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Mathunny JJ, Srinivasan HK, Kumar A, Karthik V. A Cross-Sectional Study on Fall Direction and Lower Limb Loading in Response to a Perturbation on Laterally Inclined Platform. Appl Bionics Biomech 2023; 2023:7385119. [PMID: 37928743 PMCID: PMC10624552 DOI: 10.1155/2023/7385119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 10/02/2023] [Accepted: 10/03/2023] [Indexed: 11/07/2023] Open
Abstract
Perturbation-based balance training (PBT) improves reactive stepping in older adults and people with neurological disorders. Slip-induced falls are a threat to older adults, leading to hip fractures. Fall-prone individuals must be trained to regain balance during a fall in the posterolateral direction. This study aims to analyze the characteristics of the reactive step induced by a laterally inclined platform. This cross-sectional study included 46 healthy participants who performed a "lean and release" backward fall using a platform with two inclined angles on each side. Kinovea software was used to analyze the step width. Reactive steps, characterized by crossover or medial foot placement, are preventive measures against posterolateral falls. The first objective was on the narrowed step width that was subjected to analysis using analysis of variance (ANOVA) and Tukey's post hoc assessment, indicating a tendency toward posterolateral falls. As part of our second objective, the inclined platform resulted in uneven loading between the legs, with a preference for the unloaded leg as the reactive leg (p < 0.001), as determined by Fisher's exact test and Cramer's V. These characteristics align closely with those observed in modified constraint-induced movement therapy (mCIMT). The angled platform had a significant effect on selecting the reactive leg, particularly at higher angles (p < 0.001). Thus, the study suggested that the device is capable of inducing posterolateral falls and exhibited mCIMT characteristics.
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Affiliation(s)
- Jaison Jacob Mathunny
- Department of Biomedical Engineering, SRM Institute of Science and Technology, Kattankulathur, Chennai 603203, Tamil Nadu, India
| | - Hari Krishnan Srinivasan
- Department of Biomedical Engineering, SRM Institute of Science and Technology, Kattankulathur, Chennai 603203, Tamil Nadu, India
| | - Ashok Kumar
- Department of Biomedical Engineering, SRM Institute of Science and Technology, Kattankulathur, Chennai 603203, Tamil Nadu, India
| | - Varshini Karthik
- Department of Biomedical Engineering, SRM Institute of Science and Technology, Kattankulathur, Chennai 603203, Tamil Nadu, India
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Kobari T, Murayama T, Matsuzawa K, Sakai K. Effects of a treatment program based on constraint-induced movement therapy for the lower extremities on gait and balance in chronic stroke: a 6-month follow-up pilot study. Int J Rehabil Res 2023; 46:187-192. [PMID: 37039601 DOI: 10.1097/mrr.0000000000000578] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
Constraint-induced movement therapy (CIMT) for the lower extremities CIMT (LE-CIMT) has been shown feasible and promising but the long-term outcomes remain uncertain. In this pilot study, we recruited eight participants with chronic stroke from our facility for persons with disabilities to determine changes in gait and balance throughout an extended treatment program based on the principles of LE-CIMT. The program consisted of a run-in phase (3 weeks), LE-CIMT phase (3 weeks), and maintenance phase (6 months). In the LE-CIMT phase (3.5 h/day, 5 days/week, 3 weeks), the participants received task-oriented training (3 h) and transfer package training (30 min). The maintenance phase (30 min/day, 2-3 times/week, 6 months) included a transfer package and conventional training. The assessments were performed in the beginning and after each phase using the Fugl-Meyer Assessment, 6-min walk test (6MWT), Berg Balance Scale (BBS), and 10-m walk test from which walking speed, cadence, and stride length were derived. Overall, 6MWT, BBS, walking speed, and cadence improved significantly over time (analysis of variance P < 0.001). When comparing the results from before to after the LE-CIMT phase, 6MWT, BBS, walking speed, and cadence improved significantly ( P = 0.002 to 0.022). At the end of the 6-month maintenance phase, further improvements relative to the after LE-CIMT phase were found for 6MWT, walking speed, and cadence ( P = 0.002 to 0.034). These pilot results suggest that an extended treatment program based on the principles of LE-CIMT can improve balance and more so walking in the chronic phase of stroke.
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Affiliation(s)
- Tomoyoshi Kobari
- Department of Rehabilitation Therapy, Chiba Rehabilitation Center
| | - Takashi Murayama
- Department of Rehabilitation Therapy, Chiba Rehabilitation Center
| | | | - Katsuya Sakai
- Faculty of Healthcare Sciences, Chiba Prefectural University of Health Sciences, Chiba, Japan
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Zhou M, Tu Y, Cui J, Gao P, Yi T, Wang J, Hao Q, Li H, Zhu T. Effect of constraint-induced movement therapy on lower extremity motor dysfunction in post-stroke patients: A systematic review and meta-analysis. Front Neurol 2022; 13:1028206. [DOI: 10.3389/fneur.2022.1028206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 11/01/2022] [Indexed: 11/22/2022] Open
Abstract
ObjectiveConstraint-induced movement therapy (CIMT) is a common treatment for upper extremity motor dysfunction after a stroke. However, whether it can effectively improve lower extremity motor function in stroke patients remains controversial. This systematic review comprehensively studies the current evidence and evaluates the effectiveness of CIMT in the treatment of post-stroke lower extremity motor dysfunction.MethodsWe comprehensively searched randomized controlled trials related to this study in eight electronic databases (PubMed, Embase, The Cochrane Library, Web of Science, CBM, CNKI, WAN FANG, and VIP). We evaluated CIMT effectiveness against post-stroke lower extremity motor dysfunction based on the mean difference and corresponding 95% confidence interval (95% CI). We assessed methodological quality based on the Cochrane Bias Risk Assessment Tool. After extracting the general information, mean, and standard deviation of the included studies, we conducted a meta-analysis using RevMan 5.3 and Stata 16.0. The primary indicator was the Fugl-Meyer Assessment scale on lower limbs (FMA-L). The secondary indicators were the Berg balance scale (BBS), 10-meter walk test (10MWT), gait speed (GS), 6-min walk test (6MWT), functional ambulation category scale (FAC), timed up and go test (TUGT), Brunnstrom stage of lower limb function, weight-bearing, modified Barthel index (MBI), functional independence measure (FIM), stroke-specific quality of life questionnaire (SSQOL), World Health Organization quality of life assessment (WHOQOL), and National Institute of Health stroke scale (NIHSS).ResultsWe initially identified 343 relevant studies. Among them, 34 (totaling 2,008 patients) met the inclusion criteria. We found that patients treated with CIMT had significantly better primary indicator (FMA-L) scores than those not treated with CIMT. The mean differences were 3.46 (95% CI 2.74–4.17, P < 0.01, I2 = 40%) between CIMT-treated and conventional physiotherapy-treated patients, 3.83 (95% CI 2.89–4.77, P < 0.01, I2 = 54%) between patients treated with CIMT plus conventional physiotherapy and patients treated only with conventional physiotherapy, and 3.50 (95% CI 1.08–5.92, P < 0.01) between patients treated with CIMT plus western medicine therapy and those treated only with western medicine therapy. The secondary indicators followed the same trend. The subgroup analysis showed that lower extremity CIMT with device seemed to yield a higher mean difference in FMA-L scores than lower extremity CIMT without device (4.52, 95% CI = 3.65–5.38, P < 0.01 and 3.37, 95% CI = 2.95–3.79, P < 0.01, respectively).ConclusionCIMT effectively improves lower extremity motor dysfunction in post-stroke patients; however, the eligible studies were highly heterogeneous.Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=277466.
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Aloraini SM. Effects of constraint-induced movement therapy for the lower extremity among individuals post-stroke: A randomized controlled clinical trial. NeuroRehabilitation 2022; 51:421-431. [DOI: 10.3233/nre-220139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Stroke often leads to lower extremity impairments that significantly hinders functional recovery. OBJECTIVE: To investigate the effectiveness of constraint-induced movement therapy for the lower extremity (CIMT-LE) for improving balance and ambulation among people post-stroke. METHODS: A randomized controlled, single-blinded clinical trial was conducted. Participants were recruited and randomized into one of two groups: CIMT-LE group and control. Outcome measures were the Fugl-Meyer assessment of lower extremity, Berg balance scale, ten-meter walk test and six-minute walk test. Outcome measures were collected at baseline, following the conclusion of the therapeutic programs and after three months. RESULTS: 38 participants were enrolled in the study (19 in each group). No significant differences were found between groups at baseline. At the conclusion of therapeutic programs, both groups showed significant changes compared to baseline. However, changes seen in the CIMT-LE were clinically significant. Further, at three months following the conclusion of the program, the recorded improvements were retained by participants. CONCLUSION: A CIMT-LE program compared to an intensity-matched conventional program yielded significant clinical improvements among people post-stroke. These improvements were seen in lower extremity motor recovery, postural balance and gait speed. Furthermore, these improvements were retained three months following the conclusion of the therapeutic program.
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Affiliation(s)
- Saleh M. Aloraini
- Department of Physical Therapy, College of Medical Rehabilitation, Qassim University, Buraydah 51452, Saudi Arabia
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Wang D, Xiang J, He Y, Yuan M, Dong L, Ye Z, Mao W. The Mechanism and Clinical Application of Constraint-Induced Movement Therapy in Stroke Rehabilitation. Front Behav Neurosci 2022; 16:828599. [PMID: 35801093 PMCID: PMC9253547 DOI: 10.3389/fnbeh.2022.828599] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 05/16/2022] [Indexed: 11/13/2022] Open
Abstract
Constraint-induced movement therapy (CIMT) has been widely applied in stroke rehabilitation, and most relevant studies have shown that CIMT helps improve patients' motor function. In practice, however, principal issues include inconsistent immobilization durations and methods, while incidental issues include a narrow application scope and an emotional impact. Although many studies have explored the possible internal mechanisms of CIMT, a mainstream understanding has not been established.
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Affiliation(s)
- Dong Wang
- Affiliated Hospital of Chengdu University, Chengdu, China
| | - Junlu Xiang
- Chengdu Women’s and Children’s Central Hospital, Chengdu, China
| | - Ying He
- Affiliated Hospital of Chengdu University, Chengdu, China
| | - Min Yuan
- Affiliated Hospital of Chengdu University, Chengdu, China
| | - Li Dong
- Affiliated Hospital of Chengdu University, Chengdu, China
| | - Zhenli Ye
- Affiliated Hospital of Chengdu University, Chengdu, China
| | - Wei Mao
- Chengdu Integrated TCM and Western Medical Hospital, Chengdu, China
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Lee K. EMG-Triggered Pedaling Training on Muscle Activation, Gait, and Motor Function for Stroke Patients. Brain Sci 2022; 12:brainsci12010076. [PMID: 35053819 PMCID: PMC8773827 DOI: 10.3390/brainsci12010076] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/23/2021] [Accepted: 12/28/2021] [Indexed: 02/01/2023] Open
Abstract
This study aimed to determine the effects of electromyography (EMG)-triggered pedaling training to improve motor functions in the lower extremities, muscle activation, gait, postural balance, and activities of daily living in stroke patients. Subjects were randomly allocated to two groups: the EMG-triggered pedaling training group (EMG-PTG, n = 21) and the traditional pedaling training group (TPTG, n = 20). Both groups trained five times per week for four weeks, with 50 min per session. Lower extremity motor function was assessed using the Fugl–Meyer Assessment (FMA). Muscle activation of the four muscles of the lower extremities was assessed using eight-channel electromyography, while gait ability was assessed using GaitRite. Postural balance was assessed using the Berg balance scale (BBS), the timed up and go (TUG), and functional reach tests (FRT). Daily activities were assessed using the Modified Barthel Index (MBI). For lower extremity motor function, gait ability, balance ability, and activities of daily living, the EMG-PTG showed significant improvement compared to TPTG (p < 0.05). These results suggest that EMG-triggered pedaling training effectively improves lower extremity motor function, muscle activation, gait, postural balance, and activities of daily living in stroke patients.
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Affiliation(s)
- Kyeongjin Lee
- Department of Physical Therapy, College of Health Science, Kyungdong University, Wonju 24764, Korea
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Abdullahi A, Truijen S, Umar NA, Useh U, Egwuonwu VA, Van Criekinge T, Saeys W. Effects of Lower Limb Constraint Induced Movement Therapy in People With Stroke: A Systematic Review and Meta-Analysis. Front Neurol 2021; 12:638904. [PMID: 33833730 PMCID: PMC8021771 DOI: 10.3389/fneur.2021.638904] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 02/22/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Constraint induced movement therapy (CIMT) is effective at improving upper limb outcomes after stroke. Aim: The aim of this study was to carry out a systematic review and meta-analysis of the effects of lower limb CIMT studies of any design in people with stroke. Materials/ Method: PubMED, PEDro, OTSeeker, CENTRAL, and Web of Science were searched from their earliest dates to February 2021. Lower limbs CIMT studies that measured outcomes at baseline and post-intervention were selected. Sample size, mean, and standard deviation on the outcomes of interest and the protocols of both the experimental and control groups were extracted. McMaster Critical Review Form was used to assess the methodological quality of the studies. Result: Sixteen studies with different designs were included in this review. The result showed that lower limb CIMT improves functional, physiological and person's reported outcomes including motor function, balance, mobility, gait speed, oxygen uptake, exertion before and after commencement of activities, knee extensor spasticity, weight bearing, lower limb kinematics and quality of life in people with stroke post intervention. However, there were only significant differences in quality of life in favor of CIMT post-intervention [mean difference (MD) = 16.20, 95% CI = 3.30–29.10, p = 0.01]; and at follow-up [mean difference (MD) = 14.10, 95% CI = 2.07–26.13, p = 0.02] between CIMT and the control group. Even for the quality of life, there was significant heterogeneity in the studies post intervention (I2 = 84%, p = 0.01). Conclusion: Lower limb CIMT improves motor function, balance, functional mobility, gait speed, oxygen uptake, weigh bearing, lower limb kinematics, and quality of life. However, it is only superior to the control at improving quality of life after stroke based on the current literature.
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Affiliation(s)
- Auwal Abdullahi
- Neurological Rehabilitation Unit, Department of Physiotherapy, Bayero University Kano, Kano, Nigeria.,Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Steven Truijen
- Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Naima A Umar
- Department of Physiotherapy, Muhammad Abdullahi Wase Teaching Hospital, Kano, Nigeria
| | - Ushotanefe Useh
- Lifestyle Diseases Research Entity, Faculty of Health Sciences, North-West University, Mmabatho, South Africa
| | - Victor A Egwuonwu
- Department of Medical Rehabilitation, Nnamdi Azikiwe University, Awka, Nigeria
| | - Tamaya Van Criekinge
- Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Wim Saeys
- Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Wilrijk, Belgium
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Comparing Two Different Modes of Task Practice during Lower Limb Constraint-Induced Movement Therapy in People with Stroke: A Randomized Clinical Trial. Neural Plast 2021; 2021:6664058. [PMID: 33603778 PMCID: PMC7870299 DOI: 10.1155/2021/6664058] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 12/16/2020] [Accepted: 01/19/2021] [Indexed: 12/30/2022] Open
Abstract
Background Constraint-induced movement therapy (CIMT) is used for the rehabilitation of motor function after stroke. Objectives The aim of this study was to compare the effects of lower limb CIMT that uses number of repetition of tasks with the one that uses number of hours of practice. Method The study was a randomized clinical trial approved by the Ethics Committee of Kano State Ministry of Health. Fifty-eight people with stroke participated in the study. Groups 1 and 2 performed daily 600 repetitions and 3 hours of task practice, respectively, 5 times weekly for 4 weeks. Motor impairment (primary outcome), balance, functional mobility, knee extensor spasticity, walking speed and endurance, and exertion before and after commencement of activities were assessed at baseline and postintervention. The data was analyzed using Friedmann and Mann-Whitney U tests. Result The results showed that there was only significant difference (p < 0.05) in knee extensor spasticity (group 1 (median = 0(0), mean rank = 27.50); group 2 (median = 0(0), mean rank = 31.64)), exertion before commencement of activities (group 1 (median = 0(0.5), mean rank = 21.90); group 2 (median = 1(0.5), mean rank = 37.64)), and exertion after commencement of activities (group 1 (median = 1(1), mean rank = 20.07); group 2 (median = 1(0), mean rank = 39.61) postintervention in favour of the experimental group (group 1)). Conclusion The group 1 protocol is more effective at improving outcomes after stroke.
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Constraint-Induced Movement Therapy for Improving Motor Function of the Paretic Lower Extremity After Stroke. Am J Phys Med Rehabil 2020; 99:e75-e78. [PMID: 31246610 DOI: 10.1097/phm.0000000000001249] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
A 56-yr-old woman with chronic stroke and gait dysfunction was recruited for this study. A lower-extremity constraint-induced movement therapy protocol was given consisting of 3.5 hrs/d of supervised intervention activities on 10 consecutive weekdays. Motor training was intensive and involved shaping. In addition, a group of behavior management strategies was used to induce further unsupervised practice and transference of motor skills from the laboratory to real-world situations. Changes in functional mobility, walking speed, balance, level of assistance, perceived quality of movement, and level of confidence while performing daily activities were assessed five times in both the baseline and intervention phases. The outcomes observed after the intervention were determined by calculating the difference between the average scores obtained in both phases. Changes in perceived quality of movement, level of confidence, level of assistance, and balance were observed.
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Dos Anjos S, Morris D, Taub E. Constraint-Induced Movement Therapy for Lower Extremity Function: Describing the LE-CIMT Protocol. Phys Ther 2020; 100:698-707. [PMID: 31899495 DOI: 10.1093/ptj/pzz191] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 03/20/2019] [Accepted: 10/08/2019] [Indexed: 01/26/2023]
Abstract
Constraint-induced movement therapy (CIMT) is comprised of a set of techniques shown to produce significant changes in upper extremity (UE) function following stroke and other disorders. The significant positive results obtained with the UE protocol have led to the development of LE-CIMT, an intervention to improve lower extremity (LE) function. However, some modifications of the UE protocol were needed, including omitting use of a restraint device, development of supervised motor training tasks to emphasize movement of the lower limb, and adaptation of the UE Motor Activity Log for the lower extremity. The LE-CIMT protocol includes: (1) intensive supervised training delivered for 3.5 h/d for 10 consecutive weekdays, (2) use of shaping as a strategy for motor training, (3) application of a transfer package, and (4) strongly encouraging use of the more-affected LE with improved coordination. The transfer package consists of several strategies to facilitate transfer of the improved motor skills developed during supervised treatment to everyday situations. Research to date has yielded positive results. However, the intervention protocol continues to evolve. The purpose of this article is to describe the components of the complete LE-CIMT protocol to promote further development and investigation of this approach.
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Affiliation(s)
- Sarah Dos Anjos
- Departments of Physical Therapy and Occupational Therapy, University of Alabama at Birmingham, 1720 2nd Avenue South, SHPB360, Birmingham, AL 35294 USA
| | - David Morris
- FAPTA, Department of Physical Therapy, University of Alabama at Birmingham
| | - Edward Taub
- Department of Psychology, University of Alabama at Birmingham
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Ma CC, Rao N, Muthukrishnan S, Aruin AS. A textured insole improves gait symmetry in individuals with stroke. Disabil Rehabil 2017; 40:2798-2802. [PMID: 28783984 DOI: 10.1080/09638288.2017.1362477] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE Gait asymmetry is a common consequence of stroke and improving gait symmetry is an important goal of rehabilitation. We investigated the effect of a single textured insole in improving gait symmetry in individuals with stroke. METHOD Seventeen individuals with stroke who had asymmetrical gait were recruited and required to walk with a textured insole positioned in the shoe on the unaffected side or without the insole. Gait parameters were evaluated using the instrumented walkway. Gait velocity, cadence, and symmetry indices for the spatial and temporal parameters of gait and center of pressure displacements were obtained. RESULTS When walking with a textured insole, symmetry indexes for stance, single support phases of gait, as well as center of pressure displacements improved significantly. While using a textured insole, the duration of the stance phase and a single support phase decreased on the unaffected side and increased on the affected side significantly. Gait velocity and cadence were not affected by the use of the insole. CONCLUSIONS Individuals with stroke walking with a textured insole placed in the shoe on the unaffected side improved the symmetry of their gait. The outcome provides a foundation for future investigations of the efficacy of using a single textured insole in gait rehabilitation of individuals with unilateral impairment. Implications for Rehabilitation A single textured insole positioned in the shoe on the unaffected side improved gait symmetry in individuals with stroke. Gait velocity and cadence were not affected by the use of the insole.
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Affiliation(s)
- Charlie C Ma
- a PhD Program in Rehabilitation Sciences, College of Applied Health Sciences , University of Illinois at Chicago , Chicago , IL , USA
| | - Noel Rao
- b Marianjoy Rehabilitation Hospital , Wheaton , IL , USA
| | - Sriranjini Muthukrishnan
- c Department of Neurology and Rehabilitation , University of Illinois at Chicago , Chicago , IL , USA
| | - Alexander S Aruin
- d Department of Physical Therapy , University of Illinois at Chicago , Chicago , IL , USA
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Zhu Y, Zhou C, Liu Y, Liu J, Jin J, Zhang S, Bai Y, Huang D, Zhu B, Xu Y, Wu Y. Effects of modified constraint-induced movement therapy on the lower extremities in patients with stroke: a pilot study. Disabil Rehabil 2016; 38:1893-9. [PMID: 26728501 DOI: 10.3109/09638288.2015.1107775] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE This study aimed to qualify the improvements of modified constraint-induced movement therapy (m-CIMT) on the lower limb of stroke patients via assessing the centre of mass (COM) displacement and the basic gait parameters. METHODS A total of 22 hemiplegic patients after stroke with first-time clinical cerebral infarction or haemorrhagic cerebrovascular accident were included in this study from May to December, 2014. The patients were randomly divided into m-CIMT group and the conventional therapy group (control group), and received corresponding training for five days/week for four weeks. The COM displacement and gait parameters were assessed by three-dimensional segmental kinematics method in pre-intervention and post- intervention therapy. RESULTS After four weeks of m-CIMT, the COM displacement on sagittal plane of paretic leg during stance phase was increased (pre: 91.04 ± 4.39 cm, post: 92.38 ± 4.58 cm, p < 0.05) and swing range of frontal plane was remarkably decreased (pre: 10.15 ± 3.05 cm, post: 7.83 ± 1.90 cm, p < 0.001). Meantime, the normalised swing range of COM in m-CIMT was superior to that in control group. Moreover, the gait parameters, including velocity (0.27 m/s), step width (0.10 m), step length (0.22 m) and swing time percentage (29.80%), were significantly improved by post-interventions of m-CIMT (p < 0.05). CONCLUSION The m-CIMT intervention improves the COM displacement in sagittal and frontal plane, as well as gait parameters. These suggest that m-CIMT intervention may be feasible and effective for the rehabilitation of hemiplegic gait. Implications for Rehabilitation Segmental kinematics method was used to estimate the displacement of the COM. m-CIMT interventions improved the COM displacement of patients after stroke. m-CIMT interventions improved the hemiplegic gait parameters.
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Affiliation(s)
- Yulian Zhu
- a Key Laboratory of Exercise and Health Sciences , Shanghai University of Sport , Shanghai , China ;,b Department of Rehabilitation Medicine , Huashan Hospital, Fudan University , Shanghai , China
| | - Chaosheng Zhou
- a Key Laboratory of Exercise and Health Sciences , Shanghai University of Sport , Shanghai , China ;,c Department of Rehabilitation Medicine , Affiliated Tenth People's Hospital of Tongji University , Shanghai , China
| | - Yu Liu
- a Key Laboratory of Exercise and Health Sciences , Shanghai University of Sport , Shanghai , China
| | - Jue Liu
- a Key Laboratory of Exercise and Health Sciences , Shanghai University of Sport , Shanghai , China
| | - Jiaran Jin
- a Key Laboratory of Exercise and Health Sciences , Shanghai University of Sport , Shanghai , China
| | - Shengnian Zhang
- a Key Laboratory of Exercise and Health Sciences , Shanghai University of Sport , Shanghai , China
| | - Yulong Bai
- b Department of Rehabilitation Medicine , Huashan Hospital, Fudan University , Shanghai , China
| | - Dequan Huang
- d Department of Rehabilitation Medicine , Tianshan Zhongyi Hospital , Shanghai , China
| | - Bing Zhu
- b Department of Rehabilitation Medicine , Huashan Hospital, Fudan University , Shanghai , China
| | - Yiming Xu
- b Department of Rehabilitation Medicine , Huashan Hospital, Fudan University , Shanghai , China
| | - Yi Wu
- b Department of Rehabilitation Medicine , Huashan Hospital, Fudan University , Shanghai , China
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