The Impact of Physical Exercises with Elements of Dance Movement Therapy on Anthropometric Parameters and Physical Fitness among Functionally Limited Older Nursing Home Residents.

Changes in the composition of the body mass of functionally limited older patients may contribute to a decrease in functional fitness and the development of chronic diseases. This research aimed to assess the differences in anthropometric parameters and physical fitness of older patients, over the age of 65, in a 12-week clinical intervention study. Method: The study participants were nursing home inhabitants aged 65-85 who were functionally limited. Persons meeting the inclusion criteria were assigned to one of the three groups: Group 1-basic exercises/BE group (n = 56); Group 2-physical exercises with elements of dancing/PED group (n = 57); Group 3-control group/CO group (n = 56) routine care. The data were collected at the beginning of the study and at the 12-week mark. The outcome was observed for hand grip strength (HGS), arm curl test (ACT), Barthel Index (BI), Berg Balance Scale (BBS), triceps skin fold (TSF), waist-to-hip-ratio (WHR), and arm muscle area (AMA). Results: The study included 98 women and 71 men. The average age of the participants was 74.40 years. The analysis of the effects of the 12-week exercise program showed the greatest changes in HGS, ACT, and BI in the exercise groups, especially in the PED group compared to the BE group. Statistically significant differences in the examined parameters of the PED vs. BE vs. CO groups were demonstrated in favour of the exercising groups. In conclusion, a 12-week program of group physical exercises, both PED and BE, improves physical fitness indicators and anthropometric indicators.

The impact of physical exercises with elements of dance movement therapy on the upper limb grip strength and functional performance of elderly wheelchair users living in nursing homes - a randomized control trial.

INTRODUCTION: Over the last few decades, the quality of care and the quality of life of nursing home (NH) residents have significantly improved, but insufficient physical activity and social involvement still represent substantial challenges in modern nursing facilities. The main aim of this research was to assess the influence of physical exercises with dance movement therapy (DMT) elements on strength and other fitness components of the upper limbs and the overall functional performance of NH residents in wheelchairs compared to standard exercise programmes and usual care. METHOD: The study participants were persons aged 68-85 who lived in NH and used manual wheelchairs as a primary means of mobility. Individuals meeting the inclusion criteria were assigned to one of the three groups: Group 1, basic exercise/BE group (n = 55); group 2, physical exercises with elements of dance movement therapy/PED group (n = 55); and group 3, control group, usual care/CO group (n = 55). The intervention for both exercising groups consisted of a 30-min session, two times a week, for 12 weeks in total. Outcome assessments were performed at baseline, 12 weeks after baseline (immediately after the intervention) and 24 weeks after baseline (12 weeks after the intervention). The main outcome was observed for hand grip strength (HGS), while secondary outcomes for box and block test (BBT), arm curl test (ACT), back scratch test (BS), chair sit-and-reach (CSR), peak expiratory flow (PEF), Barthel Index (BI), Berg Balance Scale (BBS) and the range of motion of the shoulder. RESULTS: Prior to the start of the exercise programmes, all the tested groups were homogeneous. After 12 weeks the PED group presented higher statistically significant scores in HGSL, BBT, ACT, BS, CSR, BI, BBS: p < 0.001 and HGSR: p = 0.01, compared to the BE group. After 24 weeks from the beginning of the intervention the comparison between the PED group and the BE group showed statistically significant differences (p < 0.001) in favour of PED group in almost all areas: HGSR, HGSL, BBT: ACT, PEF, BS, CSR, BI. After 12 and 24 weeks both intervention groups performed better than the CO in all measures except for Katz ADL and shoulder extension. CONCLUSION: Twelve weeks of physical exercises had beneficial effects on the strength and fitness of the upper limbs and overall functional performance in both exercise groups. This study demonstrated that group performing physical exercises with elements of DMT obtained statistically better scores in the majority of analysed domains than other groups. TRIAL REGISTRATION: The study was registered in the Sri Lanka Clinical Trials Registry (Registration Number - SLCTR/2018/014 - Date of Registration 16/05/2018. Accessed on https://slctr.lk/trials/1045 ).

Analysis of the association between selected factors and outcomes of treadmill gait training with biofeedback in patients with chronic stroke.

OBJECTIVE: To examine the effects of age, time from stroke onset, gender and side of paresis in gait re-education with the use of treadmill with biofeedback, in patients with chronic stroke. METHODS: The study was performed with a group of 50 patients. 10-metre walk test, 2-minute walk test, "Up and Go" test, the number of steps performed with the paretic lower limb at a distance of 10 metres, Barthel index and FIM scale were used to assess the effects of rehabilitation. RESULTS: The study shows that the subjects' abilities and fitness prior to the rehabilitation were not related to age, sex or side of paresis. Analysis of the impact of age, time from stroke and sex on rehabilitation outcomes showed no statistically significant correlations. On the other hand, analysis of rehabilitation results relative to the side of paresis showed that the latter factor significantly differentiates rehabilitation outcomes measured with gait velocity test - p= 0.045. CONCLUSION: Age, duration of time from stroke onset, and sex do not affect outcomes of gait re-education based on treadmill training in patients at a chronic stage post-stroke and Brunnstrom recovery stage 3-4. Side of paresis significantly differentiates rehabilitation outcomes measured with speed test. The best scores in all the performance measures before rehabilitation were identified in the group 3-6 years after stroke.

The Efficacy of Gait Training Using a Body Weight Support Treadmill and Visual Biofeedback in Patients with Subacute Stroke: A Randomized Controlled Trial.

BACKGROUND: This study was designed to determine whether or not gait training based on the use of treadmill with visual biofeedback and body weight support (BWS) would produce better effects in patients with subacute stroke compared to BWS treadmill training with no visual biofeedback. MATERIALS AND METHODS: 30 patients with subacute stroke were randomly assigned to do body weight supported treadmill training with visual biofeedback (BB group) or BWS treadmill training without visual biofeedback. Their gait was assessed with a 3D system (spatiotemporal gait parameters and symmetry index) and by means of 2-minute walk test (2 MWT), 10-metre walk test (10 MWT), and Timed Up & Go test. Subjects in both groups participated in 15 treadmill training sessions (30 minutes each). RESULTS: The participants from both groups achieved a statistically significant improvement in spatiotemporal gait parameters, walking speed, endurance, and mobility. The average change in the BB group after the end of the programme did not differ significantly compared to the change in the control group. The change in the symmetry index value of stance phase in the BB group was 0.03 (0.02) and in the control group was 0.02 (0.02). The difference was not statistically significant (p = 0.902). The statistically significantly higher improvement in the BB group was found in the range of walking speed (p = 0.003) and endurance (p = 0.012), but the difference between groups was of low clinical significance. CONCLUSIONS: The findings do not confirm that BWS treadmill training with the function of visual biofeedback leads to significantly greater improvement in gait compared to BWS treadmill training with no visual biofeedback at an early stage after stroke. This study was registered at ClinicalTrials.gov, ID: ACTRN12616001283460.

Changes in Gait Symmetry After Training on a Treadmill with Biofeedback in Chronic Stroke Patients: A 6-Month Follow-Up From a Randomized Controlled Trial.

BACKGROUND One of the most significant challenges for patients who survive a stroke is relearning basic motor tasks such as walking. The goal of this study was to evaluate whether training on a treadmill with visual biofeedback improves gait symmetry, as well as spatiotemporal and kinematic gait parameters, in stroke patients. MATERIAL AND METHODS Thirty patients in the chronic phase after a stroke were randomly allocated into groups with a rehabilitation program of treadmill training with or without visual biofeedback. The training program lasted 10 days. Spatiotemporal and kinematic gait parameters were evaluated. For all parameters analyzed, a symmetrical index was calculated. Follow-up studies were performed 6 months after completion of the program. RESULTS The symmetrical index had significantly normalized in terms of the step length (p=0.006), stance phase time, and inter-limb ratio in the intervention group. After 6 months, the improvement in the symmetry of the step length had been maintained. In the control group, no statistically significant change was observed in any of the parameters tested. There was no significant difference between the intervention group and the control group on completion of the program or at 6 months following the completion of the program. CONCLUSIONS Training on a treadmill has a significant effect on the improvement of spatiotemporal parameters and symmetry of gait in patients with chronic stroke. In the group with the treadmill training using visual biofeedback, no significantly greater improvement was observed.

Efficacy of gait training using a treadmill with and without visual biofeedback in patients after stroke: A randomized study.

OBJECTIVES: To evaluate the effects of gait training using a treadmill with and without visual biofeedback in patients in the late period after stroke, and to compare both training methods. DESIGN: A randomized, controlled study. SUBJECTS: Fifty people at least 6 months after stroke, randomly enrolled into groups with a rehabilitation programme of treadmill training with or without visual biofeedback. METHODS: Spatio-temporal gait parameters, walking speed, walking distance, self-reliant mobility and functional capacity were evaluated during a programme of 10 sessions over 2 weeks. RESULTS: Patients in both groups achieved statistically significant improvement. Participants in the intervention group revealed a significantly greater improvement in the shortening of the stance phase (p = 0.0045) and lengthening of the swing phase of the unaffected limb (p = 0.0042) and an increase in the unaffected limb cycle length (p = 0.0021). There were no significant differences between groups in other spatio-temporal parameters of gait or additionally assessed parameters. CONCLUSION: Gait training using a treadmill resulted in improvements in the gait and functional capacity of patients. The use of biofeedback gives better results in improving gait cycle length, duration of gait phases and swing phase speed compared with exercise on a treadmill alone.

Immediate and long-term effects of selected physiotherapy methods in patients with carpal tunnel syndrome.

BACKGROUND: Carpal tunnel syndrome is a serious therapeutic problem and it considerably impairs the patients' quality of life. Despite many studies, the effectiveness of conservative treatment is still debatable. This study aimed to evaluate the immediate and long-term effects of conservative treatment involving ultrasound therapy combined with massage and kinesiotherapy for carpal tunnel syndrome. MATERIAL AND METHODS: A total of 61 patients with carpal tunnel syndrome were assessed with regard to such symptoms as pain, numbness, tingling sensation, morning stiffness, and self-care difficulties. We used provocation tests and investigated sensory impairments, autonomic disturbances, and Lüthy's sign. Conduction in the median nerve fibres was assessed during a nerve conduction study. We performed computer-aided measurement of the hand joint range of motion and global grip strength. The tests were conducted before and on completion of a rehabilitation programme. The hands were re-examined one year later. The treatment involved ultrasound therapy, massage, and kinesiotherapy. RESULTS: The treatment outcomes confirmed the effectiveness of the therapeutic programme. Significant improvements concerning the majority of the symptoms were observed between the first and second examination as well for the entire follow-up period. We observed significant improvement in the quality of sensation, the hand range of motion and muscle strength. CONCLUSIONS: Ultrasound therapy combined with massage and kinesiotherapy brings the expected, long-term effects in patients with carpal tunnel syndrome.

The use of a treadmill with biofeedback function in assessment of relearning walking skills in post-stroke hemiplegic patients--a preliminary report.

BACKGROUND AND PURPOSE: One of the most important goals of rehabilitation of post-stroke hemiplegic patients is the recovery of their locomotion function. The aim of the study was to assess walking function recovery by means of in-patient rehabilitation procedures, as well as the effectiveness of treadmill gait training with the use of biological feedback. MATERIAL AND METHODS: The research involved groups of chronic post-stroke hemiplegic patients receiving treatment in the rehabilitation ward. Factors under scrutiny included walking speed and capacity, number of steps, weight bearing symmetry for lower extremities while standing, lower limb mobility on the Brunnström scale, and muscle tone on the Ashworth Scale. The study group patients followed a rehabilitation regime that included treadmill training aided with biofeedback function. Each study group participant exercised every day (a total of 15 times), with a single practice time ranging from 5 to 20 minutes. Control patients followed a rehabilitation regime without the additional treadmill exercises. RESULTS: Patients in both groups demonstrated improvement in locomotion abilities. In the group following the physiotherapy regime supplemented with treadmill training with the use of biofeedback, the measures of walking speed, weight bearing symmetry for lower extremities, and number of steps were better than in controls. CONCLUSIONS: Treadmill gait training with the use of biofeedback is effective for relearning locomotion functions in post-stroke hemiplegic patients and can constitute a significant type of exercise in a physiotherapy regime.