[Purpose] The purpose of this study was to investigate the effects of ankle joint mobilization with movement on knee strength, ankle range of motion, and gait velocity, compared with weight-bearing exercise in stroke patients. [Subjects and Methods] Thirty subjects with chronic stroke were divided into three groups: MWM (n = 12), WBE (n = 8), and control (n = 10). All groups attended physical therapy sessions 3 times a week for 5 weeks. Subjects in the MWM group performed mobilization with movement exercises, whilst participants in the WBE group performed weight-bearing exercises. Knee peak torque, ankle range of motion, and spatiotemporal gait parameters were evaluated before and after the interventions. [Results] Knee extensor peak torque increased significantly in both MWM and WBE groups. However, only the MWM group showed significant improvement in passive and active ankle range of motion and gait velocity, among the three groups. [Conclusion] Ankle joint mobilization with movement intervention is more effective than simple weight-bearing intervention in improving gait speed in stroke patients with limited ankle motion.
In daily activities, people often perform two or more tasks simultaneously. This is referred to as dual-tasking or multi-tasking. The purpose of this study was to examine the effects of performing dual tasks while using a mobile phone on static and dynamic postural stability. Twenty-four subjects were asked to stand on a force plate and then instructed to perform a balance task only (BT), a balance task while listening to music (BTL), a balance task while talking on the mobile phone (BTT), and a balance task while sending text messages (BTS). We used the BioRescue Ⓡ to measure postural sway and limit of stability for static and dynamic postural stability. Also the star excursion balance test (SEBT) was used to measure dynamic postural stability. A one-way ANOVA with repeated measures was used to compare the effects of the BT, BTL, BTT, and BTS. The Bonferroni's post hoc test was used to determine the differences among four tasks. Carrying out the BTS significantly decreased the limit of stability compared with carrying out the BT, BTL, and BTT (p<.05). In limit of stability, total surface area of BTT was more significantly decreased than that of BT and total surface area of BTS was more decreased than that of BT, BTL and BTT (p<.05). In the SEBT, the BTS displayed significantly smaller reach distance values compared with the BT or BTL (p<.05). These findings suggest that performing the balance task while sending text message on the mobile phone decreases dynamic postural stability, whereas performing the same task while listening to music using the mobile phone does not. Therefore, it requires more attention to maintain dynamic balance while sending text messages.
[Purpose] The purpose of this study was to identify the effects of task-oriented training with altered somatosensory input on the balance ability of chronic stroke patients. [Subjects and Methods] Twenty-six subjects with chronic stroke were divided into an experimental group (n=14) and a control group (n=12). Both groups attended physical therapy sessions five times a week for four weeks. The experimental group performed additional, task-oriented training with altered sensory input three times a week for four weeks. Limit-of-stability tests were conducted before and after the intervention. In addition, all subjects were evaluated using the Berg Balance Scale (BBS) and Korean Activities-Specific Balance Confidence Scale before and after the intervention. [Results] There was a significant interaction between time and group on BBS scores, on the total surface area of the limit of stability, and on the surface area of the limit of stability of the affected side. However, an analysis of covariance in which the baseline values of each variable served as the covariates showed that only the post-intervention BBS score of the experimental group was significantly higher than that of the control group. [Conclusion] Task-oriented training with altered somatosensory input can improve functional balance in patients with chronic stroke.
The purpose of this study was to determine the effect of ankle joint mobilization with movement (MWM) on the range of motion (ROM) in the ankle, on the muscle strength of lower extremities, and on spatiotemporal gait parameters in chronic hemiplegic patients. Fifteen subjects with chronic stroke were divided into two groups: an experimental group (8 subjects) and a control group (7 subjects). Both groups attended two or three sessions of physical therapy each week. The experimental group also attended additional MWM training sessions three times a week for five weeks. For both groups, the ROM of the ankle, the muscle strength of the lower extremities, and the spatiotemporal gait parameters in paretic limbs were evaluated before and after the training period. The results showed that the experimental group experienced more significant increases than did the control group in terms of passive (6.10%) and active (21.96%) ROM of the ankle, gait velocity (12.96%), and peak torque, of the knee flexor (81.39%), the knee extensor (24.88%), and the ankle plantar flexor (41.75%)(p<.05). These results suggest that MWM training in patients with chronic stroke may be beneficial in increasing ROM in the ankle, muscle strength in the lower extremities, and gait speed. [Chang-man An, Jong-im Won.
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