Efficacy and Safety of Caregiver-Mediated Exercise in Post-stroke Rehabilitation

OBJECTIVE: To assess the efficacy and safety of our 4-week caregiver-mediated exercise (CME) in improving trunk control capacity, gait, and balance and in decreasing concerns about post-stroke falls when there is an increase in its efficacy. METHODS: Acute or subacute stroke survivors were assigned to either the trial group (n=35) or the control group (n=37). Changes in Modified Barthel Index (MBI), Functional Ambulation Categories (FAC), Berg Balance Scale (BBS), and Trunk Impairment Scale (TIS) scores at 4 weeks from baseline served as primary outcome measures. Correlations of primary outcome measures with changes in Fall Efficacy Scale-International (FES-I) scores at 4 weeks from baseline in the trial group served as secondary outcome measures. Treatment-emergent adverse events (TEAEs) served as safety outcome measures. RESULTS: There were significant differences in changes in MBI, FAC, BBS, TIS-T, TIS-D, TIS-C, and FES-I scores at 4 weeks from baseline between the two groups (all p < 0.0001). There were no significant (p=0.0755) differences in changes in TIS-S scores at 4 weeks from baseline between the two groups. MBI, FAC, BBS, and TIS scores showed significantly inverse correlations with FES-I scores in patients receiving CME. There were no TEAEs in our series. CONCLUSION: CME was effective and safe in improving the degree of independence, ambulation status, dynamic and static balance, trunk function, and concerns about post-stroke falls in stroke survivors.

Analysis of Publication Status of Abstracts Presented at the Annual Meeting of the Korean Academy of Rehabilitation Medicine

OBJECTIVE: To analyze publication rate, time to publication and the characteristics of the abstracts presented at the annual Korean Academy of Rehabilitation Medicine (KARM) meetings. METHODS: A total of 1,027 abstracts presented at the 2008 and 2009 annual KARM meetings were enrolled in the database and searched for their subsequent citation in PubMed, KoreaMed, and Google Scholar. RESULTS: The data analysis revealed that 317 (30.87%) abstracts, were published as full-length journal articles and publication rates by subject were not significantly different. The mean time to publication was 17.17+/-10.48 months, and the journals written in English (20.39+/-10.20) required a longer duration than those written in Korean (11.94+/-8.44) with statistical significance (p<0.001). There was no statistical difference (p=0.284) in the duration between domestic (17.61+/-10.37) and foreign (16.48+/-10.51) of the 220 domestic journal articles, 190 (86.76%) were published in the Annals of Rehabilitation Medicine and the 97 articles published in foreign journals were scattered over 60 different journals. CONCLUSION: The publication rate of abstracts presented at the 2008 and 2009 annual KARM meetings was 30.87% and the mean time to publication was 17.17+/-10.48 months.

Therapeutic Effects of Mechanical Horseback Riding on Gait and Balance Ability in Stroke Patients

OBJECTIVE: To investigate the therapeutic effects of mechanical horseback riding for gait and balance parameters in post-stroke patients. METHOD: This study was a non randomized prospective positive-controlled trial over a 12 week period. From May 2011 to October 2011, 37 stroke patients were recruited from our outpatient clinic and divided into two groups. The control group received the conventional physiotherapy while the intervention group received the conventional physiotherapy along with mechanical horseback riding therapy for 12 weeks. Outcome measurements of gait included the Functional Ambulation Category (FAC) and gait part of the Performance Oriented Mobility Assessment (G-POMA) while those of balance included the Berg Balance Scale (BBS) and the balance part of the Performance Oriented Mobility Assessment (B-POMA). These measurements were taken before and after treatment. RESULTS: There were no significant differences in the baseline characteristics and initial values between the two groups. When comparing baseline and 12 weeks post treatment in each group, the intervention group showed significant improvement on BBS (39.9+/-5.7 --> 45.7+/-4.8, p=0.001) and B-POMA (10.4+/-2.6 --> 12.6+/-2.1, p=0.001), but significant improvement on gait parameters. When comparing the groups, the dynamic balance category of BBS in post treatment showed significant difference (p=0.02). CONCLUSION: This study suggests that mechanical horseback riding therapy may be an effective treatment tool for enhancing balance in adults with stroke.