Tag: stroke

Impact of lower limb spasticity on tibial nerve entrapment in patients with stroke

Hosam Magdy Metwally Abd Alhamid, Mohamed Salah El-Sayed, Ahmed Magdy Alshimy

Hosam Magdy Metwally Abd Alhamid, Mohamed Salah El-Sayed, Ahmed Magdy Alshimy – Impact of lower limb spasticity on tibial nerve entrapment in patients with stroke –  Fizjoterapia Polska 2026; 26(2); 32-37

DOI: https://doi.org/10.56984/8ZG560AT6B1

Abstract
Introduction. Stroke is the most common cause of mortality and one of the leading causes of morbidity worldwide. Polyneuropathies and entrapment neuropathies occur as complications of stroke.
Aim of the study. The purpose of this study was to examine how lower limb spasticity affected tibial nerve entrapment in patients with stroke.
Material and methods. One hundred patients with stroke, aged between 55 and 65 years, participated in the study. Each gender was divided into two equal groups: groups A and B. According to the modified Ashworth scale, grades 1 and 1+ indicated mild spasticity in group A, whereas grades 2 and 3 indicated moderate spasticity in group B. An electrodiagnostic test, including nerve conduction velocity, distal latency, and amplitude, and a clinical test, the triple compression stress test, were used to evaluate the subjects.
Results. Statistically significant differences were observed across all variables (p < 0.001). Specifically, group A demonstrated significantly shorter distal latency, higher amplitude, and faster nerve conduction velocity than group B. These findings suggest that group A exhibited better peripheral nerve function than group B.
Conclusions. This study concluded that the degree of spasticity affected tibial nerve function, with moderate spasticity being associated with greater electrophysiological damage.
Key words
stroke, spasticity, tibial nerve entrapment, paretic lower limb
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Impact of targeted trunk training on bed mobility in stroke patients

Indhu. M, Rajarajeswari. A

Indhu. M, Rajarajeswari. A – Impact of targeted trunk training on bed mobility
in stroke patients –  Fizjoterapia Polska 2025; 25(3); 259-264

DOI: https://doi.org/10.56984/8ZG7D19I16E

Abstract
Background. Stroke usually results in unilateral motor deficits in the upper and lower extremities, but its impact on trunk muscles is bilateral due to their architecture. The muscles on one side rely on the stability of the other side. While most literature focuses on improving hemiplegic limb function, the trunk is often overlooked. Impaired trunk control affects bed mobility, which is one of the basic functions that must be achieved before progressing to other activities. Early rehabilitation plays a crucial role in maximizing neuroplasticity and spontaneous recovery, leading to better outcomes.
Aim. To evaluate the impact of targeted trunk training on bed mobility in stroke patients.
Methods. Forty acute hemiparetic stroke patients with impaired bed mobility (Motor Assessment Scale [MAS] supine to side-lying grade ≤ 3) were included in this study and assigned to either a control or interventional group. Both groups underwent conventional physiotherapy, but the interventional group received additional trunk training. Bed mobility was assessed before and after 10 days of intervention using MAS components 1 and 2 and STREAM (Stroke Rehabilitation Assessment of Movement) component 5.
Results. Both groups showed significant improvement in bed mobility. However, the interventional group demonstrated much better improvement than the control group (p < 0.05).
Conclusion. Targeted trunk training significantly improved bed mobility compared to conventional physiotherapy in acute stroke patients.
Keywords
bed mobility, targeted trunk training, stroke, rehabilitation
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The effect of virtual reality-based exergaming on hand function and fine motor skills in post-stroke patients in a low-resource setting

Amelia Virshany Latif, Rumaisah Hasan, Wa Ode Sri Nikmatiyah, Yose Waluyo, Husnul Mubarak, Andi Alfian Zainuddin

Amelia Virshany Latif, Rumaisah Hasan, Wa Ode Sri Nikmatiyah, Yose Waluyo, Husnul Mubarak, Andi Alfian Zainuddin – The effect of virtual reality-based exergaming on hand function and fine motor skills in post-stroke patients in a low-resource setting –  Fizjoterapia Polska 2025; 25(3); 193-202

DOI: https://doi.org/10.56984/8ZG7D19QDHS

Abstract
Introduction. Stroke is a major cause of long-term morbidity, with more than 60% of stroke survivors experiencing persistent neurologic deficits in the upper extremities that significantly impact patients’ independence and quality of life.
Methods. This study was conducted as a randomized controlled trial involving 60 post-stroke subjects. The research was conducted from January to October 2024. Data collection included interviews, physical examination, the Fugl-Meyer Assessment for Upper Extremities Hand (FMA-UE Hand) to assess hand functional ability, and the Nine-Hole Peg Test (NHPT) to assess fine motor function. The experimental group received both conventional and virtual reality therapy exercises, while the control group received only conventional exercises for 8 weeks. The FMA-UE Hand served as the primary outcome, and the NHPT as the secondary outcome.
Results. After 8 weeks, the intervention group showed greater improvement than the control group in both hand function and fine motor skills. When added to traditional treatment, virtual reality exergames provided even more improvement in motor function than conventional therapy alone. Benefits persisted for at least one week after the end of treatment. The results indicate that, when used alongside traditional rehabilitation, virtual reality exergames offer a more enjoyable and effective method to help stroke survivors improve their motor skills and hand function.
Conclusion. This research finds that adding virtual reality (VR) exergames to traditional rehabilitation significantly improves hand functional status and fine motor ability in post-stroke patients compared to conventional therapy alone. The combined therapy offers a more effective and engaging approach to motor rehabilitation, with sustained benefits observed up to one week after treatment. These findings highlight the potential of VR exergames as a valuable addition to post-stroke rehabilitation programs.
Key words
virtual reality, rehabilitation, hand function, stroke
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Effect of transcranial direct current stimulation on balance and risk of fall in patients with strokeEffect of transcranial direct current stimulation on balance and risk of fall in patients with stroke

Mohamed N. El Bahrawy, Rewida M. El Janaini, Ashraf A. Darwesh, Heba A. Draz, Zeinab M. Abdelrehim, Noura A. Elkafrawy

 

Mohamed N. El Bahrawy et al – Effect of transcranial direct current stimulation on balance and risk of fall in patients with stroke –  Fizjoterapia Polska 2025; 25(1); 27-33

DOI: https://doi.org/10.56984/8ZG007DE38H

Abstract
Background. Balance refers to the ability to achieve and maintain a state of equilibrium where all acting forces neutralize one another and equal zero. It plays a crucial role in community ambulation and gait performance after a stroke. Post-stroke balance impairment predisposes individuals to falls, leading to negative consequences such as fall-induced injuries (including fractures), an increased fear of falling, depression, social isolation, and even death.
Purpose. To investigate the effect of transcranial direct current stimulation (tDCS) on balance and risk of falls in stroke patients.
Subjects & Methods: Thirty chronic stroke patients, both male and female, aged 45–60 years, participated in this study. Participants were randomly allocated into two equal groups: the study group and the control group. The study group (GI) received active tDCS in combination with selected physical therapy exercises, while the control group (GII) received sham tDCS and the same physical therapy exercises. Balance was assessed using the Biodex Balance System (Biodex-BS) and the Berg Balance Scale (BBS), while the risk of falls was assessed using the Timed Up and Go Test (TUG) and the Fall Efficacy Scale (FES). All outcome measures were evaluated for each patient before and after a four-week program, consisting of three sessions per week.
Results. There was a significant improvement in all measured variables (overall stability index, overall dynamic limit of stability, BBS, TUG, and FES) in the study group compared to the control group (p < 0.05).
Conclusion. tDCS effectively enhances balance and reduces the risk of falls in individuals post-stroke.
Key words
balance, risk of falls, tDCS, stroke
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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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