Posts Tagged LE

[WEB SITE] Cycling in Bed During ICU Stay May Assist Recovery – Rehab Managment

A mechanically ventilated patient in the ICU uses the RT-300 supine bicycle to strengthen his legs while Dr Michelle Kho looks on. (Photo courtesy of Marta Hewson/Photography)

A mechanically ventilated patient in the ICU uses the RT-300 supine bicycle to strengthen his legs while Dr Michelle Kho looks on. (Photo courtesy of Marta Hewson/Photography)

Critically ill, mechanically ventilated patients in the intensive care unit may safely begin in-bed cycling sessions with their therapists early on in their ICU stay, and may recover more quickly, a recent study suggests.

“People may think that ICU patients are too sick for physical activity, but we know that if patients start in-bed cycling 2 weeks into their ICU stay, they will walk farther at hospital discharge,” says Michelle Kho, an assistant professor with the School of Rehabilitation Science at McMaster University and physiotherapist at St. Joseph’s Healthcare Hamilton, in a media release from McMaster University.

Kho lead author of the TryCYCLE study, published recently in PLOS ONE, adds that, “Our TryCYCLE study finds it is safe and feasible to systematically start in-bed cycling within the first 4 days of mechanical ventilation and continue throughout a patient’s ICU stay.”

The 1-year study, conducted by Kho and her colleages, included 33 patients admitted to the ICU at St Joseph’s Healthcare Hamilton. They all were 18 years of age or older, received mechanical ventilation, and walked independently prior to receiving care.

All patients underwent 30 minutes of supine cycling using a motorized stationary bicycle affixed to the bed, 6 days a week. The special in-bed cycling equipment was provided by the St. Joseph’s Healthcare Foundation, per the release.

The patients started cycling within the first 3 days of ICU admission and cycled about 9 km on average during their ICU stay.

“Patients’ abilities to cycle during critical illness exceeded our expectations,” Kho states in the release.

Kho adds in the release that more research is needed to determine if this early cycling with critically ill patients improves their physical function. The next step could be to have several hospital ICUs start the in-bed cycling study in a pilot randomized trial.

[Source(s): McMaster University, EurekAlert]

Source: Cycling in Bed During ICU Stay May Assist Recovery – Rehab Managment

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[VIDEO] Where to place electrodes – dorsiflexion with eversion – YouTube

Δημοσιεύτηκε στις 7 Νοε 2016

These following videos show electrode positions to produce:
1. Dorsiflexion with eversion
2. Dorsiflexion with less eversion
3. Balance of 1 and 2
4. Dorsiflexion with least eversion
For more information, see our website:
http://www.odstockmedical.com/knowled…

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[Systematic Review] Effectiveness of Mirror Therapy for Lower Extremity Post-Stroke – Full Text

Summary

Background/Objective

This study reviewed the current evidence on the effectiveness of mirror therapy (MT) on improving the motor functions of the hemiplegic lower extremity (LE) in adult clients with stroke.

Methods

A systematic review was conducted of studies published in English in the 10-year period 2005–2015, retrieved from seven electronic databases: Medline, PubMed, CINAHL, PsychInfo, Science Direct, Cochrane and TBI Rehabilitation. Only articles that focused on the effects of MT on hemiparesis affecting LE function and performance were included. The methodological quality of the studies was appraised using the Physiotherapy Evidence Database Scale (PEDro).

Results

The literature search yielded 14 studies that satisfied the selection criteria, of which five (4 randomised controlled trials and 1 case study) were reviewed after screening. Despite the heterogeneity of the studies, they showed MT to be effective in improving some of the motor functions of the LE at different stages of stroke. However, they offered little evidence on MT’s long-term effects and for when is the optimal stage to start MT after stroke onset.

Conclusion

Further research is needed to determine the best treatment regimen and optimal time to initiate MT intervention in terms of the phases of stroke. No firm conclusions can be drawn on the effectiveness of MT on the hemiplegic LE until more evidence is available.

Continue —>  Systematic Review: Effectiveness of Mirror Therapy for Lower Extremity Post-Stroke

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[Systematic Review] A Decade of Progress Using Virtual Reality for Poststroke Lower Extremity Rehabilitation: Systematic Review of the Intervention Methods – Full Text PDF

Objective. To develop a systematic review of the literature, to describe the different virtual reality (VR) interventions and interactive videogames applied to the lower extremity (LE) of stroke patients, and to analyse the results according to the most frequently used outcome measures.

Material and Methods. An electronic search of randomized trials between January 2004 and January 2014 in different databases (Medline, Cinahl, Web of Science, PEDro, and Cochrane) was carried out. Several terms (virtual reality, feedback, stroke, hemiplegia, brain injury, cerebrovascular accident, lower limb, leg, and gait) were combined, and finally 11 articles were included according to the established inclusion and exclusion criteria.

Results.The reviewed trials showed a high heterogeneity in terms of study design and assessment tools, which makes it difficult to compare and analyze the different types of interventions. However, most of them found a significant improvement on gait speed, balance and motor function, due to VR intervention.

Conclusions. Although evidence is limited, it suggests that VR intervention (more than 10 sessions) in stroke patients may have a positive impact on balance, and gait recovery. Better results were obtained when a multimodal approach, combining VR and
conventional physiotherapy, was used. Flexible software seems to adapt better to patients’ requirements, allowing more specific and individual treatments.

Full Text PDF

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[ARTICLE] Therapeutic Effects of Functional Electrical Stimulation on Gait in Individuals Post-Stroke

Abstract

Functional electrical stimulation (FES) to lower extremity (LE) muscles is used by individuals post-stroke as an alternative to mechanical orthotic devices during gait or as a training modality during rehabilitation. Technological developments which improve the feasibility, accessibility and effectiveness of FES systems as orthotic and training devices, highlight the potential of FES for rehabilitating LE function in individuals post-stroke. This study presents a systematic review of the carryover effects of LE FES to motor performance when stimulation is not applied (therapeutic effects) in subjects post-stroke. A description of advances in FES technologies, with an emphasis on systems designed to promote LE function is included, and mechanisms that may be associated with the observed therapeutic effects are discussed. Eligible studies were reviewed for methodological quality, population, intervention and outcome characteristics. Therapeutic effects of FES were consistently demonstrated at the body function and activity levels when it was used as a training modality. Compared to matched treatments that did not incorporate FES, no definite conclusions can be drawn regarding the superiority of FES. When FES was used as an alternative to an orthotic device, it had no superior therapeutic effects at the activity level, yet patients still seemed to prefer it.

via Therapeutic Effects of Functional Electrical Stimulation on Gait in Individuals Post-Stroke – Online First – Springer.

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[ARTICLE] Therapeutic Effects of Functional Electrical Stimulation on Gait in Individuals Post-Stroke

Abstract

Functional electrical stimulation (FES) to lower extremity (LE) muscles is used by individuals post-stroke as an alternative to mechanical orthotic devices during gait or as a training modality during rehabilitation. Technological developments which improve the feasibility, accessibility and effectiveness of FES systems as orthotic and training devices, highlight the potential of FES for rehabilitating LE function in individuals post-stroke. This study presents a systematic review of the carryover effects of LE FES to motor performance when stimulation is not applied (therapeutic effects) in subjects post-stroke. A description of advances in FES technologies, with an emphasis on systems designed to promote LE function is included, and mechanisms that may be associated with the observed therapeutic effects are discussed. Eligible studies were reviewed for methodological quality, population, intervention and outcome characteristics. Therapeutic effects of FES were consistently demonstrated at the body function and activity levels when it was used as a training modality. Compared to matched treatments that did not incorporate FES, no definite conclusions can be drawn regarding the superiority of FES. When FES was used as an alternative to an orthotic device, it had no superior therapeutic effects at the activity level, yet patients still seemed to prefer it.

http://link.springer.com/article/10.1007/s10439-014-1148-8

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