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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An evaluation of the effectiveness of magnetotherapy as a factor supporting rehabilitation on the basis of selected biomechanic and psychotechnical indices

Mirosław Janiszewski, Anna Błaszczyk

Mirosław Janiszewski, Anna Błaszczyk – An evaluation of the effectiveness of magnetotherapy as a factor supporting rehabilitation on the basis of selected biomechanic and psychotechnical indices. Fizjoterapia Polska 2001; 1(1); 39-42

Abstract
The aim of this study was to examine the impact of longterm magnetic field stimulation on the rehabilitation of post-stroke patients and to determine how quickly these patients gain locomotor efficiency. A group of 180 patients 50-70 years old after stroke received rehabilitation and low frequency magnetic field stimulation. As a criterion for evaluation purposes the authors used selected biomechanical and psychotechnical indices. The study shows that magnetotherapy in post-stroke patients undergoing rehabilitation has a positive effect in the improvement of muscle function, motor coordination indices, and some biomechanical parameters (strength under dynamic and static circumstances).

Key words:
Stroke, magnetic fields, Rehabilitation

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Thermovisual evaluation of vascular behavior in the paretic upper limb after local cryostimulation in stroke patients

Zbigniew Śliwiński, Piotr Plaza

Zbigniew Śliwiński, Piotr Plaza – Thermovisual evaluation of vascular behavior in the paretic upper limb after local cryostimulation in stroke patients. Fizjoterapia Polska 2002; 2(2); 112-117

Abstract
Background. Stroke is the third most common cause of death, one of the most common causes of handicap, and the most common cause of disability among persons older than 40. Each year 4.6 million people around the world die from strokes, including 3.2 million in developing countries and 1.2 million in highly industrialized countries. In view of the high morbidity rate and the serious consequences of stroke, in the form of limb paresis, the authors decided to use a thermovision camera to check vascular reactions in the paretic limb by evaluating temperature changes on the skin subsequent to cryostimulation by liquid nitrogen vapors. Material and methods. Our research involved 28 patients with an average age of 61.3 years. The procedure was performed on the forearm of the paretic upper limb, which was cooled for 6 minutes (from the hand to the elbow cavity, the dorsal surface and the palm surface). Thermovision images were made 5 times for each patient. Results. The authors observed that as a result of the procedure the temperature of the cooled limb went down 12°C, and 2.6°C in the other limb. Conclusions. The results cannot be easily interpreted. In the authors’ opinion, the temperature reduction in the limb that was not cooled results from contralateralization of the consensual reflex. The present study is a preliminary report describing the phenomenon we observed.

Key words:
Stroke, Cryostimulation, thermovision, vascular behavior

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Constraint-induced movement therapy in the rehabilitation of stroke patients

Janusz Otfinowski, Bożena Jasiak-Tyrkalska, Agnieszka Bogunia, Beata Buda

Janusz Otfinowski, Bożena Jasiak-Tyrkalska, Agnieszka Bogunia, Beata Buda – Constraint-induced movement therapy in the rehabilitation of stroke patients. Fizjoterapia Polska 2004; 4(1); 19-24

Abstract

Background. This article presents some preliminary results from the rehabilitation of patients with impaired hand function after stroke. The basis for therapy was the method introduced by Taub, known as Constraint-Induced Movement Therapy (CIMT), which involves the temporary constraint of the healthy upper limb, with simultaneous intensive motor rehabilitation of the dysfunctional limb. Material and methods. Our research involved 10 patients treated in the Rehabilitation Clinic at the Jagiellonian University College of Medicine for post-stroke hemiparesis. There were 5 men and 5 women in this group, ranging in age from 57 to 77 years (ave. 66.5). The time since onset ranged from 1 to 50 months (ave. 11.4 months). CIMT was used in all patients. Results. After 2 weeks of rehabilitation all the patients required less time to perform manual tests, and showed marked functional improvement in the affected hand. Conclusions. The CIMT method is effective in the rehabilitation of patients with post-stroke hemiparesis.

Key words:
Stroke, rehabilitation of the hand, CIMT
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Selected demographic and clinical factors and the efficacy of the Constraint-Induced Movement Therapy (CIMT) of the hand after stroke

Bożena Jasiak-Tyrkalska, Janusz Otfinowski, Beata Buda

Bożena Jasiak-Tyrkalska, Janusz Otfinowski, Beata Buda – Selected demographic and clinical factors and the efficacy of the Constraint-Induced Movement Therapy (CIMT) of the hand after stroke. Fizjoterapia Polska 2007; 7(1); 21-28

Abstract

Background. The authors attempted to evaluate the effect of selected demographic and clinical factors on the efficacy of Constraint-Induced Movement Therapy (CIMT) in improving the mobility of a paretic hand following cerebral stroke. The analysis focussed on factors such as age, gender, side of paresis and time elapsed since stroke. It is commonly known that post-stroke rehabilitation is relatively difficult and poses a challenge not only to the therapeutic team, but also to the patient’s family. Despite activities geared towards improved mobility, satisfactory effects cannot always be achieved. Until recently, physiotherapy was mainly geared towards the compensation of deficits rather than functional restoration. Nowadays, specialised neurological rehabilitation centres introduce novel methods based on the concept of brain adaptability, aimed primarily at functional restoration. The CIMT method is being used more and more frequently. It can be succinctly defined as a strategy for the activation of paretic parts of the body through constraining or totally preventing the use of their healthy counterparts. Material and methods. The study group comprised 21 persons (11 women and 10 men) following cerebral stroke. Mean patient age was 65 years. The efficacy end-point for the rehabilitation approach was time required to carry out 10 basic everyday activities using the affected hand. This assessment was carried out four times: at baseline, after two weeks of intensive exercise in a hospital rehabilitation ward as well as at 4 and 12 weeks of independent practice at home. Results. The therapeutic programme lead to a highly significant (p<0.001) improvement of the performance of the motor function impaired hand. Subgroup analysis did not demonstrate any significant influence of individual factors on the efficacy of the method used to improve hand motor function after cerebral stroke. Conclusions. Regardless of the age and gender of cerebral stroke patients, the CIMT method demonstrated significant efficacy in improving hand motor function. Time elapsed since stroke has no impact on the improvement of the paretic hand using the C1MT method. Regardless of the affected side, the method activates the motor functions of the paretic hand.

Key words:
stroke, improvement of hand mobility, CIMT
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Prognostic efficacy of Berg Balance Test in assessing the risk of fall in patients after stroke

Waldemar Brola, Małgorzata Fudala, Jan Czernicki

Waldemar Brola, Małgorzata Fudala, Jan Czernicki – Prognostic efficacy of Berg Balance Test in assessing the risk of fall in patients after stroke. Fizjoterapia Polska 2009; 9(1); 31-38

Abstract
Background. The risk of fali within the first year after a cerebral stroke amounts to approximately 40%. Numerous attempts have been made to propose a simple, yet sensitive and specific test to facilitate effective identification of patients at a particularly high risk of fall. The present study therefore aimed to assess the risk of fall among post-stroke patients undergoing physical rehabilitation with the Berg Test (Berg Functional Balance Scale). Material and methods. A total of 312 patients treated initially at the Stroke Ward and later at the Department of Physical Rehabilitation and attending the Vascular Disease Outpatient Clinic of the Hospital in Końskie in 2004 were followed up over 12 months. Each patient was assessed during the initial rehabilitation period and then allocated to one of four risk groups depending on his/her score in the Berg Test. Every subsequent fali was recorded together with a brief description of any consequences. Results. 119 patients (35%) fell at least once during the 12-month period, with 36 (11.5%) sustaining serious injuries as a result. The majority of the falls (78 patients) occurred in Berg Group IV (highest risk) patients, who also sustained multiple falls and the most serious consequences. The respective number of incidents in the other groups was 24 falls in Group III, 15 falls in Group II, and only 2 falls in Group I. Conclusions. The Berg Test appears to be a simple, reliable and sensitive instrument for identifying patients most at risk of sustaining an accidental fali. Ensuring particular care for those patients may help them avoid serious consequences of falls and enhance overall rehabilitation outcomes.
Key words:
stroke, falls, risk factors, Berg Balance Scale
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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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