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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The purpose of this study was to explore whether we could provide supportive laboratory evidence for clinical observations that a stroke patient has lost functional mobility/locomotion capability based on dynamic balance responses (centre of pressure, COP sway patterns) and motor control activities (EMG patterns) during the motor task of sit-to-stand. A computerized controlled dynamic postural control assessment system was developed and used in this study. Various dynamic balance indices were introduced and derived from COP sway patterns expressed in four domains (i.e. space, time, force, and frequency). Motor control was assessed by multi-channel surface electromyography of each side of the lower limb during the same motor task. The functional mobility capability was evaluated using a traditional FIM method. Fourteen stroke patients with right hemiplegia and nine healthy elderly were recruited as the experimental and control groups respectively. Muscle activity was recorded for quadriceps, hamstrings, anterior tibialis, and triceps surae muscles and used for analysis. Centre of pressure sway patterns and ground reaction forces were registered. All signals were synchronized at 'seat-off'. Surface electromyographic patterns of activities recorded during sit-to-stand and dynamic balance indices computed from centre of pressure sway patterns were categorized and compared with the functional mobility scores. The results show that both the motor control patterns and dynamic balance indices correlated well to the extent of mobility impairment evaluated using the traditional FIM method. An important conclusion for rehabilitation medicine is that the functional mobility capability of stroke patients may be quantified analytically using dynamic balance indices and visualized graphically through EMG motor patterns.
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PMID:New quantitative and qualitative measures on functional mobility prediction for stroke patients. 949 54

It is widely assumed that only limited improvement in functional mobility is possible beyond the subacute period following ischemic stroke. Contrary to this notion, we studied "neurologically plateaued" stroke patients with chronic hemiparesis to assess whether a "task-oriented" treadmill-training regimen would improve walking speed, cadence, and gait cycle symmetry on a modified "Get-Up and Go" task. Five male patients with a mean age of 60.4 +/- 2.7 years (mean +/- S.D.) status post ischemic stroke (> 6 months prior) participated in this nonrandomized low-intensity treadmill exercise pilot study three times/week for 3 months. All patients had mild to moderate gait asymmetries due to residual hemiparesis. Patients were videotaped before and after 3 months of treadmill aerobic exercise (AEX) while performing a functional task consisting of arising from a chair, walking 3.1 m without an assistive device as fast as safely possible, and returning to sit. Gait events were timed using a 2-D Peak Motus video analysis system. After 3 months AEX training, times for the overall "get-up and return-to-sit" (GURS) task and the "straight-away walk" (SAW) segment decreased from 8.2 +/- 1.4 sec to 6.5 +/- 0.8 sec (mean +/- SEM) (p < 0.05), and from 3.7 +/- 1 sec to 2.8 +/- 0.7 sec (p < 0.05), respectively. These data represent improvements of 21% and 24% for the GURS and SAW segments, respectively. Mean velocity increased from 0.9 +/- 0.2 to 1.2 +/- 0.21 m/sec, a 33% improvement (p < 0.01). Mean cadence (steps/min) increased from 89 +/- 9 to 97 +/- 8, a 9% increase (p < 0.05). Mean stance and swing duration diminished for both paretic (P) and nonparetic (NP) limbs, and the intralimb stance/swing ratio values moved toward normal for both the paretic and nonparetic limbs. However, these latter changes reached significance only for the P limb. Interlimb stance symmetry was unchanged. The more impaired subjects experienced the greatest gains in gait velocity and temporal measures. Collectively, these findings indicate that treadmill exercise improves functional overground mobility in individuals with chronic, stable hemiparesis.
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PMID:Effects of aerobic treadmill training on gait velocity, cadence, and gait symmetry in chronic hemiparetic stroke: a preliminary report. 1122 51

A study was carried out to examine how people react to acts of intimacy between parent and child. Based on an extensive series of studies reported in 1998 by Reis who found less intimate interactions between two men who are friends than between men or women or between two women who are friends, it was reasoned that intimacy between two males may violate norms of our culture, so it was predicted that people would react less favorably to intimacy between father and son than to intimacy between father and daughter, mother and daughter, or mother and son. Men (n = 19) and women (n=26), most of whom were 18-24 years of age, read versions of a mother or father having an intimate interaction (lap-sit, hair-stroke, hug/kiss) with an 11-yr.-old daughter or son and then rated the act on a 7-point scale from good to bad. As predicted, the undergraduates rated intimate interactions between father and son less favorably than those between father and daughter, mother and daughter, and mother and son.
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PMID:Observers' reaction to parent-child intimacy. 1132 84

We evaluated arterial oxygen saturation (SaO(2)) and heart rate in acute stroke patients to determine whether routine positioning affected these physiological parameters. Measurements were recorded at the bedside non-invasively in five different positions assigned in random order each maintained for 10 min. One hundred and twenty-nine patients examined within a median of 72 h, lying on the left side resulted in slightly lower SaO(2) than lying on the right side, which was statistically significant in the patients with a right (n = 66), but not left, hemiparesis. Patients able to sit in a chair (n = 65), who mostly had less severe strokes, had a significantly higher mean SaO(2) and heart rate when sitting in the chair than when placed in any other position. About 10% of patients, especially those with a severe stroke, with right hemiparesis and concomitant chest disease, experienced falls in SaO(2) to 90% or less for >/=2 min in certain positions; the hypoxia was more likely when they were lying on their left side. These results may have implications for current practice and for future patient positioning strategies to improve outcome after stroke.
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PMID:Patient positioning influences oxygen saturation in the acute phase of stroke. 1143 82

We present 2 cases of potentially catastrophic neurologic consequences occurring in healthy individuals engaged in sit-up exercises. Two young healthy men were engaged in sit-ups when one developed a stroke and the other developed a spinal epidural hematoma. The Valsalva maneuver involved in the sit-up exercise can produce supraphysiologic increases in blood pressure, which can lead to vascular injury and serious neurologic consequences. Proper breathing should be encouraged and patients with known predisposing factors should avoid such exercises. Prompt recognition of neurologic signs and symptoms during exercise can be life saving. This is the first report of the neurologic complications of sit-ups.
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PMID:Neurologic complications of sit-ups associated with the Valsalva maneuver: 2 case reports. 1183 35

Treadmill training with body weight support was applied in 30 patients who had suffered an ischaemic stroke, with the goal of improving their independence in the activities of daily living (ADL). The following inclusion criteria were used: inability to walk (FAC-score 0 - 2); motor abilities (the ability to sit without support, a palpable muscle function of the hip extensors, abductors and the knee extensors in the affected leg); adequate cooperation, motivation and vigility; absence of muscle contractures which would affect gait; onset of therapy no later than one year after the incident. The average duration of treadmill training was 6,6 weeks. The patients' age was an average 68 years (48 - 82). 87 % of the patients were able to improve their gait within the Functional Ambulation Categories (FAC) scale. 60 % of the patients achieved the ability to walk independently without technical aid. Apart from improving their gait, the patients also attained significantly increased scores in the motor scale of the Rivermead Motor Assessment (gross function) and the motor part of the ADL scale of the Barthel Index (items 2 - 4) and the Functional Independence Measure (items 3 and 4). Treadmill training is establishing itself as an important therapeutic approach in gait rehabilitation with patients with acquired brain damage.
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PMID:[Treadmill therapy in patients after ischaemic stroke]. 1520 37

This study investigated the relationship of lower extremity joint torques and weight-bearing symmetry to sit-to-stand (STS) performance in individuals with chronic stroke. A motion analysis system and two force plates measured STS duration and weight-bearing symmetry (determined by ground reaction forces) during three self-paced and three fast-paced conditions. An isokinetic dynamometer measured maximum concentric joint torques of the paretic and non-paretic ankle, knee, and hip, which were normalized by body mass. Pearson correlations indicated that (a) paretic ankle dorsiflexion and knee extension torques related to the duration of the self-paced STS condition (r = -0.450, -0.716, respectively), (b) paretic ankle dorsiflexion, plantar flexion, and knee extension torques related to the duration of the fast-paced STS condition (r = -0.466, -0.616, -0.736, respectively), and (c) greater weight-bearing symmetry related to faster STS performance for both self-paced and fast-paced STS conditions (r = -0.565, -0.564, respectively) (P < 0.05). This evidence suggests that paretic muscle strength and the ability to load the paretic limb are important factors underlying the ability to rise from a chair in individuals with chronic stroke.
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PMID:Muscle strength and weight-bearing symmetry relate to sit-to-stand performance in individuals with stroke. 1613 47

The purpose of this study was to compare the effects of a task-oriented exercise program with and without altered sensory input on postural stability in subjects with stroke. Sixteen hemiparetic subjects, at least 6 months post-stroke, were randomly assigned to the experimental or control group, and participated in an 8-week task-oriented exercise program focusing on balance and mobility exercises. Exercises were performed under normal conditions by the control group, and under conditions of vision and surface manipulation by the experimental group. Pre- and post-test assessments involved the measurement of the center of pressure (COP) displacement during double-legged stance and sit-to-stand under four sensory conditions: (1) eyes open, normal surface; (2) eyes open, soft surface; (3) eyes closed, normal surface; and (4) eyes closed, soft surface, as well as the 10-m walking test. Results showed significant improvements (P<0.05) in COP displacement under sensory conditions (1) and (2) for the experimental group only, and limited changes for the sit-to-stand in both groups after training. Significant improvements (P<0.05) were also found in both groups for the walking test. It is concluded that a task-oriented exercise program, assisted by sensory manipulation, is more effective at improving the standing balance of stroke subjects than a conventional task-oriented program.
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PMID:Balance training following stroke: effects of task-oriented exercises with and without altered sensory input. 1643 90

A 13-year-old girl suffered a rather severe hypoxic CNS injury and was given up by the school medicine. Adequate therapy was rejected for the patient by a university clinic with the argument that there were only simple reflexes left. The patient underwent coordination dynamics therapy and could significantly improved; she now can sit, walk, eat, drink, count and speak a few words. During a 3-month intensive therapy, a 70% improvement in CNS functioning could be achieved, as quantified by the coordination dynamics, i.e. a similar improvement as could be achieved in patients after stroke and traumatic brain injury, and in cerebral palsy. The improvements in CNS functioning achieved were compared with changes occurring during development in pupils aged between 7 and 19 years. Similarities could be observed with respect to high-frequency exercising for improving CNS functioning, missing continuous concentration on a certain task, and the strong improvement of the coordination dynamics. In the Method section, the theory is presented of the Schalow coordination dynamics therapy.
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PMID:Hypoxic brain injury improvement induced by coordination dynamics therapy; a comparison with normal CNS development. 1691 1

The sit-to-stand (STS) maneuver is important to everyday function, but independence in the activity is often lost after stroke. This study sought to determine the importance of knee extension force and body weight to independence in STS. Sixty-one primarily elderly individuals admitted for acute rehabilitation after stroke participated. Isometric knee extension force was measured bilaterally by using handheld dynamometry. Body weight and height were obtained from the medical record. The ability of subjects to rise from an armless chair without assistance was observed. Independence in the maneuver was demonstrated by 40 (65.6%) subjects when hand use was allowed and 32 (52.5%) subjects when hand use was not allowed. Univariate analysis showed that knee extension forces of the weaker and stronger sides and both sides together explained STS independence, whether hand use was allowed (R(2) = 0.513-0.607) or not allowed (R(2) = 0.336-0.551). Univariate analysis did not show body weight, height, gender, or age to be important; but when considered in conjunction with bilateral knee extension forces, body weight contributed to the explanation of STS independence, whether the hands were (R(2) = 0.688) or were not (R(2) = 0.693) used. A value of 32.1% for the combined knee extension forces of the weaker and stronger sides normalized against body weight was sensitive (87.5%) and specific (85.7%) for predicting independence in STS performed with hands. A value of 40.0% for the combined force of knee extension of the weaker and stronger sides normalized against body weight was sensitive (90.3%) and specific (86.7%) for predicting independence in STS performed without hands. Although the findings of this study do not prove cause, they suggest that efforts to foster independence in STS after stroke should focus on strengthening both lower limbs. For individuals who are overweight or obese, weight loss may also help.
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PMID:Knee extension strength and body weight determine sit-to-stand independence after stroke. 1793 69


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