Effects of Rehabilitation Training Combined with Acupuncture on Upper Limb Function of Stroke Patients Based on Kinect / 医用生物力学

Objective To investigate the effect of rehabilitation training combined with acupuncture ( RTA) on upper limb function of stroke patients by Kinect. Methods Stroke patients with upper limb dysfunction werrandomly divided into control group (rehabilitation training) and treatment group ( RTA), with 15 cases in each group. The modified Barthel Index ( MBI), Fugl Meyer assessment ( FMA), and Wolf motor function test (WMFT) were compared between two groups before and after treatment. The changes in motor time ( MT), motor unit number (MUN), index of curvature (IC), elbow flexion angle (EFA), shoulder flexion angle (SFA),and shoulder adduction angle ( SAA) during three actions, namely, placing forearm on the table, extending elbow and drinking water, were evaluated by Kinect and then compared between two groups before and after treatment. Results After 6 weeks of intervention, the scores of MBI, FMA, WMFT and elbow extension in treatment group were higher than those in control group (P<0. 05). The scores of MBI, FMA, WMFT and three actions after treatment were higher than those before treatment (P<0. 05). For three actions, the improvement of MT, MUN, IC, EFA, SFA, and SAA in treatment group were better than those in control group ( P< 0. 05). Compared with pre-treatment, for the action of forearm placement on the table and elbow extension, both treatment group and control group showed an increase in EFA (P<0. 05), and a decrease in MT, MUN, IC, SFA and SA (P<0. 05). For the action of drinking water, both treatment group and control group showed an increase in EFA and SAA (P< 0. 05), and a decrease in MT, MUN, IC and SAA ( P< 0. 05). Conclusions RTA can improve the upper limb function of stroke patients. Kinect can accurately reflect the changes in upper limb function of stroke patients, and it is suitable for clinical work.

Effect of Acupuncture plus Rehabilitation Training on Upper Limb Functional Recovery in Stroke Patients / 上海针灸杂志

Objective To investigate the effect of acupuncture plus rehabilitation training on upper limb functional recovery in convalescent stroke patients.Methods One hundred and three convalescent stroke patients with upper limb motor dysfunction were randomized to a treatment group (54 cases) and a control groups (49 cases). Both group received conventional rehabilitation training. In addition, the treatment group received along-meridian syndrome differentiation-based acupuncture and the control group, sham acupuncture. Upper limb Fugl-Meyer Assessment (U-FMA) score, the Wolf Motor Function Test (WMFT) score, the modified Barthel Index (MBI) score and the 36-Item Short Form Health Survey (SF-36) score were recorded in the two groups of patients before and at the end of treatment and at the 3-month follow-up.Results In the two groups there were statistically significant differences in the U-FMA score, the WMFT score and the MBI score at the end of treatment and the 3-month follow-up compared with before (P>0.05 orP<0.01). At the end of treatment and the 3-month follow-up there were statistically significant differences in the U-FMA score, the WMFT score and the MBI score between the treatment and control groups (P<0.05 orP<0.01). The scores of SF-36 items except social functioning and bodily pain had statistically significant differences within the two groups at the end of treatment and the 3-month follow-up compared with before and between the two groups at the end of treatment and the 3-month follow-up (P<0.01 orP<0.05).Conclusion Acupuncture plus rehabilitation training can markedly improve upper limb function in stroke patients.

The reliability of four motor function tests for assessing upper extremity motor function in stroke patients / 中华物理医学与康复杂志

Objective To investigate the test-retest reliability and inter-rater reliability of the Fugl-Meyer assessment (FMA),Wolf's motor function test (WMFT),the box-block test (BBT) and the nine-hole peg test (NHPT) in assessing the upper limb motor function of stroke patients.Methods Eighteen stroke patients participated in the study.Each patient was assessed twice within 2 hours with the U-FMA,WMFT,the BBT and the NHPT.Two raters recorded each session separately.Test-retest reliability was investigated by comparing the assessment results of different sessions; interrater reliability was identified by analyzing the assessment results of different raters.Results The intraclass correlation coefficients (ICC) for the U-FMA were 0.988 on test-retest reliability and 0.959 on inter-rater reliability.The ICC of WMFT by mean and median time were respectively 0.996 and 0.393 on test-retest reliability and both 1.000 on inter-rater reliability.The ICC of WMFT by score mean was O.989 for test-retest reliability and 0.977 for inter-rater reliability.The ICC for test-retest reliability of the BBT using affected hand counts and the difference in counts between the affected and un-affected hand were respectively 0.975 and 0.982.The ICC of the NHPT using affected hand times and the difference between the affected hand and unaffected hand times were respectively 0.937 and 0.936 for test-retest reliability,and both 1.000 for inter-rater reliability.Conclusion The U-FMA,WMFT,the BBT and the NHPT are all measurements with good test-retest reliability and inter-rater reliability.They are reliable for assessing the upper extremity motor function of stroke patients.

Confiabilidade da versão brasileira do Wolf Motor Function Test em adultos com hemiparesia / Reliability of the brazilian version of the Wolf Motor Function Test in adults with hemiparesis

CONTEXTUALIZAÇÃO: O Wolf Motor Function Test (WMFT) avalia o membro superior (MS) de adultos com hemiparesia combinando medidas de tempo e qualidade de movimento em movimentos isolados e em tarefas funcionais. OBJETIVOS: Traduzir e adaptar para a língua portuguesa o formulário, a escala de habilidade funcional (EHF) e o manual de aplicação do WMFT e avaliar a confiabilidade intra e inter-observadores. MÉTODOS: Participaram 15 indivíduos com média de idade de 57,9±11,1 anos e 68,5±53,5 meses pós acidente vascular encefálico (AVE). O WMFT foi aplicado por um fisioterapeuta utilizando as informações do manual e cotado por dois outros fisioterapeutas independentes pela observação dos vídeos. Foram acrescentadas informações mais detalhadas na EHF sobre a movimentação compensatória em relação à escala original. A confiabilidade intra e interobservadores do desempenho no tempo e da EHF dos itens individuais e do escore total foi avaliada pelo Coeficiente de Correlação Intraclasse (CCI) e pelo método Bland e Altman. Kappa ponderado (Kp) foi utilizado para avaliar a concordância intra e interobservadores da EHF. RESULTADOS: O CCI interobservador do desempenho no tempo foi >0,75 em 13 das 15 tarefas. A EHF apresentou CCI interobservador entre 0,87 e 0,99 em todas as tarefas e Kp entre 0,63 e 0,92. O CCI intraobservador do tempo variou entre 0,99 e 1 e na EHF, entre 0,96 e 1. O Kp intraobservador na EHF nas tarefas variou entre 0,79 e 0,96, sendo 0,93 para o escore total. CONCLUSÃO: A versão brasileira do WMFT demonstrou confiabilidade adequada para avaliar o MS parético pós-AVE.

BACKGROUND: The Wolf Motor Function Test (WMFT) evaluates the upper limb (UL) performance of adults with hemiparesis by combining time and quality of movement measures in both isolated movements and functional tasks. OBJECTIVES: To translate and adapt the WMFT form, functional ability scale (FAS) and manual to Brazilian Portuguese and evaluate the intra and inter-rater reliabilities. METHODS: Fifteen individuals with a mean age of 57.9±11.1 years and a mean time since stroke onset of 68.5±53.5 months participated. The WMFT was administered by one physiotherapist based on information in the manual, and video observations were assessed by two other independent physical therapists. Information regarding compensatory movements was included in the FAS. Intra-class correlation coefficients (ICCs) and Bland-Altman plots were calculated to examine the intra- and inter-rater reliabilities for performance time and FAS, whereas weighted kappa (Kp) was used to examine the agreement strength for FAS. RESULTS: The inter-rater ICC values for performance time were above 0.75 in 13 of the 15 tasks. For the FAS, they ranged from 0.87-0.99 for all evaluated tasks, with Kp values ranging from 0.63-0.92. For intra-rater reliability, the ICC ranged from 0.99-1.0 and from 0.96-1.0 for time measurement and FAS, respectively. Kp values ranged from 0.79-0.96 for individual and 0.93 for total scores. CONCLUSION: The Brazilian version of the WMFT showed adequate intra- and inter-rater reliabilities for evaluating the paretic UL of individuals with stroke.

Validity and reliability of Wolf motor function test on assessing the upper extremities motor function of Chinese stroke patients in acute stage / 中国康复医学杂志

Objective: To study validity and reliability of Wolf motor function test (WMFT) on assessing the upper extremities motor function of acute stroke patients so as to guide clinical application. Method: Twenty-three stroke patients in acute stage participated in the study. Patients were assessed twice with WMFT and the upper extremities motor function test of Fugl-Meyer movement assessment (U-FMA) within one week. The correlation between the assessment results of WMFT and U-FMA were analyzed to study the validity and reliability of WMFT. Result: WMFT was highly correlated with U-FMA in total scores (r =0.922, 0.929, P＜0.001). There were high correlation in all items of WMFT between two assessment sessions. The intraclass correlation coefficients (ICC) were 0.989, 0.997 for intrarater and 0.980, 0.991 for interrater. Conclusion: The WMFT is valid and reliable on assessing upper extremities motor function of stroke patients in acute stage.