Effects of vestibular rehabilitation on postural stability in anterior circulation stroke patients: A randomized controlled trial

Ahmed Said Abd Elwahed, Wadida Hassan Abd Elkader, Soheir Shehata Rezkallah, Ehab Shaker Belal, Ahmed Ismaeil Abbas

Ahmed Said Abd Elwahed, Wadida Hassan Abd Elkader, Soheir Shehata Rezkallah, Ehab Shaker Belal, Ahmed Ismaeil Abbas – Effects of vestibular rehabilitation on postural stability in anterior circulation stroke patients: A randomized controlled trial. Fizjoterapia Polska 2021; 21(5); 172-181

Abstract
Background. Postural stability after anterior circulation stroke is considered a major cause of falling and functional dependence. Recently, special attention regarding mechanisms about standing balance recovery following stroke has been grown. Evidence supports the effectiveness of vestibular rehabilitation therapy for patients with central vestibular disorders. Objective. A randomized controlled trial was designed to investigate the effects of vestibular rehabilitation on postural stability in anterior circulation stroke patients. Methods. Thirty-six patients (27 males, 9 females) their age range from (44 to 72 years) diagnosed with anterior circulation stroke were enrolled and assigned randomly into two similar groups: experimental group (A) received vestibular rehabilitation therapy in addition to conventional treatment 3 sessions per week for six consecutive weeks, but the conventional group received only conventional treatment. All patients were assessed for postural stability using sensory organization test and berg balance scale and for gait performance using time up and go test at baseline and after 6 weeks at end of the rehabilitation process. Results. Statistical analyses using mixed design MANOVA showed that there was statistical significant difference (p < 0.05) in all outcome variables for both groups in favor to VR group especially in SOT5, SOT6 while there were non-significant differences between groups in SOT1 variable. Conclusion. Vestibular rehabilitation may be a promising approach if it is integrated as standard in the rehabilitation program for improving postural control after anterior circulation stroke affecting parieto insular region.
Key words:
vestibular rehabilitation, postural stability, anterior circulation stroke, parieto insular cortex
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Influence of biofeedback training time on muscle torque and knee excursion following semitendinosus release in spastic quadriplegic children with cerebral palsy: A randomized controlled trial

Heba A. Bahey El- Deen, Radwa S. Abdul-Rahman, Magda Ramadan Zahran, Shaimaa Abdalaleem Abdelgeleel

Heba A. Bahey El- Deen, Radwa S. Abdul-Rahman, Magda Ramadan Zahran, Shaimaa Abdalaleem Abdelgeleel – Influence of biofeedback training time on muscle torque and knee excursion following semitendinosus release in spastic quadriplegic children with cerebral palsy: A randomized controlled trial. Fizjoterapia Polska 2021; 21(5); 166-171

Abstract
Background. Medial hamstring shortening represents a serious common complication in children suffering from spastic quadriplegic cerebral palsy. Objective. The purpose of the study was to examine the efficacy of biofeedback training timing following tendon release in spastic quadriplegic cerebral palsied children. Design. a prospective, single-blind, randomized controlled trial. Setting: several hospitals across Giza and Cairo, where children were operated. Methods. Thirty spastic quadriplegic cerebral palsied children of both genders, with their ages ranged from 7 to 9 years (x ̅  = 8.2 ± 0.86 yr.) were randomly assigned into two equal groups (A and B). The control group (A) was trained using electromyographic biofeedback daily for two weeks after removal of plaster cast, in addition to an hour/ day of a designed physical therapy program, while the study group (B) was trained by electromyographic biofeedback during the immobilization period and for two weeks after removal of the cast along with the same physical therapy program as the group (A). The knee extensors’ peak torque and knee excursion angle were measured immediately and two weeks following cast removal by MERAC isokinetic system and electro-goniometer, respectively. Results. The findings exhibited a significant increase (P < 0.05) in the peak torque of knee extensors and an increase in knee excursion in the group (B) immediately and after two weeks of the cast removal when compared with the results of the group (A) after the same period. Conclusion. Applying electromyographic biofeedback training at the two-week immobilization period resulted in a strengthening of the quadriceps and maintaining the obtained range of knee extension following semitendinosus muscle release in spastic quadriplegic children with cerebral palsy.
Key words:
cerebral palsy, spastic quadriplegia, biofeedback, dynamometer
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