Hemiplegia Research Papers - Academia.edu (original) (raw)

The purpose of this study was to assess the gait asymmetries in terms of temporal and force gait parameters using Computer Dynography (CDG) system in a hemiparetic person. A 72 year male patient diagnosed as right sided cerebrovascular... more

The purpose of this study was to assess the gait
asymmetries in terms of temporal and force gait parameters
using Computer Dynography (CDG) system in a hemiparetic
person. A 72 year male patient diagnosed as right sided
cerebrovascular accident was referred to physiotherapy
department with complaints of weakness in left upper & lower
limbs and difficulty in walking in terms of impaired foot clearance
since one and half year. His computerised gait dynography was
done with Computer DynoGraphy (CDG)® system (Infotronic,
Netherlands, http://www.infotronic.nl).
It was found that there was asymmetry in his cyclogram,
gait line, histogram, force gait line, force graphic, step times
which included gait cycle, frequency, symmetry ratio, single
support time, double support time, single swing, stance time
and step time. Hence, it was concluded that CDG may be
considered as one of the useful clinical tool for the assessment
of gait asymmetries in hemiparetic patient so as to plan
therapeutic interventions.

This case report describes a specific, literature-based physiotherapy treatment and the outcome for a stroke patient with pusher behaviour. Pusher behaviour is characterized by pushing strongly towards the hemiplegic side in all positions... more

This case report describes a specific, literature-based physiotherapy treatment and the outcome for a stroke patient with pusher behaviour. Pusher behaviour is characterized by pushing strongly towards the hemiplegic side in all positions and resisting any attempt at passive correction of posture to bring the weight towards or over the midline of the body. The patient was a 71-year-old man with clear pusher behaviour due to a stroke. Therapy for the pushing behaviour was performed over a 3-week period. Motor function, mobility, disability, tone anomalies and pusher behaviour were assessed before and after the study period. Immediate effects of a single training session were assessed by clinical observation. Immediate effects on the pusher behaviour were observed when using visual and auditory feedback, but not when somatosensory input was used. These results were not maintained to the end of the treatment period. Treatment makes the patient able to use compensatory strategies for functional activities. The long-term effects should be investigated in more depth in the future.

The Bobath concept, also known as neurodevelopmental treatment, is a widely used approach in the rehabilitation of hemiparetic subjects in many countries. Despite 50 years of clinical use its effectiveness is questionable. This paper aims... more

The Bobath concept, also known as neurodevelopmental treatment, is a widely used approach in the rehabilitation of hemiparetic subjects in many countries. Despite 50 years of clinical use its effectiveness is questionable. This paper aims to examine whether there is evidence to accept neurodevelopmental treatment as an effective approach. A systematic literature search was undertaken. Fifteen trials have been selected and classified according to a 5-level hierarchic scale of evidence for clinical interventions. Results show no evidence proving the effectiveness of neurodevelopmental treatment or supporting neurodevelopmental treatment as the optimal type of treatment, but neither do methodological limitations allow for conclusions of non-efficacy. Methodological aspects of selected studies are discussed and requirements for further research are suggested.

Ankle foot orthoses (AFO) are commonly used orthotic device in order to restore the ankle foot function and to improve the balance and gait in post-stroke hemiparetic patients. However, there remain some discussions about their... more

Ankle foot orthoses (AFO) are commonly used orthotic device in order to restore the ankle foot function and to improve the balance and gait in post-stroke hemiparetic patients. However, there remain some discussions about their effectiveness on long term hemiparetic patients who had mild to moderate spasticity. To investigate the relative effect of prefabricated thermoplastic posterior leaf spring AFO (PLS-AFO) on balance and fall risk. A cross-over interventional study The Department of PMR of a tertiary hospital. Twenty-five chronic post-stroke long duration hemiparetic patients who had Ashworth grade 1-2 spasticity at affected calf muscles and lower limb Brunnstrom stage 2-3 and also able to walk independently without an assistive device. Berg Balance Scale (BERG), and the postural stability test (PST) and the fall risk test (FRT) of Biodex balance systems were used for the assessments. All of the patients were assessed with AFO and without AFO. All assessments were made with foo...

Symmetry is a gait characteristic that is increasingly measured and reported, particularly in the stroke patient population. However, there is no accepted standard for assessing symmetry making it difficult to compare across studies and... more

Symmetry is a gait characteristic that is increasingly measured and reported, particularly in the stroke patient population. However, there is no accepted standard for assessing symmetry making it difficult to compare across studies and establish criteria to guide clinical decision making. This study compares the most common expressions of spatiotemporal gait symmetry to describe post-stroke gait and makes recommendations regarding

We report a patient with severe anosognosia for hemiplegia, who recovered instantly and permanently when viewing herself in a video replay. We believe the observed dramatic reinstatement of the patient's awareness related to her... more

We report a patient with severe anosognosia for hemiplegia, who recovered instantly and permanently when viewing herself in a video replay. We believe the observed dramatic reinstatement of the patient's awareness related to her self-observation ‘from the outside’ (3rd person perspective) and ‘off-line’ (at a time later than the actual attempt to execute a movement); her anosognosia had been unaltered when she observed her plegic arm in her ipsilateral visual field (self-observation from a 1st-person perspective and ‘on-line’). To our knowledge, the role of self-observation in videos or mirrors has not being assessed in AHP to date. Our study provides preliminary evidence that, when right hemisphere damage impairs the ability to update one's body representation, judgements relying on 3rd-person and off-line self-observation may be spared in some patients and may facilitate 1st person awareness.

Emotional alterations are frequent after stroke. Anxiety is a response due to the fear from disease, although depression is a result of potential disability and restrictive lifestyle. The aim of this study was to investigate the relation... more

Emotional alterations are frequent after stroke. Anxiety is a response due to the fear from disease, although depression is a result of potential disability and restrictive lifestyle. The aim of this study was to investigate the relation between reintegration to normal living (community reintegration) of patients after stroke and their functional disabilities. Data were collected from 44 patients with chronic stroke receiving physical therapy services at Physical Medicine and Rehabilitation Clinic, University Clinical Center of Prishtina. Activities of Daily Living (ADL) were measured with the Barthel index (BI). Reintegration to Normal Living Index (RNLI) was used to measure reintegration into normal social activities, functional capacity was measured with six-minute walk test (6MWT), balance was evaluated with Berg Balance Scale (BBS),and motor functioning was assessed with Fugl- Meyer Motor Assessment (FMA). Based on statistical results it can be concluded that the RNLI score has...

To verify whether a shoulder exercises program according to Bobath reduced the shoulder pain in hemiplegic patients. We studied a total of 20 patients with pain shoulder. Ten patients are assigned to group R (submitted to rehabilitation)... more

To verify whether a shoulder exercises program according to Bobath reduced the shoulder pain in hemiplegic patients. We studied a total of 20 patients with pain shoulder. Ten patients are assigned to group R (submitted to rehabilitation) and ten to group R+E (submitted to rehabilitation and shoulder exercises program according to Bobath). Shoulder exercises program was self-performed by the patients after training in occupational rehabilitation unit. The assessment of patients was performed at admission to hospital, at discharge and three months after discharge. Shoulder pain (VAS), shoulder range of motion, disability (FIM), motor function (Fugl-Meyer scale) and spasticity (Ashworth scale) of paretic arm were evaluated in all patients. VAS was similar in both groups at admission and decreased in group R+E at discharge without reaching significant differences (p=0.253). On the contrary, VAS and Shoulder range of motion improved statistically in group R+E (p=0.0001, p<0.04 respect...

The purpose of this study was to compare the therapeutic efficacy of three exercise therapy approaches. Three groups of adult stroke patients (N = 131) participated in the study. The first group received conventional treatment that... more

The purpose of this study was to compare the therapeutic efficacy of three exercise therapy approaches. Three groups of adult stroke patients (N = 131) participated in the study. The first group received conventional treatment that consisted of traditional exercises and functional activities. The treatment of the second group was based on proprioceptive neuromuscular facilitation techniques. The third group was treated using the Bobath approach. The improvement of each patient was evaluated after six weeks of treatment in terms of functional gains in activities of daily living as measured using the Barthel index, changes in the muscle tone of the involved limbs as measured using a five-point ordinal scale, changes in the isolated motor control of the ankle and wrist as measured by tests of muscle strength and range of motion, and changes in the patients' ambulatory status as measured using a nominal scale of four categories. The therapeutic effects of exercise according to each ...

The aim of the present study was to examine the effects of balance training with visual feedback on stance and gait in school-age children with hemiplegic cerebral palsy. Ten participants between 5 and 11 years of age were assigned to... more

The aim of the present study was to examine the effects of balance training with visual feedback on stance and gait in school-age children with hemiplegic cerebral palsy. Ten participants between 5 and 11 years of age were assigned to either the training or the control group according to an aged-stratified randomization. The training corresponded to three sessions per week during six weeks. Stance and gait parameters- based on force plate data, were assessed three times in both groups: (a) at the beginning of the study (before training); (b) after six weeks; (c) after ten weeks. Spatial and temporal parameters were calculated. The results for stance showed that the training improved the performances on the tasks that were trained. More interesting, the results for gait showed that the walking pattern became more symmetrical after the training.

This review summarizes the recent advances in glenohumeral subluxation (GHS) in hemiplegic patients and analyzes the reliability and validity of clinical evaluation and the effectiveness of different treatment approaches. GHS, a common... more

This review summarizes the recent advances in glenohumeral subluxation (GHS) in hemiplegic patients and analyzes the reliability and validity of clinical evaluation and the effectiveness of different treatment approaches. GHS, a common complication of stroke, can be considered an important risk factor for shoulder pain and other problems. GHS is a complex phenomenon, and its pathomechanics are not yet fully understood. Radiographic measurements are considered the best method of quantifying GHS. Clinical evaluation can be useful as screening assessment. Functional electrical stimulation and strapping are effective in an acute stage of hemiplegia; some types of slings have been shown to be effective and may be used together with other strategies.