A B C D E F G H I J K L M N O P Q R S T U V W X Y Z All
Gore, Archana
- A Prospective Experimental Study of Effects of Cognitive Tasks on Balance in Stroke Individuals
Authors
1 PT School and Center, Seth GSMC & KEMH, Parel, Mumbai-12, IN
Source
Indian Journal of Physiotherapy & Occupational Therapy-An International Journal, Vol 6, No 3 (2012), Pagination: 51-55Abstract
Background: Load of cognitive task increases the demands on postural control and balance in stroke patients making patients more susceptible to falls. So assessing balance under dual task conditions become important aspect of rehabilitation of stroke patients.
Aims: To see the effect of cognitive task on balance in chronic stroke patients.
Settings and design: Prospective experimental study carried out at tertiary care hospital, Mumbai.
Materials and Methods: 30 Chronic stroke patients (>6 months duration) above 50 years of age were assessed for balance with modified Clinical Test of Sensory Integration of Balance (mCTSIB) scale with and without cognitive task of calculation. Outcome measure was the balance score under four different conditions of the scale with and without cognitive task.
Statistical analysis: Wilcoxson Signrank test and paired t- test were used to analyze the difference between the balance scores with and without cognitive task.
Results: Balance decreased significantly with cognitive tasks in all four conditions of the mCTSIB scale. Condition 1- EOFI: (20.4 +7.32 - 17.5 +9.099) (p <0.001). Condition 2-ECFI: (12.7+7.29 - 9.25+7.196) (p <0.001); condition 3- EOFO: (11+7.87 - 10+9.099) (p <0.001); condition 4- ECFO: (3.4+ 4.95 - 2.1+ 4.65) (p <0.001).
Conclusion: Balance decreases under different conditions with concurrent cognitive task in chronic stroke patients. Hence treatment under dual task conditions in different environments should be an integral part of balance rehabilitation in stroke patients.
Keywords
Stroke, Cognition, Postural Control, Modified CTSIB
- A Randomised Controlled Trial of Stimulation of Triceps as an Adjunct to Motor Training of Paretic Arm in Stroke Patients
Authors
1 Lilavati Hospital, Bandra, Mumbai, IN
2 PT school and center, Seth GSMC and KEMH, IN
3 PT LTMMC, Sion Hospital, IN
Source
Indian Journal of Physiotherapy & Occupational Therapy-An International Journal, Vol 6, No 3 (2012), Pagination: 82-86Abstract
Backrground: 30-60% of patients with stroke have no arm function.Spasticity causes hyperactivity in those muscles that can lead to decreased activity of their antagonists. Thus biceps spasticity can cause reduced control of triceps amounting to reduced reach function which is usually an important therapeutic goal. Some studies have evaluated efficacy of electrical stimulation (ES) on spasticity.
Aims: Purpose of the trial was to assess effect of stimulation of triceps on forward reach distancein stroke patients.
Settings and Design: Prospective, analytical, experimental, randomized and open trial done in Physiotherapy OPD of a tertiary care hospital.
Methods and Material: 50 post stroke patients, in the age group of 30 to 60year withspasticity of shoulder, elbow, wrist and hand muscles of affected extremity up to grade 2 on Ashworth Scale and Brunnstrom sequential recovery stage 3 or 4; were assessed for modified Tardieu Scale(MTS), active elbow extension range at elbow(AROM) and forward reach distance(FRD). They were randomly assigned to either of the Conventional (CG) or Experimental Group (EG). CG received motor training only whereas the EG received motor training and ES to triceps on affected upper extremity. After 3 weeks they were evaluated again for the above outcomes. Statistical tests were non-parametric tests as the data obtained was not normally distributed, as analyzed using Shapiro-Wilk test for normality. Wilcoxon Sign rank test for comparing medians in all 3 outcome measures. Mann Whitney test was also used to compare percent mean differences in both groups for all 3 outcome measures.
Results: FRD, AROM and MTS improved after 3 weeks in CG with significance of p-value of 0.0122 each and in experimental group with significance of p-value of 0.0121 each. FRD showed insignificant change between groups with p-value of 0.207. The mean percent difference in MTS, AROM and FRD was 0.007, 0.007 and 0.977 respectively.
Conclusions: Electrical Stimulation when given to the triceps muscle as an adjunct to the motor training has shown additional improvement in reducing the biceps spasticity, improving AROM but not significantly improving the FRD.
Keywords
Stroke, Motor Training, Electrical Stimulation- The Effect of Triceps Brachii Vibration on Proprioception, during Motor Performance of Elbow Joint - a Normative Study
Authors
1 P.T School and Centre, Seth G.S.Medical College and KEM Hospital, Parel, Mumbai, IN
Source
Indian Journal of Physiotherapy & Occupational Therapy-An International Journal, Vol 6, No 4 (2012), Pagination: 81-86Abstract
The purpose of the study was to find the effect of triceps brachii vibration on proprioception, during motor performance of elbow joint. 150 healthy young participants within the age group of 18 - 26 years were selected. To confirm that the method of vibration alters proprioceptive sensation, testing the limb position matching during both passive and active movements, without and with vibration was carried out. Vibration was applied directly over the triceps brachii tendon and visual feedback was restricted for all participants. Ranges of motion for both elbow joints were documented. The data obtained was analyzed statistically and results were displayed graphically.
During the vibration trials, a significant difference was found in the scores obtained by the matching limb, in the passive driven condition and active matching condition. This finding confirms that a vibratory stimulus applied to the triceps brachii, during elbow flexion, induced a illusory response resulting in a movement perceived in the direction of elbow flexion.
Thus it can be concluded that, vibration given to a muscle tendon effectively produces kinaesthetic illusion of a movement.
Keywords
Vibration, Proprioception, Kinaesthetic IllusionReferences
- Eric D Vidoni and Lara A Boyd. Motor sequence learning occurs despite disrupted visual and proprioceptive feedback. Behavioral and Brain Functions 2008. 4:32 doi:10.1186/1744-9081-4-32
- J. P. Roll, J. P. Vedel and E. Ribot. Alteration of proprioceptive messages induced by tendon vibration in man: a microneurographic study. Experimental brain research 1989; 76: 213-222.
- Roll JP, Vedel JP. Kinaesthetic role of muscle afferents in man, studied by tendon vibration and microneurography. Exp Brain Res. 1982; 47(2) :177 – 90.
- J. C. Gilhodes, J. P. Roll, and M. F. Tardy-Gervet. Perceptual and motor effects of agonist-antagonist vibration in man. Experimental brain research 1986; 61: 395- 402
- Katja Pipereit, Otmar Bock, Jean- Louis Vercher. The contribution of proprioceptive feedback to sensorimotor adaptation. Experimental brain research 2006;174: 45- 52.
- Roll JP, Vedel JP. Kinesthetic role of muscle afferents in man, studied by tendon vibration and microneurography. Experimental brain research 2006;174: 45- 52.
- C. Capaday and J. D. Cooke. Vibration induced Changes in Movement- related EMG Activity in humans. Experimental brain research 1983; 52: 139- 146.
- Daniel J. Goble and Susan H. Brown. Upper Limb Asymmetries in the Matching of Proprioceptive Versus Visual Targets. J Neurophysiol 2008; 99: 3063–3074.
- Daniel J. Goble, Susan H. Brown . The biological and behavioural basis of upper limb asymmetries in sensorimotor performance. Neuroscience and Biobehavioral Reviews 32 (2008) 598–610.
- Diane E. Adamo, Bernard J. Martin .Position sense asymmetry. Exp Brain Res 2009; 192:87–95.
- Sarah Calvin- Figuiere . Patricia Romaiguere Jean-Claude Gilhodes . Jean- Pierre Roll. Antagonist motor responses correlate with kinesthetic illusions induced by tendon Vibration. Experimental brain research 1999; 124:342- 350.
- Effect of Sensory-specific Balance Training in Elderly
Authors
1 PT School and Center, Seth GSMC & KEMH, Parel, Mumbai-400012, IN
Source
Indian Journal of Physiotherapy & Occupational Therapy-An International Journal, Vol 6, No 3 (2012), Pagination: 162-166Abstract
Background: Postural control depends upon the ability to extract peripheral sensory inputs, integrating this information within the central nervous system (CNS), coordinate and execute an appropriate motor response. Age related changes in the ability to adjust to alteration in sensory information contribute to impaired postural stability. The purpose of this study was to investigate the effect of sensory-specific balance training on balance in elderly.
Aims: To study the effect of sensory-specific balance training on the balance in elderly.
Settings and design: Prospective longitudinal comparative study carried out at tertiary care hospital, Mumbai.
Materials and Methods: 60 healthy elders were randomly assigned balance training and fall prevention education group. Sensory specific balance training was given for period of 4 weeks. Participants were reassessed at end of 4 weeks. Outcome measures were modified: Clinical Test for Sensory Interaction on Balance, Fullerton advanced balance score, activities specific balance confidence scale and 1 RM.
Statistical analysis: Wilcoxson Signed rank test and Mann Whitney test were used to analyze the difference between the balance scores within group and intergroup
Results: Balance improved significantly in all four conditions of mCTSIB scale following sensory specific balance training(p<0.001) Improvements were seen in Fullerton Advanced Balance score(p<0.001) and Activities Specific Balance Confidence Scale score(p<0.001) but there was no improvement in 1 RM(p>0.001)
Conclusion: From the study it can be concluded that sensory-specific balance training can bring about a significant improvement in balance without any change in the muscle strength.
Keywords
Modified CTSIB, Healthy Elderly, Sensory Specific Balance TrainingReferences
- Anne Shumway-Cook, Majorie Woolacott. Postural Control.In Shumway CC .Motor Control-Translating research into clinical practice. ,Williams and Wikins, 2007: 157-257.
- Rose DJ. “Fall Proof! A Comprehensive Balance and Mobility Training for Elderly.”Windor, Ontario, Canada: Human Kinetics; 2003.
- Myers AM, Fletcher PC. Descriptive and evaluative properties of the “Activities Specific Balance Confidence Scale” J. Gerentology. Series A: Bio.Sci. and Med.Sci,1998; Vol 53, Issue 4, M287-M294.
- Brzycki, MStrength testing - Predicting a one-rep max from a reps-to-fatigue. Journal of Physical Education, Recreation and Dance.1993; 64 (1), 88-90.
- Rose DJ. “Fall Proof! A Comprehensive Balance and Mobility Training for Elderly.” Multisensory training Windor, Ontario, Canada: Human Kinetics; 2003.
- www.nari.org: Tips for Healthy ageing, Avoiding falls.
- Westlake et al, Sensory-specific balance training in older adults- Effect on Position, Movement and Velocity sense at ankle. Physical Therapy Journal, May 2007; vol 87, no. 5.
- Orrell AJ, Eves. Implicit Motor Learning of a Balance Task. Gait and Posture. 2006; 9-16.
- Fernando Ribeiro. aging effect on joint proprioception:the role of physical activity in propriception preservation.Eur Rev Aging Phy Act. 2007; 4; 71-76.
- SerrC,Borel L.Synergistic interaction and fictional working range of the visual and vestibular systems in postural control; neuronal correlates Prog Brain Res.1988; 76:196-203.
- Strabe and Brandt. Importance of the visual and vestibular cortex for self motion perception in man (circular vector). Hum Neuro Bio1987; 6 211-218.
- Pomperiano O. Experimental Central Nervous System lesions and posture. Black FO eds. Vestibular and visual control on posture and locomotor equilibrium. Basel:Karger. 1985; 218-231.
- Black IB, Adler JE et al. Neurotransmitter Plasticity at the molecular level. Science.1984; 225: 1266-1270.
- Glibert PFC et al .Purkinje cell activity during motor learning. Brain Res.1977; 128: 309-328.
- Rucker D, Rowe BH,,et al. Education Intervention to reduce fall and fear of falling in patients after fragility fracture: results of a controlled pilot study. Prev Med 2006; 42: 316-319.
- Chang JT, Morton SC, et al. Intervention for prevention of falls in older adults: systemic review and meta-analysis of randomized clinical trails. BMJ; 2004; 328: 680.