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1.
Motor Control ; : 1-23, 2021 Jan 12.
Artigo em Inglês | MEDLINE | ID: mdl-33440347

RESUMO

This study aimed to investigate the dual-task cost of both motor and cognitive performances in patients with multiple sclerosis (PwMS) and in healthy controls and to determine their relationships with clinical features in PwMS. The participants performed motor tasks (postural stability, walking, and manual dexterity) and cognitive tasks (mental tracking and verbal fluency) under single- and dual-task conditions. The results showed that postural stability under dual-task conditions did not change, whereas walking and manual dexterity deteriorated, regardless of the concurrent cognitive task, in PwMS (median Expanded Disability Status Scale score: 1) and the healthy controls. Verbal fluency decreased during postural stability, whereas it increased during walking, and it was maintained during manual dexterity in both groups. Mental tracking did not change during walking; it declined during manual dexterity in both groups. Mental tracking during postural stability deteriorated in PwMS, while it did not change in the healthy controls. In general, dual-task costs were associated with baseline performances of tasks rather than clinical features. Therefore, baseline performances of both tasks should be increased for improving dual-task performance in PwMS.

2.
Turk J Med Sci ; 2020 Dec 14.
Artigo em Inglês | MEDLINE | ID: mdl-33315344

RESUMO

BACKGROUND/AIMS: Vestibular rehabilitation has an important role in the reduction of symptoms and in the recovery of patients in peripheral vestibular pathologies. Objective and subjective vestibular assessment tools are needed to assess vestibular rehabilitation effectiveness. The aims of the study were to develop the Turkish version of the internationally used Vestibular Rehabilitation Benefit Questionnaire (VRBQ) measure and to demonstrate the reliability and validity properties of the Turkish version in patients with peripheral vestibular hypofunction (PVH). MATERIALS AND METHODS: 110 patients with unilateral PVH were included. For the analysis of test-retest reliability, Turkish version of VRBQ developed by translation-back translation method was applied to patients on the day of admission and the day after admission. To assess validity, patients were also evaluated with the VRBQ, Dizziness Handicap Inventory (DHI), Vertigo Symptom Scale-Short Form (VSS-SF), Vertigo Dizziness Imbalance (VDI) Questionnaire. RESULTS: The VRBQ showed moderate to excellent internal consistency in total score and subscales scores (VRBQ-Total Cronbach?s ? = 0.91; Dizziness ? = 0.81; Anxiety ? = 0.68; Motion-Provoked Dizziness ? = 0.89; Sypmtoms ? = 0.88; Health-related Quality of Life ? = 0.87). In the test-retest reliability of VRBQ-Total score was excellent (ICC = 0.94). The Dizziness, the Anxiety, the Motion-Provoked Dizziness, Symptoms and the Health-related Quality of Life domains? ICC were found respectively 0.90, 0.89, 0.84, 0.90 and 0.92. The construct validity of the VRBQ was determined. The VRBQ total was correlated with all parameters (r: 0.308 to - 0.699, p < 0.05). The highest positive correlation was found between VRBQ total and DHI-Functional (r: 0.680). The highest negative correlation was found between VRBQ total and VDI-Total (r: - 0.699). CONCLUSIONS: The results suggest that the Turkish version of the VRBQ is reliable and valid for evaluating the vestibular rehabilitation results.

3.
Int J Rehabil Res ; 43(4): 316-323, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32804701

RESUMO

The factors associated with cognitive functions in patients with multiple sclerosis (PwMS) are not yet clear. The aims of this study were (1) to compare clinical features and physical performance in healthy controls, and PwMS with and without cognitive impairment, and (2) to determine the relationship between cognitive domains and demographics characteristics, clinical features and physical performance in PwMS. A total of 112 PwMS and 25 healthy controls participated in this study. Cognitive functions were evaluated by Brief Repeatable Battery of Neuropsychological Tests (BRB-N). Based on cognitive performances by BRB-N, PwMS were divided into two groups as MS patients with impaired (MS-I, n: 57) and with normal (MS-N, n: 55) cognitive functions. For clinical features, fatigue, mood and sleep quality were evaluated by the Fatigue Impact Scale, Beck's Depression Inventory, Pittsburgh Sleep Quality Index, respectively. For physical performances, balance and walking capacity were evaluated by posturography and Six-Minute Walking Test, respectively. The results showed that the education years, postural stability and walking capacity in MS-N and healthy controls were higher than in MS-I (P < 0.05). In addition, visuospatial memory was correlated with both postural stability under all sensory conditions and walking capacity; verbal memory was correlated with education years, postural stability on eyes closed-foam surface and walking capacity; verbal fluency was correlated with only walking capacity; information processing speed was correlated with education years, postural stability under all sensory conditions and walking capacity (P < 0.001). This study suggests that the interventions that aim to improve physical performance might protect and even improve cognitive functions in PwMS.

4.
Acta Orthop Traumatol Turc ; 54(4): 408-413, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32812874

RESUMO

OBJECTIVE: The aim of this study was to translate the Self-Reported Foot and Ankle Score (SEFAS) into Turkish and to determine the validity and reliability of the translated version in patients with foot or ankle pain. METHODS: A total of 98 patients (65 females, 33 males, mean age=39 years, age range 18-65 years) who presented with foot or ankle pain for at least one week were included in the study. SEFAS was translated into Turkish (SEFAS-T) and then back-translated into English by two bilingual translators to ensure the accuracy of translation. To determine the validity of the translated version, SEFAS-T, The Foot and Ankle Outcome Score (FAOS), and the Short Form 36 (SF-36) were administered at the first assessment on the same day. SEFAS-T was repeated five days later (Spearman's rho). Intra-class correlation coefficients (ICCs) were used for assessment of the test re-test reliability, while the Cronbach's alpha coefficient was used to assess the internal consistency of the questionnaire Results: SEFAS-T showed good test-retest reliability (ICC: 0.887). Item 4 showed poor item-total correlation and inter-item correlations. When item 4 was excluded, the Cronbach's alpha value was found as 0.906. SEFAS-T total scores showed correlation with all the FAOS sub-scores (p<0.001) and all the SF-36 components (p≤0.001) except mental health (rho: 0.149, p: 0.143). The highest correlation was found between SEFAS-T Total Score and the Sports and Recreations subscale of FAOS (rho: 0.796, p<0.001). CONCLUSION: SEFAS-T seems to be valid and reliable as a measure for foot or ankle pain in Turkish patients. LEVEL OF EVIDENCE: Level II, Diagnostic study.

5.
Mult Scler Relat Disord ; 45: 102419, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32736216

RESUMO

BACKGROUND: Cognitive impairment is common in patients with multiple sclerosis (MS). The effects of different exercise trainings on cognitive functions in patients with MS are promising. However, the effects are not yet clear in MS patients with cognitive impairment. This study aimed to investigate the effect of combined exercise training on different cognitive functions in MS patients with cognitive impairment. METHODS: Relapsing-remitting and mild disabled MS patients with cognitive impairment were randomly assigned to two groups: Exercise Group (EG, n:17) and the Control Group (CG, n:17). The EG received a combined exercise training consisting of aerobic and Pilates training in three sessions per week for 8 weeks while the CG performed the relaxation exercises at home. Cognitive functions, walking capacity, fatigue, mood, and quality of life were assessed at baseline and after eight weeks using the Brief Repeatable Battery of Neuropsychological Tests (BRB-N), Six-Minute Walk Test (6-MWT), Fatigue Impact Scale (FIS), Beck's Depression Inventory (BDI) and MS Quality of Life-54 (MSQoL-54), respectively. RESULTS: This study showed significant group-by-time interactions on long-term verbal memory, walking capacity, cognitive fatigue, and physical quality of life in favor of the EG (p<0.003). Moreover, verbal memory, visuospatial memory, verbal fluency, information processing speed, walking capacity, fatigue, and quality of life improved in the EG (p<0.05) while only verbal memory increased in the CG (p<0.05). Furthermore, the change in visuospatial memory was associated with the change in mental quality of life (r:0.352, p: 0.041) while the change in verbal fluency (r: -0.362, p:0.035) and processing speed (r: -0.356, p:0.039) were associated with the change in mood. CONCLUSION: Combined exercise training has beneficial effects on different cognitive functions in mild disabled RRMS patients with cognitive impairment. In addition, there is a mutual relationship in improvements in cognitive functions, mood, and quality of life after exercise.

6.
Eur Geriatr Med ; 11(3): 417-426, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32297254

RESUMO

PURPOSE: The objectives of this study were to examine (1) the intrarater, interrater, and test-retest reliability of the timed 360° turn test in people with Parkinson's Disease (PwPD); (2) the minimum detectable change in the timed 360° turn test times; (3) the concurrent and discriminant validity of the timed 360° turn test; (4) the cut-off times which best discriminate PwPD from healthy people and fallers from non-fallers with Parkinson's Disease (PD). METHODS: Fifty-four PwPD and 32 healthy people were included. The timed 360° turn test was administered along with Timed Up and Go Test, Berg Balance Scale, Four Square Step Test, Unified Parkinson's Disease Rating Scale, and Hoehn and Yahr Scale. In addition, PwPD were categorized into fallers and non-fallers based on fall history. Reliability analyses were assessed using intraclass correlation coefficients in a subgroup of 38 PwPD. RESULTS: The timed 360° turn test had excellent intrarater, interrater, and test-retest reliability. It was strongly correlated with other outcome measures (p < 0.001). In both sides, significant differences in the timed 360° turn test times were found between PwPD and healthy people and between fallers and non-fallers with PD (p < 0.001 and p < 0.001, respectively). The timed 360° turn test times of 3.76-3.89 s were found to best discriminate PwPD from healthy people, while 5.46-5.74 s were found to best discriminate fallers from non-fallers with PD. The minimum detectable change in the timed 360° turn test times were 1.98 s for dominant side and 1.48 s for non-dominant side in PwPD. CONCLUSIONS: The timed 360° turn test is a reliable, valid, and clinically available tool for assessing turning ability in PwPD.

7.
NeuroRehabilitation ; 46(3): 343-353, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32310197

RESUMO

BACKGROUND: Exercise training has positive effects on motor and cognitive performance which deteriorates over time in patients with Multiple Sclerosis (MS). The effects of task-oriented circuit training (TOCT) on motor and cognitive performance in patients with MS are not yet clear. OBJECTIVE: The aims of this study are to investigate the effects of TOCT on balance, walking, manual dexterity, cognitive performance, and to determine the extent to which patients are able to transfer changes in their performance to activities of daily living. METHODS: Twenty patients with MS (EDSS: 2-5.5), were randomly assigned to two groups; the task-oriented circuit training group (TOCTG, n:10) and the control group (CG, n:10). The TOCTG received TOCT twice a week for six weeks while the CG performed the relaxation exercises at home. All patients were assessed by using Modified Sensory Organization Test, Berg Balance Scale, Activities-specific Balance Confidence, Timed Up and Go, Functional Gait Assessment, 12-item Multiple Sclerosis Walking Scale, Nine-Hole Peg Test, Brief Repeatable Battery of Neuropsychological Tests, Multiple Sclerosis Neuropsychological Questionnaire. RESULTS: Balance and walking performance were improved after TOCT (p < 0.05), whereas manual dexterity and cognitive performance except for verbal memory did not change significantly (p > 0.05). The CG showed no changes in any measurements (p > 0.05). CONCLUSIONS: TOCT is quite effective to improve balance and walking in patients with MS. However, further studies are needed to determine the effect of TOCT on cognitive performance.


Assuntos
Exercícios em Circuitos/métodos , Cognição/fisiologia , Terapia por Exercício/métodos , Esclerose Múltipla , Humanos , Esclerose Múltipla/fisiopatologia , Esclerose Múltipla/psicologia , Esclerose Múltipla/reabilitação , Testes Neuropsicológicos
8.
Acta Neurol Belg ; 2019 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-31741209

RESUMO

Goal-based training such as task practice combined with aerobic training (AT) has been suggested to improve motor performance and neuroplasticity for people with Parkinson's Disease (PwPD); however, its effect on clinical outcomes is unclear. Therefore, the main aim was to investigate the effects of task-oriented circuit training combined with AT (TOCT-AT) on balance and gait in PwPD. The secondary aim was to investigate the effects of TOCT-AT on functional mobility, balance confidence, disease severity, and quality of life. Twenty-six PwPD were randomly assigned to either to the experimental group (n = 14) or the control group (n = 12). The control group received AT, while the experimental group received TOCT-AT three times a week for 8 weeks. The main outcomes were the Berg Balance Scale (BBS), Postural Stability Test (PST), Limits of Stability Test (LOS), Pull Test (PT), Six Minute Walk Test (6MWT), Timed Up and Go Test (TUG), Activities-specific Balance Confidence Scale (ABC), Unified Parkinson's Disease Rating Scale (UPDRS), and eight-item Parkinson's Disease Questionnaire (PDQ-8) were secondary outcomes. After intervention, between-group comparisons showed that the experimental group significantly improved more than the control group in all outcomes (p < 0.05). Additionally, both groups significantly improved in BBS, 6MWT, TUG, ABC, UPDRS-II, UPDRS-III, UPDRS total, and PDQ-8 (p < 0.05), while only the experimental group significantly improved in PST, LOS, and PT (p < 0.001). This study suggest that TOCT-AT could improve balance and gait performance, which could also be positively translated into functional mobility, balance confidence, disease severity, and quality of life in PwPD.

9.
Physiother Theory Pract ; : 1-12, 2019 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-31319754

RESUMO

Objectives: To investigate (1) the intrarater, interrater, and test-retest reliability of the timed 360° turn test in people with Multiple Sclerosis (MS); (2) the minimum detectable change in the timed 360° turn test times; (3) the concurrent and discriminant validity of the timed 360° turn test times; and (4) the cut-off times that best discriminate people with MS from healthy people and fallers from non-fallers with MS. Method: Sixty-one people with MS (Expanded Disability Status Scale, EDSS, 0-6.5) and 34 healthy people were recruited in this cross-sectional study. The timed 360° turn test was administered along with the Timed Up and Go Test, Berg Balance Scale, Four Square Step Test, and EDSS by two independent raters. Results: The timed 360° turn test showed good intrarater, interrater, and test-retest reliability. Minimal detectable changes were 1.49 s and 1.53 s for the dominant and non-dominant sides, respectively. The timed 360° turn test was strongly correlated with other outcome measures. Significant differences in 360° turn times were found between people with MS and healthy people and between fallers and non-fallers with MS (p < .001 and p < .001, respectively). The cut-off times of 2.65 s on the dominant side and 2.42 s on the non-dominant best discriminated people with MS from healthy people, while 3.65 s on the dominant side and 3.75 s on the non-dominant best discriminated fallers from non-fallers with MS. Conclusions: The timed 360° turn test is a simple and reliable tool for assessing turning ability in MS.

10.
NeuroRehabilitation ; 44(1): 67-77, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30814369

RESUMO

BACKGROUND: Balance disorders cause disability in stroke and increase risk of falls. The Balance Evaluation Systems Test (BESTest), examines balance, determines parameters causing balance disorders, provides information on risk factors for falls. OBJECTIVE: To investigate the sensitivity and specificity of the BESTest in determining the risk of falls in stroke patients. METHODS: Fifty patients with chronic stroke were included in the study. Balance was assessed using BESTest, Berg Balance Scale (BBS), Activity Specific Balance Confidence scale (ABC) and Biodex-BioSway Balance System. To examine the content validity of BESTest, the relationship between BESTest and other balance assessment methods was examined. The internal consistency reliability of BESTest was evaluated by Cronbach's α coefficient. Analysis of receiver operating characteristics (ROC) was performed to determine cut-off point, sensitivity and specificity. RESULTS: BESTest, BBS, ABC and Biodex-BioSway Balance System results of faller stroke patients were worse than that of non-faller (p <0.05). Internal consistency of BESTest was found to be Cronbach's α = 0.960. The BESTest value of area under curve (AUC) was 0.844, with a cut-off point of 69.44%, a sensitivity of 75% and a specificity of 84.6% (p < 0.01). CONCLUSION: BESTest is reliable and valid with high sensitivity and specificity in determining the risk of fall in stroke patients.


Assuntos
Acidentes por Quedas/prevenção & controle , Avaliação da Deficiência , Equilíbrio Postural/fisiologia , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/fisiopatologia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modalidades de Fisioterapia/normas , Psicometria , Curva ROC , Reprodutibilidade dos Testes , Fatores de Risco , Sensibilidade e Especificidade
11.
Turk J Med Sci ; 49(1): 318-326, 2019 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-30761855

RESUMO

Background/aim: Following stroke, damage to the central nervous system and adaptive changes in muscle tissue are factors responsible for the loss of muscle strength. Even though it is suggested that early physiotherapy and mobilization prevent structural adaptive changes in muscle tissue, studies regarding this issue are insufficient. The aim of this study is to investigate the effects of early physiotherapy and mobilization on quadriceps muscle thickness (QMT) in stroke patients. Materials and methods: Twelve stroke patients who were admitted to the neurology intensive care unit and 13 healthy controls were included in the study. QMT was examined at admission and discharge for each subject. Additionally, functional extremity movements, balance, and functional ambulation status were evaluated with the Stroke Rehabilitation Assessment of Movement Scale (STREAM). All of the patients were mobilized as early as possible by a physiotherapist and included in a treatment program consisting of the neurodevelopmental Bobath approach. Results: The patients' QMT values at admission and discharge were found to be similar to those of the healthy control group (P > 0.05). When the patients' QMT at the time of admission and discharge were compared, it was seen that the affected side and the nonaffected side were similar (P > 0.05). Additionally, when the admission and discharge results were compared, improvements in functional extremity movements, balance, and functional ambulation levels were observed (P < 0.05). Conclusion: It can be seen that QMT can be preserved and functional improvements can be provided through intense physiotherapy and mobilization initiated in the early period following stroke.


Assuntos
Músculo Quadríceps/diagnóstico por imagem , Reabilitação do Acidente Vascular Cerebral/métodos , Reabilitação do Acidente Vascular Cerebral/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças do Sistema Nervoso , Equilíbrio Postural/fisiologia , Músculo Quadríceps/fisiologia , Acidente Vascular Cerebral/fisiopatologia , Ultrassonografia , Caminhada/fisiologia
12.
Disabil Rehabil ; 38(12): 1163-71, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26328542

RESUMO

PURPOSE: To determine and compare the effects of core stability exercise programs performed in two different environments in lumbar disc herniation (LDH) patients. METHOD: Thirty-one patients who were diagnosed with LDH and were experiencing pain or functional disability for at least 3 months were randomly divided into two groups as land-based exercises or water specific therapy. Also, 15 age-sex-matched healthy individuals were recruited as healthy controls. Both groups underwent an 8-week (3 times/week) core stabilization exercise program. Primary outcomes were pain, trunk muscle static endurance and perceived disability level. The secondary outcome was health-related quality of life. RESULTS: Level of static endurance of trunk muscles was found to be lower in the patients compared to the controls at baseline (p < 0.05). Both treatment groups showed significant improvements in all outcomes (p < 0.05) after 8-week intervention. When two treatment groups were compared, no differences were found in the amount of change after the intervention (p > 0.05). After the treatment, static endurance of trunk muscles of the LDH patients became similar to controls (p > 0.05). CONCLUSION: According to these results, core stabilization exercise training performed on land or in water both could be beneficial in LDH patients and there is no difference between the environments. IMPLICATIONS FOR REHABILITATION: An 8-week core stabilization program performed in water or on land decrease pain level and improve functional status in LDH patients. Both programs seem beneficial to increase health-related quality of life and static endurance of trunk muscles. Core stability exercises could be performed in water as well, no differences were found between methods due to environment.


Assuntos
Terapia por Exercício/métodos , Deslocamento do Disco Intervertebral/reabilitação , Dor Lombar/reabilitação , Vértebras Lombares/fisiopatologia , Tronco/fisiopatologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Qualidade de Vida , Resultado do Tratamento , Turquia , Água
13.
NeuroRehabilitation ; 36(3): 345-53, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26409338

RESUMO

BACKGROUND: We thought that the application of Kinesio Tape (KT) on the foot and ankle in stroke patients may improve the quality of somatosensory information and may activate ankle muscles which have an important role in postural control and that ultimately balance could be improved in stroke patients. OBJECTIVE: The purpose of this study was to evaluate the effects of KT on balance in stroke patients. METHODS: Nineteen stroke patients and 16 healthy controls were included in the study. The study group was evaluated with and without KT. Balance of the all subjects was evaluated Sensory Organization Tests (SOT) by using the Computerized Dynamic Posturography. Equilibrium, Strategy Analysis and Composite Equilibrium Scores were investigated in SOT. RESULTS: Statistically significant differences were observed in all of the SOT parameters between stroke patients and healthy controls (p <  0.05). When the results with and without KT application were compared, the Equilibrium Scores in the conditions 3, 4, 6, Strategy Analysis Score in the conditions 2, 4, 6 and the Composite Equilibrium Score of the SOT were found to be improved in stroke patents (p <  0.05). CONCLUSIONS: The results obtained from KT application are promising in improving balance in stroke patients.


Assuntos
Articulação do Tornozelo/fisiologia , Fita Atlética/estatística & dados numéricos , Modalidades de Fisioterapia , Equilíbrio Postural/fisiologia , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral/diagnóstico , Adulto , Idoso , Fixadores Externos/estatística & dados numéricos , Feminino , Pé/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Modalidades de Fisioterapia/instrumentação
14.
NeuroRehabilitation ; 34(2): 337-42, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-23949064

RESUMO

BACKGROUND: Although there are evidences as to Pilates developing dynamic balance, muscle strength and flexibility in healthy people, evidences related to its effects on Multiple Sclerosis patients are insufficient. OBJECTIVES: The aims of this study were to investigate the effects of Pilates on balance, mobility, and strength in ambulatory patients with Multiple Sclerosis. METHODS: Twenty six patients were divided into two groups as experimental (n = 18) and control (n = 8) groups for an 8-week treatment program. The experimental group underwent Pilates and the control group did abdominal breathing and active extremity exercises at home. Balance and mobility were measured with Berg Balance Scale and Timed up and go test, upper and lower muscle strength with hand-held dynamometer. Confidence in balance skills while performing daily activities was evaluated with Activities Specific Balance Confidence Scale. RESULTS: Improvements were observed in balance, mobility, and upper and lower extremity muscle strength in the Pilates group (p < 0.05). No significant differences in any outcome measures were observed in the control group (p > 0.05). CONCLUSION: Due to its structure which is made up of balance and strengthening exercises, Pilates training may develop balance, mobility and muscle strength of MS patients. For this reason, we think that, Pilates exercises which are appropriate for the disability level of the patient may be suggested.


Assuntos
Técnicas de Exercício e de Movimento/métodos , Extremidade Inferior/fisiopatologia , Movimento/fisiologia , Esclerose Múltipla/reabilitação , Força Muscular/fisiologia , Equilíbrio Postural/fisiologia , Adulto , Feminino , Humanos , Locomoção/fisiologia , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/fisiopatologia , Avaliação de Resultados em Cuidados de Saúde , Método Simples-Cego , Resultado do Tratamento
15.
NeuroRehabilitation ; 33(2): 293-8, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23949051

RESUMO

BACKGROUND: Muscle strength and standing balance decrease in patients with Multiple Sclerosis (MS). OBJECTIVE: The aim of the present study was to investigate the relationship between the lower extremity isometric muscle strength and standing balance in patients with MS. METHODS: Forty-seven patients with MS and 10 healthy volunteers were included. Neurological disability level was assessed using Expanded Disability Status Scale (EDSS). Isometric strength of seven lower extremity muscles (hip flexor-extensor-abductor-adductor, knee flexor-extensor, and ankle dorsal flexor) was assessed using hand-held dynamometer. Duration of static one-leg standing balance was measured using digital chronometer. RESULTS: Hip flexor-extensor-abductor-adductor, knee flexor-extensor, and ankle dorsal flexor isometric muscle strength, and duration of one-leg standing balance were decreased in patients with MS when compared with controls (p < 0.05). All assessed lower extremity isometric muscle strength and EDSS level was related duration of one-leg standing balance in patients with MS. All assessed lower extremity isometric muscle strength (except ankle dorsal flexor) was related with EDSS. CONCLUSIONS: Hip flexor-extensor-abductor-adductor, knee flexor-extensor, and ankle dorsal flexor isometric muscle strength decreases in ambulatory MS patients. Lower extremity muscle weakness and neurological disability level are related with imbalance in MS population. Hip and knee region muscles weakness increases the neurological disability level. For the better balance and decrease neurological disability level whole lower extremity muscle strengthening should be included in rehabilitation programs.


Assuntos
Contração Isométrica/fisiologia , Extremidade Inferior/fisiopatologia , Esclerose Múltipla/fisiopatologia , Força Muscular/fisiologia , Equilíbrio Postural/fisiologia , Adulto , Feminino , Humanos , Masculino
16.
NeuroRehabilitation ; 33(3): 431-7, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23949074

RESUMO

BACKGROUND: Multiple Sclerosis (MS) patients are often referred to aquatic physical therapy, but unfortunately, researches on the effects of aquatic therapy in MS patients are limited. OBJECTIVE: The purpose of this study was to investigate the effects of Ai-Chi on balance, functional mobility, strength and fatigue in ambulatory patients with MS. METHODS: Twenty-three ambulatory female patients were divided into two groups as experimental (n = 15) or control (n = 8) for an 8-week treatment program. The experimental group underwent Ai-Chi exercises in a swimming pool and the control group performed active arm and leg exercises combined with abdominal breathing exercises at home. Static standing balance was measured with duration of one-leg stance, functional mobility was evaluated with Timed-up and Go test and 6 minute walk test, upper and lower muscle strength was assessed with hand-held dynamometer and fatigue was evaluated with Fatigue Severity Scale. RESULTS: Improvements were observed in static standing balance, functional mobility, upper and lower extremity muscle strength and fatigue in the Ai-Chi group (p < 0.05), but no significant differences in any outcome measures were observed in the control group (p > 0.05) after the intervention. CONCLUSIONS: According to these findings Ai-Chi may improve balance, functional mobility, upper and lower extremity muscle strength and fatigue in patients with MS.


Assuntos
Terapia por Exercício , Fadiga/reabilitação , Força Muscular/fisiologia , Equilíbrio Postural/fisiologia , Transtornos das Sensações/reabilitação , Adulto , Fadiga/etiologia , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Esclerose Múltipla/complicações , Dinamômetro de Força Muscular , Avaliação de Resultados em Cuidados de Saúde , Projetos Piloto , Transtornos das Sensações/etiologia , Método Simples-Cego , Estatísticas não Paramétricas , Adulto Jovem
17.
NeuroRehabilitation ; 30(4): 369-74, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22672953

RESUMO

The purpose of this study was to investigate the relationships between the upper extremity functions, upper extremity strength and hand sensation in patients with Multiple Sclerosis (MS). Twenty-two patients with MS (mean age: 38.5 ± 8.31 years, median Expanded Disability Status Scale (EDSS): 2) and 10 healthy subjects were included. Upper extremity function was measured with the Nine-hole peg test, upper extremity strength (shoulder flexion-abduction, elbow flexion, pinch and grip) with hand-held dynamometer, hand grip dynamometer and manual pinch meter, threshold of light touch-pressure with Semmes-Weinstein monofilament, duration of vibration with 128-Hz frequency tuning fork, and distance of two-point discrimination with an aesthesiometer. Strength and functional level of the upper extremity, light touch-pressure, two-point discrimination, vibration sensations of the hand were lower in patients with MS compared with healthy controls (p < 0.05). Light touch-pressure sensation of thumb and index fingers, two-point discrimination of index finger and elbow flexion strength were found to be related with upper extremity function in patients with MS (p< 0.05). These results indicate that the hand sensation, upper extremity strength and function were affected in MS patients. Additionally upper extremity functions seem to be related with light touch-pressure and two-point discrimination sensations of the hand and elbow flexion strength. Upper extremity strengthening and sensorial training of the hand may contribute to the upper extremity function in patients with MS.


Assuntos
Força da Mão/fisiologia , Mãos/inervação , Esclerose Múltipla/patologia , Esclerose Múltipla/fisiopatologia , Sensação/fisiologia , Extremidade Superior/fisiopatologia , Adolescente , Adulto , Estudos de Casos e Controles , Criança , Avaliação da Deficiência , Discriminação Psicológica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tato/fisiologia , Vibração , Adulto Jovem
18.
Neural Regen Res ; 7(24): 1900-5, 2012 Aug 25.
Artigo em Inglês | MEDLINE | ID: mdl-25624817

RESUMO

Early physiotherapy was given to 124 patients with ruptured or unruptured cerebral aneurysms who were treated by surgical clipping or endovascular embolization. Patients were divided into four groups according to their Hunt and Hess grade at admission and aneurysm treatment modality: Group 1, Hunt and Hess grade ≤ II and surgical clipping; Group 2, Hunt and Hess grade ≤ II and endovascular embolization; Group 3, Hunt and Hess grade ≥ III and surgical clipping; Group 4, Hunt and Hess grade ≥ III and endovascular embolization. Level of consciousness was evaluated using the Glasgow Coma Scale, functional status using the Glasgow Outcome Scale, level of the mobility using the Mobility Scale for acute stroke patients, and independence in activities of daily living using the Barthel Index. After early physiotherapy, the level of consciousness and functional status improved significantly in Groups 1, 3, and 4; mobility improved significantly in all groups; and independence in activities of daily living improved significantly in Groups 1 and 3. At discharge, Groups 1 and 2 had better functional status than Groups 3 and 4. Level of consciousness, functional status, mobility and independence in activities of daily living improved after early physiotherapy. These findings suggest that early physiotherapy improved the prognosis of patients with cerebral aneurysms who were treated by surgical clipping or endovascular embolization. Patients with a worse clinical status at presentation had a poorer functional status at discharge. The outcome of physiotherapy was not affected by whether surgical clipping or endovascular embolization was chosen for treatment of the aneurysm.

19.
Neural Regen Res ; 7(25): 1978-84, 2012 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-25624828

RESUMO

Fifty-one patients with mild (n = 14), moderate (n = 10) and severe traumatic brain injury (n = 27) received early rehabilitation. Level of consciousness was evaluated using the Glasgow Coma Score. Functional level was determined using the Glasgow Outcome Score, whilst mobility was evaluated using the Mobility Scale for Acute Stroke. Activities of daily living were assessed using the Barthel Index. Following Bobath neurodevelopmental therapy, the level of consciousness was significantly improved in patients with moderate and severe traumatic brain injury, but was not greatly influenced in patients with mild traumatic brain injury. Mobility and functional level were significantly improved in patients with mild, moderate and severe traumatic brain injury. Gait recovery was more obvious in patients with mild traumatic brain injury than in patients with moderate and severe traumatic brain injury. Activities of daily living showed an improvement but this was insignificant except for patients with severe traumatic brain injury. Nevertheless, complete recovery was not acquired at discharge. Multiple regression analysis showed that gait and Glasgow Coma Scale scores can be considered predictors of functional outcomes following traumatic brain injury.

20.
Disabil Rehabil ; 27(22): 1365-71, 2005 Nov 30.
Artigo em Inglês | MEDLINE | ID: mdl-16372431

RESUMO

PURPOSE: We hypothesised that six-minute walk (6MWT) distance of patients with ambulatory multiple sclerosis (MS)would differ from age-matched healthy control subjects. We also investigated the contribution of demographic, physical and physiological factors to impaired functional capacity in MS. METHOD: Thirty MS patients and 30 healthy subjects participated in this study. Respiratory muscle strength was measured. Pulmonary function test and 6MWT were performed. The Barthel Index (BI) was used to assess activities of daily living, and the Modified Ashworth Scale was used to determine spasticity. Symptomatic fatigue was measured using the Fatigue Severity Scale (FSS). RESULTS: Pulmonary function and respiratory muscle strength of ambulatory MS patients were significantly lower, and baseline heart rate and fatigue perception were significantly higher than were healthy controls (p < 0.05). MS patients reached a significantly higher exercise heart rate, and walked significantly shorter distance than did healthy subjects (p < 0.05). The BI score, baseline heart rate and FSS score together accounted for 81 percent variance in 6MWT distance of MS patients (p < 0.05). CONCLUSION: The shorter distance covered during a 6MWT is determined by the limitations in activities of daily living,resting heart rate and subjective symptomatic fatigue in ambulatory patients with MS. Respiratory muscle weakness, lung function and level of neurological impairment do not contribute to impaired functional exercise capacity in these patients.


Assuntos
Tolerância ao Exercício , Esclerose Múltipla/fisiopatologia , Caminhada/fisiologia , Atividades Cotidianas , Adulto , Estudos de Casos e Controles , Teste de Esforço , Fadiga/fisiopatologia , Feminino , Frequência Cardíaca , Humanos , Masculino , Espasticidade Muscular/fisiopatologia , Valor Preditivo dos Testes , Análise de Regressão , Testes de Função Respiratória , Músculos Respiratórios/fisiopatologia
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