Effect of Early Bedside Arm and Leg Cycle Ergometry on Sitting and Standing ability in Hospitalized acute Stroke Patients: A Randomized Controlled Trial.

Objectives: The objective of this study was to evaluate the effect of early bedside arm and leg cycle ergometer exercises as compared to routine physiotherapy on sitting and standing ability in hospitalized acute stroke patients. Materials and Methods: Thirty-four consecutive patients with acute stroke were included in the randomized controlled trial. Patients were divided into two groups based on 1:1 simple randomization Experimental group (n = 18) and control group (n = 16). Experimental Group received arm and leg cycle ergometry along with conventional physiotherapy exercises, while the patients in the control group received conventional physiotherapy exercises. Both the groups received treatment for a total duration of 50 min session, twice a day for 7 days. Preintervention and postintervention measurements were taken for both groups using performance-oriented mobility assessment, postural assessment scale for stroke, Motricity Index, and Trunk control scale. Results: Statistically significant improvement (P < 0.05) was observed in the experimental group and control groupafter intervention among all the outcome measures. Conclusions: Early bedside intervention of cycle ergometer along with routine physiotherapy is effective in improving the sitting and standing abilities, trunk control, and motor function in acute stroke survivors.

Effects of Cognitive Versus Mind-Motor Training on Cognition and Functional Skills in the Community-Dwelling Older Adults.

BACKGROUND: There is a decline in cognitive and functional skills in older adults. The objective of this study was to compare the effects of cognitive and mind-motor training (MMT) on cognition and functional skills in a community-dwelling sample of older adults. METHODS: In this observer-blinded randomized clinical trial, 40 older adults with medical stability, ability to comprehend and respond to simple verbal instructions, no diagnosed psychological disorders, absence of severe visual and hearing problems, the capacity to walk independently, and a score of more than 46 in Berg Balance Scale were included. They were randomly allocated into cognitive or MMT groups. Cognitive training (CT) was practiced with activities for memory and attention, using paper-pencil tasks. MMT was practiced using a simple, indoor based square-stepping exercise. They practiced one-hour of training per day, three days a week, for eight weeks. RESULTS: General linear model analysis showed that the time by groups was not statistically significant. The mean (standard deviation) scores in General Practitioner Assessment of Cognition Scale and Hindi Mental State Examination improved significantly (P < 0.001) following MMT [1.75 (1.29); 2.4 (1.34)] and CT [1.5 (1.36); 2.7 (0.99)]. The functional skills measured using Lawton Instrumental Activities of Daily Living Scale revealed beneficial changes for both the groups. None of the outcomes were statistically significant between the groups (P > 0.05). CONCLUSION: Both cognitive and MMTs showed similar practice effects on cognition and functional skills in community-dwelling older adults.

Dynamic Surface Exercise Training in Improving Trunk Control and Gross Motor Functions among Children with Quadriplegic Cerebral Palsy: A Single Center, Randomized Controlled Trial.

BACKGROUND: Dynamic surface provides proprioceptive and vestibular feedback with optimal level of arousal. The activities on unstable environment have greater sensorimotor experiences. There is a lack of evidence examining the benefits of dynamic surface exercise training (DSET) among the children with spastic quadriplegic cerebral palsy (CP). AIM: The aim of the study was to analyze the effect of dynamic surface exercises on trunk control and gross motor functions in children with quadriplegic CP. MATERIALS AND METHODS: A total of 30 children with spastic quadriplegic CP with Gross Motor Function Classification System of levels III and IV were recruited by the simple random sampling method (random number generator) to participate in this randomized controlled study. Recruited children were randomly divided into two groups, DSET group and standard physiotherapy training group. Both the groups received active training program lasting for 60 min, 4 days/week for 6 weeks. Gross Motor Function Measure (GMFM)-88 and Pediatric Balance Scale (PBS) scores were recorded at baseline, and at the end of 6-week post-intervention. RESULTS: Total 30 children with quadriplegic CP with mean age 6.64 ± 2.15 years in experimental group and 6.50 ±1.59 years in control group participated in the study. Experimental group showed a significant difference for GMFM and PBS scores between pre- and post-intervention with P < 0.005. A significant difference was observed in GMFM scores between experimental and control group with P < 0.005. CONCLUSION: Six-week dynamic surface exercise therapy along with standard physiotherapy was effective in improving trunk control and gross motor function performance among children with spastic quadriplegic CP aged 6-12 years.

Effects of Task-oriented Activities Based on Neurodevelopmental Therapy Principles on Trunk Control, Balance, and Gross Motor Function in Children with Spastic Diplegic Cerebral Palsy: A Single-blinded Randomized Clinical Trial.

PURPOSE: To examine the effects of task-oriented activities based on neurodevelopmental therapy (TOA-NDT) principles on trunk control, balance, and gross motor function in children with spastic diplegic cerebral palsy (SDCP). MATERIALS AND METHODS: Forty-four children with SDCP, aged 7-15 years, were recruited to participate in the randomized clinical trial. After random allocation, twenty-two (n = 22) children with SDCP participated in TOA-NDT principles and twenty-two (n = 22) in conventional physiotherapy (CPT) program. Each group underwent the treatment for a duration of 60min per day, 6 days a week for 6 weeks. Gross motor function measure-88 (GMFM-88), postural assessment scale (PAS), pediatric balance scale (PBS), and trunk impairment scale (TIS) were the outcome measures used to document the pre- and post-intervention effect. RESULTS: The mean difference of GMFM-88, PAS, PBS, and TIS was 8.53 (5.84-11.23), 0.90 (5.84-11.23), 4.86 (2.93-6.79), and 1.45 (0.30-2.60), respectively. TOA-NDT group showed improvement in all the outcomes. CONCLUSION: TOA-NDT principles are more beneficial in improving the trunk control, balance, and gross motor function parameters than CPT.