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ObjectiveTo investigate the relationship among spontaneous turning direction, balance ability and fall risk in patients with stroke during walking. MethodsFrom December, 2021 to November, 2022, 94 patients with stroke were recruited from Beijing Bo'ai Hospital. They were assessed with simple Timed 'Up and Go' Test (TUGT, TUGT1), TUGT with a cup in hand (TUGT2), and TUGT with calculation task (TUGT3). The spontaneous turning directions at the turn point were recorded, and the patients were divided into no-same group (n = 34) and same group, and the same group was further divided into affected group (n = 33) and unaffected group (n = 27), according to the spontaneous turning direction. After a spontaneous turning of each TUGT, the patients were asked to finish another TUGT turning to the opposite direction. And then, they were assessed with single leg standing test, Functional Reach Test (FRT), 360° turning test and the Morse Fall Scale (MFS). ResultsThere were the most patients with left hemiplegia in the affected group (χ2 = 7.995, P < 0.05). The time of TUGT1, TUGT2 and TUGT3 was the most in the affected group and the least in the unaffected group (F > 4.009, P < 0.05), and it was more in the affected group than in the unaffected group as post-hoc test (P < 0.05). The one leg standing time (H = 9.403, P = 0.009) and FRT distance (F = 4.300, P = 0.016) were the least in the affected group and the most in the unaffected group, and it was less in the affected group than in the unaffected group as post-hoc test (P < 0.05). The turning time (F = 4.134, P = 0.019) and turning steps (F = 5.611, P = 0.003) were the most in the affected group and the least in the unaffected group, and it was more in the affected group than in the unaffected group as post-hoc test (P < 0.05). The score of MFS was the most in the affected group and the least in the unaffected group (H = 8.192, P = 0.017), and it was more in the affected group than in the unaffected group as post-hoc test (P < 0.05). ConclusionThe stroke patients spontaneously turning to the affected side during walking usually are poorer in balance function, and in a risk of fall.
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ObjectiveTo explore the effect of aquatic treadmill training on abdominal muscle thickness and balance function in patients with hemiplegia after stroke. MethodsFrom March to October, 2021, 60 patients with hemiplegia after stroke were randomly divided into control group (n = 20), suspension group (n = 20) and aquatic treadmill group (n = 20). On the basis of comprehensive rehabilitation training, the control group received treadmill training, the suspension group received skyrail suspension walking training, and the aquatic treadmill group received treadmill training in water, for four weeks. The curative effect was evaluated by musculoskeletal ultrasound with muscle thickness of bilateral external oblique, internal oblique and transverse abdominal muscles. And they were assessed with Postural Assessment Scale for Stroke Patient (PASS) and Timed 'Up & Go' Test (TUGT) before and after treatment. ResultsAfter treatment, the thickness of external oblique and internal oblique muscles on the unaffected side, the PASS score and the TUGT time improved in all the three groups (|t| > 2.135, P < 0.05); while the thickness of external oblique, internal oblique and transverse abdominal muscles in the aquatic treadmill training group increased (|t| > 5.567, P < 0.001). The PASS score, the TUGT time, and the thickness of external oblique and internal oblique muscles on the affected side improved more in the aquatic treadmill training group than in the control group and the suspension group (P < 0.05). ConclusionThe aquatic treadmill training is more effective in strenghthening abdominal muscle to improve balance function.
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@#Objective To observe the clinical efficacy of simple knee trainer on active knee flexion in patients with hemiplegia after stroke.Methods From March, 2020 to May, 2021, 46 hemiplegics after stroke in Beijing Bo'ai Hospital were randomly divided into control group (n = 23) and experimental group (n = 23). Both groups accepted routine rehabilitation training, and the experimental group accepted knee flexion exercise training in sitting position through the simple knee trainer, for eight weeks. They were measured active knee flexion angle in sitting position and maximum flexion angle in walking before and after training, as well as Holden Functional Ambulation Category (FAC).Results Both active knee flexion angle in sitting position and maximum flexion angle in walking significantly increased in both groups after training (|t| > 6.991, P < 0.001), and increased more in the experimental group than in the control group (t > 2.185, P < 0.05). The grade of FAC also improved in both groups (|Z| > 2.828, P < 0.01), and no significant difference was found between groups (Z = -0.821, P = 0.412).Conclusion The application of simple knee trainer can effectively improve the active range of motion of knee, which may be used in clinic- and community-based rehabilitation.