Progressive Supranuclear Palsy-a Mirror Image of Parkinson’s Disease, A Literature Review of Rehabilitation Strategies

Progressive supranuclear palsy (PSP) is a rare neurodegenerative disease which mimic similar to Parkinsonism. PSP advances much quicker than in PD yet no effective medication or therapy to manage PSP available. This literature review aimed to discover the recent advances in the physical therapy treatment options for PSP. Databases such as PubMed, Elsevier and SAGE journal searched for both published and unpublished studies. Last 10-year studies were included in this review. Limited clinical trial conducted in this population due to which a structured protocol or rehabilitation strategies is missing for this condition. Balance exercise and gait training showed potential benefit and music-cued walking demonstrated participant’s satisfaction.

The Effect of Aquatic and Non-aquatic Balance Training on the Fall Risk of Patients With Grade 2 and 3 Knee Osteoarthritis: A Randomized Clinical Trial

Objectives: To compare the efficacy of balance exercises in the aquatic and Non-aquatic environments compared with control in patients with grade 2 or 3 knee Osteoarthritis (OA). Methods: For this single-blind, randomized control trial study, 43 women with mild to moderate knee OA were recruited through a simple non-probability sampling method. They were randomly assigned to the aquatic balance exercise group (n=15), Non-aquatic balance exercise group (n=15), and a control group (n=13). The intervention programs comprised aquatic and Non-aquatic balance training. Fall risk, the primary outcome, was measured by the Biodex balance system before and after the intervention. One-way ANOVA and paired sample t-test were used for analyzing data. Results: After 4 weeks training, the Mean±SD fall risk score significantly decreased from 3.49±1.14 to 2.59±1.22 (P<0.001) in the aquatic balance training group, from 3.21±0.62 to 2.19±0.62 (P<0.001) in the Non-aquatic balance training group, and from 3.77±1.13 to 3.17±1.22 (P<0.001) in the control group. Regarding between-group comparisons, we found significant differences between the Non-aquatic balance training group and the control group (P=0.03). Discussion: Despite the environment, the balance exercise program significantly improved fall risk scores among patients with grade 2 or 3 knee osteoarthritis.

Effect of 6-Week Balance Exercise by Real-Time Postural Feedback System on Walking Ability for Patients with Chronic Stroke: A Pilot Single-Blind Randomized Controlled Trial

Stroke causes balance dysfunction, leading to decreased physical activity and increased falls. Thus, effective balance exercises are needed to improve balance dysfunction. This single-blind, single-center randomized controlled trial evaluated the long-term and continuous effects of balance exercise using a real-time postural feedback system to improve balancing ability safely. Thirty participants were randomized into intervention (n = 15) and control (n = 15) groups; 11 in each group completed the final evaluation. The effect of the intervention was evaluated by muscle strength of knee extension, physical performance (short physical performance battery, the center of pressure trajectory length per second, and Timed Up and Go test [TUG]), and self-reported questionnaires (modified Gait Efficacy Scale [mGES] and the Fall Efficacy Scale) at pre (0 week), post (6-week), and at follow-up (10-week) visits. The TUG and mGES showed a significant interactive (group * time) effect (p = 0.007 and p = 0.038, respectively). The intervention group showed significant decreasing time to perform TUG from pre- to post-intervention (p = 0.015) and pre-intervention to follow-up (p = 0.016); mGES showed a significant change from pre-intervention to follow-up (p = 0.036). Thus, balance exercise using a real-time postural feedback system can confer a positive effect on the walking ability in patients with chronic stroke and increase their self-confidence in gait performance.

Immediate Effect of Kinesiology Tape on Functionality, Static and Dynamic Balance, Exercise Capacity and Posture in Users of High-Heeled Shoes

Background: Using high-heeled shoes in daily life affects the stability of walking, body posture, and functionality. So, the present study was aimed to determine the immediate effect of Kinesio-taping (KT) on functionality, static and dynamic balance, exercise capacity, posture in young women using high-heeled shoes. Methods: Thirty-seven females who were used high-heeled shoes with a mean age of 20.32{plus minus}1.37 years were divided into two groups: control (n:20) and study group(n:17). The study group's both limbs were taped medially, laterally, and dorsally with KT; no application was made to the control group. Balance [Techno Body Postural Line], functionality [vertical jump and functional reach test], exercise capacity [6-min walk test], human body posture [New York Posture Rating Chart] was assessed. Results: Use of high-heeled shoes was 8(7-9) hours/day, 5(3-5) days/week, 3(2-6.5) years in the study group versus 6(6-8) hours/day, 4(2.5-5.75) days/week for 4(2.5-5.75) years in the control group. Statistical significance in functional reach distance (cm) was found within the control (p:0.010) and study groups (p:0.005) but not between the groups (p˃0.05). Stabilometric mono pedal right foot elips area (mm2; p:0.006) and perimeter (mm;p:0.009); left foot elips area (mm2;p:0.016), perimeter (mm;p:0.023) and front/backward standard deviation (p:0.018); dynamic balance area gap percentage (%; p:0.030) were significant within the study group. Posture, vertical jump distance, exercise capacity, stabilometric test results, bipedal closed-eye&opened eye results were similar within and between the groups (p˃0.05). Conclusions: Kinesio-taping has no immediate effect on exercise capacity, vertical jump function, posture, and bipedal static balance but can modulate the functional reach function, static mono pedal leg balance, and dynamic equilibrium. Further studies are recommended to investigate the additive effect of KT with high heels and after 45 minutes, 24 hours and 72 hours.

EFEKTIVITAS BALANCE EXERCISE DAN GAIT TRAINING DALAM MENINGKATKAN KESEIMBANGAN DAN KECEPATAN BERJALAN PADA KASUS STROKE ISKEMIK

Stroke merupakan hilangnya fungsi otak secara mendadak dan memicu kelumpuhan unilateral yang dapat mengurangi kontrol postur dan keseimbangan sehingga pasien kesulitan untuk berjalan. Tujuan studi kasus ini adalah mengetahui efektivitas balance exercise dan gait training terhadap peningkatan keseimbangan dan kecepatan berjalan pada pasien stroke menggunakan parameter Timed Up and Go Test (TUGT) dan 10 Meter Walk Test (10MWT). Metode yang digunakan adalah evidence-based case report dengan pertanyaan klinis, “Bagaimana efektivitas balance exercise dan gait training terhadap peningkatan keseimbangan dan kecepatan berjalan pada kasus stroke iskemik?” dengan penelusuran bukti pada 3 database, yaitu Pubmed, science direct, dan scopus. Setelah dilakukan 6 kali evaluasi terdapat peningkatan keseimbangan dan kecepatan dimana pada evaluasi pertama didapatkan hasil pengukuran TUGT sebesar 14,14 detik, self selected velocity 0,63m/s dan fast velocity 0,66m/s. Pada evaluasi keenam didapatkan hasil sebesar 09,50 detik, self selected velocity 1,34m/s dan fast velocity 1,40m/s sehingga dapat disimpulkan bahwa balance exercise dan gait training efektif dalam meningkatkan keseimbangan dan kecepatan berjalan pada pasien stroke dengan nilai minimal detectable change (MDC) TUGT sebesar 2,9 detik dan 10MWT pada self selected velocity sebesar 0,18m/s dan fast velocity sebesar 0,13m/s serta nilai minimally clinically important difference (MCID) TUGT sebesar 3,4 detik dan 10MWT sebesar 0,16m/s.