scholarly journals Effect of Task-Specific Training on Trunk Control and Balance in Patients with Subacute Stroke

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Mohamed E. Khallaf
Keyword(s):  
Physical Therapy ◽  
Postural Control ◽  
Secondary Outcome ◽  
Control Group ◽  
Study Group ◽  
Walking Ability ◽  
Specific Training ◽  
Trunk Control ◽  
Subacute Stroke ◽  
Functional Reach Test

Objectives. Impairment of static and dynamic posture control is common after stroke. It is found to be a predictor and an essential component for balance, walking ability, and activities of daily living (ADL) outcomes. Studies investigating effect of physical therapy techniques with an aim to improve trunk function after stroke are limited. This study aimed at studying the effect of task-specific training on trunk control and balance in patients with subacute stroke. Methods. In this randomized controlled trail, thirty-four patients were alienated into two equal groups. The study group (n = 17) received task-specific training, and the control group (n = 17) received conventional physical therapy based on the neurodevelopmental technique. Task-specific training was applied through two phases with criteria of progression based on Chedoke–McMaster Stroke Assessment postural control stages. The interventions were applied in a dosage of 60 min per session, three times a week for ten weeks. Static and dynamic balance were measured by the trunk impairment scale (TIS), postural assessment scale (PAS), and functional reach test (FRT). Laser-guided digital goniometer was used to measure the trunk ranges of motions (ROM) as a secondary outcome. Results. Significant differences between the baseline and the follow-up measures including TIS, PAS, FRT, and trunk (ROM) were found in both groups ( P ≤ 0.05 ). In-between group comparison also showed significant differences between the results of both groups indicating more improvements among patients representing the study group. Conclusion. Task-specific training may be effective in improving the static and dynamic postural control and trunk ranges of motion among subacute stroke patients.

Effect of trunk control training on plantar pressure in patients with lumbar disc herniation

2020 ◽  
Vol 27 (8) ◽  
pp. 1-12
Author(s):  
Hanan Hosny M Battesha ◽  
Reda Kotb Abd Elrazik Gad Elhak
Keyword(s):  
Physical Therapy ◽  
Lumbar Disc Herniation ◽  
Plantar Pressure ◽  
Lumbar Disc ◽  
Control Group ◽  
Study Group ◽  
Trunk Control ◽  
Herniated Lumbar Disc ◽  
The Right ◽  
Therapy Programme

Background/aims Chronic spinal disc disease leads to disorders in postural movement coordination. An incorrect asymmetrical movement pattern for lower limb loading impairs proprioception and deteriorates postural stability. The aim of this study was to investigate the effect of trunk control training on the redistribution of plantar pressure to reduce the risk of posture sway while standing in patients with sciatica resulting from a herniated lumbar disc. Methods This study included 30 male and female patients with sciatica resulting from lumbar disc herniation, their ages ranged from 45–60 years. The patients were randomly assigned to two equal groups. The study group received posture stability training by using the Biodex Balance System in addition to a selected physical therapy programme. The control group received the selected physical therapy programme only. Results: The results revealed that in the study group, there was a significant increase of plantar pressure at the right and the left centre of heel, while there was a significant decrease of plantar pressure at the right and the left forefoot post treatment. In the control group, there was no significant difference in plantar pressure at the right and the left centre of the heel and forefoot post treatment. Conclusions: Trunk control training, in addition to the selected physical therapy programme, was more effective than only using the selected physical therapy programme to redistribute foot plantar pressure, which can reduce posture sway for patients with sciatica resulting from a herniated lumbar disc.

Effects of robot-assisted trunk control training on trunk control ability and balance in patients with stroke: A randomized controlled trial

2021 ◽  
pp. 1-10
Author(s):  
Dong-Hoon Kim ◽  
Tae-Sung In ◽  
Kyoung-Sim Jung
Keyword(s):  
Postural Control ◽  
Center Of Pressure ◽  
Training Session ◽  
Functional Independence ◽  
Control Group ◽  
Stroke Patients ◽  
Robot Assisted ◽  
Trunk Control ◽  
Functional Reach Test ◽  
Balance Ability

BACKGROUND: Trunk control ability is an important component of functional independence after the onset of stroke. Recently, it has been reported that robot-assisted functional training is effective for stroke patients. However, most studies on robot-assisted training have been conducted on upper and lower extremities. OBJECTIVE: The purpose of this study was to evaluate the effects of robot-assisted trunk control training on trunk postural control and balance ability in stroke patients. METHODS: Forty participants with hemiparetic stroke were recruited and randomly divided into two groups: the RT (robot-assisted trunk control training) group (n= 20) and the control group (n= 20). All participants underwent 40 sessions of conventional trunk stabilization training based on the Bobath concept (for 30 minutes, five-times per week for 8 weeks). After to each training session, 15 minutes of robotassisted trunk control training was given in the RT group, whereas the control group received stretching exercise for the same amount of time. Robot-assisted trunk control training was conducted in three programs: sitting balance, sit-to stand, and standing balance using a robot system specially designed to improve trunk control ability. To measure trunk postural control ability, trunk impairment scale (TIS) was used. Center of pressure (COP) distance, limits of stability (LOS), Berg Balance Scale (BBS) and functional reach test (FRT) were used to analyze balance abilities. RESULTS: In TIS, COP distance, LOS, BBS and FRT, there were significant improvements in both groups after intervention. More significant changes were shown in the RT group than the control group (p< 0.05). CONCLUSIONS: Our findings indicate that robot-assisted trunk control training is beneficial and effective to improve trunk postural control and balance ability in stroke patients. Therefore robot-assisted training may be suggested as an effective intervention to improve trunk control ability in patients with stroke.

scholarly journals Effect of pelvic laparoscopic implantation of neuroprosthesis in spinal cord injured subjects: a 1-year prospective randomized controlled study

Spinal Cord ◽  
2021 ◽  
Author(s):  
Helge Kasch ◽  
Uffe Schou Løve ◽  
Anette Bach Jønsson ◽  
Kaare Eg Severinsen ◽  
Marc Possover ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Outcome Measures ◽  
Outcome Measure ◽  
Secondary Outcome ◽  
Controlled Study ◽  
Control Group ◽  
Walking Ability ◽  
Data Set ◽  
Cord Injury

Abstract Study design 1-year prospective RCT. Objective Examine the effect of implantable pulse generator and low-frequency stimulation of the pelvic nerves using laparoscopic implantation of neuroprosthesis (LION) compared with neuromuscular electrical stimulation (NMES) in SCI. Methods Inclusion criteria: traumatic spinal cord injury (SCI), age 18–55 years, neurological level-of-injury Th4–L1, time-since-injury >1 year, and AIS-grades A–B. Participants were randomized to (A) LION procedure or (B) control group receiving NMES. Primary outcome measure: Walking Index for Spinal Cord Injury (WISCI-II), which is a SCI specific outcome measure assessing ability to ambulate. Secondary outcome measures: Spinal Cord Independence Measure III (SCIM III), Patient Global Impression of Change (PGIC), Penn Spasm Frequency Scale (PSFS), severity of spasticity measured by Numeric Rating Scale (NRS-11); International Spinal Cord Injury data sets-Quality of Life Basic Data Set (QoLBDS), and Brief Pain Inventory (BPI). Results Seventeen SCI individuals, AIS grade A, neurological level ranging from Th4–L1, were randomized to the study. One individual was excluded prior to intervention. Eight participants (7 males) with a mean age (SD) of 35.5 (12.4) years were allocated to the LION procedure, 8 participants (7 males) with age of 38.8 (15.1) years were allocated to NMES. Significantly, 5 LION group participants gained 1 point on the WISCI II scale, (p < 0.013; Fisher´s exact test). WISCI II scale score did not change in controls. No significant changes were observed in the secondary outcome measures. Conclusion The LION procedure is a promising new treatment for individuals with SCI with significant one-year improvement in walking ability.

Effect of the Modified Surgeon Assisted Bilateral Transversus Abdominis Plane Block on Time Required for First Analgesic Dose after Cesarean Section under Spinal Anesthesia: Randomized placebo-control

2021 ◽  
Vol 4 (3) ◽  
pp. 01-05
Author(s):  
Ahmed Mamdouh
Keyword(s):  
Placebo Group ◽  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Interquartile Range ◽  
Transversus Abdominis ◽  
Secondary Outcome ◽  
Control Group ◽  
Placebo Control ◽  
Study Group ◽  
Tap Block

Background: The transverses abdominis plane block (TAP block) is one of the widely used regional analgesic techniques in cesarean section. There are different variations of the procedure. The aim of the present study was to evaluate the analgesic effect of the modified surgeon assisted bilateral TAP block in patients undergoing cesarean section Patients&Methods: Sixty patients undergoing cesarean section under spinal anesthesia were randomized into two groups to receive either TAP block with 40 ml of bupivacaine 0.25%(study group) or 40 ml normal saline as placebo after obtaining informed consent. All patients will receive intravenous diclofencac75mg every 12 hrs postoperatively. Postoperatively, there was an assessment every 2hrs during the first 24hrs by the visual analogue pain scale (VAPS). Time to the first analgesic request will be measured as primary outcome and all patients will receive opioid on demand or VAPS > 4 with 25mg pethidine intramuscularly. Moreover, total opioid requirement in 24hrs will be measured as secondary outcome along with postoperative complications as nausea, vomiting and abdominal distention. Complications related to the TAP procedure will be also assessed. Results: The median (interquartile range) time to the first analgesic request in the first 24hrs postoperatively was significantly shorter in the placebo group compared to the study group; 4h (4, 6) and 24h (10, 24) with p value < 0.001. Postoperative opioid requirement was significantly higher in the control group (30/30{100%}) than the study group (13/30{43.3%}). The median (interquartile range) number of opioid doses was significantly higher in the placebo group compared with the study group; 2(2, 2) and 0(0, 1) respectively. At all points in the study, pain scores both were lower in the study group (p < 0.0001). Conclusion: The modified surgeon assisted bilateral TAP block is relatively new, safe and cost effective technique which provides adequate postoperative analgesia allowing for better maternal ambulation and better postoperative recovery. Trial registration: Clinicaltrial.gov registration number: NCT04623632

scholarly journals Effectiveness of Acromioclavicular Joint Mobilization and Physical Therapy vs Physical Therapy Alone in Patients with Frozen Shoulder: A Randomized Clinical Trial

2021 ◽  
Author(s):  
Mohammad Rahbar ◽  
Sepideh Ranjbar Kiyakalayeh ◽  
Bina Eftekharsadat ◽  
Behzad Izadseresht ◽  
Neda Dolatkhah
Keyword(s):  
Clinical Trial ◽  
Physical Therapy ◽  
Randomized Clinical Trial ◽  
Shoulder Pain ◽  
Acromioclavicular Joint ◽  
Frozen Shoulder ◽  
Secondary Outcome ◽  
Control Group ◽  
Joint Mobilization ◽  
Active Abduction

Abstract Background: Frozen shoulder (FS) is a prevalent musculoskeletal condition characterized by an often prolonged pain, disability and limited active and passive range of motion (ROM), however its management remains challenging yet. The objective of this trial was to compare the efficacy of acromioclavicular joint mobilization and physical therapy versus physical therapy in treatment of FS.Methods: In this single-blind randomized clinical trial, patients with diagnosis of FS were randomly allocated into mobilization + physical therapy (n=28) as experiment group, and physical therapy (n=28) as control group in two outpatient clinics of Tabriz University of Medical Sciences, Iran. The primary outcomes were self-reported shoulder pain-related disability measured by the Shoulder Pain and Disability Index (SPADI) questionnaire and goniometric assessment of shoulder ROM. The secondary outcome was the Visual Analogue Scale (VAS). Measures were performed at the baseline, immediately and one month after beginning the treatments.Results: Totally 51 patients with 25.73 ± 6.88 years old of age completed the study and their data were analyzed. VAS, SPADI, pain and disability improved more significantly in experiment group compared to control group immediately [-4.63 (-5.58- -3.67) vs. -2.22 (-2.96- -1.47), p<0.001; -23.08 (-28.63- -17.53) vs. -13.04 (-17.93- -8.16), p=0.008; -26.00 (-31.71- -20.29) vs. -16.35 (-23.39- -9.31), p=0.034 and -21.25 (-29.11- -13.39) vs. -10.98 (-17.53- -4.43), p=0.042, respectively] and one month after beginning of treatment [-5.58 (-6.45- -4.72) vs. -3.61 (-4.60- -2.62), p<0.001; -33.43 (-40.85- -26.01) vs. -20.03 (-26.00- -14.07), p=0.001; --42.83 (-49.09- -36.57) vs. -25.57 (-33.92- -17.21), p<0.001 and -27.55 (-36.19- -15.94) vs. -16.58 (-24.48- -8.67), p=0.041, respectively]. Active abduction ROM was also improved more significantly immediately after treatment in experiment group compared to control group [25.83 (11.45- 40.13) vs. 10.17 (1.02- 19.15), p=0.025], however there were no significant differences between two groups concerning other measured ROMs immediately and one month after treatment (all p>0.05). Conclusions: Acromioclavicular mobilization along with conventional physical therapy was more efficient in decreasing pain and disability and improving active abduction ROM compared to physical therapy in patients with FS. These findings would suggest a new therapeutic method for shoulder disorders with pain and disability.Trial registrationwww.irct.ir, IRCT20100605004104N7, registered 06.01.2019 (https://www.irct.ir/trial/35900)

scholarly journals Impact of Physiotherapy on Physical Capacity of 7–11-Year-Old Children with Autism Disorder

2020 ◽  
Vol 2 (11) ◽  
Author(s):  
Indrė Labanauskaitė ◽  
Agnė Lileikytė ◽  
Aistė Vasilionytė ◽  
Vilma Dudonienė ◽  
Valdas Urbonavičius ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Muscle Strength ◽  
Children With Autism ◽  
Physical Capacity ◽  
Control Group ◽  
Study Group ◽  
Healthy Children ◽  
Long Jump ◽  
Hand Muscle ◽  
Autism Disorder

Research background. Autism is one of the most difficult wide spectrum developmental disorders. Recently, striking increase in the number of autistic children is observed. Physical activation is important for the development and physical fitness of children with autism disorder. Research object – children’s balance, muscle strength and endurance. The aim was to evaluate physical capacity and impact of physiotherapy on balance, muscle strength and endurance in 7–11-yearold children with autism disorder. Methods. The study group consisted of 10 children with autism disorder (8 boys and 2 girls), the control group consisted of 18 healthy children (15 boys and 3 girls). The average age of the study group was 8.90 ± 1.4 years; in the control group 8.94 ± 1.0 years. Balance of children was assessed by Berg Balance Scale, hand grip – by dynamometry, leg muscle strength – by long jump test and squat test, and endurance of abdominal muscle – by sit up test. The results showed that physical condition of children with autism disorder was significantly poorer compared to healthy children: the balance – 43.9 ± 7.82 v. s. 55.4 ± 0.9 points; right hand muscle strength of 5.9 ± 2.06 kg v. s. 12.2 ± 3.43 kg; left – 5.3 ± 1.87 kg v. s 12.1 ± 3.43; long jump 43.0 ± 25.25 cm v. s 132.6 ± 31.87 cm; endurance of abdominal muscles 7.3 ± 2.01 v. s 19.6 ± 4.06 times per 30 s; squats 9.1 ± 4.36 v. s 27.6 ± 7.07 times per 30 s. After applying physical therapy results of all performed tests in children with autism improved significantly: balance to 49.9 ± by 5.45 points, right hand muscle strength to 7.9 ± 2.49 kg, left – 7.5 ± 2.31 kg, long jump to 79.2 ± 39.87 cm, crunches to 11.8 ± 4.54 times, squats to 14.8 ± 4.83 times, but they did not reach the results of healthy children. Conclusion. Balance, muscle strength and endurance of children with autism disorder were significantly lower than those in healthy children. Physical therapy significantly improved physical capacity of autistic children, but the level of healthy children was not reached.Keywords: autism, children, physiotherapy.

Effect of trunk stabilization exercise on abdominal muscle thickness, balance and gait abilities of patients with hemiplegic stroke: A randomized controlled trial

2020 ◽  
Vol 47 (4) ◽  
pp. 435-442 ◽  
Author(s):  
Jiyeon Lee ◽  
Jeongwoo Jeon ◽  
Dongyeop Lee ◽  
Jiheon Hong ◽  
Jaeho Yu ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Muscle Thickness ◽  
Abdominal Muscle ◽  
Secondary Outcome ◽  
Control Group ◽  
Abdominal Muscles ◽  
Stroke Patients ◽  
Trunk Stability ◽  
Functional Reach Test ◽  
Stability Training

BACKGROUND: Trunk stability has been identified as an important prerequisite of functional movement. OBJECTIVE: To investigate the effectiveness of core muscle contraction training on abdominal muscle thickness, balance, and gait ability in stroke patients. METHODS: Thirty patients with stroke were randomly assigned to two experimental groups and a control group. All groups received conventional therapeutic exercise program for six weeks. The experimental groups additionally trained trunk stability exercise with abdominal hollowing or bracing maneuvers within training time. Primary outcome measures were evaluated abdominal muscle thickness using the sonography. Secondary outcome measures were evaluated by the Functional Reach Test (FRT), Berg Balance Scale (BBS), 10-meter walk test (10MWT), and Timed Up and Go test (TUG). RESULTS: Compared with the control group, the effect of trunk stability training for the experimental groups on the abdominal muscles thickness change was observed (p < 0.05). The values in balance and gait measures, BBS, FRT, 10MWT, and TUG, showed significant improvement after the intervention periods (p < 0.05), although no significant differences were found in scores of gait and balance scales among groups. CONCLUSIONS: Trunk stability training with selective abdominal muscles activation has beneficial effects on abdominal muscles, balance, and mobility in stroke patients. Our findings might provide support for introducing stroke rehabilitation.

Economic and workload impact of therapeutic interchange of inhaler medications and nebulizer solutions

2020 ◽  
Vol 78 (1) ◽  
pp. 41-48 ◽  
Author(s):  
Elizabeth Gonzalez ◽  
Jason Alan Glick ◽  
Guogen Shan ◽  
Jeffery N Talbot
Keyword(s):  
Hospital Stay ◽  
Community Hospital ◽  
Secondary Outcome ◽  
Control Group ◽  
Study Group ◽  
Medication Costs ◽  
Metered Dose ◽  
The Mean ◽  
The Cost ◽  
Mean Cost

Abstract Purpose To examine the financial impact of automatic formulary substitution of nebulization solutions for pressurized metered dose inhalers and dry powder inhalers and the effect of the automatic substitution initiative on respiratory care practitioner (RCP) workload at a community hospital. Methods A retrospective observational study was conducted in a 326-bed nonacademic community hospital. Adult patients who received respiratory medications and had an inpatient stay, were admitted for observation, or had an emergency room visit from December 2016 through February 2017 (the control group) or from December 2017 through February 2018 (the study group) were included in the analysis. The primary outcomes were the cost of respiratory medications per hospital stay and the number of RCP visits per hospital stay. The secondary outcome was the cost of wasted doses per hospital stay. Results A total of 3,766 patients were included in the study: 2,030 in the study group and 1,736 in the control group. The mean cost of respiratory medications per hospital stay was significantly lower in the study group vs the control group ($13.29 vs $36.48, P &lt; 0.001). The mean number of RCP visits per hospital stay was also statistically lower in the study group vs the control group (11.6 vs 12.9, P = 0.04). The mean cost of wasted doses was significantly lower in study group vs the control group ($0.25 vs $22.91, P &lt; 0.001). Conclusion Automatic formulary substitution of nebulization solutions for inhaler medications significantly decreased medication costs without increasing the average number of RCP visits per hospital stay.

Low Bacterial Diet in Patients with Cytopenia after Intensive Chemotherapy for Hematological Malignancy: A Study of Efficacy and Costs.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 5548-5548
Author(s):  
Harry C. Schouten ◽  
Peter Terporten ◽  
Maartje Harbers ◽  
Riette van Boxtel ◽  
Alphons Kessels ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Preventive Measure ◽  
Secondary Outcome ◽  
Control Group ◽  
Study Group ◽  
Risk Of Infection ◽  
Outcome Parameter ◽  
Societal Costs ◽  
Gram Negative ◽  
To Receive

Abstract Patients with hematological malignancies who receive intensive chemotherapy usually develop a period of cytopenia, during which there is an increased risk of infection. In order to reduce the risk of infection several preventive measures have been adopted. Fundamentally, all of these measures were designed to prevent either acquisition of Gram negative rods or fungal pathogens from the environment, or the translocation of these potential pathogens across the mucosal barrier of the gut. The evidence for the necessity of low bacterial diet as an infection preventive measure is weak. Therefore, in this randomized, controlled study the question whether normal hospital diet is equivalent in efficacy to low bacterial diets, given as an infection preventive measure during treatment of cytopenic patients, was addressed. Intestinal colonization by aerobic Gram negative rods and yeasts has been chosen as primary endpoint. In addition, the occurrence of infections and the total costs of hospital care have been documented, in order to identify potential cost savings by the use of either diet. The patients were randomized into two groups: one group (Study group) to receive antimicrobial prophylaxis (AP) and low-bacterial diet, the other (Control group) to receive the same AP and normal hospital diet. The primary outcome parameter is colonization of faeces with Gram-negative rods or Candida species. Degree of colonization was calculated as [∑ 10log (CFU/g feces)] x [duration of episode] /[number of days on which feces culture were taken]. Next, an analysis of variance was performed taking several factors into account, such as the use of antibiotics. As secondary outcome parameters all infections, and therapeutic use of antibiotics were registered; moreover, total societal costs were calculated for each patient starting at first hospitalization until 28 days after the last discharge. In the study group 10 patients were included and evaluable, in the control group 10 patients were included and 9 evaluable. The number of cycles studied, defined as the period from starting antibiotic prophylaxis until leukocyte counts had recovered to 1000 /mm3 or higher, was 21 in the study group, and 18 in the control group. The median number of days per cycle was 28 (range 17–43) days for the study group, and 34 (range 19–60) days for the control group (NS). Regarding the primary outcome parameter, gut colonization by yeasts or Gram negative rods, no statistically significant differences between treatment groups were observed. With respect to infections as secondary outcome parameter, neither the number of days with fever nor the number of days, during which antibiotics were administered therapeutically, was different between the study and control group of patients. The numbers of fungal infections were no cases of invasive aspergillosis (IA) in the study group, 2 episodes of possible aspergillosis in the control group, and in both groups one episode of candidemia. Regarding the total societal costs no statistically significant differences were measured between normal diet and low-bacterial diet. The results indicate that low-bacterial diet and normal hospital diet are equivalent regarding colonization with yeasts and Gram negative rods, infections and total societal costs.

scholarly journals Supervised physical therapy in women treated with radiotherapy for breast cancer

2016 ◽  
Vol 24 (0) ◽  
Author(s):  
Nara Fernanda Braz da Silva Leal ◽  
Harley Francisco de Oliveira ◽  
Hélio Humberto Angotti Carrara
Keyword(s):  
Breast Cancer ◽  
Clinical Trial ◽  
Physical Therapy ◽  
Range Of Motion ◽  
External Rotation ◽  
Control Group ◽  
Study Group ◽  
Upper Limbs ◽  
Registration Number

ABSTRACT Objective: to evaluate the effect of physical therapy on the range of motion of the shoulders and perimetry of the upper limbs in women treated with radiotherapy for breast cancer. Methods: a total of 35 participants were randomized into two groups, with 18 in the control group (CG) and 17 in the study group (SG). Both of the groups underwent three evaluations to assess the range of motion of the shoulders and perimetry of the upper limbs, and the study group underwent supervised physical therapy for the upper limbs. Results: the CG had deficits in external rotation in evaluations 1, 2, and 3, whereas the SG had deficits in flexion, abduction, and external rotation in evaluation 1. The deficit in abduction was recovered in evaluation 2, whereas the deficits in all movements were recovered in evaluation 3. No significant differences in perimetry were observed between the groups. Conclusion: the applied supervised physical therapy was effective in recovering the deficit in abduction after radiotherapy, and the deficits in flexion and external rotation were recovered within two months after the end of radiotherapy. Registration number of the clinical trial: NCT02198118.

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