by stroke survivors. To determine the effect of ankle joint taping combined with functional electrical stimulation on post stroke foot drop. METHODS It was an experimental study. 10 stroke patients with foot drop were enlisted for the study by convenience sampling and randomized into two groups. The group A or treatment group (n-5) received kinesiotaping of ankle joint and functional electrical stimulation while group B or control group (n-5) received functional electrical stimulation only. Clinical assessment was done before and after study. Outcome measures were Manual Muscle Testing, active ankle dorsiflexion and time up and go test. RESULTS Improvement was recorded in both kinesiotaping of ankle joint with functional electrical stimulation and functional electrical stimulation groups for MMT and active range of ankle dorsiflexion and there was no significant improvement in time up and go test. But statistically non-significant difference between both groups is observed (Z=-2.000, p=0.46). CONCLUSIONS These results indicate that there is no clear benefit of ankle joint taping combined with functional electrical stimulation for correction of post stroke foot drop. Keywords: Foot Drop, Functional Electrical Stimulation, Ankle Joint Taping, Kinesiotaping, Dorsiflexion, Manual Muscle Testing

scholarly journals A method of hand motor control assessment in patients with post-stroke spasticity

2017 ◽  
Vol 31 (3) ◽  
pp. 55-70
Author(s):  
Jolanta Zwolińska ◽  
Mariusz Drużbicki ◽  
Lidia Perenc ◽  
Andrzej Kwolek
Keyword(s):  
Motor Control ◽  
Therapeutic Process ◽  
Hospital Treatment ◽  
Photometric Method ◽  
Stroke Patients ◽  
Post Stroke ◽  
Numerical Indicator ◽  
Based Medicine ◽  
Ashworth Scale ◽  
Hand Motor Control

Abstract Introduction: In order to assess hand spasticity in post-stroke patients, it is necessary to apply an objective and sensitive method which allows for characterising motor control. It is significant due to the necessity to monitor the effects of the therapeutic process according to the requirements of Evidence-Based Medicine (EBM). The aim of the study was to assess the usefulness of the measurement of pressure generated during a maximal palmar grasp and after its release for evaluating the level of hand motor control in poststroke patients compared to subjective scales. Material and methods: In order to characterise motor control, a numerical indicator calculated on the basis of the measurements of pressure generated during a maximal palmar grasp and after its release was suggested. To perform the measurements, 12 poststroke patients with hemiparesis were included in the study. In the research, the level of hand paresis was assessed with Brunnström Approach, the intensity of spasticity was graded with Modified Ashworth Scale, while hand motor function was classified with Fugl-Meyer Assessment (FMA). Pressure generated during a palmar grasp and after its release as well as palm area were measured with the use of a photometric method. The assessment was made twice, i.e. on the day of admission to the in-patient rehabilitation ward and after a three-week hospital treatment. Results: In the second measurement, a slight decrease in paresis intensity according to Brunnström Approach and lower intensity of spasticity according to Ashworth Scale were noted. A higher number of points in the FMA scale was observed. The values of the suggested indicator changed; however, in no case were these changes statistically significant. Conclusions: 1. Compared to other subjective scales, the usefulness of the measurement of pressure generated during a maximal palmar grasp and after its release for assessing the level of hand motor control in post-stroke patients was not confirmed. 2. The usefulness of the recommended method of spastic hand motor control assessment needs to be verified in further research carried out according to EBM requirements.

scholarly journals Camera-Based Mirror Visual Input for Priming Promotes Motor Recovery, Daily Function, and Brain Network Segregation in Subacute Stroke Patients

2019 ◽  
Vol 33 (4) ◽  
pp. 307-318 ◽  
Author(s):  
Li Ding ◽  
Xu Wang ◽  
Shugeng Chen ◽  
Hewei Wang ◽  
Jing Tian ◽  
...  
Keyword(s):  
Functional Independence ◽  
Brain Network ◽  
Motor Recovery ◽  
Clustering Coefficient ◽  
Manual Muscle Testing ◽  
Stroke Patients ◽  
Muscle Testing ◽  
Subacute Stroke ◽  
Before And After ◽  
Daily Function

Background. Camera technique–based mirror visual feedback (MVF) is an optimal interface for mirror therapy. However, its efficiency for stroke rehabilitation and the underlying neural mechanisms remain unclear. Objective. To investigate the possible treatment benefits of camera-based MVF (camMVF) for priming prior to hand function exercise in subacute stroke patients, and to reveal topological reorganization of brain network in response to the intervention. Methods. Twenty subacute stroke patients were assigned randomly to the camMVF group (MG, N = 10) or a conventional group (CG, N = 10). Before, and after 2 and 4 weeks of intervention, the Fugl-Meyer Assessment Upper Limb subscale (FMA_UL), the Functional Independence Measure (FIM), the modified Ashworth Scale (MAS), manual muscle testing (MMT), and the Berg Balance Scale (BBS) were measured. Resting-state electroencephalography (EEG) signals were recorded before and after 4-week intervention. Results. The MG showed more improvements in the FMA_UL, the FMA_WH (wrist and hand), and the FIM than the CG. The clustering coefficient (CC) of the resting EEG network in the alpha band was increased globally in the MG after intervention but not in the CG. Nodal CC analyses revealed that the CC in the MG tended to increase in the ipsilesional occipital and temporal areas, and the bilateral central and parietal areas, suggesting improved local efficiency of communication in the visual, somatosensory, and motor areas. The changes of nodal CC at TP8 and PO8 were significantly positively correlated with the motor recovery. Conclusions. The camMVF-based priming could improve the motor recovery, daily function, and brain network segregation in subacute stroke patients.

scholarly journals Pengaruh Latihan Range Of Motion (ROM) Menggenggam Bola Terhadap Kekuatan Otot Ekstremitas Atas Pasien Stroke Iskemik

2019 ◽  
Vol 14 (2) ◽  
pp. 79-86
Author(s):  
Hendri Budi ◽  
Netti Netti ◽  
Yossi Suryarinilsih
Keyword(s):  
Ischemic Stroke ◽  
Muscle Strength ◽  
Range Of Motion ◽  
Design Research ◽  
Nursing Intervention ◽  
Wilcoxon Test ◽  
Manual Muscle Testing ◽  
P Value ◽  
Stroke Patients ◽  
Muscle Testing

Stroke causes motor hemiparise disorders or weakness. Nursing intervention to overcome this is by doing range of motion (ROM) exercises grasping the ball. The purpose of the study was to identify the effect of ROM-grasping ball exercises on the strength of limb muscles for ischemic stroke patients. Quasi-experimental research type, one group pre-post test design. Research in the Neuro Ward Dr. M. Djamil Padang Hospital. The time of the research is October to December 2017. The intervention is ROM gripping ball exercises, namely rubber balls for 3 days followed by tennis balls for 2 days. Hold the ball firmly for 5 seconds then relax 10 seconds, practice repeated 10 times, frequency 3 times a day. The study population were all stroke patients in the Neuro Ward Dr. M. Djamil Padang Hospital. A sample of 10 people was obtained by purposive sampling that met the inclusion criteria. Data collection by measurement of muscle strength using Manual Muscle Testing (MMT). Data were computerized, analyzed by descriptive statistics and Wilcoxon test. The results of the study showed differences in upper limb muscle strength before and after the ROM exercise held the ball on the patient's shoulder (p value = 0.004), on the elbow of the patient (p value = 0.000), on the patient's hand (p value = 0.000), and on the patient's finger (p value = 0.000). It is recommended to nurses to implement the practice of grasping the ball to increase muscle strength of ischemic stroke patients and make it as a procedure for nursing intervention to patients to muscle strength.      

Effects of a 3D-printed orthosis compared to a low-temperature thermoplastic plate orthosis on wrist flexor spasticity in chronic hemiparetic stroke patients: a randomized controlled trial

2019 ◽  
Vol 34 (2) ◽  
pp. 194-204
Author(s):  
Yanan Zheng ◽  
Gongliang Liu ◽  
Long Yu ◽  
Yanmin Wang ◽  
Yuan Fang ◽  
...  
Keyword(s):  
Low Temperature ◽  
Control Group ◽  
Subjective Feeling ◽  
Stroke Patients ◽  
Wrist Flexor ◽  
Modified Ashworth Scale ◽  
Significant Difference ◽  
Scale Scores ◽  
3D Printed ◽  
Ashworth Scale

Objective: The aim of this study was to compare the effects of two kinds of wrist-hand orthosis on wrist flexor spasticity in chronic stroke patients. Design: This is a randomized controlled trial. Setting: The study was conducted in a rehabilitation center. Participants: A total of 40 chronic hemiparetic stroke patients with wrist flexor spasticity were involved in the study. Interventions: Patients were randomly assigned to either an experimental group (conventional rehabilitation therapy + 3D-printed orthosis, 20 patients) or a control group (conventional rehabilitation therapy + low-temperature thermoplastic plate orthosis, 20 patients). The time of wearing orthosis was about 4–8 hours per day for six weeks. Main measures: Primary outcome measure: Modified Ashworth Scale was assessed three times (at baseline, three weeks, and six weeks). Secondary outcome measures: passive range of motion, Fugl-Meyer Assessment score, visual analogue scale score, and the swelling score were assessed twice (at baseline and six weeks). The subjective feeling score was assessed at six weeks. Results: No significant difference was found between the two groups in the change of Modified Ashworth Scale scores at three weeks (15% versus 25%, P = 0.496). At six weeks, the Modified Ashworth Scale scores (65% versus 30%, P = 0.02), passive range of wrist extension ( P < 0.001), ulnar deviation ( P = 0.028), Fugl-Meyer Assessment scores ( P < 0.001), and swelling scores ( P < 0.001) showed significant changes between the experimental group and the control group. No significant difference was found between the two groups in the change of visual analogue scale scores ( P = 0.637) and the subjective feeling scores ( P = 0.243). Conclusion: 3D-printed orthosis showed greater changes than low-temperature thermoplastic plate orthosis in reducing spasticity and swelling, improving motor function of the wrist and passive range of wrist extension for stroke patients.

scholarly journals Functional electrical stimulation reduces pain and shoulder subluxation in chronic post-stroke patients?

2020 ◽  
pp. 1-5
Author(s):  
Willian Vasconcellos da Silva ◽  
Gabriele Natane de Medeiros Cirne ◽  
Edson Meneses da Silva Filho ◽  
Enio Walker Azevedo Cacho ◽  
Johnnatas Mikael Lopes ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Functional Electrical Stimulation ◽  
Total Duration ◽  
Chronic Phase ◽  
Control Group ◽  
Mcgill Pain Questionnaire ◽  
Therapeutic Effects ◽  
Stroke Patients ◽  
Post Stroke ◽  
Scale Scores

Background: Shoulder subluxation is a common complication of cerebral vascular accident (stroke) and the use of Functional Electrical Stimulation (FES) within the rehabilitation process is extremely important. Objective: To analyze the therapeutic effects of FES in the treatment of chronic shoulder subluxation in post-stroke patients. Method: This is a case study of patients with radiologically subluxation confirmed, who were randomly divided into two groups: Control Group (CG) and Treatment Group (TG). Patients were assessed before and after treatment and at the 2-month follow-up. The assessment consisted of the modified Ashworth scale; passive goniometry; Fugl-Meyer scale; McGill pain questionnaire and evaluation of shoulder subluxation by radiography. The CG did not receive physiotherapeutic intervention; and TG underwent 20 sessions of motor kinesiotherapy and FES associated with functional exercises with a total duration of 1 hour, three times a week, for 7 weeks. The data were analyzed descriptively. Results: The mean age of CG participants was 82.5 ± 1.5 years and of the TG was 70.5 ± 13.5 years. All of them were retired, sedentary, non-smokers/alcoholics and had hemiparesis on the left side. There was an approximate increase of 10o for most joint movements of the shoulder, improvement in McGill scale scores and reduction of shoulder subluxation in TG patients. Conclusion: FES associated with functional movements was effective in reducing the degree of subluxation of the shoulder joint and decreased pain in subjectsin the chronic phase of the post-stroke.

scholarly journals Positive Correlation between Left Hemisphere Lesion and Erectile Dysfunction in Post-Stroke Patients

2019 ◽  
Vol 7 (3) ◽  
pp. 363-368 ◽  
Author(s):  
Thomas Eko Purwata ◽  
Dedy Andaka ◽  
AABN Nuartha ◽  
Candra Wiratni ◽  
Ketut Sumada
Keyword(s):  
Erectile Dysfunction ◽  
Left Hemisphere ◽  
Parasympathetic Nervous System ◽  
Longitudinal Research ◽  
Health Condition ◽  
Stroke Patients ◽  
Positive Correlation ◽  
Post Stroke ◽  
Hemisphere Lesion ◽  
Subsequent Risk

BACKGROUND: Stroke is a serious health condition and the leading cause of disability, including erectile dysfunction (ED). The mechanisms and factors that predict ED in stroke are not fully elucidated. Several studies have shown a relationship between the location of the lesion in stroke with the onset of ED. The left hemispheric lesion was believed to disrupt the parasympathetic nervous system which is responsible for the regulation of erection. Stroke attack in this region therefore can be the underlying reason for ED. However, there are still contradictory findings in this area, and very few studies attempted to look at this problem, particularly among Asian male. AIM: We would like to evaluate the association between left hemisphere lesion after ischemic stroke and the subsequent risk of developing ED. METHODS: The study was conducted in the neurology polyclinic of Sanglah and Wangaya Hospital from February to August 2013. Subjects are all post-stroke patients who visited the neurology polyclinic of Sanglah and Wangaya Hospital that met inclusion and exclusion criteria. RESULTS: There is a significant positive correlation (p < 0.05) between left hemisphere lesions and ED in stroke patients with a correlation coefficient (r) = 0.361 which means weak correlation and p = 0.032. CONCLUSION: Left hemisphere lesions positively correlated with ED in stroke patients. Further longitudinal research is needed to see whether left hemisphere lesion in post-stroke patients is a risk factor for ED.

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