The effect of home exercise on the posture and mobility of people with HAM/TSP: a randomized clinical trial / Efeitos de exercícios domiciliares sobre a postura e mobilidade de pessoas com HAM/TSP: ensaio clínico randomizado

Abstract Background: Physical therapy has positive results in people with tropical spastic paraparesis (TSP). However, mobility and distance from rehabilitation centers limit the participation in outpatient programs. Objective: To evaluate the impact of a home exercise program on the posture and functional mobility of people with TSP. Methods: A randomized controlled trial comparing three groups of people who performed guided exercises from a guidebook for six months: supervised (SG), unsupervised (WG), and control (CG). Primary outcomes: postural angles (SAPO®) and functional mobility (TUG). Secondary outcomes: gait parameters (CVMob®). Results: The protocol described in the guidebook improved postural angles and functional mobility. There were also positive gait parameter effects (p<0.05). SG presented better responses than WG did, but both were preferable to CG. Conclusion: Home exercises oriented by a guidebook may benefit posture, functional mobility and gait parameters in people with TSP, and physiotherapist supervision can ensure better results.

Resumo Introdução: A fisioterapia apresenta resultados positivos em pessoas com paraparesia espástica tropical (PET). Entretanto, a dificuldade de locomoção e a distância dos centros de reabilitação limitam a participação em programas ambulatoriais. Objetivo: Avaliar o impacto de um programa de exercícios domiciliares na postura e mobilidade funcional de pessoas com PET. Métodos: Um ensaio clínico randomizado comparou três grupos de pessoas que realizaram exercícios guiados por cartilha: com supervisão (GS), sem supervisão (GN) e controle (GC) durante seis meses. Desfechos primários: ângulos posturais (SAPO®) e mobilidade funcional (TUG). Desfechos secundários: parâmetros da marcha (CVMob®). Resultados: O protocolo descrito na cartilha melhorou os ângulos posturais e a mobilidade funcional. Os resultados também foram positivos para os parâmetros da marcha (p<0,05). O GS apresentou melhores respostas que o GN, porém ambos foram preferíveis ao GC. Conclusão: Exercícios domiciliares orientados por cartilha podem ser úteis para beneficiar a postura, mobilidade funcional e parâmetros de marcha em pessoas com PET, e a supervisão do fisioterapeuta possibilita garantir melhores resultados.

Effectiveness Of Home Exercise Program With Modified Rood’s Approach On Muscle Strength In Post Cerebral Haemorrhagic Individuals Of Assam: A Randomized Trial

Background: Physical therapists are integral to the rehabilitation of patients of stroke, and home exercise program (HEP) prescription is a routine part of physical therapy care. Strength training is imperative in interventions for stroke patients. Various components of Rood’s Approach are effective in stroke rehabilitation, an aspect that has not been thoroughly explored as yet. Methods: A randomized controlled trial study was done at Gauhati Medical College & Hospital, Assam. The subjects were 236 hemorrhagic stroke patients who were randomly assigned into two groups. Both the groups were given a HEP consisting of routine physiotherapy exercises. Additionally, one group out of the two was also taught exercises based on the Rood’s approach, consisting of facilitation and inhibition techniques with the help of sensory stimulation and repetitive task-specific activity. The output was evaluated in terms of muscle strength using Manual Muscle Testing (MMT) after three months of intervention. Results: It was observed that HEP with Rood’s approach significantly improved (p<0.05) the muscle strength in shoulder flexors (p=0.038), shoulder extensors (p=0.003), shoulder abductors (p=0.033), shoulder adductors (p=0.018), elbow flexors (p=0.009), wrist flexors (p=0.044), finger flexors (p=0.011), hip flexors (p=0.007), hip extensors (p=0.015), hip adductors (p=0.00), knee flexors (p=0.00), ankle plantar flexors (p=0.00) and dorsi flexors (p=0.039). However, no improvements were observed for elbow extensors, wrist extensors, finger extensors, hip abductors and knee extensors. Conclusion:  Although it was observed that both the Groups improving their muscle strength, but HEP with Rood’s approach was found to be more effective in improving muscle strength.

Effects of Home Exercise on Sarcopenia Obesity for Aging People / 中国康复理论与实践

Objective To explore the effects of home exercise on sarcopenia obesity elderly.Methods From January to April, 2018, 80 patients with sarcopenia obesity were randomly divided into control group (CONG, n = 20), progressive resistance training group (PRTG, n = 20), aerobic exercise training group (ATG, n =20) and muscle strength combined with aerobic exercise training group (CTG, n = 20). The training groups accepted their exercise in home for eight weeks. Their body composition, muscle strength, and insulin-like growth factor 1 (IGF-1) and interleukin 6 (IL-6) in blood were measured before training, eight weeks and twelve weeks after training.Results Skeletal muscle mass increased in all the training groups compared with that of CONG after training, while fat mass, body mass index and visceral fat area reduced. Muscle strength increased in all the training groups compared with that of CONG after training, while the grip strength, knee extensor strength increased in PRTG and ATG. IGF-1 increased in PRTG and ATG, while IL-6 decreased in PRTG.Conclusion Home exercise can improve the body composition of patients with sarcopenia obesity elderly, as well as muscle strength, which may be related to increase of IGF-1 and decrease of IL-6.

The effect of a home exercise program for patients with hemophilia / 日本プライマリ・ケア連合学会誌

<b>Introduction</b> : The purpose of this study was to clarify the effectiveness of a home exercise (HE) program for hemophilic patients.<br><b>Methods</b> : An intervention study was conducted over twelve weeks for patients aged 16 to 60 years, inclusive. Exercise guidance to assist in the improvement of their knee function was provided to the patients. Using questionnaires and assessments of physical function, we measured the physical condition of the patients before and after HE. Guidance about the strengthening of knee extensor muscles, static stretching of knee flexor muscles and standing balance training, as well as advice for the promotion of physical activities, was provided on an individualized basis. Muscle force and range of motion of the knee, modified Functional Reach (mFRT), 10 meter walking time, and 3 minute gait distance were all measured. All patients were surveyed for bleeding frequency, activities of daily living (ADL), and health related quality of life (HRQOL : SF-36), respectively.<br><b>Results</b> : Twenty-two patients with an average age of 37.2 years, were included in the analysis, with 86.4% of them having a history of severe of hemophilia (coagulation factor level <0.01 IU mL−1). There were significant improvements in strength of knee extensor and range of extension of the knees, mFRT, 10 meter gait time, 3 minute gait distance, ADL, and physical function of SF 36. There was a significant correlation between Ex for locomotive activities and change of 3 minute gait distance. No increase in bleeding frequency was noted.<br><b>Conclusion</b> : HE for hemophilic patients is useful for the improvement of muscle force and range extension of the knees, mFRT, gait speed, and ADL. Individualised guidance for improvement of physical activities and knee function is necessary for improvement of overall physical function.