scholarly journals Can FES-augmented active cycling training improve locomotion in post-acute elderly stroke patients?

2016 ◽  
Vol 26 (3) ◽  
Author(s):  
Elisabetta Peri ◽  
Emilia Ambrosini ◽  
Alessandra Pedrocchi ◽  
Giancarlo Ferrigno ◽  
Claudia Nava ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Gait Velocity ◽  
Control Group ◽  
Walking Ability ◽  
Group Effect ◽  
Stroke Patients ◽  
Training Dose ◽  
Clinical Difference ◽  
Experimental Group ◽  
Cycling Training

Recent studies advocated the use of active cycling coupled with functional electrical stimulation to induce neuroplasticity and enhance functional improvements in stroke adult patients. The aim of this work was to evaluate whether the benefits induced by such a treatment are superior to standard physiotherapy. A single-blinded randomized controlled trial has been performed on post-acute elderly stroke patients. Patients underwent FES-augmented cycling training combined with voluntary pedaling or standard physiotherapy. The intervention consisted of fifteen 30-minutes sessions carried out within 3 weeks. Patients were evaluated before and after training, through functional scales, gait analysis and a voluntary pedaling test. Results were compared with an age-matched healthy group. Sixteen patients completed the training. After treatment, a general improvement of all clinical scales was obtained for both groups. Only the mechanical efficiency highlighted a group effect in favor of the experimental group. Although a group effect was not found for any other cycling or gait parameters, the experimental group showed a higher percentage of change with respect to the control group (e.g. the gait velocity was improved of 35.4% and 25.4% respectively, and its variation over time was higher than minimal clinical difference for the experimental group only). This trend suggests that differences in terms of motor recovery between the two groups may be achieved increasing the training dose. In conclusion, this study, although preliminary, showed that FES-augmented active cycling training seems to be effective in improving cycling and walking ability in post-acute elderly stroke patients. A higher sample size is required to confirm results.

scholarly journals Effects of Training for Finger Perception on Functional Recovery of Hemiplegic Upper Limbs in Acute Stroke Patients

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Naho Umeki ◽  
Jun Murata ◽  
Misako Higashijima
Keyword(s):  
Training Program ◽  
Functional Recovery ◽  
Repeated Measures ◽  
Controlled Trial ◽  
Sensory Function ◽  
Control Group ◽  
Stroke Patients ◽  
Pressure Threshold ◽  
Sensory Training ◽  
Experimental Group

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).

scholarly journals Effectiveness of a Walking Program Involving the Hybrid Assistive Limb Robotic Exoskeleton Suit for Improving Walking Ability in Stroke Patients: Protocol for a Randomized Controlled Trial (Preprint)

2019 ◽  
Author(s):  
Hideo Tsurushima ◽  
Masafumi Mizukami ◽  
Kenichi Yoshikawa ◽  
Tomoyuki Ueno ◽  
Yasushi Hada ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Gait Disturbance ◽  
Controlled Study ◽  
Control Group ◽  
Walking Ability ◽  
Stroke Patients ◽  
Robotic Exoskeleton ◽  
Walking Program ◽  
Parallel Group ◽  
Hybrid Assistive Limb

BACKGROUND Gait disturbance often occurs in stroke survivors. Recovery of walking function is challenging, as some gait disturbance due to hemiparesis often remains even after rehabilitation therapy, presenting a major obstacle towards regaining activities-of-daily-living performance and achieving social reintegration. OBJECTIVE This study aims to clarify the effectiveness of a walking program involving the wearable Hybrid Assistive Limb (HAL-TS01) robotic exoskeleton for improving walking ability in stroke patients with hemiparesis and stagnant recovery despite ongoing rehabilitation. METHODS This is a multicenter, randomized, parallel-group, controlled study (HAL group, n=27; control group, n=27). The study period includes preintervention observation (until stagnant recovery), intervention (HAL-based walking therapy or conventional rehabilitation; 5 weeks), and postintervention observation (2 weeks). Following provision of informed consent and primary registration, the patients undergo conventional rehabilitation for preintervention observation, during which the recovery of walking ability is monitored to identify patients with stagnant recovery (based on weekly assessments using the 10-meter maximum walking speed [MWS] test). Patients with an MWS of 30-60 m/minute and insufficient weekly improvement in MWS undergo secondary registration and are randomly assigned to undergo HAL-based walking therapy (HAL group) or conventional rehabilitation (control group). The primary outcome is the change in MWS from baseline to the end of the 5-week intervention. RESULTS This study began in November 2016 and is being conducted at 15 participating facilities in Japan. CONCLUSIONS Assessments of walking ability vary greatly and it is difficult to define the threshold for significant differences. To reduce such variability, our study involves conducting conventional rehabilitation to the point of saturation before starting the intervention. Stagnation in the recovery of walking ability despite conventional rehabilitation highlights the limits of current medical care. The present study may bring evidence that HAL-based therapy can overcome such limitations and induce added recovery of walking ability, which would promote the use of HAL technology in the clinical setting. CLINICALTRIAL UMIN Clinical Trials Registry UMIN000024805; https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000028545

Improvement of Hand Motor Function after Radial Shock Wave Therapy in Chronic Stroke Patients

2018 ◽  
pp. 2-12
Author(s):  
M Kamaluddin ◽  
Erna Setiawati ◽  
Tanti Ajoe Kesoema
Keyword(s):  
Shock Wave ◽  
Motor Function ◽  
Controlled Trial ◽  
Hand Function ◽  
Chronic Stroke ◽  
Control Group ◽  
Shock Wave Therapy ◽  
Stroke Patients ◽  
And Control ◽  
Experimental Group

Introduction: The Radial Shock Wave Therapy (RSWT) expected could improve spasticity and hand function in chronic stroke patients. This study aimed to find out the improvement of hand function after RSWT as an additional therapy in chronic stroke patients. Methods: Design study was a randomized controlled trial. The patients were assigned randomly to the experimental group (Infrared, Stretching, and RSWT) and control group (Infrared and Stretching) for six weeks. Hand motor function was measured using Fugl-Meyer Motor Assesment (FMA) before and after intervention. Conclusion: There were improvement of wrist and hand FMA scores in the experimental as well as control group Results: Median of wrist FMA scores in the experimental and control group before intervention were 2 and 3 respectively whereas median of wrist FMA scores in the experimental and control group after intervention were 5 and 4 respectively. Median of hand FMA scores in the experimental and control group before intervention were 4 and 4 respectively whereas median of hand FMA scores in the control and experimental group after intervention were 6 and 5 respectively. The scores of wrist- hand FMA in the control and experimental group after intervention were increased P = 0.001P < 0.001 (wrist) and P = 0.001 P < 0.001 (hand) respectively. However, difference increased of wrist and hand FMA scores in the experimental group after intervention were more significant. Keywords: Spasticity, Hand Function, Stroke, Radial Shock Therapy, Fugl-Meyer Motor Assesment

Long-term Effectiveness and Adoption of a Cellphone Augmented Reality System for Stroke Rehabilitation: Randomized Controlled Trial (Preprint)

2021 ◽  
Author(s):  
Jie Jia ◽  
Chong Li ◽  
Xinyu Song ◽  
Shugeng Chen ◽  
Chuankai Wang ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Motor Function ◽  
Controlled Trial ◽  
Control Group ◽  
Stroke Patients ◽  
Randomized Controlled ◽  
Augmented Reality System ◽  
Home Based ◽  
Experimental Group

BACKGROUND A serious game-based Cellphone Augmented Reality System (CARS) was developed for rehabilitation of stroke patients, which is portable, convenient, and suitable for self-training. OBJECTIVE The present research aimed to study the effectiveness of CARS in improving upper limb motor function and cognition function of stroke patients via conducting a long-term randomized controlled trial and analyze the patient’s acceptance of the proposed system. METHODS A randomized, double-blind, controlled trial was performed with 30 post-stroke, sub-acute phase patients. All patients in both the experimental group (n=15) and the control group (n=15) performed a 1-hour session of therapy each day, 5 days per week, for 2 weeks. Patients in the experimental group received 30 minutes of rehabilitation training with CARS and 30 minutes of conventional occupational therapy (OT) each session, while patients in the control group received conventional OT for the full 1 hour each session. The Fugl-Meyer Assessment-Upper Extremity subscale (FMA-UE), Action Research Arm Test (ARAT), Manual Muscle Test (MMT), Brunnstrom Stage (BS), and Barthel Index (BI) were used to assess motor function, and the Mini-Mental State Examination (MMSE), Add VS Sub (AVS), and Stroop Game (SG) were used to assess cognitive function before and after the 2-week treatment period. In addition, the User Satisfaction Evaluation Questionnaire (USEQ) was used to reflect the patients’ acceptance of the system in the experimental group after the final intervention. RESULTS All the assessment scores of the experimental group and control group were significantly improved after intervention (p＜0.05). The experimental group’s score of FMA-UE and ARAT increased by 11.47 and 5.86 respectively after intervention, which were both significantly higher than the increase of the control group (p＜0.01). Similarly, the score of AVS and SG in the experimental group increased by 7.53 and 6.83 respectively after the intervention, which was also higher than the control group (p＜0.01). The evaluation of the adoption of this system has three sub-dimensions. In terms of accessibility, the patients reported a mean score of 4.27±0.704 for the enjoyment of their experience with the system, 4.33±0.816 for success to use the system, 4.67±0.617 for the ability to control the system. In terms of comfort, the patients reported 4.40±0.737 for clear information provided by the system, 4.40±0.632 for comfort. In terms of acceptability, the patients reported 4.27±0.884 for usefulness in their rehabilitation, 4.67±0.617 for agreeing with CARS as a suitable tool for home-based rehabilitation. CONCLUSIONS CARS and conventional OT together-based rehabilitation were more effective in improving both upper limb motor function and cognition function as compared with conventional OT. Due to the low cost, and ease of use, CARS is also potentially suitable for home-based rehabilitation. CLINICALTRIAL The Chinese Clinical Trial Registry (ChiCTR1800017568).

scholarly journals Short-Term Effect of Kinesio Taping of Lower-Leg Proprioceptive Neuromuscular Facilitation Pattern on Gait Parameter and Dynamic Balance in Chronic Stroke with Foot Drop

Healthcare ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 271
Author(s):  
Dongyun Lee ◽  
Youngsook Bae
Keyword(s):  
Dynamic Balance ◽  
Step Length ◽  
Chronic Stroke ◽  
Foot Drop ◽  
Gait Velocity ◽  
Control Group ◽  
Stroke Patients ◽  
Short Term ◽  
Proprioceptive Neuromuscular Facilitation ◽  
Experimental Group

The aim of this study is to identify the effectiveness of proprioceptive neuromuscular facilitation (PNF) leg Kinesio taping on gait parameters and dynamic balance in chronic stroke patients with foot drop. A total 22 chronic stroke patients were randomly assigned to experimental (n = 11) and control groups (n = 11). All subjects underwent conventional therapy and gait training for 50 min. The experimental group additionally received KT of tibialis anterior muscle (TA) and hamstring muscles according to the PNF pattern. The control group received KT of only TA. The primary outcome measures that the gait parameter are gait velocity, cadence, step length, and stride length. Dynamic balance was measured by the timed up-and-go test (TUG) time and activity-specific balance confidence scale (ABC) as the secondary outcomes. All of the measurements were performed baseline and 24 h after intervention. Our results showed that the experimental group showed significant improvements in gait velocity, cadence, step length, stride length and TUG, and ABC score compared with the control group. We conclude that the short term effect of application of lower-leg KT according to the PNF pattern increased the gait ability and dynamic balance of chronic stroke patients with foot drop.

scholarly journals Comparison of Aquatic Therapy vs. Dry Land Therapy to Improve Mobility of Chronic Stroke Patients

2020 ◽  
Vol 17 (13) ◽  
pp. 4728 ◽  
Author(s):  
Sagrario Pérez-de la Cruz
Keyword(s):  
Therapy Group ◽  
Controlled Trial ◽  
Chronic Stroke ◽  
Control Group ◽  
Stroke Patients ◽  
Aquatic Therapy ◽  
Dry Land ◽  
Increased Risk ◽  
Single Leg Stance ◽  
Experimental Group

One of the most serious and disabling problems of stroke is pain and a decrease in balance, with the consequent increased risk of falls. The aim of the randomized controlled trial study was to compare the efficacy of three different treatment proposals to improve pain, gait, and balance in chronic stroke patients. Forty patients diagnosed with stroke were divided into three groups: the dry-land therapy group (control group) received sessions that included walking exercises and trunk mobility. The experimental group received Ai Chi aquatic therapy, and the combined group received alternating dry-land therapy sessions and Ai Chi aquatic therapy. The measurement instruments used were: the Tinetti balance and gait scale, the visual analog scale (VAS), 360° turn, single leg stance, and the 30-s stand test (CS-30). After twelve weeks of treatment, the results were significantly better for the combined therapy group and the experimental group compared to the dry-land therapy group (p < 0.01) in the VAS scale, CS-30, and 360° turn, although improvements were also found in the evaluations carried out in the aquatic therapy group. In total, for the Tinetti scale and single-leg stance, the differences between the groups were evident, although not statistically significant (p = 0.001). Aquatic therapy with Ai Chi and the combination of aquatic therapy with dry-land therapy was effective in improving pain, balance, and gait in patients with chronic stroke, thus improving their functional capacity and quality of life.

scholarly journals Effect of Customized Insoles on Gait in Post-Stroke Hemiparetic Individuals: A Randomized Controlled Trial

Biology ◽  
2021 ◽  
Vol 10 (11) ◽  
pp. 1187
Author(s):  
Jie Wang ◽  
Lei Qiao ◽  
Long Yu ◽  
Yanmin Wang ◽  
Redha Taiar ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Stance Phase ◽  
Controlled Trial ◽  
Weight Bearing ◽  
Gait Training ◽  
Secondary Outcome ◽  
Control Group ◽  
Stroke Patients ◽  
Randomized Controlled ◽  
Experimental Group

Background: Insoles have been widely applied to many diseases, but stroke involves complex problems and there is a paucity of research on the application of insoles in stroke patients. Aim: To evaluate the effect of customized insoles on gait in patients with hemiplegia. Design: A randomized controlled trial. Setting: Rehabilitation department of a hospital. Population: A total of 50 stroke patients were randomized into an experimental group (n = 25) or a control group (n = 25). Methods: Both groups received conventional gait training, which was conducted five times a week, every 40 min for four weeks and patients in the experimental group were required to wear customized insoles for at least 1 h per day for four weeks. The primary outcome measure was the Tinetti Gait Scale (TGS) and the secondary outcome measures were the plantar pressure test, 6-min walking test (6MWT), lower extremity Fugl–Meyer assessment (FMA-LE), Berg Balance Scale (BBS), and the modified Barthel index (MBI). Results: Compared to the control group, there were significant increases in the experimental group after four weeks (p = 0.014) and at the four week follow-up (p = 0.001) in the change in TGS, weight-bearing on the involved side (p = 0.012) or forefoot (p = 0.028) when standing, weight-bearing on the involved side (p = 0.01 6) or forefoot (p = 0.043) when walking, early stance phase (p = 0.023) and mid stance phase (p = 0.013) on the involved side, FMA-LE (p = 0.029), BBS (p = 0.005), and MBI (p = 0.009), but there were no differences in the late stance phase (p = 0.472) on the involved side when walking or in the 6MWT (p = 0.069). Conclusions: Customized insoles had great efficacy in enhancing gait performance in stroke patients.

scholarly journals Effectiveness of a Walking Program Involving the Hybrid Assistive Limb Robotic Exoskeleton Suit for Improving Walking Ability in Stroke Patients: Protocol for a Randomized Controlled Trial

10.2196/14001 ◽  
2019 ◽  
Vol 8 (10) ◽  
pp. e14001 ◽  
Author(s):  
Hideo Tsurushima ◽  
Masafumi Mizukami ◽  
Kenichi Yoshikawa ◽  
Tomoyuki Ueno ◽  
Yasushi Hada ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Gait Disturbance ◽  
Controlled Study ◽  
Control Group ◽  
Walking Ability ◽  
Stroke Patients ◽  
Robotic Exoskeleton ◽  
Walking Program ◽  
Parallel Group ◽  
Hybrid Assistive Limb

Background Gait disturbance often occurs in stroke survivors. Recovery of walking function is challenging, as some gait disturbance due to hemiparesis often remains even after rehabilitation therapy, presenting a major obstacle towards regaining activities-of-daily-living performance and achieving social reintegration. Objective This study aims to clarify the effectiveness of a walking program involving the wearable Hybrid Assistive Limb (HAL-TS01) robotic exoskeleton for improving walking ability in stroke patients with hemiparesis and stagnant recovery despite ongoing rehabilitation. Methods This is a multicenter, randomized, parallel-group, controlled study (HAL group, n=27; control group, n=27). The study period includes preintervention observation (until stagnant recovery), intervention (HAL-based walking therapy or conventional rehabilitation; 5 weeks), and postintervention observation (2 weeks). Following provision of informed consent and primary registration, the patients undergo conventional rehabilitation for preintervention observation, during which the recovery of walking ability is monitored to identify patients with stagnant recovery (based on weekly assessments using the 10-meter maximum walking speed [MWS] test). Patients with an MWS of 30-60 m/minute and insufficient weekly improvement in MWS undergo secondary registration and are randomly assigned to undergo HAL-based walking therapy (HAL group) or conventional rehabilitation (control group). The primary outcome is the change in MWS from baseline to the end of the 5-week intervention. Results This study began in November 2016 and is being conducted at 15 participating facilities in Japan. Conclusions Assessments of walking ability vary greatly and it is difficult to define the threshold for significant differences. To reduce such variability, our study involves conducting conventional rehabilitation to the point of saturation before starting the intervention. Stagnation in the recovery of walking ability despite conventional rehabilitation highlights the limits of current medical care. The present study may bring evidence that HAL-based therapy can overcome such limitations and induce added recovery of walking ability, which would promote the use of HAL technology in the clinical setting. Trial Registration UMIN Clinical Trials Registry UMIN000024805; https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000028545

scholarly journals Effectiveness of a New 3D-Printed Dynamic Hand–Wrist Splint on Hand Motor Function and Spasticity in Chronic Stroke Patients

2021 ◽  
Vol 10 (19) ◽  
pp. 4549
Author(s):  
Yu-Sheng Yang ◽  
Chi-Hsiang Tseng ◽  
Wei-Chien Fang ◽  
Ia-Wen Han ◽  
Shyh-Chour Huang
Keyword(s):  
Intervention Program ◽  
Controlled Trial ◽  
Chronic Stroke ◽  
Ease Of Use ◽  
Control Group ◽  
Stroke Survivors ◽  
Stroke Patients ◽  
Dynamic Splint ◽  
Experimental Group ◽  
At Home

Spasticity, a common stroke complication, can result in impairments and limitations in the performance of activities and participation. In this study, we investigated the effectiveness of a new dynamic splint on wrist and finger flexor muscle spasticity in chronic stroke survivors, using a randomized controlled trial. Thirty chronic stroke survivors were recruited and randomly allocated to either an experimental or control group; 25 completed the 6-week intervention program. The participants in the experimental group were asked to wear the dynamic splint at least 6 h/day at home, for the entire intervention. The participants in the control group did not wear any splint. All the participants were evaluated 1 week before, immediately, and after 3 and 6 weeks of splint use, with the modified Ashworth scale and the Fugl−Meyer assessment for upper extremity. User experience was evaluated by a self-reported questionnaire after the 6-week intervention. The timed within-group assessments showed a significant reduction in spasticity and improvements in functional movements in the experimental group. We found differences, in favor of the experimental group, between the groups after the intervention. The splint users indicated a very good satisfaction rating for muscle tone reduction, comfort, and ease of use. Therefore, this new splint can be used for at-home rehabilitation in chronic stroke patients with hemiparesis.

scholarly journals The Effect of Walking Backward on a Treadmill on Balance, Speed of Walking and Cardiopulmonary Fitness for Patients with Chronic Stroke: A Pilot Study

2021 ◽  
Vol 18 (5) ◽  
pp. 2376
Author(s):  
Ken-Wei Chang ◽  
Chih-Ming Lin ◽  
Chen-Wen Yen ◽  
Chia-Chi Yang ◽  
Toshiaki Tanaka ◽  
...  
Keyword(s):  
Pilot Study ◽  
Controlled Trial ◽  
Chronic Stroke ◽  
T Test ◽  
Control Group ◽  
Walking Ability ◽  
Walk Test ◽  
Cardiopulmonary Fitness ◽  
Experimental Group ◽  
Walking Backward

This study determines the effect of walking backward on a treadmill on balance, speed of walking and cardiopulmonary fitness for patients with chronic stroke. Subjects with chronic stroke for more than six months, whose level of Brunnstrom stage is greater than IV and who are able to walk more than eleven meters with or without assistive devices were recruited. After grouping for a single-blind clinical randomized controlled trial, the subjects were divided into two groups: eight in the control group and eight in the experimental group. All subjects were subjected to 30 min traditional physical therapy, three times a week for four weeks. The experimental group was subjected to an additional 30 min of walking backward on a treadmill. The Berg Balance Scale (BBS) and the Timed Up and Go test (TUG) were used to determine the functional balance and walking ability. The walking speed was evaluated using a timed 10-Meter Walk Test (10MWT), and the cardiopulmonary fitness was determined using a 6-Minute Walk Test (6MWT) and a pulmonary function test (PFT). All assessments were made at baseline before training commenced (pre-training) and at the end of the four-week training period (post-training). A paired t-test and an independent t-test were used to determine the effect on balance, speed of walking and cardiopulmonary fitness before and after training. The level of significance α was 0.05. After four weeks of training, the experimental group showed significant differences (p < 0.05) on TUG, BBS, 10MWT, 6MWT, forced vital capacity (FVC) and forced expiratory volume in one second (FEV1). This pilot study shows that the 30 min of walking backward on a treadmill three times a week for four weeks increased balance, speed of walking and cardiopulmonary fitness. Trial registration: Current Controlled Trials NCT02619110.

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