Improvement of Hand Motor Function after Radial Shock Wave Therapy in Chronic Stroke Patients

Author(s):  
M Kamaluddin ◽  
Erna Setiawati ◽  
Tanti Ajoe Kesoema

Introduction: The Radial Shock Wave Therapy (RSWT) expected could improve spasticity and hand function in chronic stroke patients. This study aimed to find out the improvement of hand function after RSWT as an additional therapy in chronic stroke patients. Methods: Design study was a randomized controlled trial. The patients were assigned randomly to the experimental group (Infrared, Stretching, and RSWT) and control group (Infrared and Stretching) for six weeks. Hand motor function was measured using Fugl-Meyer Motor Assesment (FMA) before and after intervention. Conclusion: There were improvement of wrist and hand FMA scores in the experimental as well as control group Results: Median of wrist FMA scores in the experimental and control group before intervention were 2 and 3 respectively whereas median of wrist FMA scores in the experimental and control group after intervention were 5 and 4 respectively. Median of hand FMA scores in the experimental and control group before intervention were 4 and 4 respectively whereas median of hand FMA scores in the control and experimental group after intervention were 6 and 5 respectively. The scores of wrist- hand FMA in the control and experimental group after intervention were increased P = 0.001P < 0.001 (wrist) and P = 0.001 P < 0.001 (hand) respectively. However, difference increased of wrist and hand FMA scores in the experimental group after intervention were more significant. Keywords: Spasticity, Hand Function, Stroke, Radial Shock Therapy, Fugl-Meyer Motor Assesment

Author(s):  
M. Kamaluddin K ◽  
Erna Setiawati ◽  
Tanti Ajoe Kesoema

IIntroduction: The Radial Shock Wave Therapy (RSWT) expected could improve spasticity and hand function in chronic stroke patients. This study aimed to find out the improvement of hand function after RSWT as an additional therapy in chronic stroke patients. Methods: Design study was a randomized controlled trial, in December 2018. The patients were assigned randomly to the experimental group (Infrared, Stretching, and RSWT) and control group (Infrared and Stretching) for six weeks. Hand motor function was measured using Fugl-Meyer Motor Assesment (FMA) before and after intervention. Results: The median values of wrist FMA scores in the experimental and control group before and after intervention were 2 vs 5 (p=0.001) and 3 vs 4 (p<0.001) respectively. The median values of hand FMA scores in the experimental and control group before and intervention were 4 vs 6 (p=0,.001) and 4 vs 5 (p<0.001). However, the delta between before and after intervention was higher in experimental group. Conclusion: The improvement of wrist and hand FMA scores after added treatment by RSWT was tend to higher.Keywords: Spasticity, Hand Function, Stroke, Radial Shock Therapy, Fugl-Meyer Motor Assesment


Author(s):  
M. Kamaluddin K ◽  
Erna Setiawati ◽  
Tanti Ajoe Kesoema

IIntroduction: The Radial Shock Wave Therapy (RSWT) expected could improve spasticity and hand function in chronic stroke patients. This study aimed to find out the improvement of hand function after RSWT as an additional therapy in chronic stroke patients. Methods: Design study was a randomized controlled trial, in December 2018. The patients were assigned randomly to the experimental group (Infrared, Stretching, and RSWT) and control group (Infrared and Stretching) for six weeks. Hand motor function was measured using Fugl-Meyer Motor Assesment (FMA) before and after intervention. Results: The median values of wrist FMA scores in the experimental and control group before and after intervention were 2 vs 5 (p=0.001) and 3 vs 4 (p<0.001) respectively. The median values of hand FMA scores in the experimental and control group before and intervention were 4 vs 6 (p=0,.001) and 4 vs 5 (p<0.001). However, the delta between before and after intervention was higher in experimental group. Conclusion: The improvement of wrist and hand FMA scores after added treatment by RSWT was tend to higher.Keywords: Spasticity, Hand Function, Stroke, Radial Shock Therapy, Fugl-Meyer Motor Assesment


Author(s):  
M. Kamaluddin K ◽  
Erna Setiawati ◽  
Tanti Ajoe Kesoema

IIntroduction: The Radial Shock Wave Therapy (RSWT) expected could improve spasticity and hand function in chronic stroke patients. This study aimed to find out the improvement of hand function after RSWT as an additional therapy in chronic stroke patients. Methods: Design study was a randomized controlled trial, in December 2018. The patients were assigned randomly to the experimental group (Infrared, Stretching, and RSWT) and control group (Infrared and Stretching) for six weeks. Hand motor function was measured using Fugl-Meyer Motor Assesment (FMA) before and after intervention. Results: The median values of wrist FMA scores in the experimental and control group before and after intervention were 2 vs 5 (p=0.001) and 3 vs 4 (p<0.001) respectively. The median values of hand FMA scores in the experimental and control group before and intervention were 4 vs 6 (p=0,.001) and 4 vs 5 (p<0.001). However, the delta between before and after intervention was higher in experimental group. Conclusion: The improvement of wrist and hand FMA scores after added treatment by RSWT was tend to higher.


2021 ◽  
Author(s):  
Jie Jia ◽  
Chong Li ◽  
Xinyu Song ◽  
Shugeng Chen ◽  
Chuankai Wang ◽  
...  

BACKGROUND A serious game-based Cellphone Augmented Reality System (CARS) was developed for rehabilitation of stroke patients, which is portable, convenient, and suitable for self-training. OBJECTIVE The present research aimed to study the effectiveness of CARS in improving upper limb motor function and cognition function of stroke patients via conducting a long-term randomized controlled trial and analyze the patient’s acceptance of the proposed system. METHODS A randomized, double-blind, controlled trial was performed with 30 post-stroke, sub-acute phase patients. All patients in both the experimental group (n=15) and the control group (n=15) performed a 1-hour session of therapy each day, 5 days per week, for 2 weeks. Patients in the experimental group received 30 minutes of rehabilitation training with CARS and 30 minutes of conventional occupational therapy (OT) each session, while patients in the control group received conventional OT for the full 1 hour each session. The Fugl-Meyer Assessment-Upper Extremity subscale (FMA-UE), Action Research Arm Test (ARAT), Manual Muscle Test (MMT), Brunnstrom Stage (BS), and Barthel Index (BI) were used to assess motor function, and the Mini-Mental State Examination (MMSE), Add VS Sub (AVS), and Stroop Game (SG) were used to assess cognitive function before and after the 2-week treatment period. In addition, the User Satisfaction Evaluation Questionnaire (USEQ) was used to reflect the patients’ acceptance of the system in the experimental group after the final intervention. RESULTS All the assessment scores of the experimental group and control group were significantly improved after intervention (p<0.05). The experimental group’s score of FMA-UE and ARAT increased by 11.47 and 5.86 respectively after intervention, which were both significantly higher than the increase of the control group (p<0.01). Similarly, the score of AVS and SG in the experimental group increased by 7.53 and 6.83 respectively after the intervention, which was also higher than the control group (p<0.01). The evaluation of the adoption of this system has three sub-dimensions. In terms of accessibility, the patients reported a mean score of 4.27±0.704 for the enjoyment of their experience with the system, 4.33±0.816 for success to use the system, 4.67±0.617 for the ability to control the system. In terms of comfort, the patients reported 4.40±0.737 for clear information provided by the system, 4.40±0.632 for comfort. In terms of acceptability, the patients reported 4.27±0.884 for usefulness in their rehabilitation, 4.67±0.617 for agreeing with CARS as a suitable tool for home-based rehabilitation. CONCLUSIONS CARS and conventional OT together-based rehabilitation were more effective in improving both upper limb motor function and cognition function as compared with conventional OT. Due to the low cost, and ease of use, CARS is also potentially suitable for home-based rehabilitation. CLINICALTRIAL The Chinese Clinical Trial Registry (ChiCTR1800017568).


Author(s):  
Sagrario Pérez-de la Cruz

One of the most serious and disabling problems of stroke is pain and a decrease in balance, with the consequent increased risk of falls. The aim of the randomized controlled trial study was to compare the efficacy of three different treatment proposals to improve pain, gait, and balance in chronic stroke patients. Forty patients diagnosed with stroke were divided into three groups: the dry-land therapy group (control group) received sessions that included walking exercises and trunk mobility. The experimental group received Ai Chi aquatic therapy, and the combined group received alternating dry-land therapy sessions and Ai Chi aquatic therapy. The measurement instruments used were: the Tinetti balance and gait scale, the visual analog scale (VAS), 360° turn, single leg stance, and the 30-s stand test (CS-30). After twelve weeks of treatment, the results were significantly better for the combined therapy group and the experimental group compared to the dry-land therapy group (p < 0.01) in the VAS scale, CS-30, and 360° turn, although improvements were also found in the evaluations carried out in the aquatic therapy group. In total, for the Tinetti scale and single-leg stance, the differences between the groups were evident, although not statistically significant (p = 0.001). Aquatic therapy with Ai Chi and the combination of aquatic therapy with dry-land therapy was effective in improving pain, balance, and gait in patients with chronic stroke, thus improving their functional capacity and quality of life.


2021 ◽  
Vol 10 (19) ◽  
pp. 4549
Author(s):  
Yu-Sheng Yang ◽  
Chi-Hsiang Tseng ◽  
Wei-Chien Fang ◽  
Ia-Wen Han ◽  
Shyh-Chour Huang

Spasticity, a common stroke complication, can result in impairments and limitations in the performance of activities and participation. In this study, we investigated the effectiveness of a new dynamic splint on wrist and finger flexor muscle spasticity in chronic stroke survivors, using a randomized controlled trial. Thirty chronic stroke survivors were recruited and randomly allocated to either an experimental or control group; 25 completed the 6-week intervention program. The participants in the experimental group were asked to wear the dynamic splint at least 6 h/day at home, for the entire intervention. The participants in the control group did not wear any splint. All the participants were evaluated 1 week before, immediately, and after 3 and 6 weeks of splint use, with the modified Ashworth scale and the Fugl−Meyer assessment for upper extremity. User experience was evaluated by a self-reported questionnaire after the 6-week intervention. The timed within-group assessments showed a significant reduction in spasticity and improvements in functional movements in the experimental group. We found differences, in favor of the experimental group, between the groups after the intervention. The splint users indicated a very good satisfaction rating for muscle tone reduction, comfort, and ease of use. Therefore, this new splint can be used for at-home rehabilitation in chronic stroke patients with hemiparesis.


2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Naho Umeki ◽  
Jun Murata ◽  
Misako Higashijima

Background. Stroke causes severe disability, including motor and sensory impairments. We hypothesized that upper limb functional recovery after stroke may be augmented by combining treatments for motor and sensory functions. In order to examine this hypothesis, we conducted a controlled trial on rehabilitation for sensory function to the plegic hand. Methods. The sensory training program consisted of several types of discrimination tasks performed under blind conditions. The sensory training program was performed for 20 min per day, 5 days a week. An experimental group of 31 patients followed this sensory program, while a control group of 25 patients underwent standard rehabilitation. The efficacy of the intervention was evaluated by the tactile-pressure threshold, handgrip strength, and the completion time of manipulating objects. A two-way repeated measures analysis of variance was used to assess interactions between group and time. Moreover, to provide a meaningful analysis for comparisons, effect sizes were calculated using Cohen’s d. Results. The mean change in the tactile pressure threshold was significantly larger in the experimental group than in the control group (p<0.05, d=0.59). Moreover, the completion times to manipulate a middle-sized ball (d=0.53) and small ball (d=0.80) and a small metal disc (d=0.81) in the experimental group were significantly different from those in the control group (p<0.05). Conclusion. The present results suggest that the sensory training program to enhance finger discrimination ability contributes to improvements in not only sensory function but also manual function in stroke patients. The trial is registered with the UMIN Clinical Trials Registry (UMIN000032025).


2012 ◽  
Vol 02 (04) ◽  
pp. 16-21
Author(s):  
Mohamed Faisal C. K. ◽  
Priyabandani Neha Om Prakash ◽  
Ajith S.

AbstractStroke is a worldwide health problem. Hand function is one of the important factors which are affected in stroke. Stroke patients are usually given a conventional physiotherapy but if an additional FNMES is given it might show better improvement. By keeping these facts in view, the present study aims at evaluating and comparing the efficacy of conventional physiotherapy and adding FNMES will make any better outcome in the acute stroke survivals. The subjects were randomly assigned to any of the two groups; control group consisted of 15 subjects who received only conventional therapy for 4 weeks and experimental group consisting of 15 subjects who received an additional FNMES along with conventional physiotherapy for 4 weeks. The hand function was assessed on day 1 and to know the recovery, at the end of four weeks of intervention with the help of action research arm test (ARAT) and box and block test (BBT). At the end of 4 weeks of intervention both the groups showed significant improvements. On ARAT, control group showed a mean of 10.2000 whereas, experimental group showed mean of 20.8000 with p = 0.001 (p ≤ 0.05) and on BBT, the control group showed a mean of 21.666 and experimental group showed 30.933 with p = 0.41 (p ≤ S 0.05). Therefore the study concludes that, though there was improvement in both the groups, the experimental group who received an additional FNMES along with conventional physiotherapy showed better improvement in hand functions in the acute stroke survivals.


2016 ◽  
Vol 27 (7) ◽  
pp. 747-757 ◽  
Author(s):  
Craig Winston LeCroy ◽  
Melinda F. Davis

Home visitation has the potential to improve parent, child, and maternal outcomes and has become a widely implemented prevention program across the United States. The purpose of this research was to use a randomized controlled trial to assess the short-term effectiveness of the Arizona Healthy Families program across a range of outcomes. Two hundred and forty-five families were randomly assigned to the experimental group (Healthy Families) or control group (Child Development assessment only). Results revealed significant findings across four domains including safety and resources, parenting attitudes and behaviors, health and maternal outcomes, and mental health and coping. These results were further corroborated with an analysis of qualitative findings that analyzed linguistic differences between how the treatment and control group described their parenting. These results add to the existing literature on the effectiveness of the Healthy Families model of home visitation.


2021 ◽  
Vol 15 ◽  
Author(s):  
Jiamin Li ◽  
Cen Chen ◽  
Shenyu Zhu ◽  
Xiulian Niu ◽  
Xidan Yu ◽  
...  

Objective: The goal of this study is to explore the effect of wrist-ankle acupuncture combined with 5-Hz repetitive transcranial magnetic stimulation (rTMS) on improving spastic state and motor function of children with spastic cerebral palsy by measuring electrophysiological parameters and behaviors.Methods: Twenty-five children with spastic cerebral palsy were enrolled in a single-blind and randomized controlled trial. The control group received 20 sessions of 5-Hz rTMS over the affected hemisphere with 1,000 pulses. The experimental group was given wrist-ankle acupuncture on the basis of the control group. Gross motor function measure (GMFM-66), muscle tension, and electrophysiological parameters of the two groups were assessed at baseline and after intervention.Results: After treatment, the GMFM-66 scores in the same groups were significantly improved (p &lt; 0.001). Besides, the R-value of soleus, gastrocnemius, and hamstring muscle decreased (p &lt; 0.05), and the results showed a trend of shortening MEP latency, increasing amplitude and duration (p &lt; 0.05). Compared to the controlled group, the experimental group displayed more excellent changes in the GMFM-66 scores and motor evoked potential (MEP) latency. The statistical results showed that the increase of GMFM-66 score and the shortening of MEP latency in the experimental group were greater than that in the control group (p &lt; 0.05). However, no significant differences were found in the assessment of muscle tension, amplitude, and duration of MEPs between two groups (p &gt; 0.05).Conclusion: Wrist-ankle acupuncture combined with 5-Hz rTMS is optimal to improve gross motor function and enhance the conductivity of corticospinal tract in children with cerebral palsy but cannot highlight its clinical superiority in improving spasticity.Clinical Trial Registration: [http://www.chictr.org.cn/index.aspx], identifier [chictr2000039495].


Sign in / Sign up

Export Citation Format

Share Document