Posts Tagged REHABILITATION

[ARTICLE] FarMyo: A Serious Game for Hand and Wrist Rehabilitation Using a Low-Cost Electromyography Device – Full Text PDF

Abstract

One of the strategies used in recent years to increase the commitment and motivation of patients undergoing rehabilitation is the use of graphical systems, such as virtual environments and serious games. In addition to contributing to the motivation, these systems can simulate real life activities and provide means to measure and assess user performance. The use of natural interaction devices, originally conceived for the game market, has allowed the development of low cost and minimally invasive rehabilitation systems. With the advent of natural interaction devices based on electromyography, the user’s electromyographic data can also be used to build these systems. This paper shows the development of a serious game focused on aiding the rehabilitation process of patients with hand motor problems, targeting to solve problems related to cost, adaptability and patient motivation in this type of application. The game uses an electromyography device to recognize the gestures being performed by the user. A gesture recognition system was developed to detect new gestures, complementing the device’s own recognition system, which is responsible for interpreting the signals. An initial evaluation of the game was conducted with professional physiotherapists.

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via FarMyo: A Serious Game for Hand and Wrist Rehabilitation Using a Low-Cost Electromyography Device | International Journal of Serious Games

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[ARTICLE] Virtual reality in the rehabilitation of patients with stroke: an integrative review – Full Text

ABSTRACT

Objective: To describe the intervention protocols to using commercial video games as virtual reality (VR) in rehabilitation of patients with stroke.

Methods: Integrative review using the descriptors “rehabilitation”, “virtual reality exposure therapy” and “videogames” in the LILACS and PUBMED databases. Articles published from 2011 to 2018 were selected.

Results: We found 1,396 articles, 1,383 were excluded and 13 were selected. Most of the articles were randomized clinical trials published in 2014 or later. The sample size varied from 5–47 adults, or adults and elders, with chronic stroke. The Nintendo Wii® was the most used video game system. The intervention happened two or three times a week, each session lasting from 30 to 60 minutes, over 2–12 weeks. Balance, upper limb motor functions, quality of life and daily living activities were the most common evaluated outcomes. The Fugl-Meyer Assessment, Berg Balance Scale, Timed Up and Go test, Barthel Scale and SF-36 were the most common outcome measurement tools.

Conclusions: The studies indicated improvement in dynamic balance, upper limb motor function and quality of life after rehabilitation using VR. The VR was more effective than conventional treatments for the outcome of dynamic balance. Two studies did not find any changes in static balance and daily living activities. Physical aspects and quality of life were the outcomes most evaluated by the researchers; as were the population with chronic strokes and protocols of long duration and low intensity. Few studies targeted immediate VR effects, performance in daily living activities and social participation.

 

Rehabilitation of a patient is a process that involves the knowledge of the professional regarding the health condition and the repercussion it has on the life of the individual, as well as a broad scientific knowledge about the functioning of the human body, so that consistent decisions may be made1. In this process, assessing the situation, planning and choosing the best available evidences to perform clinical tasks is paramount to systematize decisions and optimize results2.

Many rehabilitation techniques described in the literature may help guide the intervention of professionals, such as physical training, kinesitherapy, robotic therapy, hydrotherapy, music therapy, intracortical stimulation and mental health practices, task-oriented training, mirror therapy, among others36. Virtual reality (VR) is a therapeutic approach that has been used in the field of rehabilitation in recent years. In this approach, users interact with virtual objects through the movements of their hands and body, or through tactile interfaces (gloves, joysticks, mouse), performing actions in a simulated environment7. The invention of low-cost human movement sensors in commercial game systems has made it easier to use video games for rehabilitation8. Examples of these systems include the Kinect for Microsoft’s Xbox®, the Nintendo Wii® and the PlayStationMove® by Sony.

The use of VR has increased the potential for motor learning and neuroplasticity during rehabilitation. A study using magnetic resonance imaging found consistent results, showing a reorganization of the sensorimotor cortex9. Functional improvements have also been associated with the use of VR by rehabilitation professionals. Allain et al.10 pointed out that performing a task in a virtual kitchen anticipated carrying out the task in real life. The virtual practice of shopping for groceries is associated with an improvement in the performance of actual grocery shopping11, and patients who interact with the virtual world have fewer limitations when performing daily activities12.

When VR has been applied in the rehabilitation of patients after strokes, it has mainly been used to help in the functional recovery of upper limbs, cognitive function, posture control and balance13,14. Deficiencies in the upper limb after strokes may negatively impact the daily life of patients, by limiting their ability to carry out essential tasks that are necessary for an independent life15. The VR offers a rich environment in which patients may, after a stroke, solve problems and develop new abilities16. Considering the above, this study aimed to review and analyze information from the literature on the main intervention protocols delineated by rehabilitation professionals, using VR in commercial video game systems for the treatment of patients who had suffered strokes, while also identifying the most common outcomes found by these professionals.[…]

Continue —>  Virtual reality in the rehabilitation of patients with stroke: an integrative review

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[ARTICLE] Long-Dose Intensive Therapy Is Necessary for Strong, Clinically Significant, Upper Limb Functional Gains and Retained Gains in Severe/Moderate Chronic Stroke – Full Text

Background. Effective treatment methods are needed for moderate/severely impairment chronic stroke.

Objective. The questions were the following: (1) Is there need for long-dose therapy or is there a mid-treatment plateau? (2) Are the observed gains from the prior-studied protocol retained after treatment?

Methods. Single-blind, stratified/randomized design, with 3 applied technology treatment groups, combined with motor learning, for long-duration treatment (300 hours of treatment). Measures were Arm Motor Ability Test time and coordination-function (AMAT-T, AMAT-F, respectively), acquired pre-/posttreatment and 3-month follow-up (3moF/U); Fugl-Meyer (FM), acquired similarly with addition of mid-treatment.

Findings. There was no group difference in treatment response (P ≥ .16), therefore data were combined for remaining analyses (n = 31; except for FM pre/mid/post, n = 36). Pre-to-Mid-treatment and Mid-to-Posttreatment gains of FM were statistically and clinically significant (P < .0001; 4.7 points and P < .001; 5.1 points, respectively), indicating no plateau at 150 hours and benefit of second half of treatment. From baseline to 3moF/U: (1) FM gains were twice the clinically significant benchmark, (2) AMAT-F gains were greater than clinically significant benchmark, and (3) there was statistically significant improvement in FM (P < .0001); AMAT-F (P < .0001); AMAT-T (P < .0001). These gains indicate retained clinically and statistically significant gains at 3moFU. From posttreatment to 3moF/U, gains on FM were maintained. There were statistically significant gains in AMAT-F (P = .0379) and AMAT-T P = .003.

Many stroke survivors do not fully recover upper limb function following stroke, leading to significant disability and diminished quality of life.1 Effective treatments are needed for chronic, severely impaired stroke survivors.2 Other studies showed improved upper limb motor function in chronic stroke for mild/moderately impaired,313 with traditional “constraint induced” treatment studies enrolling only those with preserved wrist and finger extension (acceptance rate, 10%).14 However, for those with moderate/severe impairment after stroke, improvement in function has been more difficult to realize. A recent study of constraint-induced movement therapy in more severe stroke reported no clinically significant change in upper limb Fugl-Meyer assessment scores.15 Others have also tested the application of technologies and devices, in moderately/severely impaired chronic stroke survivors, with the following: functional electrical stimulation (FES),1618 sequenced bilateral and unilateral task orientated training,19 mirror therapy,20 progressive abduction loading therapy,21 contralaterally controlled FES,22 and robotics.2327 Limitations included small sample size,1618,2223 lacking control group,16,23 lacking statistically significant gains on impairment or functional measures,23 lacking clinically significant change,20,21,2325,27 lacking retention of clinically significant gains,16,19,25,26 or lacking study of retention.20,23 Furthermore, many studies do not include both a measure of impairment and an array of actual everyday functional tasks. Our work has focused on moderately/severely impaired chronic stroke survivors, and in prior work we developed and tested a protocol that combines technology applications and motor learning.28,29 We found clinically and statistically significant gains for those with moderate/severe stroke considerably beyond that reported by others (eg, gains in coordination, Fugl-Myer coordination scale [FM], and gains on the Arm Motor Ability Test [AMAT; 13 complex functional tasks]).

Others have cited this work stating that “a change in impairment of this magnitude was previously considered almost impossible in chronic stroke patients,”30 and that this is important first evidence for use of high dose neurorehabilitation.31 Therefore, we considered it important to replicate the administration of the upper limb motor learning protocol in a follow-on study and again quantify response. Another consideration was that we had not given technology a full chance in application to the “whole arm,” that is, both distal and proximal upper limb regions. Therefore, a first purpose was to replicate administration of the upper limb motor learning protocol and to include a treatment group that would receive technology applications to both distal and proximal limb regions. In addition, there were 2 important and unanswered questions regarding the dose and efficacy of this new treatment protocol.

The first question is whether a shorter treatment duration (ie, <300 hours) could produce the same degree of recovery, given that the existing protocol was tested in the paradigm of long-duration dose of 300 hours of therapy. Therefore, in the current work, we administered the same protocol as in prior work,28 and acquired mid-treatment (at 150 hours of treatment) data on the Fugl-Meyer impairment measure, which underlies complex functional task performance. We studied whether a mid-treatment plateau occurred or whether significant recovery occurred in response to the second half of treatment (mid-treatment to posttreatment).

The second question is whether the observed gains can be retained after cessation of treatment. Therefore, we studied retention of gains at 3 months after treatment ended.[…]

 

Continue —> Long-Dose Intensive Therapy Is Necessary for Strong, Clinically Significant, Upper Limb Functional Gains and Retained Gains in Severe/Moderate Chronic Stroke – Janis J. Daly, Jessica P. McCabe, John Holcomb, Michelle Monkiewicz, Jennifer Gansen, Svetlana Pundik, 2019

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[Abstract] Towards strengthening rehabilitation in health systems: Methods used to develop a WHO Package of Rehabilitation Interventions

Abstract

Achieving universal health coverage (UHC) is a World Health Organization (WHO) strategic priority. UHC means “all people receive quality health services that meet their needs without being exposed to financial hardship in paying for the services”. Rehabilitation is among the services included in UHC. As part of the WHO Rehabilitation 2030 call for action, WHO is developing its Package of Rehabilitation Interventions (PRI) to support ministries of health in planning, budgeting and integrating rehabilitation interventions into health systems. The aim of this paper is to introduce and describe the PRI and its methodology.

An advisory board composed of members from different WHO departments is overseeing the project, which is led by the WHO Rehabilitation Programme in collaboration with Cochrane Rehabilitation.

The development of the PRI is conducted in six steps: (1) Selection of health conditions (for which rehabilitation interventions will be included in the PRI) based on prevalences, related levels of disability and expert opinion; (2) identification of rehabilitation interventions and related evidence for the selected health conditions from clinical practice guidelines and Cochrane Reviews; (3) expert agreement on the inclusion of rehabilitation interventions in the PRI; (4) description of resources required for the provision of selected interventions; (5) peer review process, and (6) production of an open source web-based tool. Rehabilitation experts and consumers from all world regions will collaborate in the different steps.

In developing the PRI, WHO is taking an important step towards strengthening rehabilitation in health systems and thus, enabling more people to benefit from rehabilitation.

via Towards strengthening rehabilitation in health systems: Methods used to develop a WHO Package of Rehabilitation Interventions – Archives of Physical Medicine and Rehabilitation

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[Abstract] A novel neurocognitive rehabilitation tool in the recovery of hemiplegic hand grip after stroke: a case report.

Abstract

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.

 

via A novel neurocognitive rehabilitation tool in the recovery of hemiplegic hand grip after stroke: a case report. – PubMed – NCBI

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[ARTICLE] Home-based virtual reality training after discharge from hospital-based stroke rehabilitation: a parallel randomized feasibility trial – Full Text

Abstract

Background

Virtual reality training (VRT) uses computer software to track a user’s movements and allow him or her to interact with a game presented on a television screen. VRT is increasingly being used for the rehabilitation of arm function, balance and walking after stroke. Patients often require ongoing therapy post discharge from inpatient rehabilitation. Outpatient therapy may be limited or inaccessible due to waiting lists, transportation issues, distance etc.; therefore, home-based VRT could provide the required therapy in a more convenient and accessible setting. The objectives of this parallel randomized feasibility trial are to determine (1) the feasibility of using VRT in the home post stroke and (2) the feasibility of a battery of quantitative and qualitative outcome measures of stroke recovery.

Methods

Forty patients who can stand for at least 2 min and are soon to be discharged from inpatient or outpatient rehabilitation post stroke are being recruited in Ottawa, Canada and being randomized to control and experimental groups. Participants in the experimental group use home-based VRT to do rehabilitative exercises for standing balance, stepping, reaching, strengthening and gentle aerobic fitness. Control group participants use an iPad with apps selected to rehabilitate cognition, hand fine motor skills and visual tracking/scanning. Both groups are instructed to perform 30 min of exercise 5 days a week for 6 weeks. VRT intensity and difficulty are monitored and adjusted remotely. Weekly telephone contact is made with all participants. Ability to recruit participants, ability to handle the technology and learn the activities, compliance, safety, enjoyment, perceived efficacy and cost of program delivery will be assessed. A battery of assessments of standing balance, gait and community integration will be assessed for feasibility of completion within this population and potential for improvement following the intervention. Effect sizes will be calculated.

Discussion

The results of this study will be used to support the creation of a definitive randomized controlled trial on the efficacy of home-based VRT for rehabilitation post stroke.

Introduction and objectives

Stroke causes approximately 17,600 hospital admissions per year in Ontario and 50% of individuals who have had a stroke are left with moderate to severe impairment [12]. Most patients who are discharged from inpatient stroke rehabilitation are only 8–10 weeks post stroke and have not completely recovered. Their central nervous systems are still in a period of enhanced neuroplasticity, during which great functional change can be made [34]. Therapy outcomes are dose-dependent; intensive, high-repetition, task-oriented and task-specific therapies are most effective [56]. Therefore, for the greatest recovery possible, these patients require ongoing, intensive therapy. Most are offered this on an outpatient basis. However, for many reasons (transportation difficulties, distance from the rehabilitation center, weather etc.), not all eligible patients are able to attend outpatient therapy. Also, there is a waiting list and a limited number of outpatient therapy sessions are offered to each patient. Home-based therapy may fill an important role towards increasing the availability of rehabilitation, enabling patients to enhance or prolong their therapy and potentially improving outcomes.

Non-immersive virtual reality training (VRT) uses computer software to track the user’s movements and allow him or her to interact with a game or activity presented on a TV screen. It is convenient, timely, enjoyable and may be used for an unlimited period post stroke [78]. VRT has been shown to benefit upper extremity function, standing balance, gait and overall function in the sub-acute and chronic phases post stroke, at least as much as or more than conventional therapy [7910111213].

Home-based VRT offers a promising addition or alternative to existing rehabilitation programs that could make a significant difference in the lives of stroke survivors. A few preliminary studies have investigated the use of home-based VRT for standing balance and upper extremity recovery after stroke and shown potential feasibility of these systems for ongoing rehabilitation in the home [1415161718]. Some VRT platforms allow the user to interface via tactile devices (for example, a dynamic standing frame [14] or robotic glove [18]) while others use motion-tracking via a camera [16]. Some platforms use asynchronous monitoring to allow the therapist to monitor VRT usage and performance after the actual event [16] while others use synchronous monitoring to enable the therapist to watch in while the participant exercises; some even require constant real-time patient/therapist interaction [1719] throughout the therapy session. Users report high satisfaction with home-based VRT [1617], although actual usage can vary greatly [18]. Barriers to the use of home-based VRT include technical issues and lack of previous technical experience [18]. While some previous experience with computers is helpful, those who play video games regularly can become bored with VRT. Facilitators include the flexibility of home-based exercise, support from family and motivation from the VRT itself. Early results, available from a single randomized controlled trial (RCT) with 30 participants, suggest that home-based VRT improves standing balance and gait equally to in-clinic VRT, but that the costs are 44% lower [16].

We wish to add to these early studies of home-based VRT using a virtual reality system (Jintronix Inc.) that was initially developed for stroke rehabilitation and has also been used extensively with healthy and frail elderly individuals. The Jintronix system is marketed for institutional and home use and has a simple-to-use interface, but its home use has not yet been fully evaluated. The games are designed to incorporate motor learning principles such as multiple forms of feedback and task-specific practice that can be progressed to maintain an appropriate level of challenge. Unlike systems used in previous research, the Jintronix system includes a wide selection of games and exercises designed for the rehabilitation of sitting and standing balance, gait and upper extremity use. The system is simple to use and relatively inexpensive; a motion-tracking camera and software eliminates the need for gloves/controllers etc. It is straightforward enough for the patient to use independently; asynchronous monitoring is used to track usage and the therapist can change games and parameters remotely. The purpose of this study is to investigate the feasibility, acceptance and safety of this new, simple-to-use VRT system for use in the home, combined with asynchronous, remote support for the user. The results of this trial will support a definitive RCT in the future.

The primary objective is to assess the feasibility of using VRT in the home with patients post stroke, using quantitative and qualitative methods. Specific objectives are:

  1. 1.

    To estimate the recruitment rate of participants into the study;

  2. 2.

    To assess the ability and compliance of the participants with respect to the components of the research protocol (ability to learn VRT through the training program; ability to comply with the exercise protocol; participant retention);

  3. 3.

    To determine the safety of home-based VRT (presence of minor and major adverse events);

  4. 4.

    To assess the ability of stroke survivors and their study partners to use VRT technology in the home (i.e. technical difficulties, difficulty learning the games);

  5. 5.

    To assess the acceptability of the VRT intervention (enjoyment; perceived efficacy);

  6. 6.

    To estimate the cost for a future definitive RCT on in-home VRT.

The secondary objective is to assess the feasibility of the outcome measures, using quantitative and qualitative methods. Specific objectives are:

  1. 1.

    To assess the feasibility and acceptance of a battery of outcome measures, including physical assessments, questionnaires, an interview and a log book;

  2. 2.

    To assess the potential that home-based VRT might maintain or improve physical outcomes of standing balance, gait and general function and community integration after discharge from hospital-based stroke rehabilitation, compared to those who perform a program of iPad apps designed for fine hand motor skills and cognitive training;

  3. 3.

    To determine the sample size required for a future definitive RCT on in-home VRT.

This study is a prospective, single-site, single-blinded, parallel-group (1:1 ratio) randomized, superiority feasibility trial on the use of VRT for ongoing stroke rehabilitation after discharge from inpatient or outpatient stroke rehabilitation. A feasibility RCT was chosen in order to provide the most useful results to prepare for a future definitive RCT on the efficacy of home-based VRT. iPad apps were chosen as a comparator to VRT because they provide a control group that has equal contact with the researchers and equal time spent in an engaging activity. The use of an active control group (rather than providing control group participants with nothing) was also chosen to facilitate recruitment. The iPad apps chosen to work on hand fine motor control and cognition were not deemed to have any influence on the physical outcome measures of standing balance, gait and gross motor function. The Standard Protocol Items: Recommendation for Interventional Trials (SPIRIT) checklist is available as Additional file 1: Figure S1.[…]

 

Continue —>  Home-based virtual reality training after discharge from hospital-based stroke rehabilitation: a parallel randomized feasibility trial | Trials | Full Text

Fig. 1a  Experimental intervention – home-based virtual reality training targeting standing balance, stepping, reaching, strengthening and aerobic exercise. b Control intervention – iPad apps targeting cognition and hand fine motor control

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[Abstract] Comparison of the responsiveness of the Utrecht Scale for Evaluation of Rehabilitation (USER) and the Barthel Index in stroke patients

Abstract

Objective:
To compare the responsiveness of the Utrecht Scale for Evaluation of Rehabilitation (USER) to the responsiveness of the Barthel Index in stroke patients in an inpatient rehabilitation facility.

Design:
Observational study.

Setting:
Inpatient rehabilitation facility.

Subjects:
Consecutive stroke patients admitted for clinical rehabilitation.

Interventions:
Not applicable.

Main measures:
The USER and the Barthel Index were administered by a nurse at admission and discharge. The Effect Size and Standardized Response Mean (SRM) were calculated as measures of responsiveness.

Results:
From 198 (78%) of the 254 patients who were included in the study period, both admission and discharge data were available. At admission the mean score of the USER subscale Functional independence was 43.1 (SD = 18.9) and at discharge the mean score was 59.3 (SD = 13.8). The mean score of the Barthel Index at admission was 13.3 (SD = 5.4) and at discharge 18.4 (SD = 3.3). The Effect Size of the USER subscales Mobility, Self-care, Cognitive functioning, Pain, Fatigue and Mood were 0.85, 0.77, 0.48, 0.19, 0.40 and 0.28, respectively, and of the Barthel Index 0.94. The results for the SRM were in the same range.

Conclusion:
In inpatient rehabilitation after stroke, the USER was less responsive than the Barthel Index.

via Comparison of the responsiveness of the Utrecht Scale for Evaluation of Rehabilitation (USER) and the Barthel Index in stroke patients – Winke van Meijeren-Pont, Gerard Volker, Thea Vliet Vlieland, Paulien Goossens, 2019

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[Abstract] Pre-therapeutic Device for Post-stroke Hemiplegic Patients’ Wrist and Finger Rehabilitation

Abstract

Background/Objectives

This paper suggests a pre-therapeutic device for post-stroke hemiplegic patients’ wrist and finger rehabilitation both to decrease and analyze their muscle tones before the main physical or occupational therapy.

Method/Statistical Analysis

We designed a robot which consists of a BLDC motor, a torque sensor, linear motion guides and bearings. Mechanical structure of the robot induces flexion and extension of wrist and finger (MCP) joints simultaneously with the single motor. The frames of the robot were 3D printed. During the flexion/extension exercise, angular position and repulsive torque of the joints are measured and displayed in real time.

Findings

A prototype was 3D printed to conduct preliminary experiment on normal subject. From the neutral joint position (midway between extension and flexion), the robot rotated 120 degrees to extension direction and 30 degrees to flexion direction. First, the subject used the machine with the usual wrist and finger characteristics without any tones. Second, the same subject intentionally gave strength to the joints in order to imitate affected upper limb of a hemiplegic patient. During extension exercise, maximum repulsive torque of the normal hand was 2 Nm whereas that of the firm hand was almost 5 Nm. The result revealed that the device was capable enough to not only rotate rigid wrist and fingers with the novel robotic structure, but also present quantitative data such as the repulsive torque according to the joint orientation as an index of joint spasticity level.

Improvements/Applications

We are planning to improve the system by applying torque control and arranging experiments at hospitals to obtain patients’ data and feedbacks to meet actual needs in the field.

via Indian Journals

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[Abstract] Four-week training involving ankle mobilization with movement versus static muscle stretching in patients with chronic stroke: a randomized control trial.

Abstract

BACKGROUND:
Patients with stroke generally have diminished balance and gait. Mobilization with movement (MWM) can be used with manual force applied by a therapist to enhance talus gliding movement. Furthermore, the weight-bearing position during the lunge may enhance the stretch force.

OBJECTIVES:
This study aimed to compare the effects of a 4-week program of MWM training with those of static muscle stretching (SMS). Ankle dorsiflexion passive range of motion (DF-PROM), static balance ability (SBA), the Berg balance scale (BBS), and gait parameters (gait speed and cadence) were measured in patients with chronic stroke.

METHODS:
Twenty patients with chronic stroke participated in this study. Participants were randomized to either the MWM (n = 10) or the SMS (n = 10) group. Patients in both groups underwent standard rehabilitation therapy for 30 min per session. In addition, MWM and SMS techniques were performed three times per week for 4 weeks. Ankle DF-PROM, SBA, BBS score, and gait parameters were measured after 4 weeks of training.

RESULTS:
After 4 weeks of training, the MWM group showed significant improvement in all outcome measures compared with baseline (p < 0.05). Furthermore, SBA, BBS, and cadence showed greater improvement in the MWM group compared to the SMS group (p < 0.05).

CONCLUSIONS:
This study demonstrated that MWM training, combined with standard rehabilitation, improved ankle DF-PROM, SBA, BBS scores, and gait speed and cadence. Thus, MWM may be an effective treatment for patients with chronic stroke.

via Four-week training involving ankle mobilization with movement versus static muscle stretching in patients with chronic stroke: a randomized control… – PubMed – NCBI

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[Abstract] Use of Kinesio taping in lower-extremity rehabilitation of post-stroke patients: A systematic review and meta-analysis.

Abstract

BACKGROUND:

and purpose: The benefits of Kinesio taping (KT) in post-stroke rehabilitation have not been determined. This study aimed to evaluate its effects on lower-extremity rehabilitation in patients after a stroke.

METHODS:

A literature search was performed using EBSCOhost, Embase, Physiotherapy Evidence Database (PEDro), PubMed, Cochrane, Web of Science, China National Knowledge Infrastructure (CNKI), SinoMed, and Wanfang Data through June 2018. Randomized controlled trials (RCTs) on the use of KT during lower-extremity, post-stroke rehabilitation were selected. Meta-analysis was conducted.

RESULTS:

A total of 14 RCTs of low to moderate quality were reviewed and included 783 participants. Results indicated that KT significantly improved patients’ lower extremity spasticity, motor function, balance, ambulation, gait parameters, and daily activities, with few adverse effects.

CONCLUSION:

KT may have positive effects on lower-extremity, post-stroke rehabilitation. Due to the limited number and quality of the research, additional studies are needed to identify KT benefits.

via Use of Kinesio taping in lower-extremity rehabilitation of post-stroke patients: A systematic review and meta-analysis. – PubMed – NCBI

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