Inmeli Hastalarda Modifiye Kısıtlayarak – Zorlayıcı Hareket Tedavisinin Alt Ekstremite Fonksiyonları, Denge, Ambulasyon ve Yaşam Kalitesi Üzerine Etkileri

The purpose of this study was to compare the effects of neurophysiological based exercise approach (control group) and modified constraint induced movement therapy (experimental group) in stroke patients. Thirty patients with stroke, who were 18 or above ages and had stroke first, brunnstrom lower extremity staging ≥3, functional ambulation classification ≥2, 3-12 months were passed after stroke, without any additional physical or neurological problem included into this study. Patients were divided into two groups according to randomization method. The exercises, which were based on neurophysiological approach applied to both groups during first 4 weeks, 3 days a week, 1 hour a day and than during the next 2 weeks, 5 days a week, 2 hours a day, modified constraint induced movement therapy was applied to patients in experimental group and exercises, which were based on neurophysiological approach was performed to patients in control group. Functional mobility, spatiotemporal parameters of gait, gait speed, postural symmetry and symmetry of weight bearing, motor function, the amount of improvement perceived by patients and quality of life were evaluated three times such as pre-treatment, in fourth week and post-treatment. As a result of the study, between at fourth week and at sixth week evaluations post-treatment were difference in the walking speed, the cadence, the non-affected side step length, the affected side foot angle, step symmetry, the functional balance, postural and weight bearing symmetry, the recovery amount and the quality of life increased more in the experimental group (p0,05). As a result, modified constraint induced movement therapy had enhancing effects on lower extremity function, balance, ambulation and quality of life in patients with stroke. Modified constraint induced movement therapy could be used as an new alternative treatment for lower extremity in the stroke rehabilitation.Bu çalışmanın amacı inme hastalarında nörofizyolojik temelli egzersiz yaklaşımının (kontrol grubu) ve modifiye kısıtlayarak zorlayıcı hareket tedavisinin (çalışma grubu) etkilerinin karşılaştırılmasıdır. Çalışmaya 18 yaş ve üzerinde olan, ilk defa inme geçirmiş, Brunnstrom alt ekstremite evrelemesi ≥3, fonksiyonel ambulasyon sınıflandırması ≥2 olan, inme sonrası 3-12 ayın geçtiği ve başka ek fiziksel veya nörolojik problemin olmadığı 30 hasta dahil edilmiştir. Hastalar rastgele randomizasyon yöntemine göre 2 gruba ayrılmıştır. Çalışma ve kontrol grubundaki hastalara 4 hafta boyunca haftada 3 gün, günde 1 saat nörofizyolojik temelli egzersizler uygulanmış, sonraki 2 hafta, 5 gün, günde 2 saat olmak üzere çalışma grubuna modifiye kısıtlayarak zorlayıcı hareket tedavisi, kontrol grubuna ise nörofizyolojik temelli egzersizler uygulanmıştır. Fonksiyonel mobilite, yürümenin zaman ve mesafe parametreleri, yürüme hızı, postural simetri ve ağırlık aktarma simetrisi, motor fonksiyon, hastanın algıladığı iyileşme miktarı ve yaşam kalitesi tedavi öncesi, tedavi sonrası 4. haftada ve tedavi sonrası 6. haftada olmak üzere 3 kez değerlendirilmiştir. Çalışmanın sonucunda 4. ile 6. hafta ölçümleri arasında yürüme hızında, kadansta, sağlam taraf adım uzunluğunda, etkilenen taraf ayak açısında, adım simetrisinde, fonksiyonel dengede, postural ve ağırlık aktarma simetrisinde, iyileşme miktarı ve yaşam kalitesinde çalışma grubu lehine fark bulunmuştur (p0,05). Sonuç olarak, inmeli hastalarda modifiye kısıtlayarak zorlayıcı hareket tedavisinin alt ekstremite fonksiyonunu, dengeyi, ambulasyonu ve yaşam kalitesini geliştirici etkisi vardır. Modifiye kısıtlayarak zorlayıcı hareket tedavisi inme rehabilitasyonu kapsamında alt ekstremite için yeni bir tedavi alternatifi olarak kullanılabilir

Effects of Modified Constraint-Induced Movement Therapy for Lower Limb on Motor Function in Stroke Patients: A Randomized Controlled Study

Background: Few studies have examined the effectiveness of modified constraint-induced movement therapy (mCIMT) for the paretic lower limb following stroke. This study aimed to investigate the effects of mCIMT on motor function of the lower limb in stroke patients. Methods: A randomized, controlled study of 30 participants, who were randomized to 2 groups, was conducted. The study group received mCIMT, and the control group received neurodevelopmental therapy (NDT) for two weeks. All were evaluated for motor function through the Functional Ambulation Classification (FAC), Berg Balance Scale (BBS),10-Meter Walk Test, gait parameters (cadence and step length ratio) and postural symmetry ratio at pretreatment and post-treatment, like two times. Results: The improvements in BBS score, postural symmetry ratio, step length ratio, cadence and walking velocity had greater in the study group than the control group (P < 0.05). The improvement of FAC score was more pronounced in the study group (P = 0.005). Conclusion: mCIMT for paretic lower limb had superior effect against the NDT to enhance the motor function (gait parameters, balance, ambulation, and symmetry) in patients with stroke. mCIMT may be used as a new alternative treatment for lower limb rehabilitation

EFFECTS OF MODIFIED CONSTRAINT-INDUCED MOVEMENT THERAPY FOR LOWER LIMB ON MOTOR FUNCTION IN STROKE PATIENTS: A RANDOMIZED CONTROLLED STUDY

Background: Few studies have examined the effectiveness of modified constraint-induced movement therapy (mCIMT) for the paretic lower limb following stroke. This study aimed to investigate the effects of mCIMT on motor function of the lower limb in stroke patients. Methods: A randomized, controlled study of 30 participants, who were randomized to 2 groups, was conducted. The study group received mCIMT, and the control group received neurodevelopmental therapy (NDT) for two weeks. All were evaluated for motor function through the Functional Ambulation Classification (FAC), Berg Balance Scale (BBS),10-Meter Walk Test, gait parameters (cadence and step length ratio) and postural symmetry ratio at pretreatment and post-treatment, like two times. Results: The improvements in BBS score, postural symmetry ratio, step length ratio, cadence and walking velocity had greater in the study group than the control group (P < 0.05). The improvement of FAC score was more pronounced in the study group (P = 0.005). Conclusion: mCIMT for paretic lower limb had superior effect against the NDT to enhance the motor function (gait parameters, balance, ambulation, and symmetry) in patients with stroke. mCIMT may be used as a new alternative treatment for lower limb rehabilitation

Cross-cultural adaptation and psychometric properties of the Fear of Falling Avoidance Behavior Questionnaire in Turkish community-dwelling older adults

WOS: 000518722200001PubMed: 32135067Purpose: This study aimed to translate and adapt the Fear of Falling Avoidance Behavior Questionnaire (FFABQ) for Turkish culture and to evaluate the psychometric properties of FFABQ-Turkish in community-dwelling older adults. Methods: Eighty community-dwelling older adults (41 females) were assessed using the FFABQ-Turkish, Activities-specific Balance Confidence Scale (ABC). Fall history and severity of fear of falling (FoF) were recorded. Forty-two participants were reassessed one week apart for test-retest reliability. Internal consistency, test-retest reliability, sensitivity to change, convergent validity, construct validity, floor and ceiling effect, and scale discrimination of FFABQ-Turkish were investigated. Results: FFABQ-Turkish has high internal consistency and good test-retest reliability. Overall scores for FFABQ-Turkish were high in females, older individuals >= 75 years, and fallers. Minimal detectable change with 95% confidence was 4.51 points. There were strong and moderate correlations between FFABQ-Turkish and ABC, FoF, and the number of falls. Factor analysis demonstrated a two-factor structure. No floor and ceiling effect was found. FFABQ-Turkish could discriminate individuals without avoidance behavior from those with severe avoidance behavior. Conclusions: FFABQ-Turkish is a valid and reliable measure to assess the activity and participation restriction due to FoF, and could be used to quantify avoidance behavior in Turkish community-dwelling older adults