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1.
Johann Szecsi Martin Schiller Andreas Straube Dieter Gerling 《Archives of physical medicine and rehabilitation》2009,90(4):564-570
Szecsi J, Schiller M, Straube A, Gerling D. A comparison of functional electrical and magnetic stimulation for propelled cycling of paretic patients.
Objective
To compare isometric torque and cycling power, smoothness and symmetry using repetitive functional magnetic stimulation (FMS) and functional electrical stimulation (FES) in patients with paretic legs with preserved sensibility and in patients without sensibility.Design
Repeated-measures design.Setting
Laboratory setting.Participants
Eleven subjects with complete spinal cord injury (SCI) and 29 subjects with chronic hemiparesis (16.6±5.5mo poststroke) volunteered.Interventions
Using a tricycle testbed, participants were exposed to isometric measurements and ergometric cycling experiments, performed during both 20Hz FMS and FES stimulation. Subjects with hemiparesis and with complete SCI were stimulated at maximally tolerable level and maximal intensity, respectively.Main Outcome Measures
Maximal isometric pedaling torque and mean ergometric power, smoothness, and symmetry were recorded for voluntary, FES, and FMS conditions.Results
Two different patterns of the efficacy of FMS were identified. (1) Patients with complete SCI did not benefit (less torque and power was evoked with FMS than with FES, P<.003 and 10−4 respectively). (2) Patients with hemiplegia and preserved sensibility could improve their torque output (P<.05), smoothness, and symmetry of pedaling (P<.05) with FMS more than with FES.Conclusions
FMS is a potential alternative to surface FES of the large thigh musculature in stimulation-supported cycling of patients with partially or completely preserved sensibility. 相似文献2.
Yeh C-Y, Tsai K-H, Su F-C, Lo H-C. Effect of a bout of leg cycling with electrical stimulation on reduction of hypertonia in patients with stroke.
Objectives
To evaluate whether a bout of leg cycling in patients with stroke reduces muscle tone and to determine whether neuromuscular functional electrical stimulation (FES) to the affected leg during cycling is more effective than cycling without FES.Design
Within-subject comparison.Setting
University hospital.Participants
Patients with stroke (N=16; age range, 42-72y; <8wk poststroke) with hypertonia in the affected leg.Interventions
Subjects' affected leg (1) performed cycling exercise with the assistance of FES (assisted-cycling session) and (2) performed cycling exercise without the assistance of FES (nonassisted-cycling session). Subjects sat in a specially designed wheelchair positioned on a resistance-free roller for each 20-minute session.Main Outcome Measures
Changes in muscle tone pre- and posttest session were compared by using the Modified Ashworth Scale and the pendulum test (relaxation index and peak velocity).Results
Modified Ashworth Scale scores were significantly lower (P<.05) and relaxation index and peak velocity values were significantly higher (P<.05) after both sessions. Changes in Modified Ashworth Scale scores, relaxation index, and peak velocity values showed a significant (P<.05) difference between the 2 sessions, and assisted cycling reduced hypertonia more than nonassisted cycling.Conclusions
The hypertonia of patients with stroke showed a significant decrease immediately after a bout of leg-cycling exercise. FES-assisted leg cycling was better than nonassisted cycling for reducing hypertonia. 相似文献3.
Janssen TW Beltman JM Elich P Koppe PA Konijnenbelt H de Haan A Gerrits KH 《Archives of physical medicine and rehabilitation》2008,89(3):463-469
Janssen TW, Beltman JM, Elich P, Koppe PA, Konijnenbelt H, de Haan A, Gerrits KH. Effects of electric stimulation-assisted cycling training in people with chronic stroke.
Objective
To evaluate whether leg cycling training in subjects with chronic stroke can improve cycling performance, aerobic capacity, muscle strength, and functional performance and to determine if electric stimulation (ES) to the contralateral (paretic) leg during cycling has additional effects over cycling without ES.Design
A randomized controlled trial, with a partial double-blind design.Setting
A rehabilitation center.Participants
Twelve stroke patients (range, 18-70y), more than 5 months poststroke, with lower-extremity hemiparesis.Intervention
Subjects were randomly assigned to groups that performed cycling exercise, one with ES evoking muscle contractions and a control group with ES not evoking muscle contractions. Subjects, blinded for group assignment, trained twice a week for 6 weeks.Main Outcome Measures
Changes in aerobic capacity and maximal power output, functional performance, and lower-limb muscle strength.Results
Aerobic capacity and maximal power output significantly increased by 13.8%±19.1% and 38.1%±19.8%, but muscle strength was not significantly enhanced after training. Functional performance improved (ie, scores on the Berg Balance Scale increased by 6.9%±5.8% (P=.000) and the six-minute walk test improved by 14.5%±14.1% (P=.035). There was no significant effect on the Rivermead Mobility Index (P=.165). Training-induced changes were not significantly different between the 2 groups. Changes in cycling performance and aerobic capacity were not significantly related to changes in functional performance.Conclusions
This study showed that a short cycling training program on a semirecumbent cycle ergometer can markedly improve cycling performance, aerobic capacity, and functional performance of people with chronic stroke. The use of ES had no additional effects in this specific group of subjects with chronic stroke. 相似文献4.
Woan Shin Tan Bee Hoon Heng Karen Sui-Geok Chua Kay Fei Chan 《Archives of physical medicine and rehabilitation》2009,90(7):1202-1066
Tan WS, Heng BH, Chua KS, Chan KF. Factors predicting inpatient rehabilitation length of stay of acute stroke patients in Singapore.
Objective
To determine the predictors of hospital length of stay (LOS) of stroke patients at the point of admission.Design
A retrospective cohort study.Setting
An acute hospital rehabilitation center in Singapore.Participants
Stroke patients (N=491) admitted between March 2005 and December 2006.Interventions
None.Main Outcome Measures
Rehabilitation LOS was calculated as the total number of rehabilitation days before discharge. We measured the functional status of patients by using the Functional Independence Measure (FIM).Results
The median LOS was 29 days (mean = 30.8d). Independent clinical and sociodemographic characteristics found to significantly predict rehabilitation LOS were FIM motor score at admission, the presence of more than 3 comorbid conditions at admission, living with nonimmediate relatives before admission, and the hospital subsidy status of the patient. In particular, the admission FIM motor score explained 43% of the variation in LOS and decreased the LOS by approximately 1.1 days for each 1-point increase in score.Conclusion
Patients' socioeconomic status and family structure was found to influence LOS and should be considered in allocating resources and determining treatment need. The extent of motor function of patients at admission is an important factor influencing rehabilitation LOS and is a useful tool for facilitating rehabilitation resource planning for stroke patients. 相似文献5.
David G. Embrey Sandra L. Holtz Gad Alon Brenna A. Brandsma Sarah Westcott McCoy 《Archives of physical medicine and rehabilitation》2010,91(5):687-696
Embrey DG, Holtz SL, Alon G, Brandsma BA, McCoy SW. Functional electrical stimulation to dorsiflexors and plantar flexors during gait to improve walking in adults with chronic hemiplegia.
Objective
To determine whether functional electrical stimulation (FES) timed to activate the dorsiflexors and plantar flexors during gait improves the walking of adults with hemiplegia.Design
Randomized crossover trial.Setting
Outpatient rehabilitation clinic.Participants
Adults with hemiplegia (N=28) with a mean age ± SD of 60±10.9 years and 4.9±3.8 years postincident.Interventions
Intervention “A” included 3 months of wearing the FES system, which activated automatically during walking for 6 to 8h/d, 7d/wk, plus walking 1h/d, 6d/wk. Intervention “B” included 3 months of walking 1h/d, 6d/wk without FES. Of the 28 patients who completed the study, 15 were randomly assigned to group A-B, 13 to group B-A. Crossover occurred at 3 months.Main Outcome Measures
Variables were measured at pretreatment, 3 months, and 6 months. Three primary outcomes were selected a priori and included 2 functional variables, the 6-minute walk test and the Emory Functional Ambulatory Profile, and 1 participation variable, the Stroke Impact Scale. Secondary impairment measures included muscle strength and spasticity. Assessments were done without electrical stimulation.Results
In phase 1, patients who received treatment A (A-B group) showed improvement compared with patients who received treatment B (B-A group) on the 6-minute walk test (P=.02), Emory Functional Ambulatory Profile (P=.08), and Stroke Impact Scale (P=.03). In phase 2, the A-B group maintained improvement in all 3 primary outcomes even without FES. Both groups improved significantly on all primary outcome measures, comparing 6-month to initial measures (P≤.05).Conclusions
An FES system that stimulates dorsiflexors and plantar flexors similar to the timing of typical adult gait, combined with daily walking, can improve the walking ability of adults with hemiplegia. 相似文献6.
7.
Douglas J. Weber Elizabeth R. Skidmore Christian Niyonkuru Chia-Lin Chang Lynne M. Huber Michael C. Munin 《Archives of physical medicine and rehabilitation》2010,91(5):679-686
Weber DJ, Skidmore ER, Niyonkuru C, Chang C-L, Huber LM, Munin MC. Cyclic functional electrical stimulation does not enhance gains in hand grasp function when used as an adjunct to onabotulinumtoxinA and task practice therapy: a single-blind, randomized controlled pilot study.
Objective
To determine whether onabotulinumtoxinA injections and task practice training with or without functional electrical stimulation (FES) improve upper limb motor function in chronic spastic hemiparesis.Design
Randomized controlled trial.Setting
Outpatient spasticity clinic.Participants
Participants (N=23) had chronic spastic hemiparesis with moderate-severe hand impairment based on Chedoke-McMaster Assessment greater than or equal to 2.Interventions
OnabotulinumtoxinA injections followed by 12 weeks of postinjection task practice. Participants randomly assigned to FES group were also fitted with an orthosis that provided FES.Main Outcome Measures
Motor Activity Log (MAL)-Observation was the primary outcome. Secondary outcomes were Action Research Arm Test (ARAT) and MAL-Self-Report.Results
For the entire cohort, MAL-Observation mean item scores improved significantly from baseline to week 6 (P=.005) but did not remain significant at week 12. MAL-Self-Report mean item scores improved significantly (P=.009) from baseline to week 6 and remained significantly higher (P=.014) at week 12. ARAT total scores also improved significantly from baseline to week 6 (P=.018) and were sustained at week 12 (P=.032). However, there were no significant differences between the FES and no-FES groups for any outcome variable over time.Conclusions
Rehabilitation strategies that combine onabotulinumtoxinA injections and task practice therapy are feasible and effective in improving upper-limb motor function and reducing spasticity in patients with chronic spastic hemiparesis. However, the cyclic FES protocol used in this study did not increase gains achieved with the combination of onabotulinumtoxinA and task practice alone. 相似文献8.
Bell DR, Padua DA, Clark MA. Muscle strength and flexibility characteristics of people displaying excessive medial knee displacement.
Objective
To determine differences in strength and range of motion (ROM) between participants who exhibit medial knee displacement (MKD) during a squat that is corrected by a heel lift and those who do not.Design
Case control.Setting
Sports medicine research laboratory.Participants
Thirty-seven healthy subjects (control, 19; MKD, 18) with no lower-extremity injury in the past 6 months volunteered to participate.Interventions
Not applicable.Main Outcome Measures
Peak force was measured in newtons using a hand-held dynamometer and passive ROM was measured in degrees with a goniometer. Separate multivariate analyses of variance were used to determine differences in strength and ROM between groups. Post hoc testing was used to elucidate differences between groups.Results
The MKD group had the following: greater hip external rotation strength (P=.03), increased hip extension strength (P=.01), less plantarflexion strength (P=.007), and increased hip external rotation ROM (P=.008).Conclusions
The MKD group exhibited tight and weak ankle musculature. Interventions focusing on improving strength and ROM of the ankle may improve kinematics during a squat. 相似文献9.
Büla CJ Martin E Rochat S Piot-Ziegler C 《Archives of physical medicine and rehabilitation》2008,89(2):291-296
Büla CJ, Martin E, Rochat S, Piot-Ziegler C. Validation of an adapted Falls Efficacy Scale in older rehabilitation patients.
Objective
To determine the psychometric properties of an adapted version of the Falls Efficacy Scale (FES) in older rehabilitation patients.Design
Cross-sectional survey.Setting
Postacute rehabilitation facility in Switzerland.Participants
Seventy elderly persons aged 65 years and older receiving postacute, inpatient rehabilitation.Interventions
Not applicable.Main Outcome Measures
FES questions asked about subject’s confidence (range, 0 [none]-10 [full]) in performing 12 activities of daily living (ADLs) without falling. Construct validity was assessed using correlation with measures of physical (basic ADLs [BADLs]), cognitive (Mini-Mental State Examination [MMSE]), affective (15-item Geriatric Depression Scale [GDS]), and mobility (Performance Oriented Mobility Assessment [POMA]) performance. Predictive validity was assessed using the length of rehabilitation stay as the outcome. To determine test-retest reliability, FES administration was repeated in a random subsample (n=20) within 72 hours.Results
FES scores ranged from 10 to 120 (mean, 88.7±26.5). Internal consistency was optimal (Cronbach α=.90), and item-to-total correlations were all significant, ranging from .56 (toilet use) to .82 (reaching into closets). Test-retest reliability was high (intraclass correlation coefficient, .97; 95% confidence interval, .95−.99; P<.001). Subjects reporting a fall in the previous year had lower FES scores than nonfallers (85.0±25.2 vs 94.4±27.9, P=.054). The FES correlated with POMA (Spearman ρ=.40, P<.001), MMSE (ρ=.37, P=.001), BADL (ρ=.43, P<.001), and GDS (ρ=−.53, P<.001) scores. These relationships remained significant in multivariable analysis for BADLs and GDS, confirming FES construct validity. There was a significant inverse relationship between FES score and the length of rehabilitation stay, independent of sociodemographic, functional, cognitive, and fall status.Conclusions
This adapted FES is reliable and valid in older patients undergoing postacute rehabilitation. The independent association between poor falls efficacy and increased length of stay has not been previously described and needs further investigations. 相似文献10.
Liu J Drutz C Kumar R McVicar L Weinberger R Brooks D Salbach NM 《Archives of physical medicine and rehabilitation》2008,89(9):1686-1692
Liu J, Drutz C, Kumar R, McVicar L, Weinberger R, Brooks D, Salbach NM. Use of the six-minute walk test poststroke: is there a practice effect?
Objectives
To determine whether a practice effect occurs across 2 trials of the six-minute walk test (6MWT) among community-dwelling people within 1 year poststroke and to identify characteristics distinguishing people who show a practice effect from those who do not.Design
Secondary analysis of scores on 2 trials of the 6MWT administered approximately 30 minutes apart at baseline in a randomized controlled trial.Setting
General community.Participants
People (N=91) living in the community with a residual walking deficit within the first year of a first or recurrent stroke.Interventions
Not applicable.Main Outcome Measure
Distance walked on the 6MWT.Results
Mean 6MWT scores ± SD for trials 1 and 2 were 196±119m and 197±126m, respectively (n=83). The mean difference in 6MWT performance across trials was 0±35m (95% confidence interval [CI], -7 to 8m). The Pearson correlation coefficient between 6MWT distances was .96 (P<.001), and the intraclass correlation coefficient was .98 (95% CI, .97-.99). The Bland-Altman plot showed no clear pattern. Participants whose improvement was equal to or greater than the minimal detectable change of 29m between trials (14%) did not significantly differ from those in the rest of the study sample; however, they tended to be younger (P=.05) and more likely to have a mild or moderate gait deficit (P=.06).Conclusions
Findings do not support a practice effect across 2 trials of the 6MWT in individuals within 1 year poststroke. Thus, a practice walk does not appear necessary. Further research is recommended to evaluate the influence of young age, acute stroke, and mild-to-moderate gait deficit on practice effects. 相似文献11.
Lynne R. Sheffler Maureen T. Hennessey Jayme S. Knutson John Chae 《Archives of physical medicine and rehabilitation》2009,90(2):362-365
Sheffler LR, Hennessey MT, Knutson JS, Chae J. Neuroprosthetic effect of peroneal nerve stimulation in multiple sclerosis: a preliminary study.
Objective
To determine the neuroprosthetic effect of a peroneal nerve stimulator on tasks of functional ambulation in multiple sclerosis (MS).Design
A single point-in-time assessment of functional ambulation tasks under the conditions of no device and peroneal nerve stimulator.Setting
Outpatient academic medical center.Participants
Participants (N=11) with diagnosis of MS (>6mo), dorsiflexion weakness, and prior usage of an ankle-foot orthosis.Intervention
Surface peroneal nerve stimulator for ambulation.Main Outcome Measures
Timed 25-foot Walk portion of the MS Functional Composite; Floor, Carpet, Up and Go, Obstacle, and Stair components of the Modified Emory Functional Ambulation Profile.Results
Peroneal nerve stimulator-Stair performance was significantly enhanced (P=.05) versus no device, and statistical significance was approached for peroneal nerve stimulator-Obstacles (P=.09) versus no device. There were no significant differences between peroneal nerve stimulator and no device conditions in the remaining outcome measures.Conclusions
The neuroprosthetic effect of the peroneal nerve stimulator is modest relative to no device in the performance of specific functional tasks of ambulation in MS gait. A longitudinal, controlled trial is needed to show effectiveness. 相似文献12.
Fan Gao Thomas H. Grant Elliot J. Roth Li-Qun Zhang 《Archives of physical medicine and rehabilitation》2009,90(5):819-2500
Gao F, Grant TH, Roth EJ, Zhang L-Q. Changes in passive mechanical properties of the gastrocnemius muscle at the muscle fascicle and joint levels in stroke survivors.
Objectives
To investigate the ankle joint-level and muscle fascicle-level changes and their correlations in stroke survivors with spasticity, contracture, and/or muscle weakness at the ankle.Design
To investigate the fascicular changes of the medial gastrocnemius muscle using ultrasonography and the biomechanical changes at the ankle joint across 0°, 30°, 60°, and 90° knee flexion in a case-control manner.Setting
Research laboratory in a rehabilitation hospital.Participants
Stroke survivors (n=10) with ankle spasticity/contracture and healthy control subjects (n=10).Interventions
Not applicable.Main Outcome Measurements
At the muscle fascicle level, medial gastrocnemius muscle architecture including the fascicular length, pennation angle, and thickness were evaluated in vivo with the knee and ankle flexion changed systematically. At the joint level, the ankle range of motion (ROM) and stiffness were determined across the range of 0° to 90° knee flexion.Results
At comparable joint positions, stroke survivors showed reduced muscle fascicle length, especially in ankle dorsiflexion (P≤.048) and smaller pennation angle, especially for more extended knee positions (P≤.049) than those of healthy control subjects. At comparable passive gastrocnemius force, stroke survivors showed higher fascicular stiffness (P≤.044) and shorter fascicle length (P≤.025) than controls. The fascicle-level changes of decreased muscle fascicle length and pennation angle and increased medial gastrocnemius fascicle stiffness in stroke were correlated with the joint level changes of increased joint stiffness and decreased ROM (P<.05).Conclusions
This study evaluated specific muscle fascicular changes as mechanisms underlying spasticity, contracture, and joint-level impairments, which may help improve stroke rehabilitation and outcome evaluation. 相似文献13.
Taeyou Jung DoKyeong Lee Charalambos Charalambous Konstantinos Vrongistinos 《Archives of physical medicine and rehabilitation》2010,91(1):129-136
Jung T, Lee D, Charalambous C, Vrongistinos K. The influence of applying additional weight to the affected leg on gait patterns during aquatic treadmill walking in people poststroke.
Objective
To investigate how the application of additional weights to the affected leg influences gait patterns of people poststroke during aquatic treadmill walking.Design
Comparative gait analysis.Setting
University-based aquatic therapy center.Participants
Community-dwelling volunteers (n=22) with chronic hemiparesis caused by stroke.Interventions
Not applicable.Main Outcome Measures
Spatiotemporal and kinematic gait parameters.Results
The use of an ankle weight showed an increase in the stance phase percentage of gait cycle (3%, P=.015) when compared with no weight. However, the difference was not significant after a Bonferroni adjustment was applied for a more stringent statistical analysis. No significant differences were found in cadence and stride length. The use of an ankle weight showed a significant decrease of the peak hip flexion (7.9%, P=.001) of the affected limb as compared with no weight condition. This decrease was marked as the reduction of unwanted limb flotation because people poststroke typically show excessive hip flexion of the paretic leg in the late swing phase followed by fluctuating hip movements during aquatic treadmill walking. The frontal and transverse plane hip motions did not show any significant differences but displayed a trend of a decrease in the peak hip abduction during the swing phase with additional weights. The use of additional weight did not alter sagittal plane kinematics of the knee and ankle joints.Conclusions
The use of applied weight on the affected limb can reduce unwanted limb flotation on the paretic side during aquatic treadmill walking. It can also assist the stance stability by increasing the stance phase percentage closer to 60% of gait cycle. Both findings can contribute to the development of more efficient motor patterns in gait training for people poststroke. The use of a cuff weight does not seem to reduce the limb circumduction during aquatic treadmill walking. 相似文献14.
Background
Several approaches have emerged for measuring self-reported fear of falling. A comparison of measurement scales’ psychometric properties is needed for researchers to choose the proper scale for their study.Objectives
To compare the psychometric properties of the Falling Efficacy Scale (FES), the Activities-Specific Balance Confidence Scale (ABC) and the Geriatric Fear of Falling Measurement (GFFM).Design
Secondary analysis using baseline and 8-week data from a randomized, controlled trial on fall and fear of falling prevention.Settings
Rural area northeast of Taiwan with assessments conducted in participants’ homes.Participants
Population-based sample of 168 community-dwelling older adults aged 60 and older.Methods
During a home visit, a nurse administered the Tinetti Mobility Scale, and asked about the FES, ABC, GFFM, WHOQOL, falls, chronic illnesses and medicines taken.Results
Baseline internal consistency measured using Cronbach's alpha was 0.98 for the FES, 0.96 for the ABC and 0.88 for the GFFM. Baseline concurrent validity between the FES, ABC and GFFM measured using a correlation coefficient was 0.88 (FES vs. ABC), −0.55 (FES vs. GFFM), and −0.57 (ABC vs. GFFM), respectively, p < .001. All three instruments scores were significantly correlated at baseline with physical performance tests and WHOQOL. The GFFM demonstrated responsiveness to change at 8 weeks.Conclusions
The FES, ABC and GFFM demonstrated strong internal consistency reliability. The GFFM had stronger associations with physical and psychosocial functioning and may be more appropriate for studies focused on improving all aspects of fear of falling. Both FES and ABC instruments demonstrated ceiling effects, which may explain the lack of responsiveness to change in relatively non-frail older community-dwelling adults. Instruments sensitive to measuring lower levels of fear of falling are needed to capture the full range of this phenomenon in this population. 相似文献15.
16.
Adam T. Hirsh Aaron P. Turner Dawn M. Ehde Jodie K. Haselkorn 《Archives of physical medicine and rehabilitation》2009,90(4):646-651
Hirsh AT, Turner AP, Ehde DM, Haselkorn JK. Prevalence and impact of pain in multiple sclerosis: physical and psychologic contributors.
Objective
To characterize the prevalence and impact of pain in veterans with multiple sclerosis (MS) and to assess their association with demographic, biologic, and psychologic variables.Design
Cross-sectional cohort study linking computerized medical record information to mailed survey data.Setting
Veterans Health Administration (VHA).Participants
Sixty-four percent (2994/4685) of veterans with MS who received services in VHA and also returned survey questionnaires.Interventions
Not applicable.Main Outcome Measures
Items assessing pain intensity, pain interference, and physical and mental health functioning.Results
Ninety-two percent of participants reported bodily pain within the prior 4 weeks, with 69% of the total sample indicating pain of moderate or higher intensity. Eighty-five percent indicated that pain caused functional interference during the past 4 weeks, with 71% of the total sample reporting pain-related interference that was moderate or greater. No significant sex or race differences emerged for the pain indices. A significant but modest relationship between increasing age and pain interference emerged (r=.05, P<.01); however, age was not significantly related to pain intensity. Multivariate regression analyses identified pain intensity (β=.73), physical health functioning (β=-.07), and mental health functioning (β=-.13) variables as significant, unique contributors to the prediction of pain interference. The interaction of pain intensity and physical functioning was also significant but of minimal effect size (β=-.03).Conclusions
Pain is highly prevalent and causes substantial interference in the lives of veterans with MS. The functional impact of pain in veterans with MS is influenced by pain intensity, physical health, and emotional functioning. Clinical practice should take each of these domains into consideration and reflect a biopsychosocial conceptualization. 相似文献17.
Matthew P. Ford Laurie A. Malone Ildiko Nyikos Rama Yelisetty C. Scott Bickel 《Archives of physical medicine and rehabilitation》2010,91(8):1255-1261
Ford MP, Malone LA, Nyikos I, Yelisetty R, Bickel CS. Gait training with progressive external auditory cueing in persons with Parkinson's disease.
Objective
To investigate the progressively increasing external auditory cues during mobility training with persons with Parkinson's disease (PD).Design
Experimental.Setting
General community.Participants
Convenience sample of persons with PD (N=12) who walked independently.Interventions
Gait training to external auditory cues was based on a participant's comfortable walking pace. Training external auditory cues rates were increased if patients were able to maintain or increase stride length with increasing external auditory cues rate. Movement synchronization was not monitored during training. Participants trained for 30min/session, 3 sessions/wk, for 8 weeks.Main Outcome Measures
Walking velocity, stride length, and cadence.Results
Participants trained at a mean maximal rate of 157bpm. They showed a significant (P<.01) increase in walking velocity, stride length, and cadence after 8 weeks of training.Conclusions
Walking velocity, stride length, and cadence can significantly improve when community-dwelling persons with PD participate in progressive mobility training. 相似文献18.
Noel Lythgo Bill Marmaras Helen Connor 《Archives of physical medicine and rehabilitation》2010,91(10):1565-1570
Lythgo N, Marmaras B, Connor H. Physical function, gait, and dynamic balance of transfemoral amputees using two mechanical passive prosthetic knee devices.
Objective
To investigate the effect of the 3R90 and 3R92 (Otto Bock Healthcare) mechanical passive prosthetic knee devices on the physical function, gait, and dynamic balance (sudden stop and turn) of transfemoral amputees.Design
Intervention study with crossover design.Setting
University research center.Participants
Men (N=5; mean age ± SD, 58.8±11.9y) with unilateral transfemoral amputation.Intervention
Prosthetic knee joints (N=2; 3R90 and 3R92). Acclimatization ranged from 14 to 47 days (25.5±9.3d).Main Outcome Measures
Physical function, gait, dynamic balance.Results
The Timed Up and Go Test, 6-Minute Walk Test, and Four Square Step Test measures improved with the 3R92. Total scores on the Prosthesis Evaluation Questionnaire were similar for the 3R92 (82.0±6.3) and the participant's own or original device (83.9±4.8). These devices were rated higher than the 3R90 (65.5±16.8). Compared with the original device, gait velocity was significantly slower (5cm/s; P=.017) with the 3R92, but was unchanged for the 3R90. This difference was not considered clinically significant because the effect size was small (0.2). No other significant gait differences were found. Large temporal gait asymmetries observed with the original device remained with the 3R90 and 3R92 (step, ≈20%; single support, ≈30%; stance, ≈19%). Although no significant differences were found for the sudden-turn or sudden-stop tasks, the sudden-turn group success rates were highest with the original devices.Conclusions
Gait and symmetry measures were unchanged. Gait speed was slower with the 3R92, but this was not considered to be clinically significant. Sudden-turn success rates generally were higher with the original devices. A crossover stepping movement was more difficult to implement than a side-stepping movement during sudden turns. 相似文献19.
Catherine M. Capio Cindy H. Sit PhD Bruce Abernethy PhD 《Archives of physical medicine and rehabilitation》2010,91(8):1283-1290
Capio CM, Sit CH, Abernethy B. Physical activity measurement using MTI (Actigraph) among children with cerebral palsy.
Objective
To investigate the validity of MTI accelerometer as a physical activity (PA) measurement instrument for children with cerebral palsy (CP).Design
Participants were classified within Gross Motor Function Classification System I to III and took part in 2 activity sessions: (1) a structured activity protocol with increasing intensities and (2) a free play session. Concurrent measurements of activity counts, heart rate, and observed physical activity were performed.Setting
Data were collected on normal school days in special schools within the participants' 30-minute break period.Participants
Convenience sample of children with CP (N=31; 17 girls, 14 boys) age between 6 and 14 years (mean ± SD, 9.71±2.52y).Interventions
Not applicable.Main Outcome Measures
MTI measured activity counts, a monitoring device measured heart rate, and the System for Observing Fitness Instruction Time (SOFIT) was used for direct PA observation.Results
There were strong relationships between MTI and SOFIT (r=.75; R2=.56; P<.001) and heart rate monitor (HRM) and SOFIT (r=.65; R2=.43; P<.001) data in structured activities, but the difference between these 2 correlation coefficients was not significant (P=.46). In free play activities, the association between MTI and SOFIT data (r=.67; R2=.45; P<.001) was significantly stronger (P=.01) than that between heart rate and SOFIT data (r=.14; R2=.02; P<.001) . Bland-Altman plots showed better agreement between observed SOFIT and MTI-predicted SOFIT data than observed SOFIT and HRM-predicted SOFIT data from the linear regression analysis.Conclusions
The findings suggest that the MTI appears to be a valid instrument for measuring raw activity volume among children with CP and is suitable for use in studies attempting to characterize the PA of this population. 相似文献20.
Healey EL Burden AM McEwan IM Fowler NE 《Archives of physical medicine and rehabilitation》2008,89(4):749-753
Healey EL, Burden AM, McEwan IM, Fowler NE. The impact of increasing paraspinal muscle activity on stature recovery in asymptomatic people.