A NEW TRUNK SWAY ASSESSMENT PROTOCOL FOR STROKE PATIENTS USING A BIOFEEDBACK INERTIAL-BASED SENSING MODALITY

2012 ◽  
Vol 24 (05) ◽  
pp. 461-469 ◽  
Author(s):  
Kok-Soon Soon ◽  
Ming-Yih Lee ◽  
Chih-Chien Chang ◽  
Chun-Hou Wang ◽  
Chih-Feng Lin

Brain damage pathology can generate an irrelevant motor program leading to abnormal posture. Given this observation, we tested the hypothesis that postural control deficits are present in individuals with postural disorders. A new trunk sway assessment protocol evaluation system using an inertial-based sensing technique combined with visual-biofeedback strategies was developed. The proposed system was used to assess the angular deviation of the center of mass and enhanced balance control in patients with stroke. Twelve participants with hemiplegia were randomly divided into a visual-biofeedback group (experimental) and a without visual-biofeedback group (control), and were asked to stand as still as possible for 30 s. Postural sway data were submitted to conventional quantitative analyses of sway magnitude using a center of mass measurement. Additionally, group means were compared using parametric tests. Parameters in both the anterior-posterior and medio-lateral directions within the stroke patients were compared using paired t-tests. The experimental group showed increased postural control, indicative of reduced postural sway. Decreased complexity in the medio-lateral direction was also observed in the experimental group, suggesting both a reduction in the dynamic range available for postural control, and that their postural corrections were dominated primarily by longer-term scales. Significant interactions between the diagnostic group and visual condition were also observed for both of these measures, suggesting that the control group participants were impaired in their ability to make corrections to their sway pattern when no visual biofeedback was available. Greater sway magnitude and reduced complexity suggest that individuals with hemiplegia have deficits in sensorimotor integration and a reduced range of timescales available within which to make postural corrections.

Motricidade ◽  
2016 ◽  
Vol 12 (1) ◽  
pp. 141
Author(s):  
Giordano Marcio Gatinho Bonuzzi ◽  
Tatiana Beline Freitas ◽  
Umberto Cesar Corrêa ◽  
Andrea Michele Freudenheim ◽  
José Eduardo Pompeu ◽  
...  

<p class="ResumoAbstract">The aim of this study was to compare the learning process of a postural control task between post-stroke patients and healthy subjects. The sample was composed of 20 post-stroke individuals (Experimental Group) and 20 aged matched healthy individuals (Control Group). Participants practiced a postural control task in a virtual environment with increasing of complexity. The study design involved four phases: pre-test (five trials), acquisition phase (four blocks of thirty minutes), post-test (five trials), and retention test (five trials after a week without practice). The statistical analysis was run by a 2 x 3 ANOVA (groups x learning tests). Results: There was no difference in motor learning between Experimental Group and Control Group (F= 41.22; p=0.88). In addition, it was founded that the Control Group could learn the task in a higher-level complexity than Experimental Group (F = 4.77; p = 0.01), and both groups increased the error during the trials of practice (F = 0.53; p = 0.00) because of task complexity.  Conclusion: Therefore has been found that post-stroke individuals have the ability to learn a postural control task similar to healthy subjects, and the task complexity seems to be a key-factor in order to differentiate stroke from healthy subject's motor learning process.</p>


2016 ◽  
Vol 51 (9) ◽  
pp. 688-695 ◽  
Author(s):  
Roberto Benis ◽  
Matteo Bonato ◽  
Antonio La Torre

Context: Neuromuscular training enhances unconscious motor responses by stimulating both the afferent signals and central mechanisms responsible for dynamic joint control. Dynamic joint-control training is a vital component of injury-prevention programs. Objective: To investigate the effects of body-weight neuromuscular training on Y-Balance Test (YBT) performance and postural control in female basketball players. Design: Randomized controlled clinical trial. Setting: Basketball practice sessions. Patients or Other Participants: A total of 28 healthy elite female basketball players were randomly assigned to an experimental (n = 14) or a control group (n = 14). Intervention(s): Before their regular practice sessions, the experimental group warmed up with body-weight neuromuscular exercises and the control group with standard tactical-technical exercises twice weekly for 8 weeks. Main Outcome Measure(s): Anterior-, posteromedial-, and posterolateral-reach and composite YBT scores were measured before and after 8 weeks of training. Results: Improvement over baseline scores was noted in the posteromedial (right = 86.5 ± 4.5 cm versus 89.6 ± 2.2 cm, +3.5%, P = .049; left = 85.5 ± 4.3 cm versus 90.2 ± 2.7 cm, +5.5%, P = .038)- and posterolateral (right = 90.7 ± 3.6 cm versus 94.0 ± 2.7 cm, +3.6%, P = .016; left = 90.9 ± 3.5 cm versus 94.2 ± 2.6 cm, +3.6%, P = .011)-reach directions and in the composite YBT scores (right = 88.6% ± 3.2% versus 94.0% ± 1.8%, +5.4%, P = .0004; left = 89.2% ± 3.2% versus 94.5% ± 3.0%, +5.8%, P = .001) of the experimental group. No differences in anterior reach were detected in either group. Differences were noted in postintervention scores for posteromedial reach (right = 89.6 ± 2.2 cm versus 84.3 ± 4.4 cm, +4.1%, P = .005; left = 94.2 ± 2.6 cm versus 84.8 ± 4.4 cm, +10%, P = .003) and composite scores (right = 94.0% ± 1.8% versus 87.3% ± 2.0%, +7.1%, P = .003; left = 94.8% ± 3.0% versus 87.9% ± 3.4%, +7.3%, P &lt; .0001) between the experimental and control groups. Conclusions: Body-weight neuromuscular training improved postural control and lower limb stability in female basketball players as assessed with the YBT. Incorporating neuromuscular training into the workout routines for basketball players may enhance joint awareness and reduce the risk of lower extremity injury.


2020 ◽  
Author(s):  
Shanshan Lin ◽  
Bo Zhu ◽  
Yiyi Zheng ◽  
Guozhi Huang ◽  
Qing Zeng ◽  
...  

Abstract Background: Real-time ultrasound imaging (RUSI) has been increasingly used as a form of biofeedback when instructing and re-training muscle contraction. However, the effectiveness of the RUSI on a single sustained contraction of the lumbar multifidus (LM) and transversus abdominis (TrA) has rarely been reported. This preliminary study aimed to determine if the use of RUSI, as visual biofeedback, could enhance the ability of activation and continuous contraction of the trunk muscles including LM and TrA.Methods: Forty healthy individuals were included and randomly assigned into the experimental group and control group. All subjects performed a preferential activation of the LM and/or TrA (maintained the constraction of LM and/or TrA for 30 seconds and then relaxed for two minutes), while those in the experimental group also received visual feedback provided by RUSI. The thickness of LM and/or TrA at rest and during contraction (Tc-max, T15s, and T30s) were extracted and recorded. The experiment was repeated three times.Results: No significant differences were found in the thickness of LM at rest (P > 0.999), Tc-max (P > 0.999), and T15s (P = 0.414) between the two groups. However, the ability to recruit LM muscle contraction differed between groups at T30s (P = 0.006), with subjects in the experimental group that received visual ultrasound biofeedback maintaining a relative maximum contraction. Besides, no significant differences were found in the TrA muscle thickness at rest (P > 0.999) and Tc-max (P > 0.999) between the two groups. However, significant differences of contraction thickness were found at T15s (P = 0.031) and T30s (P = 0.010) between the two groups during the Abdominal Drawing-in Maneuver (ADIM), with greater TrA muscle contraction thickness in the experimental group.Conclusions: RUSI can be used to provide visual biofeedback, which can promote continuous contraction, and improve the ability to activate the LM and TrA muscles in healthy subjects.


2021 ◽  
Vol 7 (5) ◽  
pp. 3168-3173
Author(s):  
NING Min ◽  
ZENG Hui

Objective To study the nursing effect of individualized health education combined with cognitive training in elderly stroke patients. Methods 112 elderly stroke patients treated in the Department of Neurology of our hospital from January to June 2017 were randomly divided into experimental group and control group. In the control group, routine treatment, nursing and rehabilitation exercises were carried out, and regular health education was carried out. The experimental group, on the basis of routine treatment, nursing and rehabilitation exercise, carried out individualized health education and cognitive training combining the content of individualized health education. The effect of intervention was evaluated by Montreal Cognitive Assessment Scale (MoCA), health education questionnaire, daily life self-care scale (ADL) and nurse job satisfaction questionnaire before intervention, at the end of intervention for 4 weeks and at the end of intervention for 12 weeks. Results At the end of 4th and 12th week after intervention, the scores o MoCA, the awareness rate of health education, ADL and job satisfaction of nurses were higher than those before intervention, and the observation group was higher than that of the control group (P<0.05), with statistical difference (P<0.05). Conclusion Individualized health education combined with cognitive training can effectively improve the patients’ cognitive function, improve the patients’ awareness of stroke disease and the compliance of health education, improve the patients’ self-care ability in daily life and the satisfaction of nursing work, so as to improve the patients’ quality of life and quality of living.


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).


2020 ◽  
Vol 10 (2) ◽  
pp. 80
Author(s):  
Kyeongjin Lee

This study was conducted to investigate the effects of balance training with electromyogram-triggered functional electrical stimulation (EMG-triggered FES) to improve static balance, dynamic balance, and ankle muscle activation in stroke patients. Forty-nine participants (>6 months after stroke) were randomly assigned to the experimental group (n = 25) and the control group (n = 24). The experimental group underwent balance training with EMG-triggered FES for 40 min a day, 5 days a week, for a 6-week period in addition to general rehabilitation. The control group underwent balance training without EMG-triggered FES along with conventional therapy. Outcome measures included static balance ability, dynamic balance ability, and leg muscle activation. The static and dynamic balance abilities were significantly improved after intervention in both groups (p < 0.05), although the experimental group showed considerably greater improvement than the control group (p < 0.05). Leg muscle activation on the affected side resulted in significant improvements in the experimental group (p < 0.05) when compared with baseline but not in the control group. Balance training with EMG-triggered FES is an acceptable and effective intervention to improve the static balance, dynamic balance, and ankle muscle activation in stroke patients.


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.


2021 ◽  
Vol 11 (3) ◽  
pp. 474-481
Author(s):  
Jung-Ho Lee

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.


2021 ◽  
Vol 57 (2) ◽  
pp. 92-102
Author(s):  
Maruša Kržišnik ◽  
Barbara Horvat Rauter ◽  
Nataša Bizovčar

Gait and balance impairments contribute significantly to long-term disability after stroke. Modern concepts of stroke rehabilitation recommend a task-specific repetitive approach, such as using treadmill training. The purpose of this study was to investigate the effectiveness of using virtual reality-based treadmill training to improve balance and gait in subacute stroke patients. Twenty-two stroke patients were randomly stratified into two groups: the experimental (n = 11) and the control group (n = 11). Parameters associated with balance and gait were measured using the 6-minute walk test, the 10-meter walk test, the timed “up and go” test, the functional gait assessment, and the four square step test. Gait analysis using the zebris Rehawalk® treadmill system was also performed. Patients in the experimental group received virtual reality-based treadmill training five times a week for a period of four weeks, while those in the control group received treadmill training at the same frequency, duration, intensity, and structure, along with a progressively more difficult task demands. Significant improvements were observed in selected outcome measures in both groups after training. Patients in the experimental group experienced improvements in all of the spatiotemporal gait parameters, but there was a significant difference before and after training in duration of double support and lateral asymmetry. The findings of this pilot randomized controlled trial support the benefits of using a virtual reality-based treadmill training program to improve gait and balance in subacute stroke patients.


2018 ◽  
Vol 17 (5) ◽  
pp. 460-475
Author(s):  
Cecep Eli KOSASIH ◽  
Busakorn PUNTHMATHARITH ◽  
Umaporn BOONYASOPUN

This quasi-experimental, repeated measures design was used to examine the effects of the nursing therapeutics program for facilitating patient transition (NTPFPT) on subjective well-being, role mastery, and relationships’ well-being among adult patients who suffered from stroke in Indonesia. Purposive sampling was used to recruit the sample. The control group (n = 42) received the routine care, while the experimental group (n = 42) received the NTPFPT and routine care. The data were collected using 1) the subjective well-being inventory, 2) the role function mode, and 3) the brief family relationship scale. The Chronbach’s alpha coefficients of questionnaires 1 - 3 were .89, .77 and .89, respectively. Descriptive statistics, repeated measures ANOVA, one-way ANOWA, and t-test were used to analyze the data. The results revealed that significant differences of the mean scores of subjective well-being, role mastery and relationships’ well-being were found between the control and experimental groups (p < .000) and between three times (e.g., Day 3 of hospitalization, T1; one day before discharge, T2; and one month after discharge, T3) within group (p < .000). Significant differences between all three pair wise comparisons of these three variables were found in the experimental group (p < .000) while, two pair wise comparisons showed significant differences in the control group. The mean scores of the three variables in the experimental group measured at T2 and T3 were significantly higher than those of the control group (p < .000) whereas those of measured at T1 showed no significant differences between two groups (p > .05). Thus, it is appropriate for nurses to provide the NTPFPT to stroke patients and families. The results revealed that significant differences of the mean scores of subjective well-being, role mastery and well-being of relationships were found between the control and experimental groups (p < .000) and between three times (e.g., Day 3 of hospitalization, T1; one day before discharge, T2; and one month after discharge, T3)within group (p < .000).Significant differences between all three pair wise comparisons of these three variables were found in the experimental group (p < .000) whereas in the control group, only two pair wise comparisons were significant differences. The mean scores of the three variables in the experimental group measured at T2 and T3 were significantly higher than those of the control group (p < .000) whereas those of measured at T1 were non significant differences between two groups (p > .05). Thus, it is appropriate for nurses to provide the NTPFPT to stroke patients and families.


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