Could Self-Control and Emotion Influence Physical Ability and Functional Recovery after Stroke?

Background and Objectives: This study was conducted to determine whether self-control and emotions could influence patients' physical ability and functional recovery after stroke. Materials and Methods: Twenty-four patients within eight weeks after a stroke were included in this study (age: 54.04 ± 10.31; days after stroke: 42.66 ± 8.84). The subjects participated in tests at the baseline, four weeks later, and eight weeks later. Subjects were asked to complete the following: (1) self-control level test, (2) positive and negative emotion test, (3) knee muscle strength testing, (4) static balance test, (5) gait measurement, and (6) activities of daily living evaluation. Results: The muscle strength of the knee, static balance, gait ability, and the Functional Independence Measure score increased significantly in the stroke patients over time. A significant correlation was noted between the emotion and physical variables in stroke patients. The self-control level was significantly associated with the change in the physical variables in stroke patients over time. Conclusions: The self-control level was positively related to the increases in functional recovery of stroke patients with time, while the emotions were related more to the physical abilities.

The Effect of Transcranial Direct Current Stimulation Combined with Visual Cueing Training on Motor Function, Balance, and Gait Ability of Patients with Parkinson's Disease.

Background and Objectives: The purpose of this study was to investigate the effects of transcranial direct current stimulation (tDCS) on motor function, balance and gait ability in patients with Parkinson's disease (PD). Materials and Methods: For the experiment, 30 patients with PD were randomly assigned to the experimental group (n = 15) and the control group (n = 15). Visual cueing training was commonly applied to both groups, the experimental group applied tDCS simultaneously with visual training, and the control group applied sham tDCS simultaneously with visual training. All subjects were pre-tested before the first intervention, post-tested after completing all 4 weeks of intervention, and followed-up tested 2 weeks after the completing intervention. The tests used the Unified Parkinson's Disease Rating Scale (UPDRS) for motor function assessment, Functional Gait Assessment (FGA) for balance assessment, Freezing of Gait Questionnaire (FOG-Q) and the GAITRite system for gait ability assessment. Among the data obtained through the GAITRite system, gait velocity, cadence, step time, double support time, and stride length were analyzed. Results: The experimental group showed a significant decrease in UPDRS and a significant increase in FGA and cadence after the intervention. In addition, UPDRS and cadence showed a significant difference in the follow-up test compared to the pre-intervention test. Conclusions: This study suggests that the application of tDCS to the supplementary motor area of PD patients is useful as an adjuvant therapy for rehabilitation training of PD patients.

Effect of Low Frequency Repetitive Transcranial Magnetic Stimulation on Depression and Cognition of Patients with Traumatic Brain Injury: A Randomized Controlled Trial.

BACKGROUND This study was conducted to investigate the effects of low frequency repetitive transcranial magnetic stimulation (rTMS) of the right dorsolateral prefrontal cortex on depression and cognition in patients with traumatic brain injury. MATERIAL AND METHODS To accomplish this, 13 patients who were diagnosed with traumatic brain injury were divided into an experimental group (n=7) and a control group (n=6). The experimental group received rTMS during a 30-minute session 5 days per week for 2 weeks; the control group received sham rTMS. The patients were then evaluated for depression using the Montgomery-Asberg Depression Rating Scale (MADRS) and for cognitive function using the Trail Making Test (TMT) and the Stroop Color Word Test (SCWT). RESULTS A significant decrease in MADRS, TMT, and SCWT was observed after the intervention in the experimental group (P<0.01), and there was a significant difference in the change value of MADRS, TMT, and SCWT compared to the control group (P<0.01). Moreover, the effect size for gains in the experimental group and control group was very strong for MADRS, TMT, and SCWT (effect size=1.44, 1.49, and 1.24 respectively). CONCLUSIONS The results of this study suggest that application of low frequency rTMS to the right dorsolateral prefrontal cortex of patients with traumatic brain injury has a positive effect on depression and cognition.

Effect of mirror use on lower extremity muscle strength of patients with chronic stroke.

[Purpose] This study examines the effect on muscle strength of lower extremity muscle strength exercise while using a mirror on the non-paretic side in patients with chronic stroke. [Subjects and Methods] Subjects were randomly assigned to a non-mirror lower extremity exercise group (n=10), a mirror lower extremity exercise group (n=10), or a mirror lower extremity muscle strength exercise group (n=10). Subjects were asked to do the exercise assigned to their group (5 sets 30 times a day, 5 times weekly for 4 weeks) with general physical therapy in the hospital. Muscle strength in the knee extensor and flexor of paretic and non-paretic side were measured using electrical muscle testing device before and after the intervention. [Results] Muscle strength significantly increased within each group after intervention. No significant differences were found among the three groups. [Conclusion] This study showed that the lower extremity muscle strength exercise of the non-paretic side using a mirror has a positive effect on muscle strength in patient with chronic stroke.

Study on the design development of a multi joint ankle foot orthosis.

[Purpose] The purpose of this study was to investigate the effects of a newly designed multi joint ankle-foot orthosis on the gait and dynamic balance of stroke patients having foot drop. [Participants and Methods] This study was investigated 10 participants who were diagnosed with stroke. Patients were evaluated based on a 10-meter walk test, timed up and go test and Berg balance scale after each participant wore a plastic ankle-foot orthosis and a multi joint ankle-foot orthosis (AFO) that consisted of orthosis joints (having poster-stop joint and Klenzak joint functions). [Results] The 10-meter walk test, timed up and go test and Berg balance scale showed significant differences in the orthosis with the Klenzak joint function. [Conclusion] The appropriate use of Klenzak AFO of the newly designed multi joint AFO is expected to have a positive effect on improving the gait and balancing ability of stroke patients having foot drop.

The relationship between anterior pelvic tilt and gait, balance in patient with chronic stroke.

[Purpose] The aim of this study is to find out the association between anterior pelvic tilt and gait and balance in chronic stroke. [Subjects and Methods] Fourteen chronic stroke patients were included in this study. A palpation meter was employed to measure the anterior inclination of the pelvis. A GAITRite system automates measuring temporal and spatial gait parameters. A 10-Meter Walk test was used to measure gait speed. The Timed Up and Go test was used to measure the dynamic balance ability and gait ability of the participants. A BioRescue was used to assess balance by measuring the moving distance and area of the center of pressure. [Results] There were significant negative correlations between pelvic anterior tilt and velocity, step length, and stride. There were significant positive correlations between velocity and cadence, step length, and stride length. There were significant negative correlations between velocity and cycle time, H-H base, TUG, and 10MWT. There was significant negative correlation between cadence and cycle time and H-H base. [Conclusion] This study showed a negative correlation between pelvic anterior tilt and gait function including gait speed and step length.

Immediate Effects of Ankle Balance Taping with Kinesiology Tape for Amateur Soccer Players with Lateral Ankle Sprain: A Randomized Cross-Over Design.

BACKGROUND The objective of this study was to investigate the immediate effect on gait function when ankle balance taping is applied to amateur soccer players with lateral ankle sprain. MATERIAL AND METHODS A cross-over randomized design was used. Twenty-two soccer players with an ankle sprain underwent 3 interventions in a random order. Subjects were randomly assigned to ankle balance taping, placebo taping, and no taping groups. The assessment was performed using the GAITRite portable walkway system, which records the location and timing of each footfall during ambulation. RESULTS Significant differences were found in the velocity, step length, stride length, and H-H base support among the 3 different taping methods (p<0.05). The ankle balance taping group showed significantly greater velocity, step length, and stride length in comparison to the placebo and no taping group. The ankle balance taping group showed a statistically significant decrease (p<0.05) in the H-H base support compared to the placebo and no taping groups, and the placebo group showed significantly greater velocity in comparison to the no taping group (p<0.05). CONCLUSIONS We conclude that ankle balance taping that uses kinesiology tape instantly increased the walking ability of amateur soccer players with lateral ankle sprain. Therefore, ankle balance taping is a useful alternative to prevent and treat ankle sprain of soccer players.

Effects of the Bad Ragaz Ring Method on muscle activation of the lower limbs and balance ability in chronic stroke: A randomised controlled trial.

BACKGROUND: Recovery of balance and walking abilities is important for the rehabilitation of stroke patients. OBJECTIVES: To evaluate the effects of the Bad Ragaz Ring method on functional recovery in chronic stroke patients. METHODS: Twenty-two chronic stroke patients were randomly assigned to two groups: a Bad Ragaz Ring method group (the experimental group) or a control group. Stroke patients in the experimental group underwent Bad Ragaz Ring exercise and comprehensive rehabilitation therapy, whereas patients in the control group underwent comprehensive rehabilitation therapy alone. The participants in both groups received therapy 3 days per week for 6 weeks. Muscle activations, balance indices, and Timed Up and Go test results were assessed before and after the 6-week therapy period. RESULTS: The experimental group showed significant improvements in activations of tibialis anterior and gastrocnemius muscles, balance index, and Timed Up and Go test results as compared with preintervention results (p < 0.05), whereas the control group showed significant improvement in Timed Up and Go test (p < 0.05). Significant differences in posttraining gains in the activations of tibialis anterior and gastrocnemius muscles and in balance index were observed between the experimental and control groups (p < 0.05). Effect sizes for gains in the experimental and control groups were strong for tibialis anterior and gastrocnemius muscles (effect sizes, 1.04 and 1.45 respectively). CONCLUSION: The Bad Ragaz Ring method may be beneficial for improving balance and leg muscle activation of chronic stroke patients.

Underwater treadmill training and gait ability in the normal adult.

[Purpose] Our working hypothesis is that underwater treadmill training improves normal people's gait ability. [Subjects and Methods] Twenty-five healthy subjects with no orthopedic history of lower extremity were recruited. Gait training is performed using an underwater treadmill (HydroTrack® Underwater Treadmill System, Conray, Inc., Phoenix, AZ, USA), for twenty minutes per session, five sessions a week for four weeks. The water temperature was set at about 33 °C and the depth was fixed to reach between the subjects' xiphoid process and the navel. [Results] After the intervention, step length, velocity, and cadence increased significantly. [Conclusion] This study conducted underwater treadmill training with normal people, with positive effects on gait ability.

Immediate effect of ankle balance taping on dynamic and static balance of soccer players with acute ankle sprain.

[Purpose] This study aimed to evaluate the immediate effect of ankle balance taping on balance ability of soccer players with acute ankle sprain. [Subjects and Methods] This study was conducted with 16 subjects who were diagnosed with ankle sprain. A cross-over randomized design was used. Each subject performed three interventions in a random order. Subjects were randomly assigned to an ankle balance taping, placebo taping, and no taping. For dynamic and static balance, ability was measured using BIORescue (RM Ingenierie, Rodes, France). Limit of stability, sway length and sway speed for one minute were measured. [Results] The Limit of Stability, Sway length and Sway speed differed significantly among the three different taping methods. [Conclusion] In this study, we found that ankle balance taping was effective in terms of improving balance ability of soccer players with an ankle sprain.

Comparison therapeutic efficacy of underwater and overground walking training on the healthy subjects balancing ability.

[Purpose] This study's working hypothesis is that underwater walking training is beneficial for healthy subjects balance. [Subjects and Methods] Forty eight subjects (Underwater walking group=25, Overground walking group=23) completed the experiment. Healthy subjects with no orthopedic history of lower extremity injuries were recruited. Gait training is performed using the underwater treadmill consisted of 30-minute walking sessions, five times per week for four weeks. [Results] After the intervention, the medial-lateral and anterior-posterior balance indices increased significantly. [Conclusion] This study conducted underwater walking training on the healthy subjects, with positive effects on balancing ability.

Effects of manipulation of the thorax and intensity of the pressure biofeedback unit on the superficial cervical flexors muscle during craniocervical flexion exercise.

[Purpose] This study examined the effects of manipulation of the thorax and the intensity of the pressure biofeedback unit on the superficial cervical flexors muscle during craniocervical flexion exercise. [Subjects and Methods] Thirty three subjects participated in the experiment. Thirty three healthy people without any orthopedic history were also selected. The subjects could monitor the pressure applied to cervical vertebra 3 of the craniocervical junction by markings on the pressure biofeedback unit. Craniocervical flexion exercise was performed for 20 seconds per pressure, and two minutes of rest was allowed after exercise to reduce muscle fatigue. [Results] Significant differences in the post-training gains in the sternocleidomastoid and scalene were observed between the thorax fixation group and thorax non-fixation group. The thorax fixation group showed that muscle activation of the sternocleidomastoid and scalene was increased when the pressure biofeedback unit intensity was 40 mmHg than when pressure biofeedback unit intensity was 20 mmHg and 30 mmHg in the post-hoc result. The thorax non-fixation group showed that muscle activation of the sternocleidomastoid and scalene was higher when the pressure biofeedback unit intensity was 40mmHg compared to that when the pressure biofeedback unit intensity was 20mmHg in the post-hoc result. [Conclusion] Craniocervical flexion exercise is a clinically effective method that reduces the superficial neck flexor muscle activation.

The effect of newly designed multi joint ankle foot orthosis on the gait and dynamic balance of stroke patients with foot drop.

[Purpose] The purpose of this study is to investigate the effect of the newly designed multi joint ankle-foot orthosis on the gait and dynamic balance of stroke patients having foot drop. [Subjects and Methods] This study was conducted with 15 subjects who were diagnosed with stroke. 10-meter walk test, functional reaching test and timed up and go test were measured after each subjects wore a plastic ankle-foot orthosis and a multi joint ankle-foot orthosis that consists of orthosis joints (having free joint, anterior-stop joint, poster-stop joint, and Klenzak joint functions). In the case of the newly developed multi joint ankle-foot orthosis, the experiments were performed using posterior-stop joint and Klenzak joint. [Results] 10-meter walk test, functional reaching test and timed up and go test showed significant differences in the orthosis using posterior joint-stop function and Klenzak joint function. [Conclusion] The appropriate use of the four functions of the newly designed multi joint ankle-foot orthosis is expected to have a positive effect on improving the gait and balancing ability of stroke patients having foot drop.

Effects of repetitive transcranial magnetic stimulation on arm function and decreasing unilateral spatial neglect in subacute stroke: a randomized controlled trial.

OBJECTIVE: The objective of this study is to investigate the effect of repetitive transcranial magnetic stimulation (rTMS) on the functional recovery of stroke patients with unilateral neglect. DESIGN: Randomized controlled experimental study. SETTING: Outpatient rehabilitation hospital. SUBJECTS: Thirty patients with stroke were randomly assigned to two groups: an rTMS group (experimental) and a control group. INTERVENTIONS: Stroke patients in the experimental group underwent comprehensive rehabilitation therapy and rTMS. Stroke patients in the control group underwent sham therapy and comprehensive rehabilitation therapy. Participants in both groups received therapy 5 days per week for 4 weeks. MAIN MEASURES: Line bisection, Albert, Box and block and Grip strength tests were assessed before and after the four-week therapy period. RESULTS: A significant difference in the post-training gains in Line bisection (16.53 SD 9.78 vs. 3.60 SD 5.02), Albert (14.13 SD 4.92 vs. 3.26 SD 2.01), Box and block (15.06 SD 9.68 vs. 6.93 SD 7.52), and Grip strength tests (3.60 SD 2.66 vs 0.80 SD 1.26) was observed between the experimental group and the control group (P<0.05). In addition, the effect size for gains in the experimental and control groups was very strong in AT, BBT (effect size=2.15, 0.77 respectively). CONCLUSION: We conclude that rTMS might be effective in improvement in reduction of the unilateral neglect and motor function.

The effect of mirror therapy on balance ability of subacute stroke patients.

BACKGROUND: Rehabilitation of subacute stroke patients represents a major challenge. OBJECTIVE: This study was conducted to examine the effects of mirror therapy on balance ability among subacute stroke patients. METHODS: The patients were assigned to a mirror therapy group (n = 17) or a sham therapy group (n = 17). Participants in the experimental group received mirror therapy and conventional rehabilitation therapy for a total of 60 minutes (mirror therapy: 30 minutes; conventional rehabilitation therapy: 30 minutes) per day, with a 10 minute rest period halfway through the session. Participants in the experimental group received training 5 days/week for 4 weeks. Participants in the control group received sham therapy and conventional rehabilitation therapy for a total of 60 minutes (sham therapy: 30 minutes, conventional rehabilitation therapy: 30 minutes) per day on the same day. Balance Index (BI) scores were obtained using a balance measurement system. RESULTS: A significant difference in post-training gains for the overall stability index and medial and lateral stability index was observed between the experimental group and the control group (p < 0.05). CONCLUSION: We conclude that mirror therapy may be beneficial in improving balance ability among subacute stroke patients.

The effects of trunk stabilization exercise using a Swiss ball in the absence of visual stimulus on balance in the elderly.

[Purpose] This study was undertaken to investigate the effects of the balance exercises with a Swiss ball on static and dynamic balance abilities in elderly (≥65 years) subjects. [Subjects and Methods] Twenty elderly subjects with no relevant orthopedic history of a back condition were selected for trunk stabilization exercises with a Swiss ball (Thera-Band, USA). The subjects performed these trunk stabilization exercises for 20 minutes, five times per week for 4 weeks. The experimental group (n=10) was blindfolded during these balance exercises, while the control group control group (n=10) was not. [Results] The experimental group showed significant improvements in velocity in the evaluation of static balance and in time, total distance, and left/right movement distance in the evaluation of dynamic balance after the intervention, whereas the control group showed significant improvements in time in the evaluation of dynamic balance. A significant intergroup difference was observed after the intervention for velocity gain. [Conclusion] Exercising with a blindfold stimulates other senses by blocking visual information, and hence it enhances improvements in balance ability.

Effects of mental practice on normal adult balance ability.

[Purpose] This study aimed to examine the effects of mental practice on the balance abilities of normal individuals. [Subjects and Methods] Thirty subjects were randomly assigned to an experimental or control group (n=15 each). Participants in both groups performed balance training in a seated position on a gym ball for 20 minutes per session, five sessions per week, for 4 weeks. Members of the experimental group also performed mental practice for 10 minutes before the balance training. After the intervention, balance measuring equipment (Good Balance, Metitur, Finland) was used to quantitatively measure balance ability. [Results] Significant post-training gains were observed in the mediolateral, index of balance function, and time variables of participants of the experimental group. [Conclusion] The application of mental practice with balance training positively affected balance ability.

The effects of a pelvic belt on trunk and lower extremity muscles in the bridge position.

[Purpose] The purpose of this study was to investigate the effects of a pelvic belt on the activities of trunk and lower extremity muscles in normal adults. [Subjects and Methods] The subjects were 20 normal individuals without a history of orthopedic problems. The pelvic compression belt (The Com-Pressor, OPTP, Minneapolis, MN, USA) was an adjustable body belt with four elastic compression bands that provide stabilizing pressure and was designed to adjust the amount of force applied and to alter sites of compression. The body belt was placed below the anterior superior iliac spine, and stabilizing pressure was applied to the belt using the elastic compression bands in the bridge position after confirming the site of compression. [Results] The subjects showed a significant decrease in muscle activation in the erector spinae, oblique internus abdominis, rectus femoris, and biceps femoris while wearing the pelvic belt. [Conclusion] The use of a pelvic compression belt with external pelvic compression might improve pelvic joint stability and alter neuromotor control of the lumbopelvic and thigh muscles.

The effects of visual biofeedback using ultrasonograpy on deep trunk muscle activation.

[Purpose] The objective of this study is to investigate the effect of visual biofeedback using ulatrasonography on the functional improvement of deep trunk muscle. [Subjects and Methods] This study selected ten healthy people without orthopedic history and information on the study. The average ages, heights, and weights were 22.70 ± 2.06 years old, 171.15 ± 9.18 cm, and 66.86 ± 8.88 kg in the experimental group, respectively. The abdominal drawing-in maneuver were executed for subjects through monitoring the status of muscle contraction using ultrasonic waves. And motor control exercises were performed during 6 weeks, 20 minutes/day and three times/week. We collected the data using electromyography MP150 system (BIOPAC system Inc., CA, USA) in order to measure trunk muscle activation. [Results] The subjects showed significant improvements in Internal oblique abdominis and lumbar multifidus muscle after intervention. [Conclusion] Visual biofeedback training using ultrasonography might be effective in improving function of the deep trunk muscle.

Immediate effects of forearm elastic and nonelastic taping on wrist flexor muscle and grip strength of normal adults.

[Purpose] The purpose of this study was to examine the effects of forearm elastic taping on grip and wrist flexor muscle strength. [Subjects and Methods] This was a single-blind, crossover study. This study selected 40 healthy subjects with no history of orthopedic disorders and was conducted after consent to participate was obtained. Grip and wrist flexor muscle strength of subjects were assessed by a handheld dynamometer and a Commander Muscle Tester, respectively, with forearm elastic taping or nonelastic taping. [Results] After application of forearm elastic taping, grip strength and wrist flexor muscle strength significantly increased compared with the nonelastic taping group. [Conclusion] Application of forearm elastic taping is considered to have positive effects on improving wrist and grip strength.