Journal of Neurologic Physical Therapy最新文献

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JNPT Congratulates APTA 2022 Award Winners. JNPT祝贺APTA 2022获奖者。
IF 3.8 3区 医学
Journal of Neurologic Physical Therapy Pub Date : 2022-10-01 DOI: 10.1097/NPT.0000000000000419
{"title":"JNPT Congratulates APTA 2022 Award Winners.","authors":"","doi":"10.1097/NPT.0000000000000419","DOIUrl":"https://doi.org/10.1097/NPT.0000000000000419","url":null,"abstract":"","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10050884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association of Lower Limb Focal Spasticity With Kinematic Variables During Walking in Traumatic Brain Injury. 创伤性脑损伤患者行走过程中下肢局灶性痉挛与运动学变量的关系。
IF 3.8 3区 医学
Journal of Neurologic Physical Therapy Pub Date : 2022-07-01 DOI: 10.1097/NPT.0000000000000400
Gavin Williams, Megan Banky
{"title":"Association of Lower Limb Focal Spasticity With Kinematic Variables During Walking in Traumatic Brain Injury.","authors":"Gavin Williams,&nbsp;Megan Banky","doi":"10.1097/NPT.0000000000000400","DOIUrl":"https://doi.org/10.1097/NPT.0000000000000400","url":null,"abstract":"<p><strong>Background and purpose: </strong>Focal muscle spasticity is defined as spasticity that affects a localized group of muscles. It is prevalent in many adult-onset neurological conditions, yet the relationship of focal muscle spasticity with walking remains unclear. Therefore, the aim of this study was to determine the relationship of focal muscle spasticity with the kinematics of walking in traumatic brain injury (TBI).</p><p><strong>Methods: </strong>Ninety-one participants with TBI underwent clinical gait analysis and assessment of focal lower limb muscle spasticity in a prospective cross-sectional study. A matched group of 25 healthy controls (HCs) were recruited to establish a reference dataset. Kinematic data for each person with and without focal muscle spasticity following TBI were compared with the HC cohort at a matched walking speed.</p><p><strong>Results: </strong>The TBI and HC cohorts were well matched. Only those with focal hamstring muscle spasticity walked significantly different to those without. They had significantly greater knee flexion (23.4° compared with 10.5°, P < 0.01) at initial contact. There were no other significant differences in kinematic variables between those with and without focal muscle spasticity. There was no significant association between focal muscle spasticity and walking speed.</p><p><strong>Discussion and conclusions: </strong>Focal muscle spasticity and abnormal kinematics whilst walking were common in this cohort of people with TBI. However, focal muscle spasticity had little relationship with kinematic variables, and no significant relationship with walking speed. This finding has implications for the treatment of focal muscle spasticity to improve walking following TBI. Focal muscle spasticity had little relationship with kinematic variables and walking speed in this cohort of people with TBI who could walk without assistance.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A381).</p>","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10398318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Use of an EMG-Controlled Game as a Therapeutic Tool to Retrain Hand Muscle Activation Patterns Following Stroke: A Pilot Study. 使用肌电控制游戏作为中风后手部肌肉激活模式再训练的治疗工具:一项试点研究。
IF 3.8 3区 医学
Journal of Neurologic Physical Therapy Pub Date : 2022-07-01 DOI: 10.1097/NPT.0000000000000398
Na Jin Seo, Alex Barry, Mohammad Ghassemi, Kristen M Triandafilou, Mary Ellen Stoykov, Lynn Vidakovic, Elliot Roth, Derek G Kamper
{"title":"Use of an EMG-Controlled Game as a Therapeutic Tool to Retrain Hand Muscle Activation Patterns Following Stroke: A Pilot Study.","authors":"Na Jin Seo,&nbsp;Alex Barry,&nbsp;Mohammad Ghassemi,&nbsp;Kristen M Triandafilou,&nbsp;Mary Ellen Stoykov,&nbsp;Lynn Vidakovic,&nbsp;Elliot Roth,&nbsp;Derek G Kamper","doi":"10.1097/NPT.0000000000000398","DOIUrl":"https://doi.org/10.1097/NPT.0000000000000398","url":null,"abstract":"<p><strong>Background/purpose: </strong>To determine the feasibility of training with electromyographically (EMG) controlled games to improve control of muscle activation patterns in stroke survivors.</p><p><strong>Methods: </strong>Twenty chronic stroke survivors (>6 months) with moderate hand impairment were randomized to train either unilaterally (paretic only) or bilaterally over 9 one-hour training sessions. EMG signals from the unilateral or bilateral limbs controlled a cursor location on a computer screen for gameplay. The EMG muscle activation vector was projected onto the plane defined by the first 2 principal components of the activation workspace for the nonparetic hand. These principal components formed the x- and y-axes of the computer screen.</p><p><strong>Results: </strong>The recruitment goal (n = 20) was met over 9 months, with no screen failure, no attrition, and 97.8% adherence rate. After training, both groups significantly decreased the time to move the cursor to a novel sequence of targets (P = 0.006) by reducing normalized path length of the cursor movement (P = 0.005), and improved the Wolf Motor Function Test (WMFT) quality score (P = 0.01). No significant group difference was observed. No significant change was seen in the WMFT time or Box and Block Test.</p><p><strong>Discussion/conclusions: </strong>Stroke survivors could successfully use the EMG-controlled games to train control of muscle activation patterns. While the nonparetic limb EMG was used in this study to create target EMG patterns, the system supports various means for creating target patterns per user desires. Future studies will employ training with the EMG-controlled games in conjunction with functional task practice for a longer intervention duration to improve overall hand function.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A379).</p>","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9232857/pdf/nihms-1775132.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10099033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Is Sleep the Next Frontier in Movement Science? 睡眠是运动科学的下一个前沿吗?
IF 3.8 3区 医学
Journal of Neurologic Physical Therapy Pub Date : 2022-07-01 DOI: 10.1097/NPT.0000000000000408
George Fulk
{"title":"Is Sleep the Next Frontier in Movement Science?","authors":"George Fulk","doi":"10.1097/NPT.0000000000000408","DOIUrl":"https://doi.org/10.1097/NPT.0000000000000408","url":null,"abstract":"","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10042690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Rasch Validation of the Mini-BESTest in People With Parkinson Disease. Mini-BESTest在帕金森病患者中的Rasch验证。
IF 3.8 3区 医学
Journal of Neurologic Physical Therapy Pub Date : 2022-07-01 DOI: 10.1097/NPT.0000000000000401
Franco Franchignoni, Marco Godi, Stefano Corna, Andrea Giordano
{"title":"Rasch Validation of the Mini-BESTest in People With Parkinson Disease.","authors":"Franco Franchignoni,&nbsp;Marco Godi,&nbsp;Stefano Corna,&nbsp;Andrea Giordano","doi":"10.1097/NPT.0000000000000401","DOIUrl":"https://doi.org/10.1097/NPT.0000000000000401","url":null,"abstract":"<p><strong>Background and purpose: </strong>The Mini-BESTest is a balance measure with robust psychometric properties widely used in people with Parkinson disease. The aim of this study was to examine-with advanced psychometric techniques-some key properties of the Mini-BESTest (including unidimensionality, functioning of rating categories, internal construct validity, reliability indexes) in a consecutive sample of individuals with Parkinson disease admitted for balance rehabilitation.</p><p><strong>Methods: </strong>Confirmatory factor analysis and Rasch analysis (partial credit model) were performed on 193 individual raw scores of the Mini-BESTest items.</p><p><strong>Results: </strong>Confirmatory factor analysis fit indices and principal component analysis of the residuals confirmed the scale's unidimensionality. At Rasch analysis, the 3-level rating scale demonstrated appropriate functioning. All items fitted the Rasch model. Item response dependence was negligible. No differential item functioning was found across gender and age groups.</p><p><strong>Discussion and conclusions: </strong>We confirmed and extended the evidence (demonstrated in different populations) on the general psychometric soundness of the Mini-BESTest, even when tested with rigorous statistical methods. In addition, 2 forms were created: (i) to transform raw scores into linear estimates of dynamic balance; and (ii) to compare the individual's item responses with those expected by the Rasch model (thus providing an aid for tailored interventions) and manage missing responses. Further independent studies using advanced psychometric techniques are warranted, also in people with balance disturbances of different etiology. Our study further increases the confidence in using the Mini-BESTest to assess dynamic balance in people with Parkinson disease and provides some useful additional clinical aids for interpreting the results and calculating more precise change scores.See the Supplementary Video, available at: http://links.lww.com/JNPT/A384.</p>","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10099511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Commentary on: "Use of an EMG-Controlled Game as a Therapeutic Tool to Retrain Hand Muscle Activation Patterns Following Stroke: A Pilot Study". 评论:“使用肌电控制的游戏作为中风后再训练手部肌肉激活模式的治疗工具:一项试点研究”。
IF 3.8 3区 医学
Journal of Neurologic Physical Therapy Pub Date : 2022-07-01 DOI: 10.1097/NPT.0000000000000407
R James Cotton, Caitlin Newman
{"title":"Commentary on: \"Use of an EMG-Controlled Game as a Therapeutic Tool to Retrain Hand Muscle Activation Patterns Following Stroke: A Pilot Study\".","authors":"R James Cotton,&nbsp;Caitlin Newman","doi":"10.1097/NPT.0000000000000407","DOIUrl":"https://doi.org/10.1097/NPT.0000000000000407","url":null,"abstract":"","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10044733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluating the Impact of a Regional Student-Led Physiotherapy Clinic Model to Improve Self-Reported Function in Community-Dwelling Adults With Neurological Diagnoses. 评估区域学生主导的物理治疗诊所模式对改善社区居住的神经系统诊断成人自我报告功能的影响。
IF 3.8 3区 医学
Journal of Neurologic Physical Therapy Pub Date : 2022-07-01 DOI: 10.1097/NPT.0000000000000399
Andrea Hams, Neil Bell, Taryn Jones
{"title":"Evaluating the Impact of a Regional Student-Led Physiotherapy Clinic Model to Improve Self-Reported Function in Community-Dwelling Adults With Neurological Diagnoses.","authors":"Andrea Hams,&nbsp;Neil Bell,&nbsp;Taryn Jones","doi":"10.1097/NPT.0000000000000399","DOIUrl":"https://doi.org/10.1097/NPT.0000000000000399","url":null,"abstract":"<p><strong>Background and purpose: </strong>Neurological conditions are a major cause of health morbidity that negatively impacts function and quality of life (QoL). Despite this burden, community services are disproportionally scarce. Student-led physiotherapy services (SLSs) are a model that can increase community access to health care while providing authentic clinical experiences for students. SLSs consistently demonstrate high client satisfaction; however, limited evaluation of the impact of this model on the client's clinical outcomes exists. Therefore the aim of this project was to evaluate the impact of a physiotherapy student-led community-based rehabilitation service.</p><p><strong>Methods: </strong>The SLS operated 4 days a week over a 15-week period. Forty-two community-dwelling clients (mean age 74 years) with a neurological diagnosis were included. During initial consultation, participants completed basic demographics, up to 3 Patient-Specific Functional Scales (PSFSs) and a QoL questionnaire (World Health Organization Quality of Life-Brief Questionnaire [WHOQOL-BREF]). At discharge, participants completed the WHOQOL-BREF, PSFS, and a patient experience survey. Risk event data were also collected.</p><p><strong>Results: </strong>Over half of the PSFS items targeted mobility (55%). There was a significant improvement (P < 0.05) in median change (quartiles) for pre-/post-PSFS scores for clients whose primary condition was balance 1.0 (0.0-3.0), cerebrovascular accident 1.0 (2.0-3.0) or multiple Sclerosis 1.0 (1.0-2.0), and mean (SD) WHOQOL-BREF scores for Physical Health (12.2 ± 1.5 to 13.1 ± 1.3) and Social Relationships (12.7 ± 2.7 to 16.6 ± 3.3). Patient experience survey results indicated that clients had confidence and trust in students. No adverse events were reported.</p><p><strong>Discussion and conclusions: </strong>The SLS model provides a strategy to increase access to health care and clinical placement capacity. Findings demonstrated improved self-rated function, QoL, and positive patient experience for community-dwelling clients with nonacute neurological diagnoses.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A380).</p>","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10099510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Physical Activity After Transient Ischemic Attack or Mild Stroke Is Business as Usual. 短暂性脑缺血发作或轻度中风后的身体活动照常进行。
IF 3.8 3区 医学
Journal of Neurologic Physical Therapy Pub Date : 2022-07-01 DOI: 10.1097/NPT.0000000000000395
Maria Sammut, Kirsti Haracz, David Shakespeare, Coralie English, Gary Crowfoot, Natalie Fini, Michael Nilsson, Heidi Janssen
{"title":"Physical Activity After Transient Ischemic Attack or Mild Stroke Is Business as Usual.","authors":"Maria Sammut,&nbsp;Kirsti Haracz,&nbsp;David Shakespeare,&nbsp;Coralie English,&nbsp;Gary Crowfoot,&nbsp;Natalie Fini,&nbsp;Michael Nilsson,&nbsp;Heidi Janssen","doi":"10.1097/NPT.0000000000000395","DOIUrl":"https://doi.org/10.1097/NPT.0000000000000395","url":null,"abstract":"<p><strong>Background and purpose: </strong>Regular, sustained moderate-to-vigorous physical activity (MVPA) is a recommended strategy to reduce the risk of recurrent stroke for people who have had transient ischemic attack (TIA) or mild stroke. This study aimed to explore attitudes toward, and experience of engaging in physical activity by adults following a TIA or mild stroke.</p><p><strong>Methods: </strong>Constructivist grounded theory methodology informed data collection and analysis. Interviews from 33 adults with TIA or mild stroke (mean age 65 [SD 10] years, 48% female, 40% TIA) were collected.</p><p><strong>Results: </strong>Business as usual characterized physical activity engagement post-TIA or mild stroke. Most participants returned to prestroke habits, as either regular exerciser or nonexerciser, with only a small number making changes. Influencing factors for physical activity participation included information, challenges, strategies, and support. Business as usual was associated with a perceived lack of information to suggest a need to change behaviors. Nonexercisers and those who decreased physical activity emphasized challenges to physical activity, while regular exercisers and those who increased physical activity focused on strategies and support that enabled participation despite challenges.</p><p><strong>Discussion and conclusion: </strong>Information about the necessity to engage in recommended physical activity levels requires tailoring to the needs of the people with TIA or mild stroke. Helpful information in combination with support and strategies may guide how to navigate factors preventing engagement and might influence the low level of physical activity prevalent in this population.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1 available at: http://links.lww.com/JNPT/A376).</p>","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10044743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Vestibular Rehabilitation for Peripheral Vestibular Hypofunction: An Updated Clinical Practice Guideline From the Academy of Neurologic Physical Therapy of the American Physical Therapy Association. 外周前庭功能障碍的前庭康复:来自美国物理治疗协会神经物理治疗学会的最新临床实践指南。
IF 3.8 3区 医学
Journal of Neurologic Physical Therapy Pub Date : 2022-04-01 DOI: 10.1097/NPT.0000000000000382
Courtney D Hall, Susan J Herdman, Susan L Whitney, Eric R Anson, Wendy J Carender, Carrie W Hoppes, Stephen P Cass, Jennifer B Christy, Helen S Cohen, Terry D Fife, Joseph M Furman, Neil T Shepard, Richard A Clendaniel, J Donald Dishman, Joel A Goebel, Dara Meldrum, Cynthia Ryan, Richard L Wallace, Nakia J Woodward
{"title":"Vestibular Rehabilitation for Peripheral Vestibular Hypofunction: An Updated Clinical Practice Guideline From the Academy of Neurologic Physical Therapy of the American Physical Therapy Association.","authors":"Courtney D Hall,&nbsp;Susan J Herdman,&nbsp;Susan L Whitney,&nbsp;Eric R Anson,&nbsp;Wendy J Carender,&nbsp;Carrie W Hoppes,&nbsp;Stephen P Cass,&nbsp;Jennifer B Christy,&nbsp;Helen S Cohen,&nbsp;Terry D Fife,&nbsp;Joseph M Furman,&nbsp;Neil T Shepard,&nbsp;Richard A Clendaniel,&nbsp;J Donald Dishman,&nbsp;Joel A Goebel,&nbsp;Dara Meldrum,&nbsp;Cynthia Ryan,&nbsp;Richard L Wallace,&nbsp;Nakia J Woodward","doi":"10.1097/NPT.0000000000000382","DOIUrl":"https://doi.org/10.1097/NPT.0000000000000382","url":null,"abstract":"<p><strong>Background: </strong>Uncompensated vestibular hypofunction can result in symptoms of dizziness, imbalance, and/or oscillopsia, gaze and gait instability, and impaired navigation and spatial orientation; thus, may negatively impact an individual's quality of life, ability to perform activities of daily living, drive, and work. It is estimated that one-third of adults in the United States have vestibular dysfunction and the incidence increases with age. There is strong evidence supporting vestibular physical therapy for reducing symptoms, improving gaze and postural stability, and improving function in individuals with vestibular hypofunction. The purpose of this revised clinical practice guideline is to improve quality of care and outcomes for individuals with acute, subacute, and chronic unilateral and bilateral vestibular hypofunction by providing evidence-based recommendations regarding appropriate exercises.</p><p><strong>Methods: </strong>These guidelines are a revision of the 2016 guidelines and involved a systematic review of the literature published since 2015 through June 2020 across 6 databases. Article types included meta-analyses, systematic reviews, randomized controlled trials, cohort studies, case-control series, and case series for human subjects, published in English. Sixty-seven articles were identified as relevant to this clinical practice guideline and critically appraised for level of evidence.</p><p><strong>Results: </strong>Based on strong evidence, clinicians should offer vestibular rehabilitation to adults with unilateral and bilateral vestibular hypofunction who present with impairments, activity limitations, and participation restrictions related to the vestibular deficit. Based on strong evidence and a preponderance of harm over benefit, clinicians should not include voluntary saccadic or smooth-pursuit eye movements in isolation (ie, without head movement) to promote gaze stability. Based on moderate to strong evidence, clinicians may offer specific exercise techniques to target identified activity limitations and participation restrictions, including virtual reality or augmented sensory feedback. Based on strong evidence and in consideration of patient preference, clinicians should offer supervised vestibular rehabilitation. Based on moderate to weak evidence, clinicians may prescribe weekly clinic visits plus a home exercise program of gaze stabilization exercises consisting of a minimum of: (1) 3 times per day for a total of at least 12 minutes daily for individuals with acute/subacute unilateral vestibular hypofunction; (2) 3 to 5 times per day for a total of at least 20 minutes daily for 4 to 6 weeks for individuals with chronic unilateral vestibular hypofunction; (3) 3 to 5 times per day for a total of 20 to 40 minutes daily for approximately 5 to 7 weeks for individuals with bilateral vestibular hypofunction. Based on moderate evidence, clinicians may prescribe static and dynamic balance exercises for","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/77/36/jnpt-46-118.PMC8920012.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39692392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 62
Symmetry Is Associated With Interlimb Coordination During Walking and Pedaling After Stroke. 对称性与中风后行走和蹬车时的肢间协调有关。
IF 3.8 3区 医学
Journal of Neurologic Physical Therapy Pub Date : 2022-04-01 DOI: 10.1097/NPT.0000000000000377
Brice T Cleland, Sheila Schindler-Ivens
{"title":"Symmetry Is Associated With Interlimb Coordination During Walking and Pedaling After Stroke.","authors":"Brice T Cleland,&nbsp;Sheila Schindler-Ivens","doi":"10.1097/NPT.0000000000000377","DOIUrl":"https://doi.org/10.1097/NPT.0000000000000377","url":null,"abstract":"<p><strong>Background and purpose: </strong>Asymmetry during walking may be explained by impaired interlimb coordination. We examined these associations: (1) propulsive symmetry with interlimb coordination during walking, (2) work symmetry with interlimb coordination during pedaling, and (3) work symmetry and interlimb coordination with clinical impairment.</p><p><strong>Methods: </strong>Nineteen individuals with chronic stroke and 15 controls performed bilateral, lower limb pedaling with a conventional device and a device with a bisected crank and upstroke assistance. Individuals with stroke walked on a split-belt treadmill. Measures of symmetry (%Propulsionwalk, %Workped) and interlimb phase coordination index (PCIwalk, PCIped) were computed. Clinical evaluations were the lower extremity Fugl-Meyer (FMLE) and walking speed. Associations were assessed with Spearman's rank correlations.</p><p><strong>Results: </strong>Participants with stroke displayed asymmetry and impaired interlimb coordination compared with controls (P ≤ 0.001). There were significant correlations between asymmetry and impaired interlimb coordination (walking: R2 = 0.79, P < 0.001; pedaling: R2 = 0.62, P < 0.001) and between analogous measures across tasks (%Workped, %Propulsionwalk: R2 = 0.41, P = 0.01; PCIped, PCIwalk: R2 = 0.52, P = 0.003). Regardless of task, asymmetry and interlimb coordination were correlated with FMLE (R2 ≥ 0.48, P ≤ 0.004) but not walking speed. There was larger within group variation for %Propulsionwalk than %Workped (Z = 2.6, P = 0.005) and for PCIped than PCIwalk (Z = 3.6, P = 0.003).</p><p><strong>Discussion and conclusions: </strong>Pedaling may provide useful insights about walking, and impaired interlimb coordination may contribute to asymmetry in walking. Pedaling and walking provide distinct insights into stroke-related impairments, related to whether the task allows compensation (walking > pedaling) or compels paretic limb use (pedaling > walking). Pedaling a device with a bisected crank shaft may have therapeutic value.Video Abstract available for more insight from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A365).</p>","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8904653/pdf/nihms-1734838.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9333774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
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