Background and Introduction: Fatigue has been defined as a feeling of early exhaustion, weariness, lack of energy and aversion to effort. Glader et al suggest that survivors of stroke with fatigue have a higher fatality rate three years after stroke due to its association with sedentary lifestyle. Neuromuscular fatigue is defined as an activity induced impairment in the ability to exert force, and is quantified by the reduction in force that a muscle or muscles can exert following or during an activity. Fatigue of the paretic leg muscles is likely to greatly impact walking function post-stroke. Therefore, quantitative measures of neuromuscular fatigue of the paretic leg muscles are expected to be associated with walking function in people post-stroke. There is scant research, which specifically investigates neuromuscular fatigue following stroke. The purpose of the study was to assess and compare the contribution of neuromuscular fatigue in patients following stroke with age and gender matched healthy participants. Methodology: Subjects (N=80) were divided into experimental group (N=40) and control group (N=40) by purposive sampling. Patients who were already been diagnosed with chronic stroke (>6months) by Registered Medical Practitioner (RMP) were included in the study. The muscle activity of the quadriceps and hamstrings on the subject's paretic as well as non-paretic side were recorded using Dual Bio Amp/Stimulator. Pre-fatigue inducing exercise (Electromyography) EMG signals (integral mean values in mVs) were recorded by performing Maximal Voluntary Contraction (MVC) of both the muscles. Post-fatigue inducing exercise EMG signals (integral mean values in mVs) by performing Sit-To-Stand test (STS). Visual Analog Fatigue Scale (VAFS) was used to assess the subjective levels of fatigue pre and post exercise while Fatigue Severity Scale (FSS) was used to assess chronic fatigue. Results: In paretic, non-paretic and control study group, the mean pre-fatigue EMG activity of hamstrings is significantly higher compared to mean post-fatigue EMG activity of hamstrings (P-value<0.001). In paretic, non-paretic and control study group, the mean pre-fatigue EMG activity of quadriceps is significantly higher compared to mean post-fatigue EMG activity of quadriceps (P-value<0.001). Conclusion: It was concluded that there is a difference seen in the peripheral neuromuscular fatigue in the chronic stroke individuals when compared with age and gender matched control group.
Background: Diabetes is considered as a pandemic in both developing and developed countries and also a factor for increase in the rate of falls as it has potential to affect nervous system. Loss of balance is identified as a leading cause of increase in the risk of falls. Two Point Discrimination (TPD) can be a cost effective tool in early detection of impaired balance due to its role in sensory integration through mechanoreceptors and in turn providing compensatory postural adjustments. Thus, this study was aimed to determine the correlation between TPD and balance in patients with Type 2 Diabetes Mellitus (T2DM). Subjects and Methods: 149 patients aged 30-60 years having history of T2DM for 2 or more years able to perceive 10g of monofilament on the foot and being able to walk independently were included in this study. TPD was measured on plantar surface of toes for the patients in supine lying by Digital Vernier Caliper (DVC). Single Leg Stance Test (SLST) eyes open and eyes closed was measured for static balance. Timed Up and Go test (TUG) was measured for dynamic balance. Data was analysed using Spearman's correlation coefficient. Results: TPD showed moderately negative correlation with SLST eyes open (r =-0.296) and SLST eyes closed (r =-0.336) and showed a weak positive correlation with TUG (r =0.188) the p value < 0.05 for all. Conclusion: This study concluded that there is a correlation between TPD perception and Balance in patients with Type II Diabetes Mellitus.
Background:- Fear of Falling (FoF) is described as a disproportionate fear of falling or the notion that one cannot avoid falling. To remain physically active, you must maintain your balancing function. Fear of falling is one of the leading causes of actual falls among the elderly, according to previous research. In hospitalized aged people, falls and starts falling injuries are more prevalent than in community-dwelling seniors. It is an established fact that with age the person’s ability to maintain balance reduces and along with FoF further restricts mobility and movement. Hence finding correlation among them is important, because no exact correlation has been done between the two. Methodology – The research was carried out in Pune, India. The approach of easy sampling was used to choose 90 samples. Individuals above the age of 60 were chosen based on selected studies. The Falls Efficacy Scale-International was used to quantify fear of falling, while FICSIT-4 and TUG were used to record stationary and non - stationary balance. Results - The data was therefore correlated using Pearson's correlation coefficient after passing the Normality test.
Background: Most of falls in elderly occur in the event of unexpected external perturbations. For this reason the Anticipatory and Reactive balance should be emphasized upon. Weighted torso balance training (WTBT), though a novel concept, has proved its merit on improving balance in patients with neurological deficits like Stroke, MS etc. This study thus aims towards determining the effectiveness of WTBT on anticipatory and reactive balance in elderly individuals. Subjects and Methods: In this comparative study, 36 patients aging 60-75 yrs and those meeting the selection criteria were selected. Anticipatory and reactive balance was measured using MiniBESTest. Subjects were randomly divided into two groups. Both groups received comprehensive balance training 3 times a week for 3 weeks. The experimental group performed the same exercises while wearing a weighted vest. MiniBESTest was administered post 3 weeks of exercises, data upon checking for normalcy, was analyzed using t-test. Results: Within group analysis of 33 subjects (3 dropouts) for MiniBESTest and its 4 sub components showed statistically significant results (p<0.01) for both groups. Between group analysis showed that WTBT was statistically more significant (p<0.0001) than conventional balance training in improving anticipatory balance, reactive balance, sensory orientation and overall MiniBESTest scores. Conclusion:This study concluded that WTBT as an adjunct to conventional balance training is more effective than conventional balance training alone in improving anticipatory and reactive balance in elderly individuals.
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