Objective:To evaluate the effectiveness of mirror therapy on lower extremity motor recovery, balance and mobility in patients with acute stroke.Design:A randomized, sham-controlled, assessor blinded, pilot trial.Setting:Inpatient stroke rehabilitation unit.Subjects:First time onset of stroke with mean post-stroke duration of 6.41 days, able to respond to verbal instructions, and Brunnstrom recovery stage 2 and above were enrolled.Intervention:Mirror therapy group performed 30 minutes of functional synergy movements of non-paretic lower extremity, whereas control group underwent sham therapy with similar duration. In addition, both groups were administered with conventional stroke rehabilitation regime. Altogether 90 minutes therapy session per day, six days a week, for two weeks duration was administered to both groups.Outcome Measures:Lower extremity motor subscale of Fugl Meyer Assessment (FMA), Brunnel Balance Assessment (BBA) and Functional Ambulation Categories (FAC).Results:Amongst the 22 patients included, equal number of patients participated in mirror group (N = 11) and control group (N = 11). Baseline variables were similar in both groups, except for Brunnstrom recovery stage. There was no statistical difference between groups, except for FAC. (FMA: P = 0.894; BBA: P = 0.358; FAC: P = 0.02). Significance was set at P < 0.05.Conclusion:Administration of mirror therapy early after stroke is not superior to conventional treatment in improving lower limb motor recovery and balance, except for improvement in mobility.
As the life span of human beings has increased, the quality of life of the elderly has also become a concern. Like any other part of the body, larynx also undergoes changes due to aging. Due to anatomical and physiological changes; voice can also undergo changes as age increases.Voice is produced by the interactive function of Respiratory, Laryngeal and Resonatory System. Age related structural changes to these systems will in-turn change the voice parameters. The respiratory system provides the aerodynamic force (i.e., sub glottal pressure) needed to set the vocal folds into vibration and initiate phonation. Due to aging there can be loss of elasticity of the lung tissue, weakening of respiratory muscles and stiffening of the thorax which will alter the lung volumes, [1] this in turn can affect the phonation. ABSTRACTBackground: Aging larynx can cause changes in the voice. Knowledge about the normal changes in voice parameters is important in differentiating it from pathological voices. This study is a preliminary investigation on the age related changes in the parameters of voice in geriatric normal subjects, which has been scarcely reported in the Indian literature. Materials and Methods: Our study focused on the changing acoustic parameters of voice due to aging in normal geriatric subjects. The acoustic parameters of males and females with normal voice between the age groups of 60 to 80 were studied. 20 subjects in each category (male and female) were included in the study. All the subjects were taken after clearance from ENT to rule out any vocal pathology. The parameters taken were fundamental frequency, formants (f1, f2), jitter and shimmer. Results and Discussion: Our study shows that there are not any significant changes in the acoustic parameters either in males or in females across the age of 60 years to 80 years. However when compared to adult norms (18-25 yrs) the acoustic values are showing a difference both in males as well as in females in fundamental frequency. Comparison was also done between males and females between the age group of 60 to 80 years. Males differed from females significantly for the parameters of fundamental frequency and formant frequencies (f1 and f2 ) only and not for the parameters of jitter and shimmer.
Objective Anecdotal evidence shows that the Shaker exercise and its modifications improve pharyngeal muscle contraction. However, there is no experimental evidence for the same. Thus, the present study examined the effect of modified Shaker exercise on the amplitude and duration of pharyngeal muscle contraction using cervical auscultation. Design The study follows a cross-sectional study design, where 50 healthy individuals (23 males and 27 females) performed modified Shaker exercise and noneffortful swallow during 10 ml water swallowing. Swallow sound characteristics were analyzed with and without modified Shaker exercise using cervical auscultation. Results The results of mixed ANOVA revealed significant differences for the amplitude of swallow sound with modified Shaker exercise (mean = 47.24, SD = 20.64) when compared to noneffortful swallow (mean = 28.19, SD = 10.26) at p < 0.05. However, no significant difference was obtained for the swallow sound duration with (mean = 0.19, SD = 0.07) and without (mean = 0.18, SD = 0.07) modified Shaker exercise at p > 0.05. No significant difference across the genders was also noted at p > 0.05. Conclusion The outcomes of the study suggest that modified Shaker exercise improves the amplitude of pharyngeal muscle contraction. Further studies are needed to confirm this finding using gold standard tools like videofluoroscopy.
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