Effect of Acupuncture at Huatuo Jiaji Points plus Virtual Balancing Game on Balance Function in Stroke Patients / 上海针灸杂志

Objective To investigate the effect of acupuncture at Huatuo jiaji points plus virtual balancing game on balance function in stroke patients.Methods Fifty patients with poststroke balance dysfunction were randomly allocated: 25 cases to the treatment group and 25 cases to the control groups. The treatment group received acupuncture at Huatuo jiaji points plus virtual balancing game-based rehabilitation training and the control group, virtual balancing game-based rehabilitation training alone. The Berg Balance Scale (BBS) score, the Timed Up and Go Test (TUGT) score, the COP offset distance indices (EO2, EC2, EOTS and EO1) and the modified Barthel Index (MBI) score were recorded in the two groups before and after treatment.Results There were statistically significant pre-/post-treatment differences in the BBS score, the TUGT score, the COP offset distance indices and the MBI score in the two groups of patients (P<0.05). There were statistically significant post-treatment differences in the BBS score, the TUGT score, the COP offset distance indices and the MBI score between the treatment and control groups (P<0.05).Conclusion Acupuncture at Huatuo jiaji points plus virtual balancing game is an effective way to treat poststroke balance dysfunction.

Accuracy of Timed Up and Go Test for screening risk of falls among community-dwelling elderly / Acurácia do Timed Up and Go Test para rastrear risco de quedas em idosos da comunidade

OBJECTIVE: To determine the accuracy of the Timed Up and Go Test (TUGT) for screening the risk of falls among community-dwelling elderly individuals. METHOD: This is a prospective cohort study with a randomly by lots without reposition sample stratified by proportional partition in relation to gender involving 63 community-dwelling elderly individuals. Elderly individuals who reported having Parkinson's disease, a history of transitory ischemic attack, stroke and with a Mini Mental State Exam lower than the expected for the education level, were on a wheelchair and that reported a single fall in the previous six months were excluded. The TUGT, a mobility test, was the measure of interested and the occurrence of falls was the outcome. The performance of basic activities of daily living (ADL) and instrumental activities of daily living (IADL) was determined through the Older American Resources and Services, and the socio-demographic and clinical data were determined through the use of additional questionnaires. Receiver Operating Characteristic Curves were used to analyze the sensitivity and specificity of the TUGT. RESULTS: Elderly individuals who fell had greater difficulties in ADL and IADL (p<0.01) and a slower performance on the TUGT (p=0.02). No differences were found in socio-demographic and clinical characteristics between fallers and non-fallers. Considering the different sensitivity and specificity, the best predictive value for discriminating elderly individuals who fell was 12.47 seconds [(RR=3.2) 95%CI: 1.3-7.7]. CONCLUSIONS: The TUGT proved to be an accurate measure for screening the risk of falls among elderly individuals. Although different from that reported in the international literature, the 12.47 second cutoff point seems to be a better predictive value for Brazilian elderly individuals.

OBJETIVO: Determinar a acurácia do Timed Up and Go Test (TUGT) para rastrear risco de quedas em idosos da comunidade. MÉTODO: Trata-se de um estudo de coorte prospectivo com amostra sorteada aleatoriamente, sem reposição e estratificada por partilha proporcional em relação ao sexo de 63 idosos da comunidade. Excluíram-se idosos com doença de Parkinson, ataque isquêmico transitório, acidente vascular encefálico, Miniexame do Estado Mental inferior ao considerado normal de acordo com a escolaridade, movimentação exclusiva por cadeira de rodas e relato de uma queda nos seis meses anteriores à primeira entrevista. O TUGT, um teste de mobilidade, foi a medida testada, e o desfecho, a ocorrência de queda. Mensuraram-se atividades básicas (ABVD) e instrumentais de vida diária (AIVD) pela Older American Resources and Services e dados sociodemográficos e clínicos por questionário complementar. Para analisar a sensibilidade e a especificidade do TUGT, utilizou-se a Receiver Operating Characteristic Curves (ROC). RESULTADOS: Os idosos que caíram tinham maior dificuldade na execução de ABVD e AIVD (p<0,01) e desempenho mais lento no TUGT (p=0,02). Quanto às características sociodemográficas e clínicas, não houve diferença entre idosos que caíram e os que não caíram. Considerando as diferentes sensibilidades, especificidades e razões de verossimilhança, o melhor valor preditivo para discriminar idosos que caíram foi 12,47 segundos [(RR=3,2) IC95%: 1,3-7,7]. CONCLUSÃO: O TUGT é acurado para rastrear risco de quedas em idosos. O cut-off de 12,47 segundos, embora diferente da literatura internacional, parece ser um melhor valor preditivo para idosos brasileiros.

The value of the timed “up and go” test at the evaluation of functional mobility in stroke patients / 中国康复理论与实践

@#ObjectiveTo evaluate the effect of the timed “up and go” test (TUGT) on measuring functional mobility of stroke patients.MethodsNinety hemiparetic stroke patients participated in this study. The balance, gait speed and disability of patients were measured by Berg balance scale (BBS), maximal gait speed and functional independence measure (FIM) to find out the critical value of TUGT.ResultsA good relationship existed among TUGT and the BBS,gait speed and FIM (r=-0.926—-0.674,P<0.001).The percentage of independent walking of stroke patients whose TUGT scores <10s or>20s were 100% and 8.3%. The optimal cut off values of TUGT to predict the independent walking of patients were 15.2s, and in stroke group sensitivity and specificity of TUGT were 89.4% and 79.1%.Conclusion TUGT is a reliable instrument with adequate concurrent validity to measure the functional mobility of stroke patients.

Factors related to Changes of Ambulatory Status in Elderly Nursing Home Residents

PURPOSE: To define the events surrounding mobility change in frail ambulatory elderly. METHODS: We retrospectively studied a cohort of 87 ambulatory residents of a chronic care hospital. Demographic data, medication, chronic condition, the Charlson Comorbidity Index(CCI), and ADLs were recorded. Mobility change was measured by the Timed Up & Go Test(TUGT) at baseline in July 1993 and follow-up in July 1996. This study determined the outcome status(dead, mon-ambulatory, ambulatory) and determined the reasons for ambulatory decline in individual subjects. RESULTS: During this period 31(36%) expired; 16(18%) became nonambulatory(wheel-chair dependent or bed-ridden) and 40(46%) remained ambulatory. Of those remaining ambulatory, TUGT performance was maintained in 26(30%), declined by 2X in 10(11%) and 4(5%) could not follow the test due to mental or behavioral problems. In the 16 nobambulatory subjects, 5(31%) lost mobility after an acute event, 11(69%) lost their mobility by slow decline. Factors associated with becoming nonambulatory include baseline CCI(p=0.01), frequency of medication change(p=0.009) and falls(p=0.004). CONCLUSION: CCI, medication change and falls were found to be associated with loss in mobility. The identification of risk factors for mobility change may be useful to target preventive measure.