ObjectiveTo identify the potential predictors of ambulatory function in subacute stroke patients, and to determine the contributing factors according to gait severity.MethodsFifty-three subacute stroke patents were enrolled. Ambulatory function was assessed by gait speed and endurance. Balance function was evaluated by the Berg Balance Scale score (BBS) and the Timed Up and Go test (TUG). The isometric muscular strengths of bilateral knee extensors and flexors were measured using an isokinetic dynamometer. Cardiovascular fitness was evaluated using an expired gas analyzer. Participants were assigned into the household ambulator group (<0.4 m/s) or the community ambulator group (≥0.4 m/s) based on gait severity.ResultsIn the linear regression analyses of all patients, paretic knee isometric extensor strength (p=0.007) and BBS (p<0.001) were independent predictors of gait endurance (R2=0.668). TUG (p<0.001) and BBS (p=0.037) were independent predictors of gait speed (R2=0.671). Paretic isometric extensor strength was a predictor of gait endurance (R2=0.340, p=0.008). TUG was a predictor of gait speed (R2=0.404, p<0.001) in the household ambulator group, whereas BBS was a predictive factor of gait endurance (R2=0.598, p=0.008) and speed (R2=0.713, p=0.006). TUG was a predictor of gait speed (R2=0.713, p=0.004) in the community ambulator group.ConclusionOur results reveal that balance function and knee extensor isometric strength were strong predictors of ambulatory function in subacute stroke patients. However, they work differently according to gait severity. Therefore, a comprehensive functional assessment and a different therapeutic approach should be provided depending on gait severity in subacute stroke patients.
[Purpose] The aim of this study was to evaluate the efficacy of mechanical massage via
Endermologie® after total knee arthroplasty in reducing edema and pain and
improving knee range of motion, in the early postoperative period. [Subjects and Methods]
Eighteen patients with knee edema following total knee arthroplasty were randomly assigned
to the intervention group (n=8) or the control group (n=10). The intervention group
received mechanical massage therapy using Endermologie® and the control group
received conventional physical therapy for 20 minutes a day, 5 times a week from the
seventh day postsurgery. Clinical assessments included active knee flexion and extension
range of motion, knee pain using a numeric rating scale, the operated limb circumference,
the soft tissue cross-sectional area using ultrasonography, the extracelluar fluid volume,
and single frequency bioimpedance analysis at 5 kHz using bioelectrical impedance
spectroscopy. [Results] Both groups showed significant reduction in edema and pain, and
improvement in active knee flexion at the end of treatment. There were no significant
inter-group differences before or after treatment. [Conclusion] Mechanical massage could
be an alternative way of managing knee edema after total knee arthroplasty in early
postoperative recovery.
Aquatic treadmill exercise elicited significantly better peak cardiorespiratory responses than land treadmill exercise and may be as effective for early intensive aerobic training in subacute stroke patients.
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