Tag: stroke

Učinak kognitivnog treninga na odabrane parametre hoda kod pacijenata s moždanim udarom

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

Sažetak
Pozadina. Rana kognitivna rehabilitacija ne samo da može pomoći pacijentima s moždanim udarom u prevladavanju kognitivnih oštećenja, već im može pomoći i u ponovnom stjecanju sposobnosti za svakodnevne aktivnosti. Međutim, nema mnogo podataka o tome kako kognitivni trening utječe na prostorno-vremenske parametre hoda kod pacijenata preživjelih moždani udar.
Cilj. Ispitati utjecaj kognitivnog treninga na odabrane parametre hoda kod pacijenata s moždanim udarom.
Ispitanici i metode. U istraživanje je uključeno četrdeset pacijenata s blagim kroničnim ishemijskim moždanim udarom, dobi od 45 do 60 godina, oba spola, nasumično raspoređenih u dvije jednake skupine (G1 i G2). Za procjenu kognitivne funkcije pacijenata korišteni su Montrealska skala kognitivne procjene (MOCA) i sustav Rehacom. Biodex uređaj za treniranje hoda korišten je za mjerenje nekoliko varijabli hoda svih pacijenata. Rehacom kognitivni trening i odabrani fizioterapeutski program primijenjeni su na studijsku skupinu (G1). Isti fizioterapeutski program primijenjen je i na kontrolnu skupinu (G2). Liječenje je provedeno tijekom osam tjedana, tri puta tjedno, svaki drugi dan. Sve varijable procijenjene su prije i poslije intervencije.
Rezultati. Duljina koraka i brzina hoda, kao i MOCA skala kod G1, bili su znatno viši nakon tretmana nego kod G2 (p = 0.001). Korelacija između duljine koraka i srednjeg vremena reakcije (MRT) bila je umjereno negativna i statistički značajna (r = -0.698, p = 0.001).
Zaključak. Kognitivni trening ima pozitivan učinak na poboljšanje odabranih prostornih i vremenskih parametara hoda kod pacijenata s moždanim udarom.

Ključne riječi
moždani udar, kognitivni trening, parametri hoda, MOCA, prostorno-vremenski parametri

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Utjecaj vježbi u vodi s ili bez vanjskih uređaja za uzgon na poboljšanje ravnoteže nakon moždanog udara: pregled

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

Sažetak:
Uvod. Moždani udar jedan je od vodećih uzroka invaliditeta, što može rezultirati spastičnošću, poremećajem hoda i ravnoteže. Metode rehabilitacije na kopnu su istražene, a zbog zabrinutosti oko stresa na zglobove i mišiće istraživači istražuju alternativne pristupe, uključujući vježbe u vodi.
Cilj. Sažeti dostupne podatke o tome utječu li vježbe u vodi, s ili bez vanjskih uređaja za uzgon, na poboljšanje ravnoteže nakon moždanog udara.
Materijali i metode. U ovom je istraživanju korišten pregled literature kako bi se pronašli odgovori na istraživačka pitanja. Prikupljeni članci su sintetizirani pomoću TIDIER kontrolnog popisa, a pretraživanje je provedeno u raznim bazama podataka.
Rezultati. Nakon procesa odabira, pronađeno je 20 prikladnih članaka. Detalji o populaciji, intervencijama i ishodima su navedeni.
Zaključci. Vježbe u vodi su učinkovite za pacijente nakon moždanog udara. Ove metode vježbanja pokazale su učinkovitost u poboljšanju ravnoteže. Potrebno je analizirati mnoge praktične metode vježbanja u vodi u budućim istraživanjima.
Ključne riječi:
vježbe u vodi, moždani udar, ravnoteža, rizik od pada

 

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Istraživanje odnosa između tjelesne aktivnosti i razine depresije s ponovnim pojavama moždanog udara: opservacijska presječna studija

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

Sažetak:
Pozadina. Sve se češće prepoznaje složen odnos između tjelesnog zdravlja i mentalne dobrobiti, posebno kod osoba koje su pretrpjele moždani udar. Ključno je uključiti intervencije koje naglašavaju tjelesnu aktivnost kao ključni element uspješne rehabilitacije nakon moždanog udara i sprječavanja ponovnih moždanih udara. Ova studija imala je za cilj procijeniti odnos između razina tjelesne aktivnosti i depresije te ponovnih moždanih udara.
Metode. Ovo presječno istraživanje uključilo je 60 pacijenata u dobi od 30 do 85 godina, svi su primali ambulantno liječenje moždanog udara u bolnici u Indoneziji. Ponovni moždani udar definiran je kao doživljavanje drugog udara unutar tri mjeseca nakon početnog. Među svim sudionicima, 12 je doživjelo ponovljeni moždani udar, dok 48 nije. Podaci o tjelesnoj aktivnosti i razinama depresije prikupljeni su pomoću kratke verzije IPAQ-a i PHQ-9 upitnika. Provedena je jednostavna logistička regresija kako bi se procijenila povezanost tjelesne aktivnosti i razina depresije s ponovnim pojavama moždanog udara, uz prilagodbu za dob i spol.
Rezultati. Pacijenti s višim razinama tjelesne aktivnosti imali su manju vjerojatnost ponovnog moždanog udara (OR = 0.534, 95% CI 0.201; 1.422), p = 0.027. Suprotno tome, pacijenti s višim razinama depresije imali su veću vjerojatnost za ponovni moždani udar (OR = 2.055, 95% CI 1.115; 3.787), p = 0.021.
Zaključak. Studija ističe nisku tjelesnu aktivnost i visoke razine depresije kao važne čimbenike koji povećavaju ponavljanje moždanog udara, naglašavajući hitnu potrebu za promicanjem tjelesne aktivnosti i podrškom mentalnom zdravlju u rehabilitaciji pacijenata nakon moždanog udara.

Ključne riječi:
moždani udar, tjelesna aktivnost, post-moždana depresija, ponovni moždani udar

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Učinci dodatne mentalne slikovne obuke na funkciju donjih udova kod bolesnika s moždanim udarom liječenih virtualnom stvarnošću

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

Sažetak: Cilj. Procijeniti mogu li bolesnici s moždanim udarom koji primaju kombiniranu trening usmjeren na zadatke i trening u virtualnoj stvarnosti dodatno profitirati dodavanjem motoričke slikovne obuke u pogledu senzomotorne funkcije donjih udova, ravnoteže, hoda i rizika od pada.
Materijal i metode. Trideset bolesnika s kroničnim moždanim udarom (40-60 godina) sudjelovalo je u ovoj jednokrilnoj randomiziranoj kontroliranoj studiji, regrutiranih metodom uzorkovanja pogodnosti, slučajno raspoređenih u eksperimentalnu skupinu ili kontrolnu skupinu. Eksperimentalna skupina je prošla trening u virtualnoj stvarnosti u kombinaciji s mentalnim slikama, dok je kontrolna skupina primala trening u virtualnoj stvarnosti uz konvencionalno liječenje. Obje intervencije trajale su 6 tjedana, s 3 sesije tjedno. Podaci su prikupljeni pomoću Bergove skale ravnoteže, Fugl-Meyerove procjene donjih udova, Viskonsinske skale hoda, testa ustajanja i hoda i testa hodanja na 10 metara na početku, te nakon 3 i 6 tjedana.
Rezultati. Sudionici u eksperimentalnoj skupini pokazali su značajno bolje rezultate u usporedbi s kontrolnom skupinom na svim mjerama istraživanja (P < 0.05). Nadalje, obje skupine su se značajno poboljšale u usporedbi s početnim vrijednostima (P < 0.05).
Zaključci. Integracija motoričke slikovne obuke u rehabilitacijske planove bolesnika s kroničnim moždanim udarom liječenih treningom usmjerenim na zadatke i treningom u virtualnoj stvarnosti značajno poboljšava rezultate pacijenata.
Registar kliničkih ispitivanja: NCT05812638

Ključne riječi: Motorička slika, Moždani udar, Funkcija donjih udova, Exergaming, Hod

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Učinkovitost umjerene do visoke tjelesne aktivnosti među populacijom s predviđenim rizikom od moždanog udara. Pilot studija

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

Sažetak
Pozadina. Sve veća prevalencija moždanog udara, posebno među mlađim populacijama u zemljama poput Indije, zahtijeva učinkovite preventivne strategije. Promjenjivi faktori rizika kao što su hipertenzija, dijabetes i pušenje značajno doprinose incidenciji moždanog udara. Ova studija fokusira se na provedbu 12-tjednog programa umjerene do visoke tjelesne aktivnosti (MVPA) kako bi se adresirali ti faktori rizika i smanjila incidencija moždanog udara.
Metodologija. Studija je uključivala strukturiranu MVPA intervenciju među pojedincima s rizikom od moždanog udara, naglašavajući dosljedno pridržavanje protokolu. Ključni ishodi, uključujući sistolički krvni tlak, natašte razinu glukoze u krvi i ukupne razine kolesterola, bili su nadgledani. Poboljšanja kardiovaskularne kondicije ocijenjena su pomoću Cooperovog trkačkog testa. Studija je također ispitivala izvodljivost i prihvatljivost MVPA intervencije kroz stope pridržavanja sudionika.
Rezultati. MVPA skupina pokazala je značajna smanjenja sistoličkog krvnog tlaka, natašte razine glukoze u krvi i ukupnih razina kolesterola u usporedbi s kontrolnom skupinom. Ti nalazi naglašavaju učinkovitost MVPA u upravljanju glavnim faktorima rizika od moždanog udara. Osim toga, sudionici su pokazali poboljšanu kardiovaskularnu izdržljivost, ističući pozitivan utjecaj programa na opće kardiovaskularno zdravlje. Visoke stope pridržavanja u MVPA skupini ukazale su na izvodljivost provedbe strukturiranih vježbačkih protokola za pojedince s rizikom od moždanog udara.
Zaključak. Ova pilot studija pokazuje učinkovitost 12-tjednog MVPA programa u smanjenju ključnih faktora rizika od moždanog udara i poboljšanju kardiovaskularne kondicije među pojedincima s rizikom od moždanog udara. Nalazi naglašavaju važnost strukturiranih vježbačkih intervencija u naporima prevencije moždanog udara. Iako obećavajući, daljnja istraživanja s većim uzorcima i duljim trajanjima potrebna su za uspostavljanje održivih koristi i izvodljivosti takvih intervencija. Implementacija prilagođenih MVPA programa ima značajan potencjał u ublažavanju rizika od moždanog udara, nudeći vrijedne uvide za globalne strategije prevencije moždanog udara.
moždani udar, MVPA, faktori rizika za moždani udar, tjelesna aktivnost
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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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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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