Development of a functional training protocol to improve lower limb motor recovery in early sub-acute stroke patients

Meenakshi Jharbade, Sivakumar Ramachandran, Shankar V, John M Solomon


Meenakshi Jharbade, Sivakumar Ramachandran, Shankar V, John M Solomon – Development of a functional training protocol to improve lower limb motor recovery in early sub-acute stroke patients. Fizjoterapia Polska 2022; 22(1); 234-239

Streszczenie
Abstract
Background. Functional training is a common intervention practiced in stroke rehabilitation. The efficacy of lower limb functional training to improve functions has been widely tested in patients with chronic stroke. Improvement in function generally does not reflect changes in motor recovery. The effect of this training on motor recovery has been less explored. Moreover, a standard protocol for lower limb functional training is elusive in literature.
Aim. To develop an intervention protocol of functional training for lower extremity to improve motor recovery and functions in acute and early subacute stroke patients.
Methods. Study was conducted in two phases. First phase involved literature review to identify the components for functional training for lower extremity in patients with stroke. Second phase involved two rounds of Delphi survey to design an intervention protocol. First round of Delphi survey was conducted to identify the functions of lower extremity that can be used as components of training and second round was conducted to receive the consensus on activities of lower extremity which can be practiced in acute and early subacute stroke patients.
Results. Functions of lower extremity and exercises of functional training which received consensus of atleast 70% and above in Delphi survey are selected to design the protocol. Weight-bearing, postural control, sit to stand, stepping, walking, standing, manipulation function was selected to design activities for functional training.
Conclusion. A Functional training protocol was developed with activities for weight bearing, postural control, manipulation and walking function.
Key words:
stroke, physiotherapy, functional training, rehabilitation, task oriented exercise
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Functional symptoms of core stability improvement in rehabilitation of patients with low back pain syndrom

Tomasz Łosień, Krzysztof Banasiak, Katarzyna Kniaziew-Gomoluch, Marek Woszczak, Beata Kita

T. Łosień, K. Banasiak, K. Kniaziew-Gomoluch, M. Woszczak, B. Kita – Functional symptoms of core stability improvement in rehabilitation of patients with low back pain syndrome. Fizjoterapia Polska 2019; 19(4); 142-148

Abstract
Aim. The goal of the below work was to estimate the effectiveness of deep torso muscles exercises and its influence on the low back pain syndrome.
Material and methods: Research group consisted of 46 individuals, including 30 women and 16 men, who suffered from the low back pain syndrome. Age range of patients was between 32 and 62 years old, with the average age of 47 years old. Two research tools were used in the above work, the international questionnaire Revised Oswestry Low Back Pain Disability which contains 10 questions about the pain sensations during performing daily activities, and self-created questionnaire containing 6 questions including one about the level of pain felt by the patient. After filling both questionnaires patients took part in the 30 day long rehabilitation program where exercises strengthening the deep torso muscles were performed. After they finished the program, the individuals were asked to fill questionnaires again.
Results. Total level of health complaints after training cycle was 7.91 and decreased in a statistically significant way in relation to the value before the training cycle when it was 23.59, the difference being 15.67. The results arousing from the study clearly indicate a decrease in pain sensations among patients submitted to this analysis. After a full monthly therapy, average perceptible pain measured by the VAS scale decreased by 2.2 points and amounted to 3.67 points.
Conclusions. Performed tests clearly indicate that deep muscle exercise therapy repeated in cycles significantly reduced the subjective pain sensations among examined patients. General physical fitness improvement was also observed. Final results of research prove that strengthening of the torso muscles is an effective way of low back pain treatment.

Key words:
low back pain syndrome, functional training, deep torso muscles, VAS, Revised Oswestry Low Back Pain Disability Questionary

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