Trunk Restraint Therapy: The Continuous Use Of The Harness Could Promote Feedback Dependence In Poststroke Patients: A Randomized Trial.

The objective of this study was to evaluate the long-term effects of the task-specific training with trunk restraint compared with the free one in poststroke reaching movements. The design was randomized trial. The setting was University of Campinas (Unicamp). Twenty hemiparetic chronic stroke patients were selected and randomized into 2 training groups: trunk restraint group (TRG) (reaching training with trunk restraint) and trunk free group (TFG) (unrestraint reaching). Twenty sessions with 45 minutes of training were accomplished. The patients were evaluated in pretreatment (PRE), posttreatment (POST) and 3 months after the completed training (RET) (follow-up). Main outcome measures were modified Ashworth scale, Barthel index, Fugl-Meyer scale, and kinematic analysis (movement trajectory, velocity, angles). A significant improvement, which maintained in the RET test, was found in the motor (P < 0.001) and functional (P = 0.001) clinical assessments for both groups. For trunk displacement, only TFG obtained a reduction statistical significance from PRE to the POST test (P = 0.002), supporting this result in the RET test. Despite both groups presenting a significant increase in the shoulder horizontal adduction (P = 0.003), only TRG showed a significant improvement in the shoulder (P = 0.001--PRE to POST and RET) and elbow (P = 0.038--PRE to RET) flexion extension, and in the velocity rate (P = 0.03--PRE to RET). The trunk restraint therapy showed to be a long-term effective treatment in the enhancement of shoulder and elbow active joint range and velocity rate but not in the maintenance of trunk retention. Trial registration: NCT02364141.94e64

Trunk Restraint Therapy: The Continuous Use Of The Harness Could Promote Feedback Dependence In Poststroke Patients A Randomized Trial

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)The objective of this study was to evaluate the long-term effects of the task-specific training with trunk restraint compared with the free one in poststroke reaching movements. The design was randomized trial. The setting was University of Campinas (Unicamp). Twenty hemiparetic chronic stroke patients were selected and randomizedinto2traininggroups: trunkrestraintgroup(TRG) (reachingtraining with trunk restraint) and trunk free group (TFG) (unrestraint reaching). Twenty sessions with 45minutes of training were accomplished. The patientswere evaluated in pretreatment (PRE), posttreatment (POST) and 3 months after the completed training (RET) (follow-up). Main outcome measures were modified Ashworth scale, Barthel index, Fugl-Meyer scale, and kinematic analysis (movement trajectory, velocity, angles). A significant improvement, which maintained in the RET test, was found in the motor (P< 0.001) and functional (P = 0.001) clinical assessments for both groups. For trunk displacement, only TFG obtained a reduction statistical significance fromPRE to the POST test (P = 0.002), supporting this result in the RET test. Despite both groups presenting a significant increase in the shoulder horizontal adduction (P = 0.003), only TRGshowed a significant improvement in the shoulder (P = 0.001 -PRE to POST and RET) and elbow (P = 0.038 -PRE to RET) flexion extension, and in the velocity rate (P = 0.03 -PRE to RET). The trunk restraint therapy showed to be a long-term effective treatment in the enhancement of shoulder and elbow active joint range and velocity rate but not in the maintenance of trunk retention.9412Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)FAPESP [06/61199-5]CNPq [302189/2004-1

Trunk restraint therapy: the continuous use of the harness could promote feedback dependence in poststroke patients a randomized trial

The objective of this study was to evaluate the long-term effects of the task-specific training with trunk restraint compared with the free one in poststroke reaching movements. The design was randomized trial. The setting was University of Campinas (Unicamp). Twenty hemiparetic chronic stroke patients were selected and randomizedinto2traininggroups: trunkrestraintgroup(TRG) (reachingtraining with trunk restraint) and trunk free group (TFG) (unrestraint reaching). Twenty sessions with 45minutes of training were accomplished. The patientswere evaluated in pretreatment (PRE), posttreatment (POST) and 3 months after the completed training (RET) (follow-up). Main outcome measures were modified Ashworth scale, Barthel index, Fugl-Meyer scale, and kinematic analysis (movement trajectory, velocity, angles). A significant improvement, which maintained in the RET test, was found in the motor (P< 0.001) and functional (P = 0.001) clinical assessments for both groups. For trunk displacement, only TFG obtained a reduction statistical significance fromPRE to the POST test (P = 0.002), supporting this result in the RET test. Despite both groups presenting a significant increase in the shoulder horizontal adduction (P = 0.003), only TRGshowed a significant improvement in the shoulder (P = 0.001 -PRE to POST and RET) and elbow (P = 0.038 -PRE to RET) flexion extension, and in the velocity rate (P = 0.03 -PRE to RET). The trunk restraint therapy showed to be a long-term effective treatment in the enhancement of shoulder and elbow active joint range and velocity rate but not in the maintenance of trunk retention9412CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQFUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESP302189/2004-106/61199-

Gait Analysis Comparing Parkinson's Disease With Healthy Elderly Subjects.

There is a lack of studies comparing the kinematics data of idiopathic Parkinson's disease (IPD) patients with healthy elder (HE) subjects, and when there is such research, it is not correlated to clinical measures. To compare the spatio-temporal and kinematic parameters of Parkinsonian gait with the HE subjects group and measure the relation between these parameters and clinical instruments. Twelve patients with IPD and fifteen HE subjects were recruited and evaluated for clinical instruments and gait analysis. There were statistically significant differences between HE group and the IPD group, in stride velocity, in stride length (SL), and in the hip joint kinematic data: on initial contact, on maximum extension during terminal contact and on maximum flexion during mid-swing. Regarding the clinical instruments there were significant correlated with in stride velocity and SL. Clinical instruments used did not present proper psychometric parameters to measure the IPD patient's gait, while the 3D system characterized it better.6881-

Gait analysis comparing Parkinson's disease with healthy elderly subjects Comparação da doença de Parkinson com idosos saudáveis através da análise da marcha

There is a lack of studies comparing the kinematics data of idiopathic Parkinson's disease (IPD) patients with healthy elder (HE) subjects, and when there is such research, it is not correlated to clinical measures. OBJECTIVE: To compare the spatio-temporal and kinematic parameters of Parkinsonian gait with the HE subjects group and measure the relation between these parameters and clinical instruments. METHOD: Twelve patients with IPD and fifteen HE subjects were recruited and evaluated for clinical instruments and gait analysis. RESULTS: There were statistically significant differences between HE group and the IPD group, in stride velocity, in stride length (SL), and in the hip joint kinematic data: on initial contact, on maximum extension during terminal contact and on maximum flexion during mid-swing. Regarding the clinical instruments there were significant correlated with in stride velocity and SL. CONCLUSION: Clinical instruments used did not present proper psychometric parameters to measure the IPD patient's gait, while the 3D system characterized it better.<br>Poucos estudos comparam os dados cinemáticos de pacientes com doença de Parkinson idiopática (DPI) com indivíduos idosos saudáveis, e quando realizam não correlacionam com medidas clínicas. OBJETIVO: Comparar os parâmetros espaço-temporais e cinemáticos da marcha na DP com os de idosos saudáveis (IS) e avaliar a relação entre estes parâmetros com os instrumentos clínicos. MÉTODO: Doze pacientes com DPI e quinze IS foram recrutados e avaliados por instrumentos clínicos e de análise de marcha. RESULTADOS: Houve diferenças estatísticas significantes entre o grupo de IS e o de DPI na velocidade da marcha e no comprimento do passo (CP), nos dados cinemáticos das articulações do quadril: no contato inicial, na máxima extensão no apoio e na máxima flexão na oscilação. No que diz respeito aos instrumentos clínicos houve significativa correlação com a velocidade da marcha e SL. CONCLUSÃO: Os instrumentos clínicos utilizados não apresentaram adequados parâmetros psicométricos para a avaliação da marcha dos indivíduos com DPI, enquanto uma avaliação em 3D caracteriza melhor a marcha destes indivíduos