Introduction Individuals who have experienced stroke are often described as apathetic, having lost of interest, and unmotivated. This might be a problem in achieving treatment results. It is still unclear what impact age and gender have on the motivation. The Aim of Research To evaluate motivation influence on the effectiveness of occupational therapy in patients with stroke. Methods Study included 30 patients who experienced acute stroke. Multidimensional Health Locus of Control (MHLC) scale has been used for motivation assessment. Internal persons' motivation was evaluated to determine how much a person believes that his recovery depends on his own behaviour and external persons' motivation—how a person relates his state of health to the impact of the surrounding people. Performance of daily activities was assessed using Functional Independency Measure (FIM). Results At the beginning of rehabilitation of the patients with stroke, external motivation was greater than the internal one. At the end of rehabilitation internal motivation has increased by 1.8±0.4 points, while the external motivation decreased by 2.4±0.6 points (p<0.05). At the beginning of rehabilitation patients independence in activities of daily living assessed with FIM was 70.0±2.9 points. At the end of rehabilitation their ability to perform daily activities improved by 26.9±1.9 points and reached 96.9±2.7 points (p<0.05). We found statistically significant (p<0.05) moderate correlation (r=0.72) between patients internal motivation at the beginning of the rehabilitation and increase of independence after rehabilitation. Conclusion Older patients had lower internal motivation than younger ones, and independence in daily activities improvement was influenced by younger age and by brain damage depth.
A stroke (cerebrovascular accident - CVA) is a significant social-economic issue. Approximately 15-30% of all patients develop life-long disability, 20% require over 3 months of specialized care in healthcare institutions, and the majority of the patients never recover the ability to maintain a proper vertical position. Such CVA sequelae as balance disturbances not only negatively affect patients' daily physical activity, but also result in social isolation. A number of standardized clinical scales, tests, and instrumental examination techniques have been proposed for evaluating not only post-CVA balance function, but also any changes in this function following various interventions. Even though scientific literature lists numerous methods and instruments for the improvement of balance after a CVA, not all of them are equally effective, and there have been rather controversial evaluations of some techniques. Nevertheless, the application of the majority of the techniques as complementary or alternative measures to traditional physical therapy (PT) frequently yields better results.
Background and Objectives: Repetitive transcranial magnetic stimulation (rTMS) is being widely used for treating upper extremity paresis after stroke, however, evidence of applying high-frequency rTMS (HF-rTMS) on the ipsilesional hemisphere for upper extremity motor recovery remains limited. This systematic review aimed to investigate the effect of high-frequency repetitive transcranial magnetic stimulation for upper extremity motor function recovery after a first-time ischaemic stroke. Materials and Methods: This systematic review was prepared according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. A comprehensive literature search was performed to identify all studies published before 12 February 2021. The search was performed on the following databases: PubMed, Ovid, The Cochrane Library. Results: A total of 6440 studies were found in the databases and four trials were included in the review. Three of the studies were randomized control trials (RCT), and one was a pseudo-RCT. Three of the studies showed good methodological quality and one study was rated as excellent. Fugl-Meyer Assessment (FMA) was performed in three out of four studies and the score significantly increased in the HF-rTMS treatment group compared with sham stimulation in all trials. Other measures used in the studies were handgrip strength, shoulder abduction, Motricity Index, Wolf Motor Function Test (WMFT), and Box and Block, although these tests did not show unanimous results. Overall, all four studies conveyed significantly better results in at least one test that was performed for hand motor function evaluation in a 10 Hz stimulation group while none of the tests showed any advantage for sham stimulation groups. Two studies reported headache as an adverse event (six patients in total). Conclusion: The overall results showed that HF-rTMS may increase impaired upper extremity motor function better than sham stimulation in stroke patients.
[Purpose] The aim of study was to evaluate the impact of physical therapy on the recovery of motor and mental status in patients who sustained a severe traumatic brain injury, according to coma duration in acute and post-acute rehabilitation. [Subjects and Methods] The study population comprised patients with levels of consciousness ranging from 3 to 8 according to Glasgow Coma Scale score. The patients were divided into 2 groups based on coma duration as follows: group 1, those who were in a coma up to 1 week, and group 2, those who were in a coma for more than 2 weeks. The recovery of the patients’ motor function was evaluated according to the Motor Assessment Scale and the recovery of mental status according to the Mini-Mental State Examination. [Results] The evaluation of motor and mental status recovery revealed that the patients who were in a coma up to 1 week recovered significantly better after physical therapy during the acute rehabilitation than those who were in a coma for longer than 2 weeks. [Conclusion] The recovery of motor and mental status of the patients in acute rehabilitation was significantly better for those in a coma for a shorter period.
Early inpatient rehabilitation is extremely important in functional improvement of patients suffering from cerebral stroke. From our point of view, in rehabilitation of patients after cerebral stroke, the estimation of sensorimotor reactions that enables the evaluation of sensorimotor functional changes is highly relevant. The article describes the comparison of sensorimotor reactions in two subgroups – stroke patients and healthy individuals – by applying Sensoneck system. The evaluation was performed before early stage of rehabilitation and thereafter (following early rehabilitation). In order to estimate the correlation between changes in functional independence and sensorimotor reactions, Functional Independence Measure was used. The study revealed that stroke patients had sensorimotor dysfunctions. During early rehabilitation, the quality of motion performance improved slightly, and sensorimotor reactions improved statistically significantly (P<0.05). The relationship between Functional Independence Measure and Sensoneck scores was not significant (P>0.05).
This pilot study gives evidence on the effect of low frequency 2-10 Hz vibration on young physically inactive subjects and associations with blood flow in limbs. For the study purposes, low frequency 2-10 Hz vibration was applied for the subjects in the lying position, and a special device, patented at Kaunas University of Technology, was used to generate low frequency vibrations. Altered temperatures in feet were measured with a thermovisual camera, which records thermal changes. Thermovisual measurement was performed in a warm room (20-21 °C). The entire procedure lasted 45 minutes. Thermovisual measurement was performed 15 minutes before vibration, 15 minutes during vibration and 15 minutes after vibration. For temperature analysis, 2 points on the subjects' feet were chosen: the central point on the foot where the highest temperature was taken and the peripheral point on the foot where the lowest temperature was measured. Heart rate variability was measured by the Elite HRV programme. The data analysis of temperature in both the central and the peripheral points of the foot under low frequency 2-10 Hz vibration showed insignificant changes in temperature and blood flow; however, the differences determined were insignificant. The assessment of heart rate variability demonstrated that there were statistically significant differences before, during and after vibration. A tendency of the heart rate to increase shows that the heart also reacts to any changes when peripheral blood flow in feet is affected. A reverse dependence was determined: low temperature in the foot increases heart rate variability and, vice versa, increasing temperature decreases heart rate variability. It would be expedient and useful to conduct results with those of healthy subjects.
Background and Objectives: The aim of this study was to assess the effects of physiotherapy with aerobic exercise together with temporomandibular joint range of motion exercises (supervised) and physiotherapy with aerobic exercise only (unsupervised), also to review the correlations between neck movements, pain, temporomandibular joint range of motion movements and quality of life in individuals with migraine. Methods: The flexion, extension and lateral flexion of the cervical spine were measured in degrees with a mechanical goniometer and pressure pain thresholds with algometer. Quality of life was assessed with the SF-36 questionnaire and temporomandibular joint range of motion with a centimeter. Results: The study showed statistically significant cervical flexion results in both groups (p < 0.05), masticatory muscle results and temporomandibular joint range of motion between the groups (p < 0.05). A correlation between left upper trapezius muscle pain and cervical lateral flexion was observed in the intervention group. Physical activity correlated with cervical extension, activity limitation due to physical ailments and general health. A correlation between temporomandibular joint and right-side masticatory muscles pain was found. A correlation between upper trapezius muscle pain and left- as well as right-side temporalis muscles were found in the control group. Strong correlations were found between pain and activity limitation due to physical ailments and emotional state. The temporomandibular joint range of motion strongly correlated with activity limitation due to physical ailments. Conclusions: Physiotherapy based on aerobic exercises together with temporomandibular joint exercises was more effective than physiotherapy based on aerobic exercise for decreasing pain, increasing pressure pain thresholds and cervical range of motion.
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