The Effectiveness of Additional Core Stability Exercises in Improving Dynamic Sitting Balance, Gait and Functional Rehabilitation for Subacute Stroke Patients (CORE-Trial): Study Protocol for a Randomized Controlled Trial.

BACKGROUND: Trunk impairment produces disorders of motor control, balance and gait. Core stability exercises (CSE) are a good strategy to improve local strength of trunk, balance and gait. Methods and analysis: This is a single-blind multicenter randomized controlled trial. Two parallel groups are compared, and both perform the same type of therapy. A control group (CG) (n = 110) performs conventional physiotherapy (CP) (1 h per session) focused on improving balance. An experimental group (EG) (n = 110) performs CSE (30 min) in addition to CP (30 min) (1 h/session in total). EG is divided in two subgroups, in which only half of patients (n = 55) perform CSE plus transcutaneous electrical nerve stimulation (TENS). Primary outcome measures are dynamic sitting, assessed by a Spanish version of Trunk Impairment Scale and stepping, assessed by Brunel Balance Assessment. Secondary outcomes are postural control, assessed by Postural Assessment Scale for Stroke patients; standing balance and risk of fall assessed by Berg Balance Scale; gait speed by BTS G-Walk (accelerometer); rate of falls, lower-limb spasticity by Modified Ashworth Scale; activities of daily living by Barthel Index; and quality of life by EQ-5D-5L. These are evaluated at baseline (T0), at three weeks (T1), at five weeks (end of the intervention) (T2), at 17 weeks (T3) and at 29 weeks (T4). Study duration per patient is 29 weeks (a five-week intervention, followed by a 24-week post-intervention).

Aplicabilidad y limitaciones de las pruebas de ejecución funcional en el cribado de fragilidad al alta de un centro de atención intermedia / Applicability and limitations of physical performance tests for frailty screening on discharge from an intermediate care hospital

INTRODUCCIÓN: La fragilidad puede ser detectada con distintas herramientas y en múltiples entornos. Entre los diferentes sistemas de cribado, la velocidad de marcha (VM) y el Timed Up-and- Go (TUG) se postulan como sistemas sencillos y fácilmente aplicables. Existen pocos datos sobre su aplicabilidad en pacientes hospitalizados en centros de atención intermedia. MATERIAL Y MÉTODOS: Estudio descriptivo para determinar la aplicabilidad de la VM y el TUG como herramientas de cribado de fragilidad en un hospital de atención intermedia, así como una estimación de la prevalencia de fragilidad al alta mediante estas pruebas de ejecución funcional. Se consideraron frágiles los pacientes con una VM<1m/s y/o un TUG>12s. Se incluyeron todos pacientes atendidos por la unidad de rehabilitación del centro a lo largo del año 2015. RESULTADOS: Novecientos nueve fueron los pacientes incluidos (edad media de 80,12 años). De estos, solo 205 (22,6%) estaban en condiciones de realizar la VM y TUG en el momento del alta; de estas 205 personas, el 89,8% (VM) y el 92,2% (TUG) presentaban criterios de fragilidad, no habiendo diferencias estadísticamente significativas entre ambas herramientas (p = 0,25). CONCLUSIONES: La utilización de la VM y el TUG para el cribado de fragilidad tiene una aplicabilidad limitada en el entorno de atención intermedia. A pesar de ello, los resultados obtenidos indican una alta prevalencia de fragilidad en este entorno. Serán necesarios más estudios para corroborar estos datos

INTRODUCTION: Frailty screening can be performed with different tools and in multiple settings. Among the different evaluation systems, gait speed (GS) and Timed Up-and-Go (TUG) are postulated as simple and easy to apply systems. There are few data on the prevalence of frailty in intermediate care centre inpatients. MATERIAL AND METHODS: Descriptive study to determine the applicability of GS and TUG as frailty screening tools in an intermediate care hospital, as well as an estimate of frailty prevalence at discharge. Frailty was considered when GS<1m/s and / or TUG>12seconds. The study included all patients attending the rehabilitation unit of the centre throughout 2015. RESULTS: A total of 909 patients were included (mean age of 80.12 years). Only 205 (22.6%) were able to perform GS and TUG at discharge from the rehabilitation unit. Frailty prevalence for this group was between 89.8% (GS) and 92.2% (TUG), with no statistical differences between both tools (P=.25). CONCLUSIONS: The applicability of GS and TUG for frailty screening in intermediate care hospitals is limited. Despite this, the results obtained suggest a high prevalence of frailty. More studies will be necessary to corroborate this data

[Applicability and limitations of physical performance tests for frailty screening on discharge from an intermediate care hospital]. / Aplicabilidad y limitaciones de las pruebas de ejecución funcional en el cribado de fragilidad al alta de un centro de atención intermedia.

INTRODUCTION: Frailty screening can be performed with different tools and in multiple settings. Among the different evaluation systems, gait speed (GS) and Timed Up-and-Go (TUG) are postulated as simple and easy to apply systems. There are few data on the prevalence of frailty in intermediate care centre inpatients. MATERIAL AND METHODS: Descriptive study to determine the applicability of GS and TUG as frailty screening tools in an intermediate care hospital, as well as an estimate of frailty prevalence at discharge. Frailty was considered when GS<1m/s and / or TUG>12seconds. The study included all patients attending the rehabilitation unit of the centre throughout 2015. RESULTS: A total of 909 patients were included (mean age of 80.12 years). Only 205 (22.6%) were able to perform GS and TUG at discharge from the rehabilitation unit. Frailty prevalence for this group was between 89.8% (GS) and 92.2% (TUG), with no statistical differences between both tools (P=.25). CONCLUSIONS: The applicability of GS and TUG for frailty screening in intermediate care hospitals is limited. Despite this, the results obtained suggest a high prevalence of frailty. More studies will be necessary to corroborate this data.