İnme sonrası bireylerde elastik gövde ortezi kullanımının gövde pozisyon hissi ve denge üzerine anlık etkisi
Öz
Amaç: Duyu, algı, motor kayıplarına yol açan inme; denge, postüral stabilite ve mobiliteyi etkilemektedir. Gövde pozisyon hissi ve stabilitesi ekstremite fonksiyonları açısından önemlidir. Fizyoterapi ve rehabilitasyonda ortotik cihazlar da dahil olmak üzere, gövde kontrolünün arttırılmasına yönelik çeşitli yöntemler kullanılmaktadır. Bu çalışma, inme sonrası bireylerde elastik gövde ortezinin gövde repozisyon hissi ve denge üzerindeki anlık etkisini araştırmayı amaçladı.
Yöntem: Çalışmaya 28 inme geçirmiş, aynı yaş grubunda 28 sağlıklı, toplam 56 birey dahil edildi. Repozisyon hissi ve denge, gövde ortezli ve ortezsiz olarak, HUMAC NORM izokinetik cihazı, Gövde Bozukluk Ölçeği, İnme Hastaları İçin Postüral Değerlendirme Ölçeği ve Fonksiyonel Uzanma Testleriyle değerlendirildi.
Bulgular: Grup içi ve gruplar arasında gövde korseli ve korsesiz olarak repozisyon hissi bakımından anlamlı farklılık bulunmadı (p˃0,05). İnme Hastaları İçin Postüral Değerlendirme Ölçeği skorları anlamlı değişiklik göstermedi (p˃0,05). Fonksiyonel Uzanma Testinde korse kullanımı lehine hem çalışma hem kontrol grubunda anlamlı farklılık bulundu (sırasıyla p=0,013 and p<0,001). Çalışma grubu Gövde Bozukluk Skalasında korseli ve korsesiz anlamlı değişiklik gösterdi (p=0,003). Fonksiyonel Uzanma ve Gövde Repozisyon Testi ortalama farkları iki grupta da anlamlı farklılık göstermedi (p˃0,05).
Sonuç: Bu çalışmada, elastik gövde ortezi kullanımının bazı fonksiyonel testlerde anlık etkisinin olduğu fakat repozisyon hissi bakımından etkili olmadığı sonucuna varıldı. İnmeli bireylerde repozisyon hissini etkileyen faktörlerin incelenmesini ve bu doğrultuda yeni fizyoterapi uygulamalarının etkinliğinin araştırılmasını önermekteyiz.
Anahtar Kelimeler
Kaynakça
- 1. Geurts AC, de Haart M, van Nes IJ, et al. A review of standing balance recovery from stroke. Gait Posture. 2005;22:267-281.
- 2. Chung EJ, Kim JH, Lee BH. The effects of core stabilization exercise on dynamic balance and gait function in stroke patients. J Phys Ther Sci. 2013;25:803-806.
- 3. Verheyden G, Vereeck L, Truijen S, et al. Additional exercises improve trunk performance after stroke: a pilot randomized controlled trial. Neurorehabil Neural Repair. 2009;23:281-286.
- 4. Verheyden G, Nieuwboer A, Van de Winckel A, et al. Clinical tools to measure trunk performance after stroke: a systematic review of the literature. Clin Rehabil. 2007;21:387-394.
- 5. Onursal Kılınç Ö, Ayvat E, Ayvat F, et al. The relationship between trunk position sense and postural control in ataxic individuals. Gait Posture. 2019;68:258-263.
- 6. Li KY, Wu YH. Clinical evaluation of motion and position sense in the upper extremities of the elderly using motion analysis system. Clin Interv Aging. 2014;9:1123-1131.
- 7. Lee AS, Cholewicki J, Reeves NP et al. Comparison of trunk proprioception between patients with low back pain and healthy controls. Arch Phys Med Rehabil. 2010;91:1327-1331.
- 8. Oh DS, Choi JD. The effect of motor imagery training for trunk movements on trunk muscle control and proprioception in stroke patients. J Phys Ther Sci. 2017;29:1224-1228.
- 9. Ryerson S, Byl NN, Brown DA, et al. Altered trunk position sense and its relation to balance functions in people post-stroke. J Neurol Phys Ther. 2008;32:14-20.
- 10. Karatas M, Çetin N, Bayramoglu M, et al. Trunk muscle strength in relation to balance and functional disability in unihemispheric stroke patients. Am J Phys Med Rehabil. 2004;83:81-87.
- 11. Dickstein R, Sheffi S, Ben Haim Z, et al. Activation of flexor and extensor trunk muscles in hemiparesis. Am J Phys Med Rehabil. 2000;79:228-234.
- 12. Ebenbichler GR, Oddsson LI, et al. Sensory-motor control of the lower back: implications for rehabilitation. Med Sci Sports Exerc. 2001;33:1889-1898.
- 13. Verheyden G, Vereeck L, Truijen S, et al. Trunk performance after stroke and the relationship with balance, gait and functional ability. Clin Rehabil. 2006;20:451-458.
- 14. Katsuhira J, Miura N, Yasui T, et al. Efficacy of a newly designed trunk orthosis with joints providing resistive force in adults with post-stroke hemiparesis. Prosthet Orthot Int. 2016;40:129-136.
- 15. Thijssen DH, Paulus R, van Uden CJ, et al. Decreased energy cost and improved gait pattern using a new orthosis in persons with long-term stroke. Arch Phys Med Rehabil. 2007;88:181-186.
- 16. Maguire C, Sieben JM, Erzer F, et al. How to improve walking, balance and social participation following stroke: a comparison of the long term effects of two walking aids--canes and an orthosis TheraTogs--on the recovery of gait following acute stroke. A study protocol for a multi-centre, single blind, randomised control trial. BMC Neurol. 2012;12:18-27.
- 17. Goldberg A, Hernandez ME, Alexander NB. Trunk repositioning errors are increased in balance-impaired older adults. J Gerontol A Biol Sci Med Sci. 2005;60:1310-1314.
- 18. Verheyden G, Nieuwboer A, Mertin J, et al. The trunk impariment scale: a new tool to measure motor impairment of the trunk after stroke. Clin Rehabil. 2004;18:326-334.
- 19. Benaim C, Perennou DA, Villy J, et al. Validation of a standardized assessment of postural control in stroke patients. The postural assessment scale for stroke patients (PASS). Stroke. 1999,30:1862-1868.
- 20. Duncan PW, Weiner DK, Chandler J, et al. Functional reach: a new clinical measure of balance. J Gerontol. 1990;45:192-197.
- 21. Cholewicki J, Shah KR, McGill KC. The effects of a 3-week use of lumbosacral orthoses on proprioception in the lumbar spine. J Orthop Sports Phys Ther. 2006;36:225-231.
- 22. van Poppel MN, de Looze MP, Koes BW, et al. Mechanisms of action of lumbar supports. Spine. 2000;25:2103-2113.
- 23. Saeys W, Vereeck L, Truijen S, et al. Randomized controlled trial of truncal exercises early after stroke to improve balance and mobility. Neurorehabil Neural Repair. 2012;26:231-238.
- 24. Seo D, Lee S, Kwon O. Comparison of the changes in thickness of the abdominal Wall muscles of stroke patients according to the duration of their illness as observed using ultrasonographic images. J Phys Ther Sci. 2013;25:817-819.
- 25. Liao CF, Liaw LJ, Wang RY, et al. Electromyography of symmetrical trunk movements and trunk position sense in chronic stroke patients. J Phys Ther Sci. 2015;27:2675-2681.
- 26. Wee SK, Hughes AM, Warner MB et al. Effect of trunk support on upper extremity function in people with chronic stroke and people who are healthy. Phys Ther. 2015;95:1163-1171.
- 27. Jung K, Kim Y, Chung Y et al. Weight-shift training improves trunk control, proprioception and balance in patients with chronic hemiparetic stroke. Tohoku J. Exp. Med. 2014;232:195-199.
- 28. Koçak FA, Kurt EE, Koçak Y, et al. Validity and interrater/intrarater reliability of the Turkish version of the postural assessment scale for stroke patients (PASS-Turk). Top Stroke Rehabil. 2019;26:373-381.
- 29. Breistein K, Gjelsvik BEB, Jørgensen L. The Postural Assessment Scale for Stroke Patients: translation into Norwegian, cultural adaptation, and examination of reliability. Eur J Physiother. 2017;19: 207-214.
- 30. Lesser M, Borst J, Dekerlegand J. Use of the postural assessment scale for stroke patients in determining acute care discharge recommendations. J Acute Care Phys Ther. 2017;8:79-85.
- 31. Smith PS, Hembree JA, Thompson ME. Berg balance scale and functional reach: determining the best clinical tool for individuals post-acute stroke. Clin Rehabil. 2004;18:811-818.
- 32. Alenazi AM, Alshehri MM, Alothman S, et al. Functional reach, depression scores, and number of medications are associated with number of falls in people with chronic stroke. PM R. 2018;10:806-816.
- 33. Çankaya H, Bakar Y. Investigation of the effect of corset use on balance and muscle activation in stroke patients. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi. 2018;9:33-42.
Immediate effect of elastic trunk orthosis on trunk positioning sense and balance in post-stroke individuals
Öz
Purpose: Stroke; causing sensory, perception, motor loss, affects balance, postural stability and mobility. Position sense of trunk and its stability are important in terms of limb functions. Various methods are used in physiotherapy and rehabilitation, including orthotic devices to increase trunk control. This study aimed to investigate the immediate effect of elastic trunk orthosis on trunk repositioning sense and balance in post-stroke individuals.
Methods: A total of 56, 28 with stroke and 28 age matched healthy individuals, were included into study. Repositioning sense and balance were evaluated with and without a trunk orthosis, using the HUMAC NORM isokinetic device, Trunk Impairment Scale, Postural Assessment Scale for Stroke Patients, and Functional Reach Tests.
Results: There was no significant difference within and between groups on trunk repositioning sense with and without corset use (p˃0.05). Postural Assessment Scale for Stroke Patients scores did not show significant change (p˃0.05). There was a significant difference in favour of corset use in both study and control groups in functional reach test (p=0.013 and p<0.001 respectively). Study group showed significant change with and without corset scores in Trunk Impairment Scale (p=0.003). Mean differences on Functional Reach Test and Trunk Repositioning Test showed no significant difference in both groups (p˃0.05).
Conclusion: The use of trunk orthosis has an immediate effect in some functional tests, but not in terms of repositioning sense were concluded. We propose to examine the factors affecting the repositioning sense in individuals with stroke and to investigate the effectiveness of new physiotherapy applications accordingly.
Anahtar Kelimeler
Orthosis Position sense Postural balance Proprioception Stroke
Destekleyen Kurum
Yoktur.
Teşekkür
Authors thank to all participants for their existence in this study and Bolu Abant Izzet Baysal University Physical Therapy and Rehabilitation Hospital for their allowance to use isokinetic device and the facility.
Kaynakça
- 1. Geurts AC, de Haart M, van Nes IJ, et al. A review of standing balance recovery from stroke. Gait Posture. 2005;22:267-281.
- 2. Chung EJ, Kim JH, Lee BH. The effects of core stabilization exercise on dynamic balance and gait function in stroke patients. J Phys Ther Sci. 2013;25:803-806.
- 3. Verheyden G, Vereeck L, Truijen S, et al. Additional exercises improve trunk performance after stroke: a pilot randomized controlled trial. Neurorehabil Neural Repair. 2009;23:281-286.
- 4. Verheyden G, Nieuwboer A, Van de Winckel A, et al. Clinical tools to measure trunk performance after stroke: a systematic review of the literature. Clin Rehabil. 2007;21:387-394.
- 5. Onursal Kılınç Ö, Ayvat E, Ayvat F, et al. The relationship between trunk position sense and postural control in ataxic individuals. Gait Posture. 2019;68:258-263.
- 6. Li KY, Wu YH. Clinical evaluation of motion and position sense in the upper extremities of the elderly using motion analysis system. Clin Interv Aging. 2014;9:1123-1131.
- 7. Lee AS, Cholewicki J, Reeves NP et al. Comparison of trunk proprioception between patients with low back pain and healthy controls. Arch Phys Med Rehabil. 2010;91:1327-1331.
- 8. Oh DS, Choi JD. The effect of motor imagery training for trunk movements on trunk muscle control and proprioception in stroke patients. J Phys Ther Sci. 2017;29:1224-1228.
- 9. Ryerson S, Byl NN, Brown DA, et al. Altered trunk position sense and its relation to balance functions in people post-stroke. J Neurol Phys Ther. 2008;32:14-20.
- 10. Karatas M, Çetin N, Bayramoglu M, et al. Trunk muscle strength in relation to balance and functional disability in unihemispheric stroke patients. Am J Phys Med Rehabil. 2004;83:81-87.
- 11. Dickstein R, Sheffi S, Ben Haim Z, et al. Activation of flexor and extensor trunk muscles in hemiparesis. Am J Phys Med Rehabil. 2000;79:228-234.
- 12. Ebenbichler GR, Oddsson LI, et al. Sensory-motor control of the lower back: implications for rehabilitation. Med Sci Sports Exerc. 2001;33:1889-1898.
- 13. Verheyden G, Vereeck L, Truijen S, et al. Trunk performance after stroke and the relationship with balance, gait and functional ability. Clin Rehabil. 2006;20:451-458.
- 14. Katsuhira J, Miura N, Yasui T, et al. Efficacy of a newly designed trunk orthosis with joints providing resistive force in adults with post-stroke hemiparesis. Prosthet Orthot Int. 2016;40:129-136.
- 15. Thijssen DH, Paulus R, van Uden CJ, et al. Decreased energy cost and improved gait pattern using a new orthosis in persons with long-term stroke. Arch Phys Med Rehabil. 2007;88:181-186.
- 16. Maguire C, Sieben JM, Erzer F, et al. How to improve walking, balance and social participation following stroke: a comparison of the long term effects of two walking aids--canes and an orthosis TheraTogs--on the recovery of gait following acute stroke. A study protocol for a multi-centre, single blind, randomised control trial. BMC Neurol. 2012;12:18-27.
- 17. Goldberg A, Hernandez ME, Alexander NB. Trunk repositioning errors are increased in balance-impaired older adults. J Gerontol A Biol Sci Med Sci. 2005;60:1310-1314.
- 18. Verheyden G, Nieuwboer A, Mertin J, et al. The trunk impariment scale: a new tool to measure motor impairment of the trunk after stroke. Clin Rehabil. 2004;18:326-334.
- 19. Benaim C, Perennou DA, Villy J, et al. Validation of a standardized assessment of postural control in stroke patients. The postural assessment scale for stroke patients (PASS). Stroke. 1999,30:1862-1868.
- 20. Duncan PW, Weiner DK, Chandler J, et al. Functional reach: a new clinical measure of balance. J Gerontol. 1990;45:192-197.
- 21. Cholewicki J, Shah KR, McGill KC. The effects of a 3-week use of lumbosacral orthoses on proprioception in the lumbar spine. J Orthop Sports Phys Ther. 2006;36:225-231.
- 22. van Poppel MN, de Looze MP, Koes BW, et al. Mechanisms of action of lumbar supports. Spine. 2000;25:2103-2113.
- 23. Saeys W, Vereeck L, Truijen S, et al. Randomized controlled trial of truncal exercises early after stroke to improve balance and mobility. Neurorehabil Neural Repair. 2012;26:231-238.
- 24. Seo D, Lee S, Kwon O. Comparison of the changes in thickness of the abdominal Wall muscles of stroke patients according to the duration of their illness as observed using ultrasonographic images. J Phys Ther Sci. 2013;25:817-819.
- 25. Liao CF, Liaw LJ, Wang RY, et al. Electromyography of symmetrical trunk movements and trunk position sense in chronic stroke patients. J Phys Ther Sci. 2015;27:2675-2681.
- 26. Wee SK, Hughes AM, Warner MB et al. Effect of trunk support on upper extremity function in people with chronic stroke and people who are healthy. Phys Ther. 2015;95:1163-1171.
- 27. Jung K, Kim Y, Chung Y et al. Weight-shift training improves trunk control, proprioception and balance in patients with chronic hemiparetic stroke. Tohoku J. Exp. Med. 2014;232:195-199.
- 28. Koçak FA, Kurt EE, Koçak Y, et al. Validity and interrater/intrarater reliability of the Turkish version of the postural assessment scale for stroke patients (PASS-Turk). Top Stroke Rehabil. 2019;26:373-381.
- 29. Breistein K, Gjelsvik BEB, Jørgensen L. The Postural Assessment Scale for Stroke Patients: translation into Norwegian, cultural adaptation, and examination of reliability. Eur J Physiother. 2017;19: 207-214.
- 30. Lesser M, Borst J, Dekerlegand J. Use of the postural assessment scale for stroke patients in determining acute care discharge recommendations. J Acute Care Phys Ther. 2017;8:79-85.
- 31. Smith PS, Hembree JA, Thompson ME. Berg balance scale and functional reach: determining the best clinical tool for individuals post-acute stroke. Clin Rehabil. 2004;18:811-818.
- 32. Alenazi AM, Alshehri MM, Alothman S, et al. Functional reach, depression scores, and number of medications are associated with number of falls in people with chronic stroke. PM R. 2018;10:806-816.
- 33. Çankaya H, Bakar Y. Investigation of the effect of corset use on balance and muscle activation in stroke patients. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi. 2018;9:33-42.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Makaleler |
| Yazarlar | |
| Yayımlanma Tarihi | 10 Eylül 2021 |
| Gönderilme Tarihi | 26 Mart 2020 |
| Yayımlandığı Sayı | Yıl 2021 Cilt: 8 Sayı: 2 |
