Posts Tagged Exercise
[ARTICLE] Effect of Exercise on Gait Kinematics and Kinetics in Patients with Chronic Ischaemic Stroke – Full Text
It is estimated that one in 5 women and one in 6 men will sustain a stroke up to the age of 75 years  . The main purpose of rehabilitation in such patients is to achieve the maximum possible personal performance, physical and psychological, with the ultimate goal of regaining a level of functional independence that will allow them to be re-integrated into social life as much as possible  . However, stroke patients often adopt a sedentary lifestyle     . This may be attributed to 1) factors associated with patients themselves, such as depression, lack of interest or motivation, decreased perception, decreased confidence, ignorance that exercise is possible and desirability and fear of falls, of a new stroke or other undesirable effects; 2) practical factors, such as lack of support from family or other social actors, inability to access exercise sites, inadequate public transport, health professionals’ ignorance of the availability of physical activity services; 3) financial cost      . Conversely, exercise in groups may improve patient motivation  .
In 2014, the council of the American Heart Association and the American Stroke association (AHA/ASA) revised the exercise recommendations for stroke patients at all stages of their recovery  . Therefore, the aim of this study was to assess the effect of an exercise programme based on these recommendations on gait kinematics and kinetics of ischaemic stroke patients in the chronic phase of recovery.[…]
[Abstract] A Preliminary Study of Dual-Task Training Using Virtual Reality: Influence on Walking and Balance in Chronic Poststroke Survivors
Stroke is a leading cause of death and disability in the Western world, and leads to impaired balance and mobility.
To investigate the feasibility of using a Virtual Reality-based dual task of an upper extremity while treadmill walking, to improve gait and functional balance performance of chronic poststroke survivors.
Twenty-two individuals chronic poststroke participated in the study, and were divided into 2 groups (each group performing an 8-session exercise program): 11 participated in dual-task walking (DTW), and the other 11 participated in single-task treadmill walking (TMW). The study was a randomized controlled trial, with assessors blinded to the participants’ allocated group. Measurements were conducted at pretest, post-test, and follow-up. Outcome measures included: the 10-m walking test (10 mW), Timed Up and Go (TUG), the Functional Reach Test (FRT), the Lateral Reach Test Left/Right (LRT-L/R); the Activities-specific Balance Confidence (ABC) scale, and the Berg Balance Scale(BBS).
Improvements were observed in balance variables: BBS, FRT, LRT-L/R, (P < .01) favoring the DTW group; in gait variables: 10 mW time, also favoring the DTW group (P < .05); and the ABC scale (P < .01). No changes for interaction were observed in the TUG.
The results of this study demonstrate the potential of VR-based DTW to improve walking and balance in people after stroke; thus, it is suggested to combine training sessions that require the performance of multiple tasks at the same time.
[ARTICLE] Effect of Exercise on Gait Mechanics in a Patient with Severe Gait Disorder Due to Chronic Ischaemic Stroke: A Case Study – Full Text
We describe the effects of an exercise programme based on the American Heart Association and American Stroke Association guidelines for stroke patients on gait mechanics in a patient with severe gait disorder due to chronic ischaemic stroke. A 74-year-old female patient, with right hemiparesis as a result of a stroke attack before 18 months followed an 8-week exercise programme, consisting of three hourly sessions per week. Patient’s gait mechanics were evaluated before and after the intervention using a three-dimensional gait analysis system, with six infrared cameras, two force plates, and an electronic timing system. Exercise led to increase of spatial and decrease of temporal gait parameters, increase of joint range of motion and lower limb muscle powers during the entire gait cycle and increase of the moments in the support phase. In conclusion, exercise had a positive effect on this patient’s gait pattern and improved her functionality.
Stroke is the most common cause of serious long-term disability  . Although the rate of neurological recovery is rapid in the first 4 weeks after the stroke  , functionality improvement seems to extend beyond this period, possibly through the development of compensatory strategies against neurological deficits  . However, patients often adopt a sedentary lifestyle that leads to dependence on other people, but also to increased risk of falls and recurrence of stroke  , or other cardiovascular events   . In particular, patients after stroke are significantly less physically active in comparison with the elderly who suffer from chronic musculoskeletal diseases or other cardiovascular diseases     . A sedentary lifestyle exacerbates further their cardiovascular function and the already impaired functional capacity   . Furthermore, it leads to increased fatigue, muscle atrophy and weakness, osteoporosis and impaired circulation in the lower limbs. Finally, the greater dependence of patients with stroke on others for daily activities and their impaired ability for usual social activities can have serious negative psychological effects  .
In 2014, the American Heart Association and American Stroke Association (AHA/ASΑ) published the revised recommendations on exercise in patients with stroke  . Nevertheless, to the best of our knowledge, there is no data concerning the effect of the above exercise programme on patients’ gait pattern. Importantly, gait pattern affects muscle and joint loads during movement and thus on the long-term function of the skeletal system    . We herein describe the effect of an exercise programme based on these recommendations on gait mechanics in a patient with severe gait disorder resulting from an ischaemic stroke in the chronic phase of rehabilitation.
Depression is common among brain injury survivors, with half of all survivors experiencing it in the first year following their injury.
It can also develop as the person starts to understand the full impact of their injury, and can lead to feelings of hopelessness and altered self-esteem and identity as the survivor reflects over the changes that they are facing, and may continue to face in the future.
With expert support from Dr Elizabeth Kent and Dr Cliodhna Carroll, from Kent Clinical Neuropsychology Service, and with feedback from brain injury survivors, we’ve put together some top tips to help cope with depression.
More detailed information can be found on our factsheet Depression after brain injury.
The information provided here is not intended to replace medical advice, so if you are experiencing symptoms of depression always speak to your GP or other healthcare professional.
Try to talk to your family or friends about how you’re feeling and why you may appear to be distant. If you find it difficult to speak about how you feel, try to find other ways of communicating such as writing a letter. Consider talking to your employer about depression if you feel that it’s affecting your work performance.
Try to avoid becoming socially isolated. It’s important to spend at least some time socialising with people on a face-to-face basis. If you struggle in crowds, try to arrange meeting a friend at a quiet location. Alternatively, consider finding a local support or activity group that you can attend, such as a local Headway group or branch.
Engage in activities that you enjoy doing, such as listening to uplifting music, creating art or reading a book. Research indicates that these activities can be useful ways of coping with depression. And don’t be afraid to try something new!
Educate yourself on the effects of brain injury. Understanding your injury may be the first step towards accepting it, which might help with managing depression. The Headway website is a good place to start.
Try to exercise for a few minutes every day. This may be difficult if you experience fatigue or have limited mobility. However, exercise is a proven method of improving low mood. Try to set yourself a routine, for example taking a short walk around the neighbourhood in the morning, or doing some gentle stretches for five minutes every afternoon.
Seek support from other services such as the Headway helpline or your local Headway support group or branch. There are also depression-specific support groups, where people can get peer support from others who are also affected by depression, although these tend to be non-brain injury specific.
Identify and seek help for specific issues in your life that may be causing or contributing to the depression, for example financial or relationship problems.
Speak to your doctor about your general health, including any potential hormonal imbalances that can arise after brain injury.
Make a ‘soothe box’
Consider putting together a ‘soothe box’. This is a box that contains personal items that may make you feel better and help you to cope when you are feeling depressed. You could put things in it such as photos or letters, or things that soothe your senses such as perfumes or soft fabrics.
Use wellbeing techniques
Consider wellbeing techniques such as mindfulness, yoga, meditation or other relaxation methods. Although there is limited research to prove their effectiveness, brain injury survivors often report benefiting from them. Speak to a therapist if you are considering trying any of these, as they may be able to guide you through learning how to effectively use them.
Maintain a healthy lifestyle. This involves enjoying a healthy diet, drinking plenty of water, avoiding alcohol and trying to ensure that you have a good night’s sleep.
Severe depression can cause some people to feel suicidal. This is characterised by extremely negative thoughts about oneself or the future, which can lead to the person thinking about or attempting to end their own life.
It is vital that anyone experiencing suicidal thoughts seeks help – however infrequently the thoughts occur and regardless of whether they intend to act on them.
Please, do not ignore these thoughts in the hope that they will go away.
Be honest and talk to your family or friends about how you’re feeling. Alternatively, you can speak confidentially to your GP.
You can also contact the Headway helpline on 0808 800 2244, or speak to Samaritans on its 24-hour support line 116 123.
If you are having recurring thoughts of suicide, ring NHS 111 or make an emergency appointment with your GP.
Explore the links below to access our resources on the psychological effects of brain injury.
If you would like to discuss this issue in more detail, please contact our national helpline on 0808 800 2244 or email@example.com.
[Abstract] Adaptive Physical Activity for Stroke: An Early-Stage Randomized Controlled Trial in the United States
Background. As stroke survival improves, there is an increasing need for effective, low-cost programs to reduce deconditioning and improve mobility.
Objective. To conduct a phase II trial examining whether the community-based Italian Adaptive Physical Activity exercise program for stroke survivors (APA-Stroke) is safe, effective, and feasible in the United States.
Methods. In this single-blind, randomized controlled trial, 76 stroke survivors with mild to moderate hemiparesis >6 months were randomized to either APA-Stroke (N = 43) or Sittercise (N = 33). APA-Stroke is a progressive group exercise regimen tailored to hemiparesis that includes walking, strength, and balance training. Sittercise, a seated, nonprogressive aerobic upper body general exercise program, served as the control. Both interventions were 1 hour, 3 times weekly, in 5 community locations, supervised by exercise instructors.
Results. A total of 76 participants aged 63.9 ± 1.2 years, mean months poststroke 61.8 ± 9.3, were included. There were no serious adverse events; completion rates were 58% for APA-Stroke, 70% for Sittercise. APA-Stroke participants improved significantly in walking speed. Sample size was inadequate to demonstrate significant between-group differences. Financial and logistical feasibility of the program has been demonstrated. Ongoing APA classes have been offered to >200 participants in county Senior Centers since study completion.
Conclusion. APA-Stroke shows great promise as a low-cost, feasible intervention. It significantly increased walking speed. Safety and feasibility in the US context are demonstrated. A pivotal clinical trial is required to determine whether APA-Stroke should be considered standard of care.
via Adaptive Physical Activity for Stroke: An Early-Stage Randomized Controlled Trial in the United States – Mary Stuart, Alexander W. Dromerick, Richard Macko, Francesco Benvenuti, Brock Beamer, John Sorkin, Sarah Chard, Michael Weinrich, 2019
In this short episode, Dr. Patrick discusses some of the compelling science including observational studies, randomized controlled trials, and human mechanistic studies that suggests exercise is a powerful tool for preventing or managing the symptoms of depression and mental illness. Moreover, she talks about the specific types of exercise and exercise parameters that evidence suggests might be the most helpful for depression.
▶︎ Get the episode’s show notes https://www.foundmyfitness.com/episod…
▶︎ View the new massively in-depth FoundMyFitness depression topic page: https://www.foundmyfitness.com/topics…
▶︎ See the full interview with Dr. Charles Raison https://www.foundmyfitness.com/episod…
▶︎ Get a copy of Dr. Charles Raison’s book “The New Mind-Body Science of Depression” https://www.amazon.com/New-Mind-Body-…
▶︎ Did you enjoy this podcast? It was brought to you by people like you! Visit our crowdsponsor page where you can learn more about how to support the podcast and access a growing number of premium members benefits. https://www.foundmyfitness.com/crowds…
DISCLAIMER: This video is not meant to be a substitute for expert diagnosis or treatment of clinical conditions.
[Abstract] Soymilk ingestion immediately after therapeutic exercise enhances rehabilitation outcomes in chronic stroke patients: A randomized controlled trial. – NeuroRehabilitation
Study investigated the effects of an 8-week rehabilitation exercise program combined with soymilk ingestion immediately after exercise on functional outcomes in chronic stroke patients.
Twenty-two stroke patients were randomly allocated to either the soymilk or the placebo (PLA) group and received identical 8-weeks rehabilitation intervention (3 sessions per week for 120 minutes each session) with corresponding treatment beverages. The physical and functional outcomes were evaluated before, during, and after the intervention. The 8-week rehabilitation program enhanced functional outcomes of participants.
The immediate soymilk ingestion after exercise additionally improved hand grip strength, walking speed over 8 feet, walking performance per unit lean mass, and 6-Minute Walk Test performance compared with PLA after the intervention. However, the improvements in the total score for Short Physical Performance Battery and lean mass did not differ between groups.
This study demonstrated that, compared with rehabilitation alone, the 8-week rehabilitation program combined with immediate soymilk ingestion further improved walking speed, exercise endurance, grip strength, and muscle functionality in chronic stroke patients.
[Abstract] A novel neurocognitive rehabilitation tool in the recovery of hemiplegic hand grip after stroke: a case report.
Stroke has significant physical, psychological and social consequences. Recent rehabilitation approaches suggest that cognitive exercises with dual-task (sensory-motor) exercises positively influence the recovery and function of the hemiplegic hand grip. The purpose of this study was to describe a rehabilitation protocol involving the use of a new neurocognitive tool called “UOVO” for hand grip recovery after stroke. A 58-year-old right-handed male patient in the chronic stage of stroke, presenting with left-sided hemiparesis and marked motor deficits at the level of the left hand and forearm, was treated with the UOVO, a new rehabilitation instrument based on the neurocognitive rehabilitation theory of Perfetti. The patient was evaluated at T0 (before treatment), T1 (after treatment) and T2 (2 months of follow-up). At T2, the patient showed improvements of motor functions, shoulder, elbow and wrist spasticity, motility and performance. This case report explores the possibility of improving traditional rehabilitation through a neurocognitive approach with a dual-task paradigm (including motor and somato-sensory stimulation), specifically one involving the use of an original rehabilitation aid named UOVO, which lends itself very well to exercises proposed through the use of motor imagery. The results were encouraging and showed improvements in hemiplegic hand grip function and recovery. However, further studies, in the form of randomized controlled trials, will be needed to further explore and confirm our results.
[NEWS] New Virtual Reality Therapy game could offer relief for patients with chronic pain, mobility issues
A Virtual Reality Therapy game (iVRT) which could introduce relief for patients suffering from chronic pain and mobility issues has been developed by a team of UK researchers.
Dr Andrew Wilson and colleagues from Birmingham City University built the CRPS app in collaboration with clinical staff at Sandwell and West Birmingham Hospitals NHS Trust for a new way to tackle complex regional pain syndrome and to aid people living with musculoskeletal conditions.
Using a head mounted display and controllers, the team created an immersive and interactive game which mimics the processes used in traditional ‘mirror therapy’ treatment. Within the game, players are consciously and subconsciously encouraged to stretch, move and position the limbs that are affected by their conditions.
Mirror therapy is a medical exercise intervention where a mirror is used to create areflective illusion that encourages patient’s brain to move their limb more freely. This intervention is often used by occupational therapists and physiotherapists to treat CRPS patients who have experienced a stroke. This treatment has proven to be successful exercises are often deemed routine and mundane by patients, which contributes to decline in the completion of therapy.
Work around the CRPS project, which could have major implications for other patient rehabilitation programmes worldwide when fully realised, was presented at the 12th European Conference on Game Based Learning (ECGBL) in France late last year.
Dr Wilson, who leads Birmingham City University’s contribution to a European research study into how virtual reality games can encourage more physical activity, and how movement science in virtual worlds can be used for both rehabilitation and treatment adherence, explained, “The first part of the CRPS project was to examine the feasibility of being able to create a game which reflects the rehabilitation exercises that the clinical teams use on the ground to reduce pain and improve mobility in specific patients.”
“By making the game enjoyable and playable we hope family members will play too and in doing so encourage the patient to continue with their rehabilitation. Our early research has shown that in healthy volunteers both regular and casual gamers enjoyed the game which is promising in terms of our theory surrounding how we may support treatment adherence by exploiting involvement of family and friends in the therapy processes.”
The CRPS project was realized through collaborative working between City Hospital, Birmingham, and staff at the School of Computing and Digital Technology, and was developed following research around the provision of a 3D virtual reality ophthalmoscopy trainer.
Andrea Quadling, Senior Occupational Therapist at Sandwell Hospital, said “The concept of using virtual reality to treat complex pain conditions is exciting, appealing and shows a lot of potential. This software has the potential to be very helpful in offering additional treatment options for people who suffer with CRPS.”