Posts Tagged strength

[Poster] A Toolkit for Objective Clinical Outcome Measures of Muscle Tone – Archives of Physical Medicine and Rehabilitation

To evaluate a wearable sensor-based toolkit for quantifying muscle tone in patients with upper motor neuron syndrome (UMNS).

Source: A Toolkit for Objective Clinical Outcome Measures of Muscle Tone – Archives of Physical Medicine and Rehabilitation

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[Abstract] Effects of ankle biofeedback training on strength, balance, and gait in patients with stroke – PEDro

Effects of ankle biofeedback training on strength, balance, and gait in patients with stroke
Kim S-J, Cho H-Y, Kim K-H, Lee S-M
Journal of Physical Therapy Science 2016 Sep;28(9):2596-2600
clinical trial
PURPOSE: This study aimed to investigate the effects of ankle biofeedback training on muscle strength of the ankle joint, balance, and gait in stroke patients. SUBJECTS AND METHODS: Twenty-seven subjects who had had a stroke were randomly allocated to either the ankle biofeedback training group (n = 14) or control group (n = 13). Conventional therapy, which adhered to the neurodevelopmental treatment approach, was administered to both groups for 30 minutes. Furthermore, ankle strengthening exercises were performed by the control group and ankle biofeedback training by the experimental group, each for 30 minutes, 5 days a week for 8 weeks. To test muscle strength, balance, and gait, the Biodex isokinetic dynamometer, functional reach test, and 10 m walk test, respectively, were used. RESULTS: After the intervention, both groups showed a significant increase in muscle strength on the affected side and improved balance and gait. Significantly greater improvements were observed in the balance and gait of the ankle biofeedback training group compared with the control group, but not in the strength of the dorsiflexor and plantar flexor muscles of the affected side. CONCLUSION: This study showed that ankle biofeedback training significantly improves muscle strength of the ankle joint, balance, and gait in patients with stroke.

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Source: PEDro – Search Detailed Search Results

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[Abstract] A Meta-Analysis and Systematic Literature Review of Virtual Reality Rehabilitation Programs

Highlights

  • Virtual reality rehabilitation (VRR) programs are growing in popularity
  • VRR programs are more effective than traditional rehabilitation programs
  • Excitement, physical fidelity, and cognitive fidelity may cause VRR program success
  • More research is needed to better understand VRR programs

Abstract

A recent advancement in the study of physical rehabilitation is the application of virtual reality rehabilitation (VRR) programs, in which patients perform practice behaviors while interacting with the computer-simulation of an environment that imitates a physical presence in real or imagined worlds. Despite enthusiasm, much remains unknown about VRR programs. Particularly, two important research questions have been left unanswered: Are VRR programs effective? And, if so, why are VRR programs effective? A meta-analysis is performed in the current article to determine the efficacy of VRR programs, in general, as well as their ability to develop four specific rehabilitation outcomes: motor control, balance, gait, and strength. A systematic literature review is also performed to determine the mechanisms that may cause VRR program success or failure. The results demonstrate that VRR programs are more effective than traditional rehabilitation programs for physical outcome development. Further, three mechanisms have been proposed to cause these improved outcomes: excitement, physical fidelity, and cognitive fidelity; however, empirical research has yet to show that these mechanisms actually prompt better rehabilitation outcomes. The implications of these results and possible avenues for future research and practice are discussed.

Source: A Meta-Analysis and Systematic Literature Review of Virtual Reality Rehabilitation Programs

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[REVIEW] Mobility and the Lower Extremity | EBRSR – Evidence-Based Review of Stroke Rehabilitation – Full Text PDF

Chapter 9

Mobility and the Lower Extremity

Rehabilitation techniques of sensorimotor complications post stroke fall loosely into one of two categories; the compensatory approach or the restorative approach. While some overlap exists, the underlying philosophies of care are what set them apart. The goal of the compensatory approach towards treatment is not necessarily on improving motor recovery or reducing impairments but rather on teaching patients a new skill, even if it only involves pragmatically using the non-involved side (Gresham et al. 1995). The restorative approach focuses on traditional physical therapy exercises and neuromuscular facilitation, which involves sensorimotor stimulation, exercises and resistance training, designed to enhance motor recovery and maximize brain recovery of the neurological impairment (Gresham et al. 1995).In this review, rehabilitation of mobility and lower extremity complications is assessed. An overview of literature pertaining to the compensatory approach and the restorative approach is provided. Treatment targets discussed include balance retraining, gait retraining, strength training, cardiovascular conditioning and treatment of contractures in the lower extremities. Technologies used to aid rehabilitation include assistive devices, electrical stimulation, and splints.

For evidence tables, please click here.

Source: Mobility and the Lower Extremity | EBRSR – Evidence-Based Review of Stroke Rehabilitation

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[Abstract] Muscle strengthening for hemiparesis after stroke: A meta-analysis

Abstract

Introduction

Muscle weakness is a common consequence of stroke and can result in a decrease in physical activity. Changes in gait performance can be observed, especially a reduction in gait speed, and increased gait asymmetry, and energy cost is also reported.

Objective

The aim was to determine whether strengthening of the lower limbs can improve strength, balance and walking abilities in patients with chronic stroke.

Method

Five databases (Pubmed, Cinhal, Cochrane, Web of Science, Embase) were searched to identify eligible studies. Randomized controlled trials were included and the risk of bias was evaluated for each study. Pooled standardized mean differences were calculated using a random effects model. The PRISMA statement was followed to increase clarity of reporting.

Results

Ten studies, including 355 patients, reporting on the subject of progressive resistance training, specific task training, functional electrical stimulation and aerobic cycling at high-intensity were analysed. These interventions showed a statistically significant effect on strength and the Timed Up-and-Go test, and a non-significant effect on walking and the Berg Balance Scale.

Conclusion

Progressive resistance training seemed to be the most effective treatment to improve strength. When it is appropriately targeted, it significantly improves strength.

Source: Muscle strengthening for hemiparesis after stroke: A meta-analysis

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[CASE STUDY] Effects of a novel forced intensive strengthening technique on muscle size and upper extremity function in a patient with chronic stroke – Full Text PDF

[Purpose] This research demonstrated a forced intensive strength technique as a novel treatment for muscle power and function in the affected upper extremity muscle to determine the clinical feasibility with respect to upper extremity performance in a stroke hemiparesis.

[Subject and Methods] The subject was a patient with chronic stroke who was dependent on others for performing the functional activities of his affected upper extremity. The technique incorporates a comprehensive approach of forced, intensive, and strength-inducing activities to enhance morphological changes associated with motor learning of the upper extremity. The forced intensive strength technique consisted of a 6-week course of sessions lasting 60 minutes per day, five times a week.

[Results] After the 6-week intervention, the difference between relaxation and contraction of the affected extensor carpi radialis muscle increased from 0.28 to 0.63 cm2, and that of the affected triceps brachii muscle increased from 0.30 to 0.90 cm2. The results of clinical tests including the modified Ashworth scale (MAS; from 1+ to 1), muscle strength (from 15 to 32 kg), the manual function test (MFT; scores of 16/32 to 27/32 score), the Fugl-Meyer assessment (FMA; scores of 29/66 to 49/66 score), and the Jebsen-Taylor hand function test (JTHFT; from 38/60 to 19/60 sec) were improved.

[Conclusion] Our results suggest that the forced intensive strength technique may have a beneficial effect on the muscle size of the upper extremity and motor function in patients with chronic stroke.

Full Text PDF [456K]

Source: Effects of a novel forced intensive strengthening technique on muscle size and upper extremity function in a patient with chronic stroke

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[ARTICLE] Effects of a novel forced intensive strengthening technique on muscle size and upper extremity function in a patient with chronic stroke – Full Text PDF

[Purpose] This research demonstrated a forced intensive strength technique as a novel treatment for muscle power and function in the affected upper extremity muscle to determine the clinical feasibility with respect to upper extremity performance in a stroke hemiparesis.

[Subject and Methods] The subject was a patient with chronic stroke who was dependent on others for performing the functional activities of his affected upper extremity. The technique incorporates a comprehensive approach of forced, intensive, and strength-inducing activities to enhance morphological changes associated with motor learning of the upper extremity. The forced intensive strength technique consisted of a 6-week course of sessions lasting 60 minutes per day, five times a week.

[Results] After the 6-week intervention, the difference between relaxation and contraction of the affected extensor carpi radialis muscle increased from 0.28 to 0.63 cm2, and that of the affected triceps brachii muscle increased from 0.30 to 0.90 cm2. The results of clinical tests including the modified Ashworth scale (MAS; from 1+ to 1), muscle strength (from 15 to 32 kg), the manual function test (MFT; scores of 16/32 to 27/32 score), the Fugl-Meyer assessment (FMA; scores of 29/66 to 49/66 score), and the Jebsen-Taylor hand function test (JTHFT; from 38/60 to 19/60 sec) were improved.

[Conclusion] Our results suggest that the forced intensive strength technique may have a beneficial effect on the muscle size of the upper extremity and motor function in patients with chronic stroke.

Source: Effects of a novel forced intensive strengthening technique on muscle size and upper extremity function in a patient with chronic stroke

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[ARTICLE] The Effect of Transcutaneous Electrical Nerve Stimulation (TENS) Applied to the Foot and Ankle on Strength, Proprioception and Balance: A Preliminary Study – Full Text PDF

Abstract

Background: Transcutaneous electrical nerve stimulation (TENS) promotes upper motor neuron excitability which has the potential to improve function. As a precursor to clinical trials, we investigated the potential efficacy of TENS on strength, proprioception and balance in healthy older adults.

Method:

  • Design: A paired-sample randomized crossover trial. No stimulation was the control.
  • Intervention: A one-off session of TENS (Modulated frequency: 70-130Hz, 5 second cycle) via a conductive sock.
  • Participants: 25 healthy older volunteers with no pre-existing balance or mobility limitations or contra-indications to TENS.
  • Outcomes: Dorsiflexor and plantarflexor strength and proprioception using an isokinetic dynamometer and balance (postural sway and forward reach test).
  • Analysis: Paired t-tests

Results: None of the parameters showed any significant changes with TENS (p>0.05).

Conclusions: The stimulation of cutaneous sensory nerve endings of the foot with the application of TENS showed no immediate effect on the ankle proprioception, lower leg muscle strength, and postural stability. The concern that TENS would have a distracting impact on sensation and balance was not supported according to these results.

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[ARTICLE] Reliability of muscle strength assessment in chronic post-stroke hemiparesis: a systematic review and meta-analysis

Abstract

Background:Muscle weakness is the main cause of motor impairment among stroke survivors and is associated with reduced peak muscle torque.

Objective:To systematically investigate and organize the evidence of the reliability of muscle strength evaluation measures in post-stroke survivors with chronic hemiparesis.

Data Sources:Two assessors independently searched four electronic databases in January 2014 (Medline, Scielo, CINAHL, Embase).

Study Selection:Inclusion criteria comprised studies on reliability on muscle strength assessment in adult post-stroke patients with chronic hemiparesis.

Data Extraction:We extracted outcomes from included studies about reliability data, measured by intraclass correlation coefficient (ICC) and/or similar. The meta-analyses were conducted only with isokinetic data.

Results:Of 450 articles, eight articles were included for this review. After quality analysis, two studies were considered of high quality. Five different joints were analyzed within the included studies (knee, hip, ankle, shoulder, and elbow). Their reliability results varying from low to very high reliability (ICCs from 0.48 to 0.99). Results of meta-analysis for knee extension varying from high to very high reliability (pooled ICCs from 0.89 to 0.97), for knee flexion varying from high to very high reliability (pooled ICCs from 0.84 to 0.91) and for ankle plantar flexion showed high reliability (pooled ICC = 0.85).

Conclusion:Objective muscle strength assessment can be reliably used in lower and upper extremities in post-stroke patients with chronic hemiparesis.

Source: Maney Online – Maney Publishing

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[ARTICLE] Reliability of muscle strength assessment in chronic post-stroke hemiparesis: a systematic review and meta-analysis

Abstract

Background: Muscle weakness is the main cause of motor impairment among stroke survivors and is associated with reduced peak muscle torque.

Objective: To systematically investigate and organize the evidence of the reliability of muscle strength evaluation measures in post-stroke survivors with chronic hemiparesis.

Data Sources: Two assessors independently searched four electronic databases in January 2014 (Medline, Scielo, CINAHL, Embase).

Study Selection: Inclusion criteria comprised studies on reliability on muscle strength assessment in adult post-stroke patients with chronic hemiparesis.

Data Extraction: We extracted outcomes from included studies about reliability data, measured by intraclass correlation coefficient (ICC) and/or similar. The meta-analyses were conducted only with isokinetic data.

Results: Of 450 articles, eight articles were included for this review. After quality analysis, two studies were considered of high quality. Five different joints were analyzed within the included studies (knee, hip, ankle, shoulder, and elbow). Their reliability results varying from low to very high reliability (ICCs from 0.48 to 0.99). Results of meta-analysis for knee extension varying from high to very high reliability (pooled ICCs from 0.89 to 0.97), for knee flexion varying from high to very high reliability (pooled ICCs from 0.84 to 0.91) and for ankle plantar flexion showed high reliability (pooled ICC = 0.85).

Conclusion: Objective muscle strength assessment can be reliably used in lower and upper extremities in post-stroke patients with chronic hemiparesis.

via Maney Online – Maney Publishing.

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