Aims: The principal aims of this research were 1) to extend existing knowledge of the everyday sit-to-walk (STW) transfer in subjects with stroke and in matched controls by exploring temporal, kinematic, and kinetic aspects, and 2) to investigate the relations between some clinical and laboratory measures of postural control and locomotion in stroke rehabilitation and research. Methods: Ten community-living subjects with stroke (mean age 59 years) and ten matched controls were enrolled in the STW studies (Studies I, II, and IV). In the study regarding relations between clinical and laboratory measures the same samples (part of Study II) and also 20 outpatient subjects with stroke (mean age 50 years) participated (Study III). Data collections were performed in laboratory environments with clinical assessment instruments, video cameras, force plates and a movement analysis system. Results: 1) Study I: A temporal aspect of STW was studied. Four phases were defined. The subjects with stroke used significantly more time during the 2nd STW phase, defined from seat-off to the loading peak of the 1st swing leg. Study II: A movement aspect of STW was investigated. The stroke subjects generated significantly less centre of mass momenta in horizontal and vertical directions, and the momenta peaks occurred significantly earlier than in the controls. Study IV: A force aspect of STW was explored. The subjects with stroke generated significantly larger propulsive impulse beneath the (non-paretic) stance buttock and significantly more braking impulses were exerted by both buttocks and particularly by the stance foot. 2) Part of Study II: A strong correlation was found between the clinical measure Fluidity Scale and the laboratory measure Fluidity Index. Study III: Moderate correlations were shown between Berg Balance Scale, ratings of weight distribution during quiet stance, and force measures. Conclusions: The findings of the STW studies show a changed force interaction between the lower extremities post-stroke, likely influencing movement patterns and temporal characteristics of the everyday transfer. The results are considered to reflect compensatory motor strategies. The results of the studies on relations between some clinical and laboratory measures indicate that the strength of the relation is multidimensional.

Tyrimo objektas: pacientų, patyrusių galvos smegenų insultą funkcinis mobilumas. Tyrimo problema. Insultas yra trečioji pagal dažnį mirties priežastis išsivysčiusiose šalyse (Dias et al., 2007). Įvykus insultui sutrinka motorinės, sensorinės ir pažintinės funkcijos. Gali būti labai pažeista ėjimo funkcija. Eisenos atgavimas yra svarbiausias reabilitacijos tikslas (Dias et al., 2007). Tyrimo tikslas – nustatyti grupinių ir individualių kineziterapijos procedūrų poveikį pacientų, patyrusių galvos smegenų insultą, mobilumui. Tyrimo uždaviniai. 1) Įvertinti tiriamųjų pusiausvyrą pagal Berg skalę prieš ir po grupinių ir individualių kineziterapijos procedūrų taikymo; 2) Įvertinti tiriamųjų pusiausvyrą sėdint, atsistojimą iš sėdimos padėties bei ėjimą pagal judesių įvertinimo skalę prieš ir po grupinių ir individualių kineziterapijos procedūrų taikymo; 3) Įvertinti tiriamųjų ėjimą pagal testą „Stotis ir eiti“ prieš ir po grupinių ir individualių procedūrų taikymo; 4) Nustatyti koreliacinius ryšius tarp tirtų rodiklių. Tyrimo metodika. Taikant grupinius ir individualius užsiėmimus buvo vertinama 30-ties tiriamųjų (amžius 74,4±4,3 m.) patyrusių insultą ne mažiau kaip prie 36 mėn. pusiausvyra ir ėjimas pagal Berg pusiausvyros skalę, modifikuotą judesių įvertinimo skalę bei „Stotis ir eiti“ testą prieš ir po kineziterapijos. Rezultatai. Berg pusiausvyros skalės rezultatai individualios kineziterapijos grupėje prieš kineziterapiją buvo 39,6±5,89, po kineziterapijos – 44,5±6,0 balo... [toliau žr. visą tekstą] / Problem. Stroke is the third common cause of mortality in developed countries (Dias et al., 2007). Several disabilities occur after stroke, including loss of motor, sensory and cognitive functions. Gait in stroke patients can be greatly disrupted. Restoration of gait is a major goal in the rehabilitation of stroke patients (Dias et al., 2007). Aim: to compare the effectiveness of group therapy and individual physiotherapy on the functional mobility in stroke patients. Objectives. 1) to assess balance in stroke patients according Berg Balance Scale before and after group and individual physiotherapy; 2) to assess sitting balance, standing and walking in stroke according Motor Assessment Scale before and after group and individual physiotherapy; 3) to evaluate walking in stroke patients according Up & Go test before and after group and individual physiotherapy; 4) to find correlation among assessed values. Methods. Balance and walking were assessed in 30 stroke patients (age 74.4±4.3 years) according to Berg Balance Scale, Motor Assessment Scale and Up & Go test applying group or individual physiotherapy. Time after stroke was no less than 36 months. All measures were done before and after physiotherapy. Results. Results of Berg Balance Scale before and after individual physiotherapy were: 39.6±5.89 and 44.5±6.0 score respectively; Results of Berg Balance Scale before and after group physiotherapy were: 39.0±6.21 and – 44.6±5.99 scores respectively. Results of Motor... [to full text]

Background: Evidence-based complementary treatment options for multiple sclerosis (MS) are limited. Objective: To investigate the effect of hippotherapy plus standard care versus standard care alone in MS patients. Methods: A total of 70 adults with MS were recruited in five German centers and randomly allocated to the intervention group (12 weeks of hippotherapy) or the control group. Primary outcome was the change in the Berg Balance Scale (BBS) after 12 weeks, and further outcome measures included fatigue, pain, quality of life, and spasticity. Results: Covariance analysis of the primary endpoint resulted in a mean difference in BBS change of 2.33 (95% confidence interval (CI): 0.03–4.63, p = 0.047) between intervention (n = 32) and control (n = 38) groups. Benefit on BBS was largest for the subgroup with an Expanded Disability Status Scale (EDSS) ⩾ 5 (5.1, p = 0.001). Fatigue (−6.8, p = 0.02) and spasticity (−0.9, p = 0.03) improved in the intervention group. The mean difference in change between groups was 12.0 (p < 0.001) in physical health score and 14.4 (p < 0.001) in mental health score of Multiple Sclerosis Quality of Life-54 (MSQoL-54). Conclusion: Hippotherapy plus standard care, while below the threshold of a minimal clinically important difference, significantly improved balance and also fatigue, spasticity, and quality of life in MS patients.

No description available.