Effect of Ankle Kinesio Taping on Dynamic Balance in Stroke Patients- A Pilot Study

Background: Stroke causes partial brain loss, which leads to a functional abnormality of the brain, which produces a variety of symptoms the most prevalent of which is balance affection. Kinesio tape is a thin, light and elastic material which does not immobilize the joint and allows for free movement irrespective of the tape. It serves to facilitate or inhibit the muscle as needed and provides joint stability which will help improve balance function. It is also used to reduce pain, which is a typical complaint in stroke patients. Objective: To assess for immediate and post effects of kinesio tape in stroke patients using Berg Balance Scale and 10 Meter walk test. Method: A total of 15 participants were chosen based on inclusion and exclusion criteria. Before application of kinesio tape, the Berg balance scale and a 10-meter walk test were performed and recorded. Following the application, the subjects were reassessed, and the outcomes of the 5-day follow-up were recorded. These scores were statistically analyzed. Result: The statistical analysis showed that there is a significant increase in the dynamic balance function post kinesio tape application. An average increase of 5 scores in BBS was noted and average improvement of 5.70 seconds in 10MWT. Conclusion: This study concludes that there is a significant improvement on dynamic balance after application of kinesio tape in stroke patients. Key words: Stroke, kinesio tape, dynamic balance.

Аналіз наявних інструментів оцінювання впливу фізичної терапії на осіб з хворобою Паркінсона

Резюме. Правильний і обґрунтований вибір інструментальних методів оцінювання функціо-нального стану пацієнта є обов’язковою умовою адекватної фізичної терапії. Особливе місце цей аспект займає в системі нейрореабілітації пацієнтів з хворобою Паркінсона в Україні, оскільки на сьогодні кількість осіб, що потребують систематичної фізичної терапії, сягає 23 900 тис. Наростаюча маніфестація моторних і немоторних симптомів при хворобі Паркін-сона, від яких часто вирішальною мірою залежить тяжкість стану пацієнта, негативно впливає на якість його життя. Наявні функціональні порушення, які є самостійними проявами хвороби Паркінсона, вимагають специфічного підходу до комплексного інструментального досліджен-ня цих порушень для визначення диференційно-діагностичних критеріїв та оцінювання впливу фізіотерапевтичного втручання. Мета. Проаналізувати наявні інструменти оцінювання впливу фізичної терапії на осіб з хворобою Паркінсона. Методи. Теоретичний аналіз та узагальнення зарубіжних даних спеціальної науково-методичної літератури з питань застосування інстру-ментів оцінювання при хворобі Паркінсона та їх інформативності і надійності у фізичній терапії. Результати. Представлені дані свідчать, що ефективність запроваджених заходів фізичної терапії при хворобі Паркінсона залежить від правильно підібраних інструментів оцінювання, які дозволяють оцінити моторні і немоторні проблеми через призму життєдіяльності і якості життя пацієнта. Основним інструментом оцінювання для вирішення цього питання вважаєть-ся Уніфікована рейтингова шкала хвороби Паркінсона MDS-UPDRS, яка дозволяє об’єктивно оцінити моторні і немоторні аспекти життя пацієнта і його рухову активність. Оскільки наявні моторні й аксіальні рухові порушення негативно впливають на повсякденну функціональну активність пацієнта, для верифікації цих порушень пропонують використовувати тест для оці-нювання часу підйому і ходьби (Timed Up and Go (TUG)); тест з подвійним завданням (Dual-Task TUG (TUG-DT)) та шкалу рівноваги Берга (Berg Balance Scale (BBS)). Але виходячи з того, що ці тести недостатньо чутливі до невеликих змін у рухливості при хворобі Паркінсона, особливо на середніх і пізніх стадіях захворювання, їх доцільно поєднувати з одним із кількісних тестів для оцінювання ходьби: 10-метровим тестом ходьби (10 Meter Walk Test (10MW)) та 6-хвилинним тестом ходьби (Six Minute Walk Distance (6MWT)). Поняття «життєдіяльність» включає в себе не тільки переміщення, її оцінювання має бути доповнено аналізом ступеня впливу наявних по-рушень на повсякденну діяльність, тобто на якість життя пацієнта. Найбільш інформативними інструментами для проведення цього аналізу є універсальні і специфічні при хворобі Паркінсо-на опитувальники з метою оцінювання стану здоров’я SF-36, EuroQOL (EQ-5D) і PDQ-39 (The Parkinson’s Disease Questionnaire). Результати аналізу та узагальнення даних науково-мето-дичної літератури дають підставу встановити, що маніфестація порушень та їх варіабельність при хворобі Паркінсона стають серйозною проблемою у досягненні кінцевого результату за-проваджених заходів фізичної терапії на всіх стадіях захворювання. Використання в комплексі стандартної експертно-реабілітаційної діагностики спеціальних інструментів оцінювання дозволяє об’єктивізувати оцінювання клінічної інформації та стимулює розроблення особисто-орієнтованих реабілітаційних стратегій із застосуванням заходів фізичної терапії, спрямованих на покращення якості життя пацієнтів з хворобою Паркінсона. Ключові слова: хвороба Паркінсона, фізична терапія, якість життя, інструменти оцінювання, достовірність, надійність, валідність.

Effect of Executive Dysfunction on Posture Control and Gait after Stroke

Objective. The purpose of the study was to observe the effects of executive dysfunction (ED) on gait and postural control during walking after stroke. Methods. In this study, 34 subjects with stroke and ED (8 women and 26 men; age, 55.41 ± 7.89 years; time since stroke onset, 1.3 ± 0.12 months) were recruited. Stroop color-word test (SCWT), 10-meter walk test (10MWT), timed-up-and-go test (TUGT), and gait analysis were evaluated. The correlation among the correct number of Stroop tasks (SCWT-C), the number of time-consuming tasks (SCWT-T), the amount of interference (SIE-M and SIE-T) and posture control, and gait-related parameters was analyzed. Results. The results indicated that SCWT-C was negatively correlated with 10MWT, TUGT, and bilateral symmetry ( P < 0.05). However, there was no significant correlation between SCWT-C and stride ( P > 0.05). A significant negative correlation was seen between SCWT-C and bilateral symmetry ( P < 0.05). There was no significant correlation between SCWT-T and stride ( P > 0.05). SCWT-T was positively correlated with TUGT, 10MWT, and bilateral symmetry ( P < 0.05). SIE-T was positively correlated with TUGT and bilateral symmetry ( P < 0.05). There was no significant correlation between SIE-T and 10MWT or stride ( P > 0.05). SIE-M was positively correlated with TUGT and bilateral symmetry ( P < 0.05). There was no significant correlation between SIE-T and 10MWT or stride ( P > 0.05). Conclusions. ED is closely related to the decline in postural control and the occurrence of falls. In the early phases of stroke rehabilitation, physiotherapists should focus on the patients’ executive function to accelerate the recovery of postural control.

Effects of Treadmill Training and Stationary Cycling Training to Improve Ambulatory Function and Cardiovascular Fitness

Background: Stroke is a universal health care disease, the important cause of long time disability in world. Stroke leads to an inactive living, physical restrictions, and not good physical levels, which are related with common post-stroke participation limits. Aerobic capability and walking ability are decreased in old chronic patients of stroke. Aim: To determine the effects of treadmill training and stationary cycling training to improve ambulatory function and cardiovascular fitness in hemiparetic stroke patients Methods: 54 chronic stroke patients were allocated to treadmill training group(n=27) or stationary cycle exercise group (n=27). All participants received conventional physical therapy along with treadmill or stationary cycle training. The 10MWT was conducted to measure gait function and 6 min walk test was used to measure cardiovascular health. Results: The mean of treadmill group for 10 meter walk test is 10.01 + 15.48. The mean of stationary cycle group for 10 meter walk test is 9.80 + 6.77. The mean of treadmill group for 6 min walk test is 22.04+ 17.45. The mean of stationary cycle group for 6 min walk test is 23.20+ 22.92. The p value of 0.000 shows significant difference. This significant difference reflects that both interventions show equal improvement in participants. There is significant difference between pre and post treatment values of both interventions. Both intervention groups displayed significant effect in ambulatory functions and cardiovascular fitness. The results between groups were non significant, it means both interventions showed equal effect but results with in groups were significant. Conclusion: The study showed that treadmill training and stationary cycling training equally enhanced the gait ability and cardiovascular health of chronic stroke patients. Therefore, these exercises could be used to enhance walking and cardiovascular health in management of stroke. Keywords: treadmill training, stationary cycle training, ambulatory function, cardiovascular fitness, stroke

The effect of whole body vibration on gait dynamics after chronic stroke in Pakistan; A Randomized Controlled Clinical Trial

Objective: To determine the effect of whole body vibration (WBV) therapy on gait dynamics in chronic stroke patients in a tertiary care hospital. Methods: The present study was randomized, assessor-blinded, parallel-group, clinical trial conducted at Physiotherapy Department, Lahore General Hospital, Lahore, Pakistan, from November 2017 to April 2019. After taking written informed consent, 64 chronic stroke patients were randomly allocated (1:1) to routine physiotherapy (RP) group (n=32) and whole-body vibration (WBV) group (n=32) by computer random number generator method. Twelve sessions of vibration therapy were given to WBV group with an amplitude of 3 mm and frequency of 20Hz. Sessions comprises of 5 bouts of 120 seconds with 60 seconds rest intervals for 6 days/week x 2 weeks in erect standing position. The outcome measure was score of Timed Up and Go test (TUG test) and 10 Meter Walk test (10MWT) before and after intervention. Mann Whitney U Test and Wilcoxon Signed Rank test were used to analyze data. Results: After 2-week intervention, significant difference was seen in TUG, 10 Meter Walk test Slow Speed (10MWTSS), 10 Meter Walk test fast speed (10MWTFS) score for both treatment groups (p-value<0.05). However patients in WBV group had better improvement as compared to patients in the RP group. Conclusions: Initiation of walk and Walking Speed improved with Whole-body vibration therapy in chronic stroke survivors in Pakistan. Clinical Trial Number: IRCT20190328043131N1 Key Words: Stroke, Whole body Vibration, Rehabilitation, Walk Initiation, Walking Speed, Continuous...

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.

Improved Physiological Gait in Acute and Chronic SCI Patients After Training With Wearable Cyborg Hybrid Assistive Limb

In recent years robotic devices became part of rehabilitation offers for patients suffering from Spinal Cord Injury (SCI) and other diseases. Most scientific publications about such devices focus on functional outcome. The aim of this study was to verify whether an improvement in physiological gait can be demonstrated in addition to the functional parameters after treatment with neurological controlled HAL® Robot Suit. Fifteen subjects with acute (&lt;12 months since injury, n = 5) or chronic (&gt;12 months since injury, n = 10) incomplete paraplegia (AIS B, n = 0/AIS C, n = 2/AIS D, n = 8) or complete paraplegia (AIS A, n = 5) with zones of partial preservation participated. Subjects underwent a body weight supported treadmill training for five times a week over 12 weeks using HAL®. At baseline and at the end of the study a gait analysis was performed and additional functional parameters such as 10-Meter-Walk-Test, Timed-Up-and-Go-Test, 6-Minutes-Walk-Test, and WISCI II score were collected. Results were evaluated for whole group and individually for acute and chronic subgroups. All functional parameters improved. Differences were also found in physiological parameters such as phases of gait cycle and accompanied by significant improvement in all spatiotemporal and gait phase parameters. The presented study shows signs that an improvement in physiological gait can be achieved in addition to improved functional parameters in patients with SCI after completing 12-week training with HAL®.Trial Registration: DRKS, DRKS00020805. Registered 12 February 2020—Retrospectively registered, https://www.drks.de/DRKS00020805.

A Prospective Clinical Observational Study on Protocol Based Sushrutas Avasthanusar Management of Pakshagata (Ischemic Stroke)

Stroke is one of the leading cause of death and the treatment so far has no promising results. Though ample research is being carried out for alleviating the disease and new avenues are being explored in acute management followed by physical rehabilitation and physiotherapy etc, yet the disease have not been dominated and remain incurable.. Pakshaghata treatment schedule adopted according to the stage i.e. in acute stage the immediate aim is to maintain the lifestyle and to prevent the further complications treatment based on avastha helps in reversal of pathology, so here protocol is developed which is already being followed giving promising results in acute conditions need to be documented. Objective: The study was undertaken to assess the efficacy of Avasthanusar chikitsa in the management of Ischemic stroke (Pakshagata). Methods:10 patients of acute ischemic stroke directly coming to Sushrut Ayurved Hospital were enrolled after confirming the CT/MRI as per diagnostic criteria and those who were fitting in inclusion criteria. All the 10 patients underwent the who whole treatment protocol according to avastha but the time, medicines were totally individualised. Results:1.In Pitta samasargaja avastha Glass gow coma scale showed 91.49 % improvement which was highly significant. In Kapha samasrgaj avastha NINDH stroke scale and Barthel index showed significant improvement of 83.7%. 3 .In Vataja samsargaja avastha Modified Rankin scale and 10 meter walk test showed 72.5% & 86.21% improvement respectively which was highly significant. Interpretation And Conclusion: In Pittasamsargaja avastha when presenting symptoms are mada , murcha and akashepaka the both Dosha and vyadhi viparita chikitsa is done simultaneously by teekshana nasya and sheeta upakramas., Once pittaja laxanas are reduced kapaha/ amahara chikitsa is done, In vata samsargaja chikitsa Brihmana chikitsa is done.

Effects of Multi-Directional Step-Up Training with Rhythmic Auditory Stimulation on Gait and Balance Ability in Stroke Patients

The purpose of this study was to investigate the effects of multi-directional step-up training with rhythmic auditory stimulation on gait and balance ability in stroke patients and also to help develop fall prevention and exercise programs for returning to daily life after stroke. The intervention method was randomly assigned to sixteen stroke patients, eight patients each in the experimental group and the control group. The experimental group carried out multi-directional step-up training with rhythmic auditory stimulation, and the control group performed only multi-directional step-up training. The training proceeded twelve times for 30 minutes for four weeks, and functional gait assessment, 10-meter walk test, and dynamic (by the Berg balance scale) and static (by Balancia software, Mintosys, Korea) balance ability assessments were conducted to examine the effect of the training on improving balance and gait ability. The study compared and analyzed the differences in the amount of change within the groups before and after training, and the differences in the amount of change between the two groups. Both groups showed more improved results after training than before in all assessments that measured gait and balance ability (p < 0.05). However, the experimental group showed a greater difference in the amount of change in every gait and balance ability assessment compared to the control group. (p < 0.05). Therefore, multi-directional step-up training can be an efficient intervention to improve the gait and balance ability of stroke patients and when accompanied by rhythmic auditory stimulation, the effectiveness could be maximized.