Tag: stroke

Effect of transcutaneous electrical nerve stimulation applied to acupuncture points on gait and quality of life in stroke patients

Maram A. Mahmoud, Nahed A. Salem, Ebtesam Fahmy, Amina M. Awad, Asmaa A. Salem, Rania M. Tawfik

Azal Raed Aboluhom et al.– Effect of transcutaneous electrical nerve stimulation applied to acupuncture points on gait and quality of life in stroke patients –  Fizjoterapia Polska 2024; 24(5); 462-469

DOI: https://doi.org/10.56984/8ZG020C3UHN

Streszczenie Wprowadzenie. Spastyczność poudarowa jest upośledzeniem powodującym trudności, które negatywnie wpływają na chód i jakość życia (QoL). Wykazano, że nieinwazyjne techniki, takie jak przezskórna elektryczna stymulacja nerwów (TENS), mają właściwości przeciwspastyczne. Cel. Ocena dodatkowego wpływu TENS zastosowanej w punktach akupunkturowych na spastyczność, chód oraz jakość życia u pacjentów z przewlekłym udarem. Metody. Przeprowadzono randomizowane kontrolowane badanie z udziałem trzydziestu pacjentów po udarze obojga płci w wieku 45-60 lat. Zostali oni losowo przydzieleni do grupy badawczej i kontrolnej, po 15 pacjentów w każdej grupie. Pacjenci w grupie kontrolnej uczestniczyli w zaprojektowanym programie fizjoterapii, natomiast uczestnicy grupy badawczej realizowali ten sam program fizjoterapii z dodatkiem TENS w punktach akupunkturowych na chorej kończynie dolnej. Mierzone zmienne obejmowały zmodyfikowaną skalę Ashwortha (MAS) do oceny spastyczności, kwestionariusz jakości życia WHOQOL-BREF do oceny QoL oraz Biodex Gait Trainer do pomiaru czasoprzestrzennych parametrów chodu. Oceny wszystkich zmiennych przeprowadzono przed i po interwencji. Wyniki. Zaobserwowano istotną statystycznie poprawę wszystkich mierzonych zmiennych w obu grupach po leczeniu (p < 0,05), z wyjątkiem wyniku MAS dla grupy kontrolnej, który był nieistotny (p = 0,65). W grupie badawczej odnotowano istotne zmniejszenie wyniku MAS (p = 0,03) oraz istotny wzrost prędkości chodu, długości kroku po stronie chorej i zdrowej, czasu podparcia na jednej kończynie po stronie chorej oraz wyników WHOQOL-BREF w porównaniu z grupą kontrolną po leczeniu (p < 0,05). Wnioski. Przezskórna elektryczna stymulacja nerwów (TENS) zastosowana w punktach akupunkturowych może być skutecznym, bezpiecznym i opłacalnym uzupełnieniem programu fizjoterapii w celu poprawy spastyczności, chodu i jakości życia u pacjentów z przewlekłym udarem.
Słowa kluczowe udar, spastyczność, TENS, punkty akupunkturowe, chód, jakość życia
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Effect of cognitive training on selected gait parameters in patients with stroke

Asmaa Tahoon, Nahed Salem, Enas Elsayed, Ebtesam Fahmy, Rasha M Hegazy, Ahmed M. Aboeleneen, Rayan Jastania, Ayman A Alhammad, Shereen S. Mohamed

 

Asmaa Tahoon et al. – Effect of cognitive training on selected gait parameters in patients with stroke –  Fizjoterapia Polska 2024; 24(4); 25-32

DOI: https://doi.org/10.56984/8ZG01A8L8M9

Abstract
Background. Not only may early cognitive rehabilitation help stroke patients with their cognitive impairment, but it can also help patients restore their capabilities to do everyday activities. There isn’t much data on how cognitive training affects spatiotemporal gait variables in stroke survivors.
Objective. To examine the impact of cognitive training on selected gait parameters in stroke patients.
Subjects and Methods.  Forty male and female patients with mild ischemic chronic stroke, ranging in age from 45 to 60 years, were recruited and distributed into two equal groups at random (G1 and G2). The Montreal Cognitive Assessment Scale (MOCA) and the Rehacom system were utilized to evaluate the patient’s cognitive function. The Biodex gait trainer device was utilized to measure several gait variables for all patients. Rehacom cognitive training and a selected physiotherapy program were administered to the study group (G1). The similar selected physiotherapy program utilized for the G1 was applied to the control group (G2). For eight weeks, the treatment was administrated three sessions each week, day after day. All variables were evaluated before- and after-intervention.
Results. The step length and walking speed, as well as the MOCA scale score of G1, were significantly higher after treatment than those of G2 (p = 0.001). The correlation between step length and median reaction time (MRT) was moderate negative significant correlation (r = – 0.698, p = 0.001).
Conclusion. Cognitive training has a beneficial impact on improving the selected spatiotemporal gait parameters in stroke patients.
Keywords
stroke, cognitive training, gait parameters, MOCA. spatiotemporal parameters
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Effect of water-based exercise with or without external buoyancy devices in influencing balance improvement in stroke: scoping review

Ribka Theresia, Farid Rahman

 

Ribka Theresia, Farid Rahman – Effect of water-based exercise with or without external buoyancy devices in influencing balance improvement in stroke: scoping review –  Fizjoterapia Polska 2024; 24(3); 350-355

DOI: https://doi.org/10.56984/8ZG020A6ZN

Abstract:
Background. Stroke is one of the leading causes of disability that can result in spasticity, gait disturbances, and balance disorders. Land-based rehabilitation methods have been explored, and concerns about joint and muscle stress have led researchers to investigate alternative approaches, including water-based exercise.
Aim. To summarize the available data related to the clinical picture of whether there is a difference in the effect of water-based exercises with or without external buoyancy devices in influencing balance improvement in stroke.
Material and methods. The method used in this study is Scoping Review, which aims to find answers to questions from researchers related to the literature on the research topic. The collected articles will be synthesized using the TIDIER checklist, and articles will be searched through various databases.
Results. After conducting the article selection process, 20 suitable articles were found. The details of articles related to population, interventions, and outcome measures are listed.
Conclusion. Water-based exercises are efficient for stroke patients. These exercise methods showed effectiveness in improving balance in stroke patients. Many practical water-based exercise methods must be analyzed, especially for stroke patients, in future research.

Keywords:
water-based exercise, stroke, balance, fall risk

 

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Investigating the relationship between physical activity and depression level with stroke recurrences: An observational cross-sectional study

Lailla Affianti Fauzi, Wara Kushartanti, Novita Intan Arovah, Fauzi, Regina Maria, Adliah Anwar

 

Lailla Affianti Fauzi, Wara Kushartanti, Novita Intan Arovah, Fauzi, Regina Maria, Adliah Anwar – Investigating the relationship between physical activity and depression level with stroke recurrences: An observational cross-sectional study –  Fizjoterapia Polska 2024; 24(3); 210-215

DOI: https://doi.org/10.56984/8ZG020AKKK

Abstract:
Background. The complex relationship between physical health and mental well-being, especially for those who have undergone a stroke, is increasingly acknowledged. It is crucial to include interventions that emphasize physical activity as a crucial element in successful stroke rehabilitation and preventing subsequent strokes. This research aimed to evaluate the relationship between physical activity and depression levels with stroke recurrences.
Method. This cross-sectional investigation enrolled 60 patients aged between 30 and 85 years, all receiving outpatient stroke treatment in a hospital in Indonesia. Stroke recurrence was defined as experiencing a second stroke within three months after the initial stroke. Among the total participants, 12 had experienced recurrent strokes, while 48 had not. Data on physical activity and depression levels were gathered using the IPAQ short form and PHQ-9 instruments. Simple logistic regression was conducted to assess the association between physical activity and depression levels with stroke recurrence, adjusting for age and sex.
Result. Patients with higher physical activity levels were less likely to experience recurrent strokes (OR = 0.534, 95% CI 0.201; 1.422), p = 0.027. In contrast, patients with higher depression levels were more likely to experience recurrent strokes (OR = 2.055, 95% CI 1.115; 3.787), p = 0.021.
Conclusion. The study highlights low physical activity and high depression as influential factors in increasing stroke recurrence, underscoring the need to promote physical activity and mental health support in stroke rehabilitation.

Keywords:
stroke, physical activity, post-stroke depression, recurrent stroke

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Effects of additional mental imagery training on lower limb function in stroke patients treated with virtual reality

Tahir Masood, Tasmiya Asghar, Arshad Nawaz Malik

 

Tahir Masood, Tasmiya Asghar, Arshad Nawaz Malik – Effects of additional mental imagery training on lower limb function in stroke patients treated with virtual reality –  Fizjoterapia Polska 2024; 24(2); 89-93

DOI: https://doi.org/10.56984/8ZG56083OG

Abstract
Aim. To evaluate whether stroke patients receiving combined task-oriented and virtual reality training could further benefit from adding motor imagery training with regard to lower limb sensorimotor function, balance, gait, and fall risk. Material and Methods. Thirty chronic stroke patients (40-60 years) participated in this single-blind randomized controlled trial, recruited through a convenience sampling method, randomly assigned to either an experimental group or a control group. The experimental group underwent virtual reality training combined with mental imagery, while the control group received virtual reality training alongside conventional treatment. Both interventions lasted for 6 weeks, with 3 sessions per week. The data was collected with Berg Balance Scale, Fugl-Meyer Assessment for Lower Extremity, Wisconsin Gait Scale, Timed Up and Go Test, and 10-meter Walk Test at baseline, and after 3 and 6 weeks. Results. Participants in the experimental group showed significantly better performance compared to the control group on all study measures (P < 0.05). Further, both groups improved significantly compared to baseline (P < 0.05). Conclusions. Integrating motor imagery training into rehabilitation plans of chronic stroke patients treated with task-oriented and virtual reality training significantly improves patient outcome. Clinical trials registry: NCT05812638
Keywords
Motor imagery, Stroke, Lower limb function, Exergaming, Gait
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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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Use of the posturography platform as a tool for quantitative assessment of imbalance and postural control in post-stroke patients in chronic phase

Paulina Magdalena Ostrowska, Rita Hansdorfer-Korzon, Rafał Studnicki, Dawid Spychała


Paulina Magdalena Ostrowska, Rita Hansdorfer-Korzon, Rafał Studnicki, Dawid Spychała – Use of the posturography platform as a tool for quantitative assessment of imbalance and postural control in post-stroke patients in chronic phase. Fizjoterapia Polska 2023; 23(1); 142-163

DOI: https://doi.org/10.56984/8ZG07B4A3

Abstract
Background. Imbalance during standing, which is usually observed as an asymmetry in the weight shifting toward to the unaffected side of the body, is one of the most common factors affecting the independence and quality of life of post-stroke patients. Clinical assessment of imbalance in post-stroke patients is often conducted by visual observation using standardised tools (balance tests). However, quantitative analysis, using a posturographic platform, is more accurate and provides more information about the patient’s functional status. The TYMO® device, used in this study, is a portable posturography platform that measures tilts of the body’s center of mass and reports the results of the rehabilitation process. It enables an objective, direct and quantitative assessment of the patient’s functional status. Such an assessment can contribute to significant effectiveness of physiotherapy and consequently improve the patient’s quality of life and shorten the period of abstinence from work. Objective. Quantitative assessment of imbalance and postural control using a posturography platform (TYMO®) in patients after ischaemic stroke, in the chronic phase, as an important component of the functional diagnosis process and rehabilitation programme design. To emphasise the role of the posturography platform (TYMO®) as a tool for measuring static balance – symmetry of body weight distribution, and a tool for monitoring and reporting the results of physiotherapy treatment. Methods. In the current study, before and after two weeks of rehabilitation, quantitative measurements of balance on the TYMO® platform were made in a group of subjects (n = 60: adults, after ischemic stroke – first stroke episode, in chronic phase – up to 5 years after the stroke incident occurred) undergoing therapy using neurophysiological methods (PNF – Proprioceptive Neuromuscular Facilitation and NDT-Bobath – Neurodevelopmental Treatment according to the Bobath concept) and the SPIDER system (Strengthening Program for Intensive Developmental Exercises and activities for Reaching health capability). Measurements included: the distance marked by the patient’s center of mass while performing the test, the medial-lateral and anterior-posterior tilts of the subject’s body, the area of movement marked by the body’s center of mass, the average speed at which the patient performed the movement to maintain the required position, and the distribution of the subject’s weight. Based on the posturographic results obtained before therapy, it was possible to design a targeted rehabilitation programme. The magnitude of the difference in measurements before and after rehabilitation made it possible to assess the impact of the therapy on the patient’s balance. In addition, it was a specific indicator of the accuracy of the selection of physiotherapeutic treatment (a large difference in the mean results before and after therapy reflected an improvement in the parameters of postural control, hence the effectiveness of the therapy) and determined the direction of the future rehabilitation programme. Results and conclusions. The parameters measured by the TYMO® platform are crucial in assessing the functional status of post-stroke patients, especially with regard to postural control or balance disorders. The results described confirm the validity of using quantitative assessment, using the posturography platform, as an important component of the functional diagnostic process and designing an rehabilitation programme. The TYMO® platform itself is a useful tool for measuring, monitoring and reporting the effects of physiotherapeutic treatment in post-stroke patients.
Key words:
stroke, body weight distribution, balance, quantitative assessment, posturographic platform
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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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