全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用:99美元

查看量下载量

相关文章

更多...

Sit-to-Stand in People with Stroke: Effect of Lower Limb Constraint-Induced Movement Strategies

DOI: 10.1155/2014/683681

Full-Text   Cite this paper   Add to My Lib

Abstract:

Background. Weight-bearing asymmetry and impaired balance may contribute to the increased fall risk in people with stroke when rising to stand from sitting. Objective. This study investigated the effect of constraint-induced movement (CIM) strategies on weight-bearing symmetry and balance during sit-to-stand in people with stroke. Methods. A nonrandom convenience sample of fifteen people with stroke performed the sit-to-stand task using three CIM strategies including a solid or compliant (foam) block strategy, with the unaffected limb placed on the block, and an asymmetrical foot position strategy, with the unaffected limb placed ahead of the affected limb. Duration of the task, affected limb weight-bearing, and centre of pressure and centre of mass displacement were measured in the frontal and sagittal plane. Results. Affected limb weight-bearing was increased and frontal plane centre of pressure and centre of mass moved toward the affected limb compared to baseline with all CIM strategies. Centre of mass displacement in the sagittal plane was greater with the compliant block and asymmetrical foot strategies. Conclusions. The CIM strategies demonstrated greater loading of the affected limb and movement of the centre of pressure and centre of mass toward the affected limb. The compliant block and asymmetrical foot conditions may challenge sagittal plane balance during sit-to-stand in people with stroke. 1. Introduction People with stroke have a higher risk of falling compared with their age matched peers [1–4] with many falls occurring during transition movements including rising to stand from sitting [1, 5, 6]. STS in people with stroke is characterized by greater loading on the unaffected limb [6–10] and larger frontal plane centre of pressure (COP) displacement compared with age matched healthy adults [8, 10, 11]. Previous authors have equated larger total COP displacement with balance impairment [8, 10, 11]. Weight-bearing asymmetry and impaired balance may contribute to the increased fall risk in people with stroke [8]. Consequently, improved weight-bearing symmetry and balance during STS are goals of rehabilitation in this population. Constraint-induced movement (CIM) therapy is a treatment strategy designed to increase affected limb weight-bearing during STS in people with stroke. Three CIM strategies for the lower limb include placement of the unaffected limb ahead of the affected limb [7, 9, 12–16] and placement of the unaffected limb on a solid [14] or compliant (foam) [7] block during STS practice. The CIM strategies are designed to increase

References

[1]  L. Nyberg and Y. Gustafson, “Patient falls in stroke rehabilitation: a challenge to rehabilitation strategies,” Stroke, vol. 26, no. 5, pp. 838–842, 1995.
[2]  F. A. Batchelor, S. F. Mackintosh, C. M. Said, and K. D. Hill, “The effect of limited english proficiency on falls risk and falls prevention after stroke,” Age and Ageing, vol. 41, no. 1, pp. 104–107, 2012.
[3]  A. Forster and J. Young, “Incidence and consequences of falls due to stroke: a systematic inquiry,” British Medical Journal, vol. 311, no. 6997, pp. 83–86, 1995.
[4]  F. Tung, Y. Yang, C. Lee, and R. Wang, “Balance outcomes after additional sit-to-stand training in subjects with stroke: a randomized controlled trial,” Clinical Rehabilitation, vol. 24, no. 6, pp. 533–542, 2010.
[5]  H. C. White, “Post-stroke hip fractures,” Archives of Orthopaedic and Traumatic Surgery, vol. 107, no. 6, pp. 345–347, 1988.
[6]  D. Hyndman, A. Ashburn, and E. Stack, “Fall events among people with stroke living in the community: circumstances of falls and characteristics of fallers,” Archives of Physical Medicine and Rehabilitation, vol. 83, no. 2, pp. 165–170, 2002.
[7]  D. Brunt, B. Greenberg, S. Wankadia, M. A. Trimble, and O. Shechtman, “The effect of foot placement on sit to stand in healthy young subjects and patients with hemiplegia,” Archives of Physical Medicine and Rehabilitation, vol. 83, no. 7, pp. 924–929, 2002.
[8]  P. Cheng, M. Liaw, M. Wong, F. Tang, M. Lee, and P. Lin, “The sit-to-stand movement in stroke patients and its correlation with falling,” Archives of Physical Medicine and Rehabilitation, vol. 79, no. 9, pp. 1043–1046, 1998.
[9]  J. Lecours, S. Nadeau, D. Gravel, and L. Teixera-Salmela, “Interactions between foot placement, trunk frontal position, weight-bearing and knee moment asymmetry at seat-off during rising from a chair in healthy controls and persons with hemiparesis,” Journal of Rehabilitation Medicine, vol. 40, no. 3, pp. 200–207, 2008.
[10]  S. Chou, A. M. K. Wong, C. Leong, W. Hong, F. Tang, and T. Lin, “Postural control during sit-to stand and gait in stroke patients,” American Journal of Physical Medicine and Rehabilitation, vol. 82, no. 1, pp. 42–47, 2003.
[11]  A. Leroux, H. Pinet, and S. Nadeau, “Task-oriented intervention in chronic stroke: changes in clinical and laboratory measures of balance and mobility,” American Journal of Physical Medicine and Rehabilitation, vol. 85, no. 10, pp. 820–830, 2006.
[12]  G. Roy, S. Nadeau, D. Gravel, F. Malouin, B. J. McFadyen, and F. Piotte, “The effect of foot position and chair height on the asymmetry of vertical forces during sit-to-stand and stand-to-sit tasks in individuals with hemiparesis,” Clinical Biomechanics, vol. 21, no. 6, pp. 585–593, 2006.
[13]  G. Roy, S. Nadeau, D. Gravel, F. Piotte, F. Malouin, and B. J. McFadyen, “Side difference in the hip and knee joint moments during sit-to-stand and stand-to-sit tasks in individuals with hemiparesis,” Clinical Biomechanics, vol. 22, no. 7, pp. 795–804, 2007.
[14]  A. D. S. Rocha, R. J. Knabben, and S. M. Michaelsen, “Non-paretic lower limb constraint with a step decreases the asymmetry of vertical forces during sit-to-stand at two seat heights in subjects with hemiparesis,” Gait and Posture, vol. 32, no. 4, pp. 457–463, 2010.
[15]  C. Duclos, S. Nadeau, and J. Lecours, “Lateral trunk displacement and stability during sit-to-stand transfer in relation to foot placement in patients with hemiparesis,” Neurorehabilitation and Neural Repair, vol. 22, no. 6, pp. 715–722, 2008.
[16]  A. C. R. Camargos, R. Rodrigues-de-Paula-Goulart, and L. F. Teixeira-Salmela, “The effects of foot position on the performance of the sit-to-stand movement with chronic stroke subjects,” Archives of Physical Medicine and Rehabilitation, vol. 90, no. 2, pp. 314–319, 2009.
[17]  P. Cheng, S. Wu, M. Liaw, A. M. K. Wong, and F. Tang, “Symmetrical body-weight distribution training in stroke patients and its effect on fall prevention,” Archives of Physical Medicine and Rehabilitation, vol. 82, no. 12, pp. 1650–1654, 2001.
[18]  M. Galli, V. Cimolin, M. Crivellini, and I. Campanini, “Quantitative analysis of sit to stand movement: experimental set-up definition and application to healthy and hemiplegic adults,” Gait and Posture, vol. 28, no. 1, pp. 80–85, 2008.
[19]  D. A. Winter, F. Prince, J. S. Frank, C. Powell, and K. F. Zabjek, “Unified theory regarding A/P and M/L balance in quiet stance,” Journal of Neurophysiology, vol. 75, no. 6, pp. 2334–2343, 1996.
[20]  E. Taub, J. E. Crago, L. D. Burgio et al., “An operant approach to rehabilitation medicine: overcoming learned nonuse by shaping,” Journal of the Experimental Analysis of Behavior, vol. 61, no. 2, pp. 281–293, 1994.
[21]  S. Hesse, M. Schauer, M. Malezic, M. Jahnke, and K.-H. Mauritz, “Quantitative analysis of rising from a chair in healthy and hemiparetic subjects,” Scandinavian Journal of Rehabilitation Medicine, vol. 26, no. 3, pp. 161–166, 1994.
[22]  L. M. Inkster and J. J. Eng, “Postural control during a sit-to-stand task in individuals with mild Parkinson's disease,” Experimental Brain Research, vol. 154, no. 1, pp. 33–38, 2004.
[23]  E. Britton, N. Harris, and A. Turton, “An exploratory randomized controlled trial of assisted practice for improving sit-to-stand in stroke patients in the hospital setting,” Clinical Rehabilitation, vol. 22, no. 5, pp. 458–468, 2008.

Full-Text

Contact Us

service@oalib.com

QQ:3279437679

WhatsApp +8615387084133