Improving the utility of the Brunnstrom recovery stages in patients with stroke

Huang, Chien‐Yu; Lin, Gong‐Hong; Huang, Yijing; Song, Chen-Yi; Lee, C. K. M.; How, Mon-Jane; Chen, Yi-Miau; Hsueh, I-Ping; Chen, Mei-Hsiang; Hsieh, Ching-Lin

doi:10.1097/md.0000000000004508

Cited by 75 publications

(29 citation statements)

References 24 publications

(27 reference statements)

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“…27 Information was collected on the presence of paralysis, localization and the stage of paralysis according to the Brunnstrom Recovery Stages (BRS). 28 In addition, we calculated the total rehabilitation therapy units received during hospitalization (units per day, 1 unit = 20 min therapy) through reviews of the medical chart.…”

Section: Data Collectionmentioning

confidence: 99%

Chair‐stand exercise improves post‐stroke dysphagia

Yoshimura¹,

Wakabayashi

Nagano³

et al. 2020

Geriatrics Gerontology Int

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Aim: To elucidate the effects of whole-body exercise on clinical outcomes, including dysphagia status, between stroke patients with dysphagia who are undergoing convalescent rehabilitation. Methods: This retrospective cohort study included consecutive patients with post-stroke dysphagia in a rehabilitation hospital in Japan between 2016 and 2018. Dysphagia was defined as a Food Intake Level Scale (FILS) score <7. Participants were asked to perform a repeated chair-stand exercise as a whole-body exercise in addition to the convalescence rehabilitation program. Study outcomes included the FILS score and presence of dysphagia at discharge, the Functional Independence Measure-motor (FIM-motor) score and length of stay. Multivariate analyses were used to determine whether the frequency of daily chair-stand exercise was independently associated with study outcomes, after adjusting for potential confounders; P < 0.05 was considered statistically significant. Results: Of the 637 patients admitted, 148 stroke patients with dysphagia (mean age 72.7 years; 48.6% men) were included in the final analysis dataset. The median daily frequency of repeated chair-stand exercise was 36 (12-65). In multivariate analyses, the frequency of chair-stand exercise was independently associated with the FILS score at discharge (β = 0.231, P = 0.015), the presence of dysphagia at discharge (odds ratio: 0.982, P = 0.035), FIM-motor at discharge (β = 0.205, P = 0.008) and its gain (β = 0.237, P = 0.013), and length of hospital stay (β = −0.042, P < 0.001). Conclusions: Chair-stand exercise is associated with preferable clinical outcomes, including dysphagia status, activities of daily living and length of hospital stay, in stroke patients with dysphagia. Post-stroke dysphagia rehabilitation should include whole-body exercises in addition to conventional rehabilitation programs.

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Section: Data Collectionmentioning

confidence: 99%

Chair‐stand exercise improves post‐stroke dysphagia

Yoshimura¹,

Wakabayashi

Nagano³

et al. 2020

Geriatrics Gerontology Int

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“…The results also showed a slight difference in BRS among the two participants. This might be due to the low sensitivity of the Brunnstrom scale as the participants had to achieve all the movements in the higher stage to move to that stage [12].…”

Section: Discussionmentioning

confidence: 99%

“…The second assessment used was the BRS with high level of reliability (0.91-0.92) [12]. It is used to identify the stage of motor recovery in post-stroke patients based on the current level of spasticity and voluntary movement [13].…”

Section: Measurement Toolsmentioning

confidence: 99%

The Effectiveness of Mirror Therapy on Upper Limb Function in Stroke Patients: A Single Case Experimental Design

et al. 2019

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To assess the effectiveness of Mirror Therapy (MT) on Upper Limb (UL) function of sub-acute stroke patients. Methods: This study is a single case experimental design with two participants. Twenty minutes of MT were implemented four times a week over a period of four weeks. For baseline phase, repeated measurements were performed six times for one participant and four times for the other participant using Fugl-Meyer Motor Function Assessment (FMA), and it was applied twice a week during the intervention phase. Brunnstrom Recovery Stages (BRS) and Barthel Index (BI) were applied once before the baseline phase, as well as prior and after the intervention phase. Results: Based on Percentage of Non-overlapping Data (PND) for FMA subtests, MT had questionable effectiveness on UL for both participants, and MT was unreliable intervention on wrist function. For the hand, of the second participant, MT had questionable effectiveness, whereas for the first participant it was unreliable intervention. For coordination, MT was fairly effective for the first participant and had questionable effectiveness for the second participant. BRS-Arm scores indicated improvements for the second participant from 3 (out of 6) to 4. BRS-Hand scores indicated improvements for the first participant from 5 (out of 6) to 6. No changes were shown in BI. Discussion: This study revealed that MT had positive effects on some sections of UL motor function and coordination, whereas no change in wrist motor function was observed. No functional improvements in BI and slight difference in BRS were noticed.

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“…As clinical characteristics, the severity of motor paralysis of a paretic lower limb and the knee extension strength of a non-paretic lower limb were assessed by physical therapists. The severity of motor paralysis of a paretic lower limb was evaluated using the Brunnstrom recovery stage (BRS)19, 20 ) . The BRS was scored on a 6-level Likert-type scale (stage I to VI) where a higher stage represented better motor function.…”

Section: Participants and Methodsmentioning

confidence: 99%

Early effects of a knee-ankle-foot orthosis on static standing balance in people with subacute stroke

et al. 2019

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[Purpose] The purpose of this study was to evaluate the early effects of a knee-ankle-foot orthosis on static standing balance in people with subacute stroke. [Participants and Methods] Timed static standing balance in four standing conditions (feet apart with eyes open, feet apart with eyes closed, feet together with eyes open, and tandem stance with eyes open) was assessed in 29 inpatients (mean age: 67.3 ± 13.3 years) with subacute stroke with and without a knee-ankle-foot orthosis on the paretic lower limb. [Results] In the group of participants who were unable to stand without a knee-ankle-foot orthosis, the proportion of participants who were able to stand with a knee-ankle-foot orthosis was significantly increased in the following conditions: feet apart with eyes open and feet apart with eyes closed. In the group of participants who were able to stand without a knee-ankle-foot orthosis, the mean duration of time for which the participants with a knee-ankle-foot orthosis were able to stand was significantly longer than that for those without a knee-ankle-foot orthosis for all standing conditions. [Conclusion] A knee-ankle-foot orthosis may be a useful assistive device to support static standing balance for people with subacute stroke.

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Improving the utility of the Brunnstrom recovery stages in patients with stroke

Cited by 75 publications

References 24 publications

Chair‐stand exercise improves post‐stroke dysphagia

Chair‐stand exercise improves post‐stroke dysphagia

The Effectiveness of Mirror Therapy on Upper Limb Function in Stroke Patients: A Single Case Experimental Design

Early effects of a knee-ankle-foot orthosis on static standing balance in people with subacute stroke

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