The effect of early rehabilitation on locomotor function in post-stroke patients – preliminary report

Emil Domański, Magdalena Wilk, Wojciech Kiebzak, Zbigniew Śliwiński

Emil Domański, Magdalena Wilk, Wojciech Kiebzak, Zbigniew Śliwiński – The effect of early rehabilitation on locomotor function in post-stroke patients – preliminary report. Fizjoterapia Polska 2008; 8(1); 83-95

Abstract
Background. Cerebral stroke is defined by the WHO as sudden onset of rapidly developing clinical signs of focal disturbance of cerebral function, with symptoms lasting longer then 24h, or leading to death, caused by changes in the arterial or vascular system of the brain. The aim of this study was to assess the effect to early rehabilitation on the locomotor function in stroke patients. Material and method. A group of 30 patients with hemiparesis within 24h after the onset of stroke and after 14 days of rehabilitation. The locomotor assessment was carried out according to the PNF functional status of muscles and gait patterns. Activities of daily living were evaluated according to the Repty Functional Index (RFI) and the Simple Chart of Locomotor Activities (PKCM). The level of disability was graded to the Rankin scale. For logistic reasons, the study did not include a control group, so that the paper is treated as a preliminary report.Results. Locomotor improvement was achieved in 40% of patients, with reduction in disability in 50%. Improved locomotor function led to urinary function improvement in 50% of patients. Motor dysfunction of the upper limb was reduced thanks to physiotherapy in 40% of patients. Conclusions. Early rehabilitation leads to improved function as defined by the functional status of muscles and hait patterns. The adopted rehabilitation programme resulted in improved functional indepedence evaluated on the basis of the Repty Functional Index (WFR) and Simple Chart of Activities (PKCM). The locomotor improvement resulted in urinary improvement in 50% of patients. Early rehabilitation improved the locomotor function of the paretic upper limb. The conclusions need to be verified in further studies with control groups.
Key words:
cerebral stroke, hemiparesis, early rehabilitation, functional status
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Thermovisual evaluation of temperatures of the upper limbs following cryostimulation in post-stroke patients

Zbigniew Śliwiński, Piotr Płaza, Krzysztof Gieremek, Wojciech Kufel, Beata Michalak, Bartłomiej Halat, Grzegorz Śliwiński, Magdalena Wilk

Zbigniew Śliwiński, Piotr Płaza, Krzysztof Gieremek, Wojciech Kufel, Beata Michalak, Bartłomiej Halat, Grzegorz Śliwiński, Magdalena Wilk – Thermovisual evaluation of temperatures of the upper limbs following cryostimulation in post-stroke patients. Fizjoterapia Polska 2008; 8(1); 23-34

Abstract
Background. Cerebral stroke is a very serious life-threatening condition regardiess of the clinical picture at the onset. In most cases cerebral stroke is a consequence of systemic vascular diseases such as atherosclerosis or hypertension. Material and methods. The study group comprised 103 patients, including 52 post-stroke patients with a paretic upper limb and 51 healthy participants. The group of stroke patients included 18 women and 34 men, while the healthy group consisted of 41 women and 10 men. The mean age of the male patients was 55.6 and of the female patients 66.1 years. The mean age of the control group was 37.2 years. Local cryostimulation was applied to the hand and forearm of the paretic limb in the stroke patients and to the hand the forearm of the right upper limb in the healthy group. The limb was exposed to cold for 6 minutes. The temperatures were measured using an Agema 570 thermovision camera.Results. Subjecting only one forearm to cryotherapy procedures results in a decrease in temperature. In the post-stroke patients the return to the basseline value after the procedure was more rapid. This is possibly connected with more efficient mechanisms protecting the body against loss of warmth, since in this group temperature values were higher. In the control group the temperature in the non-cooled limb decreases by an average of 1.6 st.C, compared to only 1.3 st.C in the stroke patients. Conclusions. The temperatures of an area in the forearm exposed to 6 minutes of cryotherapy were different in the post-stroke patients and in the healthy controls. This is probably attributable to stroke-related brain damage. Contralateralization, i. e. the decline of temperature in the non-cooled limb, occurred both in the post-stroke patients and in the healthy controls. Temperature decreases produced by the exposure of limbs to cold were higher in the stroke patients than in the healthy participants. The temperature returned to baseline more rapidly in the post-stroke patients. The temperature in the cooled limb dod not return to, or exceed, baseline value fifteen minutes after the procedure.
Key words:
cerebral stroke, cryostimulation, thermovision, vascular play
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Usefulness of Kinesiology Taping in post-stroke patients rehabilitated with the PNF method. Preliminary report

Zbigniew Śliwiński, Marta Kopa, Bartłomiej Halat, Beata Michalak, Wojciech Kufel, Henryk Racheniuk, Magdalena Wilk, Marcin Krajczy, Jan Szczegielniak

Zbigniew Śliwiński, Marta Kopa, Bartłomiej Halat, Beata Michalak, Wojciech Kufel, Henryk Racheniuk, Magdalena Wilk, Marcin Krajczy, Jan Szczegielniak – Usefulness of Kinesiology Taping in post-stroke patients rehabilitated with the PNF method. Preliminary report. Fizjoterapia Polska 2008; 8(3); 325-334

Abstract
Background. Physiotherapy employs a number of kinesiotherapeutic methods based on understanding the course of the development- and movement-related neurophysiological processes, with PNF being one of the methods. Rehabilitation of stroke patients produces better results if different methods are combined, e. g. PNF and KT. Material and methods. The study involved 15 post-stroke patients, including 10 men and 5 women, aged 39-72. Each subject was examined once. Two muscle tone tests according to the Ashworth scale and three functional tests of the paralyzed upper extremity (prior to the therapy, on completion of PNF therapy and following functional KT application) were performed. The upper extremity function test consisted in the subject picking up an object. The distance [cm] between the object and the table surface was measured. Each patient underwent a 45-60 minute rehabilitation session using the PNF method. Additionally, KT was applied onto the radiocarpal joint extensor muscles.Results. Muscle tone according to the Ashworth scale did not change. The mean functional test results [cm] were as follows: 3.8 prior to the therapy, 6.6 post-PNF, and 7.8 post-KT. In two subjects the functional test results did not change, whereas the upper extremity function in the remaining 13 subjects improved after PNF therapy. A marked improvement was observed following the application of KT. In 10 patients, the additional KT application considerably facilitated PNF-based rehabilitation. Conclusions. A combined PNF and KT therapy contributes to improvement of function in the paralyzed extremity. Functional KT application proved to be useful and to facilitate PNF rehabilitation, and so the two modalities may and even should be combined. Although the patients were only subjected to a single PNF session, the function of the upper extremity improved. An even more marked improvement was observed following the functional application of KT. Muscle tone according to the Ashworth scale did not change significantly on completion of the therapy. However, it did not have a decisive influence on the positive results of the functional tests. We did not observe a correlation between the combined PNF and KT therapy and the duration of the post-stroke period was.
Key words:
Kinesiology Taping applications, PNF method, cerebral stroke
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Assessment of gait patiem following Kinesiology Taping application in patients after cerebral stroke

Beata Michalak, Bartłomiej Halat, Wojciech Kufel, Marta Kopa, Jacek Łuniewski, Katarzyna Bogacz, Magdalena Wilk, Marcin Krajczy, Anna Lipińska, Jan Szczegielniak, Zbigniew Śliwiński

Beata Michalak, Bartłomiej Halat, Wojciech Kufel, Marta Kopa, Jacek Łuniewski, Katarzyna Bogacz, Magdalena Wilk, Marcin Krajczy, Anna Lipińska, Jan Szczegielniak, Zbigniew Śliwiński – Assessment of gait patiem following Kinesiology Taping application in patients after cerebral stroke. Fizjoterapia Polska 2009; 9(2); 133-142

Abstract
Background. The authors present an assessment of gait pattern in stroke patients subjected to comprehensive physiotherapy inclu-ding Kinesiology Taping applications. Material and methods. The KT group included 20 patients (13 men and 7 women) who were subjected to Kinesiology Taping. KT applications were not used in the control group, which consisted of 5 women and 15 men. Ali patients underwent physical, neurological and functional examinations, which constituted the basis for designing a rehabilitation program. Results. The analysis of the results indicates that functional KT application to the anterior tibial muscie, ligamentous KT application to the Achilles tendon and muscular KT application to the soleus muscie significantly contributed to improving ankle joint function. Patients treated with KT applications demonstrated improved gait patterns, visible as balanced step length and an extended support phase main-taining the body weight. When learning and analyzing the gait pattern, the midstance phase (fuli loading) is a significant element prece-ding the propulsion phase. This assessment of gait patterns following KT application in stroke patient is an innovative study. Conclusions. Muscular and ligamentous Kinesiology Taping applications reduce the spastic tension of the lower limb muscles para-lyzed as a result of cerebral stroke, The beneficial effect of Kinesiology Taping described by the founders ofthis method reduces the congestive edema of the limbs paralyzed as a result of a cerebral stroke and improve the gait pattern. The rehabilitation program applied in this study increased the gait speed of the stroke patients.
Key words:
Kinesiology Taping, muscular applications, ligamentous applications, corrective applications, cerebral stroke
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PNF method of gait analysis in patients after ischemic stroke

Piotr Lutowski, Łukasz Sielski, Katarzyna Lutowska

Piotr Lutowski, Łukasz Sielski, Katarzyna Lutowska – PNF method of gait analysis in patients after ischemic stroke. Fizjoterapia Polska 2011; 11(2); 143-154

Abstract
Cerebral stroke is one of the most common diseases of the nervous system. Paresis or hemiparesis are the main consequences of this diseases. For patients and their carers, such disorders are burdensome as they affect multiple aspects of everyday life. The study was a research project aimed at determining the effect of gait reeducation using PNF approach in patients with the history of ischemic cerebral stroke.he sample comprised 23 patients with the history of ischemic cerebral stroke, admitted to the rehabilitation unit. The patients were qualified for the study based on Berg Balance Scale, informed consent and the value of weight bearing symmetry index for the lower limbs.The study consisted of:• tandem balance test used to calculate weight bearing symmetry index for the lower limbs,• walk test at a distance of 20 m. to determine gait velocity and step length,• Subjective assessment of individual gait phases based on observation,• Berg Balance Scale.Improvement in all the studied parameters was noted in the studied sample.Proprioceptive Neuromuscular Facilitatiobn (PNF) is an effective method of rehabilitation for patients with the history of ischemic cerebral stroke. It contributes to improvement in the qualitative and quantitative parameters of gait.
Key words:
cerebral stroke, Rehabilitation, PNF method, Gait
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Ocena efektów plastrowania dynamicznego (PD) z wykorzystaniem inteligentnego robota neurologicznego Fourier M2 u chorych po udarze mózgu z niedowładem połowiczym

Marcin Krajczy, Edyta Krajczy, Ewa Gajda-Krajczy, Bartosz Frydrych, Katarzyna Bogacz, Jacek Łuniewski, Jan Szczegielniak

M. Krajczy, E. Krajczy, E. Gajda-Krajczy, B. Frydrych, K. Bogacz, J. Łuniewski, J. Szczegielniak – Evaluation of effects of kinesiotaping with use of the intelligent fourier M2 neurological robot in patients with hemiparesis; Fizjoterapia Polska 2018; 18(1); 32-48

Streszczenie

Cel. Celem badania jest ocena efektów plastrowania dynamicznego (PD) z wykorzystaniem inteligentnego robota neurologicznego Fourier M2 u chorych po udarze mózgu z niedowładem połowiczym.
Materiał i metody. W badaniu udział wzięło 28 pacjentów (10 kobiet i 17 mężczyzn, średnia: 63,48 lat) po udarze mózgu niedokrwiennym z niedowładem połowiczym (14 lewostronnych, 13 prawostronnych), którzy wyrazili świadoma zgodę na udział w badaniu. Pacjentów podzielono przy pomocy komputerowego programu ALEA, z własnym algorytmem randomizującym, na grupę BA – 14 oraz KO – 14 osób. W celu przeprowadzenia badania wykorzystano inteligentnego robota rehabilitacyjnego Fourier M2, służącego do diagnostyki i terapii kończyny górnej.
Wyniki i wnioski. W badaniu wykazano istotne statystycznie efekty w 1, 3, 4 dobie badania pod postacią procentowej poprawy aktywnego ruchu w grupie BA jako efekt działania aplikacji plastrowania dynamicznego.
W ocenie pozostałych wyników badania, wykazano efekty zarówno plastrowania dynamicznego jak i terapii z udziałem robota neurologicznego, u chorych po udarze mózgu z niedowładem połowiczym. W ocenie tych wyników efekty terapii były porównywalne w obu grupach.
Inteligentny robot Forier M2 jest przydatnym i obiektywnym urządzeniem do diagnostyki, terapii oraz oceny efektów fizjoterapii u chorych po udarze mózgu z dysfunkcją kończyny górnej.

Słowa kluczowe:
plastrowanie dynamiczne, robot neurologiczny, fourier M2, udar mózgu, niedowład połowiczy

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Zastosowanie terapii wymuszeniem ruchu u pacjentów po udarze mózgu

Beata Tyszkiewicz, Agnieszka Drozd, Rita Hansdorfer-Korzon, Maja Nowacka-Kłos

B. Tyszkiewicz, A. Drozd, R. Hansdorfer-Korzon, M. Nowacka-Kłos – The Application of Constraint-Induced Movement Therapy in Patients after Stroke. FP 2017; 17(1); 104-115

Streszczenie
Co roku, około 10,5 mln osób na świecie doświadcza pierwszego udaru mózgu, czego częstym skutkiem jest niepełnosprawność fizyczna. Około 70-80% doznaje, w różnym stopniu, zaburzenia funkcji kończyny górnej, co znacznie pogarsza codzienne funkcjonowanie. W ostatnich latach rozwijano wiele różnych sposobów usprawniania po udarze, zwłaszcza tych, które wpływają na plastyczność mózgu. Należy do nich m.in. terapia wymuszeniem ruchu (CIMT, Constraint-Induced Movement Therapy), która bazuje na aktywnym udziale pacjenta. Podczas intensywnych treningów niedowładnej kończyny, druga, mniej zajęta kończyna, jest unieruchamiana. Wszystkie komponenty CIMT wspomagają zjawisko plastyczności mózgu. Przeprowadzono wiele badań, w których udowodniono, że terapia CIMT (oraz jej modyfikacja mCIMT) uważana jest za jedną z najbardziej efektywnych form kinezyterapii poprawiającą funkcję niedowładnej kończyny górnej po udarze. Terapia CIMT jest przeznaczona głównie dla pacjentów z łagodnym i umiarkowanym niedowładem kończyny górnej, stosowana jest zwykle w okresie przewlekłym po udarze mózgu.

Słowa kluczowe:
udar mózgu, niedowład kończyny górnej, plastyczność mózgu, terapia wymuszeniem ruchu (CIMT)

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