Effect of Scapular Kinesiotaping as an Adjunct to Dynamic Neuromuscular Stabilization Exercises on Upper Extremity Functions in Stroke Patients

Background and Purpose: Stroke is one of the leading causes of death and disability in India. Upper extremities get more affected in Middle cerebral artery syndrome. Stroke patients have lack of functional ability of upper extremity due to scapular malalignment resulting from paralysis of the scapular muscles. Kinesiotape helps to realign the muscles and thus it becomes easy to activate or inhibit them. We hypothesised that Dynamic Neuromuscular Stabilisation exercises along with kinesiotape could improve upper extremity function. Methodology: Ethical clearance was obtained. Informed consent was taken. 30 patients were selected according to inclusion and exclusion criteria. 15 subjects were randomly divided into experimental and control group. Subjects were given Dynamic neuromuscular stabilisation exercises for scapular strengthening. The experimental group was given Kinesiotaping to the scapula using muscle technique. Pre and post treatment assessment was done using Upper Extremity Function Index, grip strength and scapular abduction position with MB ruler. Result: The intergroup comparison revealed a highly significant difference for upper extremity function index and grip strength whereas scapular abduction was not significant. Conclusion: The Scapular Kinesiotaping as an adjunct to Dynamic Neuromuscular Stabilization Exercises is significantly effective to improve upper extremity functions and grip strength in post stroke patients. Key words: Stroke, Upper Extremity Functions, Dynamic Neuromuscular Stabilization Exercises, Scapular Kinesiotaping.

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Effect of proprioceptive sensation and feedback required for motor learning on function, activity, and daily life behavior of patients after nerve injury

World Journal of Advanced Research and Reviews ◽

10.30574/wjarr.2021.11.3.0462 ◽

2021 ◽

Vol 11 (3) ◽

pp. 474-481

Author(s):

Jung-Ho Lee

Keyword(s):

Upper Extremity ◽

Daily Activities ◽

Control Group ◽

Mirror Therapy ◽

Stroke Patients ◽

Proprioceptive Sensation ◽

Significant Difference ◽

Upper Extremity Function ◽

Function Activity ◽

Experimental Group

Purpose: This study investigated the effects of modified mirror therapy and taping therapy for providing feedback on upper extremity function, activity, and daily activities of stroke patients. Methods: This study was conducted with 20 stroke patients and randomly assigned 10 subjects to the experimental group and 10 to the control group. In the experimental group, after proprioceptive neuromuscular stimulation treatment, the mirror therapy program was implemented. In the control group, upper extremity taping was performed before proprioceptive neuromuscular facilitation treatment. In this study, a prior evaluation using JTT, FIM, and MAL was performed before intervention to evaluate the patient's function and daily life behavior. Post-tests were performed after the last treatment. Results: In the paired-sample T-test used for within-group comparison of JTTs, FIM, and MAL, there was a significant difference between pre- and post-test for all groups. But there was no statistically significant difference between experimental group 1 and experimental group 2 in an independent t-test conducted to compare the effect sizes of treatments. Conclusion: In other words, by applying mirror therapy and taping therapy that can increase proprioceptive sensation and feedback information in stroke patients, upper extremity function and daily activities can be increased.

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Effect of Leap Motion-based 3D Immersive Virtual Reality Usage on Upper Extremity Function in Ischemic Stroke Patients

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20190129 ◽

2019 ◽

Vol 77 (10) ◽

pp. 681-688 ◽

Cited By ~ 3

Author(s):

Muhammed Nur ÖGÜN ◽

Ramazan KURUL ◽

Mustafa Fatih YAŞAR ◽

Sule Aydin TURKOGLU ◽

Şebnem AVCI ◽

...

Keyword(s):

Virtual Reality ◽

Ischemic Stroke ◽

Upper Extremity ◽

Self Care ◽

Functional Independence ◽

Control Group ◽

Immersive Virtual Reality ◽

Extremity Function ◽

Upper Extremity Function ◽

And Control

ABSTRACT Immersive virtual reality (VR) is a technology that provides a more realistic environmental design and object tracking than ordinary VR. The aim of this study was to investigate the effectiveness of immersive VR on upper extremity function in patients with ischemic stroke. Sixty-five patients with ischemic stroke were included in this randomized, controlled, double-blind study. Patients were randomly divided into VR (n = 33) and control (n = 32) groups. The VR group received 60 minutes of the upper extremity immersive VR rehabilitation program and the control group received 45 minutes of conventional therapy and 15 minutes of a sham VR program. Rehabilitation consisted of 18 sessions of therapy, three days per week, for six weeks. The outcome measures were the Action Research Arm Test (ARAT), Functional Independence Measure (FIM), Fugl-Meyer Upper Extremity Scale (FMUE) and Performance Assessment of Self-Care Skills (PASS). In both the VR and control groups all parameters except the PASS improved over time. However independent t-test results showed that all of the FMUE, ARAT, FIM and PASS scores were significantly higher in the VR group compared with the control (p < 0.05). The minimal clinically important difference (MCID) scores of the FMUE and ARAT were higher than the cut-off MCID scores described in the literature in the VR group, whereas the FIM scores were below the cut-off MCID scores. All scores in the control group were below the cut-off scores. Immersive VR rehabilitation appeared to be effective in improving upper extremity function and self-care skills, but it did not improve functional independence.

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Effectiveness and cost-effectiveness of an optimized process of providing assistive technology for impaired upper extremity function: Protocol of a prospective, quasi-experimental non-randomized study (OMARM)

Technology and Disability ◽

10.3233/tad-210335 ◽

2021 ◽

pp. 1-14

Author(s):

Uta Roentgen ◽

Loek van der Heide ◽

Ingrid E.H. Kremer ◽

Huub Creemers ◽

Merel A. Brehm ◽

...

Keyword(s):

Cost Effectiveness ◽

Assistive Technology ◽

Upper Extremity ◽

Randomized Study ◽

Intervention Group ◽

Control Group ◽

Full Potential ◽

Extremity Function ◽

Quasi Experimental ◽

Upper Extremity Function

BACKGROUND: Impaired upper extremity function due to muscle paresis or paralysis has a major impact on independent living and quality of life (QoL). Assistive technology (AT) for upper extremity function (i.e. dynamic arm supports and robotic arms) can increase a client’s independence. Previous studies revealed that clients often use AT not to their full potential, due to suboptimal provision of these devices in usual care. OBJECTIVE: To optimize the process of providing AT for impaired upper extremity function and to evaluate its (cost-) effectiveness compared with care as usual. METHODS: Development of a protocol to guide the AT provision process in an optimized way according to generic Dutch guidelines; a quasi-experimental study with non-randomized, consecutive inclusion of a control group (n= 48) receiving care as usual and of an intervention group (optimized provision process) (n= 48); and a cost-effectiveness and cost-utility analysis from societal perspective will be performed. The primary outcome is clients’ satisfaction with the AT and related services, measured with the Quebec User Evaluation of Satisfaction with AT (Dutch version; D-QUEST). Secondary outcomes comprise complaints of the upper extremity, restrictions in activities, QoL, medical consumption and societal cost. Measurements are taken at baseline and at 3, 6 and 9 months follow-up.

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Effectiveness of self-administered mirror therapy on upper extremity impairments and function of acute stroke patients: study protocol

Trials ◽

10.1186/s13063-021-05380-9 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Venkadesan Rajendran ◽

Deepa Jeevanantham ◽

Céline Larivière ◽

Ravinder-Jeet Singh ◽

Lisa Zeman ◽

...

Keyword(s):

Acute Stroke ◽

Upper Extremity ◽

Outcome Measure ◽

Outcome Evaluation ◽

Secondary Outcome ◽

Mirror Therapy ◽

Stroke Patients ◽

Extremity Function ◽

Upper Extremity Function ◽

Experimental Group

Abstract Background Many therapeutic interventions are performed by physiotherapists to improve upper extremity function and/or activities of daily living (ADL) in stroke patients. Mirror therapy (MT) is a simple technique that can be self-administered by the patients with intact cognition following patient education by a skilled physiotherapist. However, the effectiveness of self-administered MT in post-stroke patients in upper extremity function remains unclear. Therefore, the objective of this study is to examine the effectiveness of MT in improving upper extremity function and recovery in acute stroke patients. Methods This study is a single-center, prospective, randomized, open-label, controlled trial with blinded outcome evaluation (PROBE design), in which a total of 36 eligible acute stroke patients will be randomly assigned to control (n=18) and experimental group (n=18). Participants in the control group will receive regular rehabilitation interventions whereas participants in the experimental group will receive MT education in addition to their regular interventions for 4 weeks. Study outcome The primary outcome measure will be upper extremity function that will be measured using the Fugl-Meyer Assessment scale and the Wolf Motor Function Test. The secondary outcome measure will be behaviors related to ADL as estimated using the Modified Barthel Index. Outcome measures will be assessed at baseline and at 4 weeks post-rehabilitation intervention/MT. Results A two-way repeated analysis of variance (ANOVA) with time and group effects will be used to analyze between-group differences. The level of significance will be set at P < 0.05. Conclusion The results of the study will provide critical information to include self-administered MT as an adjuvant to regular interventions and may facilitate recovery of the upper extremity function of stroke patients. Trial registration ClinicalTrials.gov NCT04542772. Registered on 9 September 2020. Protocol version: Final 1.0.

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Abstract 2580: How Frequent Is Impaired Arm And Hand Function After First Occasion Of Stroke? An Unselected Population From A Stroke Unit With A Geographical Catchment.

Stroke ◽

10.1161/str.43.suppl_1.a2580 ◽

2012 ◽

Vol 43 (suppl_1) ◽

Author(s):

Katharina Stibrant Sunnerhagen ◽

Hanna C Persson

Keyword(s):

Upper Extremity ◽

Stroke Unit ◽

Catchment Area ◽

Hand Function ◽

Stroke Onset ◽

Stroke Patients ◽

Extremity Function ◽

Unselected Population ◽

Upper Extremity Function ◽

Impaired Motor Function

Introduction Reduced upper extremity function after stroke has previously been reported in 70-80% of patients with stroke in the acute stage and is one of the most common impairments after acute stroke impaired motor function, both in upper and lower extremity, influence the stroke unit care and planning of the rehabilitation, partly due to the economic costs. There is limited information in upper extremity function within the first days after a stroke. Prior studies include either both first and recurrent stroke or only one type of stroke. Objectives To investigate the frequency impaired arm and hand function in an unselected group of patients with first occasion of stroke. Method All patients at a stroke unit at Sahlgrenska University Hospital were assessed during 18 months. From the hospital records, the patients were identified, the patient charts were read and first stroke diagnosis was confirmed (by either imaging or clinical assessment). Impaired upper extremity function was defined in the following manner: assessed with the Modified Motor Assessment Scale (M-MAS UAS -95) by physiotherapist working at the stroke unit within 72 hours after stroke onset or if this was found in the patients chart, other standardized assessments of upper extremity function performed by the physical therapist, the occupational therapist or the physicians on the ward. Results During the study period 984 patients with first ever stroke (438 women 44.5%) were admitted to the stroke unit. A total of 213 patients were not at the stroke unit within 72 hours after onset and therefore excluded; 90 patients had unclear stroke onset time, 49 patients were located at another ward, 36 patients were in the intensive care unit, 25 in other hospitals in Sweden and 12 patients were hospitalized in another country. There were 771 patients over 18 years old at the stroke unit within 72 hours after stroke onset. Of these 56 patients (7.3%), were not living in the catchment area and therefore excluded. Of the 715 patients living in the geographical catchment area, 58, (8.1%) hade other upper extremity injury prior the stroke onset. Of the remaining first ever stroke patients (n=657), 311 patients (47.3%) hade impaired arm and hand function within 72 hours after stroke onset. Conclusion The frequency of impaired upper extremity function in this unselected population of first occasion of stroke is lower than previously reported. The Copenhagen stroke study noted 69 % impaired at admission and 43 % at one week. This indicates that today’s stroke patients present less frequent with impaired motor function in the upper extremity. However, they may have difficulties in functional activities which may influence content of rehabilitation process.

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