Tag: udar

Effectiveness of moderate to vigorous physical activity among stroke risk predicted population. A pilot study

N. Shazia Neelam, H.Manjunatha, P. Senthil, Saina Swathi,P. Antony Leo Aseer, K.C. Gayathri

N. Shazia Neelam, H.Manjunatha, P. Senthil, Saina Swathi,P. Antony Leo Aseer, K.C. Gayathri – Effectiveness of moderate to vigorous physical activity among stroke risk predicted population. A pilot study –  Fizjoterapia Polska 2024; 24(1); 105-113

DOI: https://doi.org/10.56984/8ZG2EF80LR

Abstract
Background. The increasing prevalence of stroke, particularly among younger populations in countries like India, necessitates effective preventive strategies. Modifiable risk factors such as hypertension, diabetes, and smoking contribute significantly to stroke incidence. This study focuses on the implementation of a 12-week moderate to vigorous physical activity (MVPA) program to address these risk factors and reduce stroke incidence.
Methodology. The study involved a structured MVPA intervention among individuals at risk of stroke, emphasizing consistent adherence to the protocol. Key outcomes, including systolic blood pressure, fasting blood glucose, and total cholesterol levels, were monitored. Cardiovascular fitness improvements were assessed using the Cooper’s Run Test. The study also examined the feasibility and acceptability of the MVPA intervention through participant adherence rates.
Results. The MVPA group exhibited significant reductions in systolic blood pressure, fasting blood glucose, and total cholesterol levels compared to the control group. These findings underscore the efficacy of MVPA in managing major stroke risk factors. Additionally, participants demonstrated enhanced cardiovascular endurance, highlighting the program’s positive impact on overall cardiovascular health. High adherence rates in the MVPA group indicated the feasibility of implementing structured exercise protocols for individuals at risk of stroke.
Conclusion. This pilot study demonstrates the effectiveness of a 12-week MVPA program in reducing key stroke risk factors and improving cardiovascular fitness among individuals at risk of stroke. The findings emphasize the importance of structured exercise interventions in stroke prevention efforts. While promising, further research with larger sample sizes and longer durations is necessary to establish the sustained benefits and feasibility of such interventions. Implementing tailored MVPA programs holds significant potential for mitigating stroke risk, offering valuable insights for global stroke prevention strategies.
Keywords
stroke, MVPA, risk factors of stroke, physical activity
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Effect of pilates training on cognitive functions in patients with stroke: A randomized controlled trial

Raghda Nasr Nassar, Nawal Abou Shady, Mohamed Nabil El-Bahrawy, Ahmed Abdelalim


Raghda Nasr Nassar, Nawal Abou Shady, Mohamed Nabil El-Bahrawy, Ahmed Abdelalim – Effect of pilates training on cognitive functions in patients with stroke: A randomized controlled trial. Fizjoterapia Polska 2022; 22(5); 26-30

DOI: https://doi.org/10.56984/8ZG20ASbq

Streszczenie

Purpose. To investigate the effect of pilates training on cognitive functions in patients with stroke. Materials and Methods. Forty Right stroke patients (Left hemiparesis) of both genders with age ranged from 50–65 years old were recruited randomly and divided into two equal groups; Study group (I) received pilates training therapy and selected physical therapy program for 6 weeks, Control group (II) received the same selected physical therapy program only for 6 weeks. Pre- and post-treatment assessment using RehaCom System, Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) were done for all patients. Results. Cognitive disorders (Attention, Memory, Reaction behavior and logical reasoning) were significantly improved in study group (pilates training therapy) more than control group (selected physical therapy program). cognitive disorders were improved in both groups with the best improvement results of group (I) more than group (II). Conclusion. Pilates Training program considered an effective physical therapy method for improving cognitive disorders in patients with stroke.

Słowa kluczowe:
stroke, pilates training, cognitive disorders

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Classification of Stroke Riskometer AppTM into low, moderate and high stroke risk range

N. Shazia Neelam, P. Senthil, S. Saina Swathi, S.Subramanian, A. Mohamed Nainar, L. Haribabu, E. Vijayabharathi


N. Shazia Neelam, P. Senthil, S. Saina Swathi, S.Subramanian, A. Mohamed Nainar, L. Haribabu, E. Vijayabharathi – Classification of Stroke Riskometer AppTM into low, moderate and high stroke risk range. Fizjoterapia Polska 2022; 22(4); 22-26

DOI: https://doi.org/10.56984/8ZG1A624g

Abstract
Background. Stroke is one of the leading of the causes of disability and according to the global burden of disease (GBD) study in 2010 it is the second leading cause of death worldwide. Developing countries reported 85% global burden of stroke enduring 80 percent of death due to hemorrhagic strokes. Stroke-related hospitalization rate in India is 46 per 100,000 persons. However Stroke Riskometer App can be used to significantly improve stroke and Non- Communicable disease prevention, since it operates on latest expansions in risk allocution/communication, International guidelines on stroke and Cardio-Vascular Disease prevention. However, the app does not classify the risk individuals into low, moderate and high categories which will not create any impact over the high risk individual, therefore it calls for the need to classify the tool into low, moderate and high risk ranges. Aim. To classify the Stroke Riskometer App into low, moderate and high stroke risk ranges among adult and elderly population. Methods. Participants were 250 samples selected from Chettinad Academy of Research and Education and S.A. Poly Clinic, Chennai, for over a_period of 6 months (April 2021-September 2021) and the Stroke Riskometer questionnaire along with Framingham Stroke Profile was filled, risk percentage from both the tools were recorded using the App for each individual. Results. Frequency analysis and Chi-square tests were performed, classifying the range into < 5% as low, 6-10% as moderate and > 10% as high risk in Stroke Riskometer tool. In Chi-square test it showed n = 104 as low risk, n = 11 as moderate risk,n = 14 as high risk in both FRS and Stroke Riskometer respectively. The chi-square value is 24.224 and the significant p value is < 0.0001showing that the value is performing well with FRS score. Conclusion. Though the App was classified into ranges it need to be continually developed and validated with larger sample size, heterogenous population and robust ethnic groups.

Keywords
stroke risk factors, stroke, stroke risk scores, ischemic stroke, non-communicable

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The impact of comprehensive spa treatment with the use of a stabilometric platform on postural balance control and functional fitness of patients after a stroke

Agnieszka Nitera-Kowalik, Iwona Sarzyńska-Długosz, Małgorzata Łukowicz, Agnieszka Malec, Robert Owsiński, Wiesław Bujalski

Agnieszka Nitera-Kowalik, Iwona Sarzyńska-Długosz, Małgorzata Łukowicz, Agnieszka Malec, Robert Owsiński, Wiesław Bujalski – The impact of comprehensive spa treatment with the use of a stabilometric platform on postural balance control and functional fitness of patients after a stroke. Fizjoterapia Polska 2022; 22(1); 76-93

Abstract
Introduction. Loss of postural balance control is a symptom that occurs in 60% of stroke patients, limiting patients’ mobility and functional efficiency. The reconstruction of lost functions can be achieved thanks to comprehensive spa treatment with the use of a modern device for the assessment and training of balance – a stabilometric platform.
The objective was to assess the impact of comprehensive spa treatment, including therapy on a stabilometric platform, on balance and functional fitness of stroke patients undergoing rehabilitation at the 21st Military Spa and Rehabilitation Hospital in Busko-Zdrój.
Material and methods. Seventeen patients were examined: 6 patients (35.3%) after a haemorrhagic stroke and 11 patients (64.7%) after an ischemic stroke diagnosed according to ICD-10: I.69, G.81; including 4 (23.5%) women and 13 (76.5%) men. Patients in the study group aged 35 to 70 (58.06 on average) received spa and rehabilitation treatment at the 21st Military Spa and Rehabilitation Hospital in Busko-Zdrój. The examinations were carried out from May 2019 to October 2020 as part of the project “Establishing a research laboratory for methods of rehabilitation of patients with musculoskeletal disorders”. The patients were subject to a comprehensive spa treatment program, extended with objective assessment and exercises on the Alfa stabilometric platform. Selected tests and clinical scales were used for the functional assessment of patients: Timed Up and Go test (TUG test), 10-meter walk test (10 Meter Walk Test), 2-minute walk test (2MWT). The patients were assessed on the day of commencing the spa treatment and after three weeks.
Results. Objective improvement of balance parameters in the stabilometric evaluation after 3 weeks of spa and rehabilitation treatment was noticed in the younger group of patients with right hemiparesis long after a stroke. Patients with left hemiparesis achieved shorter task completion times in the 10MWT and TUG clinical tests. In addition, they covered a longer distance in the 2MWT test.
Conclusions. The program of comprehensive spa and rehabilitation treatment, enriched with training with the use of the Alpha stabilometric platform, had a positive effect on the improvement of balance parameters and gait function in patients long after a stroke. Therapy on a stabilometric platform with the use of biofeedback should be a standard element of therapy in stroke patients.
Key words:
spa treatment, stroke, stabilometric platform
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Comparing between the efficacy of underwater treadmill and over-ground treadmill training program on trunk kinematics in stroke patients: A randomized controlled trial

Zeinab M. Abdelrehim, Nahed A. Salem, Hossam M. El khatib, Mahmoud Y. Elzanaty

Zeinab M. Abdelrehim, Nahed A. Salem, Hossam M. El khatib, Mahmoud Y. Elzanaty – Comparing between the efficacy of underwater treadmill and over-ground treadmill training program on trunk kinematics in stroke patients: A randomized controlled trial. Fizjoterapia Polska 2021; 21(5); 14-18

Abstract
Background. Gait disorder is a common clinical problem for stroke survivors. Trunk movement, control and symmetry are important prerequisite for gait. Trunk kinematics rarely investigated during gait cycle. Objective. This study was conducted to compare between the efficacy of underwater treadmill training program (TTP) and over-ground (TTP) in improving trunk kinematics during the gait cycle of stroke patients. Study design. randomized control trial. Methods. Forty male patients suffering from post-stroke gait deficits were assigned randomly into two equal groups: study group (A): received underwater treadmill training program. Control group (B) received over-ground treadmill training program. Patients of both groups were assessed for trunk range of motion (ROM) during gait cycle using slow motion video and goniometer iPad application. Assessment was done before and after four weeks of treatment for both groups. Results. the comparison between groups post treatment showed a significant increase in trunk lateral flexion toward affected and significant decrease in trunk lateral flexion toward unaffected during stance phase with increase in trunk symmetry between both sides in the study group (A) compared with that of control group (B). Conclusion. under water TTP is more effective than over-ground TTP on improving trunk kinematics during the gait cycle of stroke patients.
Key words:
stroke, trunk kinematics, underwater treadmill, over-ground treadmill
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Assessment of the effects of therapy with the use of the Fourier M2 neurological smart robot in post-stroke patients with hemiplegia

Igor Świerkowski, Marcin Krajczy, Ewa Jach, Piotr Kęsicki, Katarzyna Bogacz, Jacek Łuniewski, Jan Szczegielniak

I. Świerkowski, M. Krajczy, E. Jach, P. Kęsicki, K. Bogacz, J. Łuniewski, J. Szczegielniak – Assessment of the effects of therapy with the use of the Fourier M2 neurological smart robot in post-stroke patients with hemiplegia. Fizjoterapia Polska 2021; 21(4); 210-220

Abstract
Objective. The objective of the study is to assess the effect of upper limb therapy with the use of the Fourier M2 smart robot in post-stroke patients with right and left hemiplegia. Material and methods. The study included 13 post-stroke patients with hemiplegia. The study group consisted of 11 men and 2 women. Eight patients experienced a left-sided stroke and five patients experienced a right-sided stroke. The patients were assessed using the Fourier M2 robot. Inclusion criteria for the study were the occurrence of a stroke, hemiplegia, dysfunction of the upper limb, and restricted mobility. The patients underwent a 10-day therapy with the use of the Fourier M2 smart robot, which is used for diagnostics, planning and conducting therapy. Statistical calculations were performed using the Statscloud application. Results: On the first day, the caloric values were lower (Mdn = 1.60) than on the last day (Mdn = 3.60), which proves the effects of using a smart robot in the neurorehabilitation of post-stroke patients. The Wilcoxon test shows a statistically significant difference: z = −3.18; p = 0.003, r = −0.62. On the first day, the result was lower (Mdn = 1,231.00) compared to the last day (Mdn = 1,591.00), which proves the effects of using a smart robot in the neurorehabilitation of post-stroke patients. The Wilcoxon test shows a statistically significant difference: z = −2.48; p = 0.018, r = −0.49. On the last day, the score values are higher (M = 196.85, SD = 93.14) than on the first day (M = 137.46, SD = 99.96), which proves the effects of using a smart robot in the neurorehabilitation of post-stroke patients. The T-test shows that the difference was statistically significant: t(12) = −3.22; p = 0.007, Cohen dav = 0.62, observed force = 0.32. With a random pair of values, there is a 73.08% chance that the last day’s value would be higher than the first day’s value. On the first day, the distance values were lower (Mdn = 23.00) than on the last day (Mdn = 52.80), which proves the effects of using a smart robot in the neurorehabilitation of post-stroke patients. The Wilcoxon test shows that the difference was statistically significant: z = −3.11; p = 0.003, r = −0.61. On the first day, the average speed values were lower (Mdn = 4.50) than on the last day (Mdn = 4.60), which proves the effects of using a smart robot in the neurorehabilitation of post-stroke patients. The Wilcoxon test shows that the difference is statistically significant: z = −2.76; p = 0.009, r = −0.54. On the first day, the proportion of active movement was higher (M = 27.25, SD = 21.72) than on the last day (M = 25.54, SD = 24.73), which does not prove the effects of using a smart robot in neurorehabilitation stroke patients. The T-test shows that the difference was not statistically significant: t(12) = 0.31, p = 0.758, Cohen dav = 0.07, observed force = 0.04. In the case of a pair of randomly selected values, there is a 52.93% chance that the values on the first day would be higher than on the last day.
Conclusions. 1. The use of the Fourier M2 smart robot does not have a positive effect on increasing the proportion of active movement in post-stroke patients with hemiplegia. 2. The use of the Fourier M2 smart robot has a positive effect on the improvement of the average speed of movement in post-patients with hemiplegia.
3. The use of the Fourier M2 smart robot has a positive effect on increasing the functionality of the upper limb in post-stroke patients with hemiplegia.
Key words:
stroke, neurology, robot, upper limb, hemiplegia
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Subjective assessment of the effects of different approaches to rehabilitation of patients after cerebral stroke

Tomasz Wolny, Edward Saulicz, Rafał Gnat, Mirosław Kokosz, Michał Kuszewski, Andrzej Myśliwiec

Tomasz Wolny, Edward Saulicz, Rafał Gnat, Mirosław Kokosz, Michał Kuszewski, Andrzej Myśliwiec – Subjective assessment of the effects of different approaches to rehabilitation of patients after cerebral stroke. Fizjoterapia Polska 2009; 9(3); 223-231

Abstract
Background. Paying attention to the individual needs of the patient during treatment planning is becoming an important element of contemporary rehabilitation of post-stroke patients. The patient should not only be the recipient, but also a co-author of the programme of rehabilitation administered to him or her. The study hypothesis was that the type of rehabilitation treatment would influence the patient’s subjective evaluation of the effects of rehabilitation. Material and methods. The study involved a group of 64 stroke patients. All subjects were divided randomly into three groups (A, B and C). Subjective assessment of the efficacy of rehabilitation was based on a specially prepared questionnaire. Patients were followed up for about 21 days, during which period they were administered comprehensive rehabilitation. Group A received traditional post-stroke therapy. The rehabilitation programme for Group B included individual kinesiotherapy based on the PNF method. The programme for Group C comprised individual kinesiotherapy based on the PNF method supplemented with tensing neuromobilisations of peripheral nerves of the paretic upper extremity. Results. Overall, the highest average number of points (x = 11.5394), corresponding to the most marked subjective impro -vement, was recorded in Group C, while the least marked effect was noted in Group A (x = 8.1751). Conclusions. The subjective assessment of the effects of rehabilitation treatment correlated significantly with the type of rehabilitation administered.
Key words:
self-assessment, physiotherapy, stroke, therapeutic effects
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Evaluation of the effectiveness of Butler’s neuromobilisations in reducing disorders of stereognosis of impaired upper extremity in late-stage stroke patients

Tomasz Wolny, Edward Saulicz, Rafał Gnat

Tomasz Wolny, Edward Saulicz, Rafał Gnat – Evaluation of the effectiveness of Butler’s neuromobilisations in reducing disorders of stereognosis of impaired upper extremity in late-stage stroke patients. Fizjoterapia Polska 2010; 10(2); 95-102

Abstract
Background: A review of contemporary literature indicates that the rehabilitation of stroke patients is chiefly based on reeducation and compensation techniques addressing motor deficits, even though pure motor hemiparesis occurs very rarely. We assumed that tensional neuromobilisations of the impaired upper extremity in late-stage post-stroke patients influence disorders of stereognosis (tactile perception of natural objects)Material and method: The study involved a group of 64 stroke patients. The subjects were divided randomly into two subgroups (A and B). To assess tactile perception, all patients had to identify 10 commonly used objects by touch. During the 21-day follow-up, all patients were subjected to comprehensive rehabilitation. The therapeutic programme for Group A included selected physical modalities and individual kinesiotherapy based on the PNF method. The treatment in Group B additionally included tensional neuromobilisations of peripheral nerves of the impaired upper extremity. Results: Analysis of variance showed significant variation only for the test measurement factor (p &lt;0.01), which was due to significant intra-group differences in Group B (p&lt;0.05; Tukey test).Conclusions: The greatest improvement in the assessment of the tactile perception of everyday objects was obtained in the group which received PNF therapy supplemented with neuromobilisations of peripheral nerves of the impaired upper extremity.
Key words:
stereognosis, physiotherapy, stroke, therapeutic effects
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Poststroke physiotherapy of the patient with pusher syndrome – case study

Jakub Stolarski, Jan Kochanowski, Joanna Trochimiuk, Sebastian Wójtowicz

Jakub Stolarski, Jan Kochanowski, Joanna Trochimiuk, Sebastian Wójtowicz – Poststroke physiotherapy of the patient with pusher syndrome – case study. Fizjoterapia Polska 2010; 10(4); 317-323

Abstract
Postural disturbances in stroke patients may present as pusher syndrome. The aim of the study was to describe the treatment process and outcomes of physiotherapy of a post-ischaemic stroke patient with co-existing pusher syndrome. We describe a 78-year-old patient (S.L.) with left hemiplegia and pusher syndrome. Magnetic Resonance Imaging (MRI) revealed an ischaemic focus with a small haemorrhage in the posterior thalamus and posterior limb of the internal capsule. The patient underwent physiotherapy based on Proprioceptive Neuromuscular Facilitation (PNF). The pusher syndrome, which was diagnosed in the late stage of hospitalisation, was measured with the Scale for Contraversive Pushing (SCP), in which the patient scored 3.75 pts. Intensive rehabilitation started in the early post-stroke phase helped the patient achieve independence in changing position and sitting without assistance or support. The pushing behaviour did not improve in spite of appropriate therapy and verbal instructions. After 33 days of hospitalisation and physiotherapy at a Neurology Department, the patient was transferred to a Neurorehabilitation Unit for further rehabilitation. The pusher syndrome slowed down the recovery and reduced possibilities for applying rehabilitation in high positions (sitting and standing) in the early stage of post-stroke physiotherapy.
Key words:
physiotherapy, Stroke, pusher syndrome, PNF
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Influence of proprioceptiveneuromuscular facilitation (PNF) on the degree of spasticity in late-stage stroke patients

Tomasz Wolny, Edward Saulicz, Rafał Gnat, Mirosław Kokosz, Andrzej Myśliwiec, Michał Kuszewski

Tomasz Wolny, Edward Saulicz, Rafał Gnat, Mirosław Kokosz, Andrzej Myśliwiec, Michał Kuszewski – Influence of proprioceptiveneuromuscular facilitation (PNF) on the degree of spasticity in late-stage stroke patients. Fizjoterapia Polska 2011; 11(1); 1-8

Abstract
The complex pathophysiology of spasticity depends on the interaction between facilitation and inhibition of spinal and supraspinal neural centres and pathways. Contemporary medicine has developed several methods to treat spasticity. However, none of them has offered superior efficacy. This study aimed to investigate differences in the degree of spasticity between patients subjected to traditional post-stroke rehabilitation and rehabilitation based on the PNF method.A total of 64 stroke patients were enrolled. They were randomly divided into Group A and Group B. The modified six-grade Ashworth scale was used to evaluate the level of spasticity. During a 21-day follow-up, all subjects underwent intensive comprehensive rehabilitation. Group A received traditional stroke therapy. Group B received kinesiotherapy based on the PNF method.Both groups demonstrated significant improvements. In Group A, the degree of improvement in the final examination was 1.8% compared to baseline. In Group B, an improvement of 7.8% was registered already after the first session. The degree of improvement at the end of treatment was 16.86%. No significant inter-group differences were noted at baseline. The final evaluation showed significant differences.A regimen based on the PNF method resulted in greater reduction in spasticity than the traditional approach.
Key words:
spasticity, PNF, physiotherapy, Stroke, Therapeutic effects
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