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BACKGROUND: After a stroke, most patients often suffer reduced walking ability and balance. Restoring walking ability and improving balance are major goals of stroke rehabilitation. Treadmills are often used in clinical setups to achieve these goals. Adding dimensions to the visual feedback in addition to the mirror for real-time frontal view is proven to enhance the gait. It is, therefore, important to design additional real-time visual feedback in treadmill training, in particular for the sagittal view involved side. OBJECTIVE: The objective of this study is to test if the real-time sagittal visual feedback during treadmill training is superior to the conventional mirror feedback treadmill training program of equivalent intensity in improving walking speed and balance after stroke. METHODS/DESIGN: The RE-VISIT trial (Real-time Visual feedback after Stroke in Treadmill training) is registered in the Clinical Trial Registry of India (CTRI/2023/10/058299). In this two-arm randomized control trial, which will be a single-blinded study, 42 eligible stroke survivors undergoing rehabilitation will be randomly allocated (1:1 ratio) to either real-time visual sagittal feedback along with front mirror (experimental) group or only front mirror treadmill training (control) group, all the participants will receive 15 sessions of treadmill training for up to 15 min at a safe self-selected speed over 5-6 weeks. The RE-VISIT (experimental) group will receive real-time, visual sagittal view feedback of the involved lower limb trajectory along with the routine front mirror view during treadmill training and will be asked to modify their gait pattern. The control group will receive treadmill walking training only with the routine front mirror view feedback. Clinical and gait assessments will be conducted at the baseline, immediately following the final session of training, and at the 9th week during follow-up. The outcome measures of interest are walking speed (primary) and balance (secondary), which will be measured prior to baseline, post 15 sessions of training, and at the 9th week following training. DISCUSSION: This REVISIT trial will provide insight and contribute to the existing innovation and modifications of incorporating realtime visual feedback during treadmill training in post-stroke gait rehabilitation. The findings will help the better designing of a gait rehabilitation program with a treadmill for post-stroke subjects to improve walking speed, and balance for those who have greater difficulties in community ambulation. We anticipate that those in the REVISIT training will demonstrate improved walking ability.
CONTEXTO: Após o acidente vascular cerebral, a maioria dos pacientes frequentemente sofre redução da capacidade de caminhar e do equilíbrio. Restaurar a capacidade de caminhar e melhorar o equilíbrio são os principais objetivos da reabilitação do AVC. As esteiras são frequentemente usadas em ambientes clínicos para atingir esses objetivos. Está comprovado que adicionar dimensões ao feedback visual, além do espelho para visão frontal em tempo real, melhora a marcha. É, portanto, importante projetar feedbacks visuais adicionais em tempo real no treinamento em esteira, em particular para o lado envolvido na visão sagital. OBJETIVO: O objetivo deste estudo é testar se o feedback visual sagital em tempo real durante o treinamento em esteira é superior ao programa de treinamento em esteira com feedback de espelho convencional de intensidade equivalente na melhoria da velocidade de caminhada e equilíbrio após acidente vascular cerebral. MÉTODOS/ DESENHO: O ensaio RE-VISIT (feedback visual em tempo real após acidente vascular cerebral no treinamento em esteira) está registrado no Registro de Ensaios Clínicos da Índia (CTRI/2023/10/058299). Neste ensaio de controle randomizado de dois braços, que será um estudo cego, 42 sobreviventes de AVC elegíveis em reabilitação serão alocados aleatoriamente (proporção de 1:1) para feedback sagital visual em tempo real junto com grupo de espelho frontal (experimental) ou apenas Grupo de treinamento em esteira com espelho frontal (controle), todos os participantes receberão 15 sessões de treinamento em esteira por até 15 minutos em uma velocidade segura e autosselecionada durante 5-6 semanas. O grupo RE-VISIT (experimental) receberá feedback visual em tempo real da visão sagital da trajetória dos membros inferiores envolvidos, juntamente com a visão rotineira do espelho frontal durante o treinamento em esteira e será solicitado a modificar seu padrão de marcha. O grupo de controle receberá treinamento de caminhada em esteira apenas com o feedback rotineiro da visão do espelho frontal. Avaliações clínicas e de marcha serão realizadas no início do estudo, imediatamente após a sessão final de treinamento e na 9ª semana durante o acompanhamento. As medidas de resultados de interesse são a velocidade de caminhada (primária) e o equilíbrio (secundário), que serão medidos antes da linha de base, após a 15ª sessão de treinamento e na 9ª semana após o treinamento. DISCUSSÃO: este ensaio REVISIT fornecerá insights e contribuirá para a inovação e modificações existentes na incorporação de feedbacks visuais em tempo real durante o treinamento em esteira na reabilitação da marcha pós-AVC. As descobertas ajudarão no melhor desenho de um programa de reabilitação da marcha com esteira para indivíduos pós-AVC para melhorar a velocidade de caminhada e o equilíbrio para aqueles que têm maiores dificuldades na deambulação comunitária. Prevemos que aqueles no treinamento REVISIT demonstrarão melhor capacidade de caminhada.
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Acidente Vascular Cerebral , Retroalimentação Sensorial , Velocidade de CaminhadaRESUMO
Abstract Introduction: Duchenne muscular dystrophy (DMD) is a recessive genetic disease linked to the X chromosome, leading to progressive muscle tissue loss. Initially, there is difficulty getting up from the floor and an increased frequency of falls. Maintaining ambulation as long as possible is essential, and the use of ankle-foot orthosis (AFO) has been investigated as an ally in this process. Objective: To verify the prescription and use of an AFO for ambulant boys with DMD. Methods: Information was collected using the medical records of 181 patients with DMD from the Neuropediatric Service of the Instituto de Puericultura e Pediatria Martagão Gesteira of the Universidade Federal do Rio de Janeiro. Variables used were: age at the first medical appointment, age at first symptoms, age at loss of independent gait, time between the first symptoms and loss of gait, prescription of orthosis, time of use, and surgical intervention in the lower limbs. Results: The orthosis was prescribed for 63.5% of patients and used by 38.1%. The range of orthosis time was 2 to 4 years (62.3%). The night sleep period was the most prescribed for orthosis use, with 67.2%. Patients who used the orthosis for a longer time were older at gait loss. However, the children who arrived earlier for the first appointment had a higher frequency of orthosis prescriptions and later loss of gait. Conclusion: The use of AFO can help maintain ambulation for longer in boys with DMD.
Resumo Introdução: A distrofia muscular de Duchenne (DMD) é uma doença genética recessiva ligada ao cromossomo X, que cursa com a perda progressiva do tecido muscular. Inicialmente, observa-se dificuldade para levantar do chão e aumento dafrequência de quedas. A manutenção da deambulação pelo maior tempo possível é importante e o uso de órtese tornozelo-pé (OTP) tem sido investigado como aliado nesse processo. Objetivo: Verificar a prescrição e uso de OTP para meninos deambulantes com DMD. Métodos: As informações foram coletadas dos prontuários de 181 pacientes com DMD do Serviço de Neuropediatria do Instituto de Puericultura e Pediatria Martagão Gesteira, da Universidade Federal do Rio de Janeiro. As variáveis utilizadas foram: idade na primeira consulta, idade aos primeiros sintomas, idade na perda da marcha independente, tempo entre os primeiros sintomas e a perda da marcha, prescrição de órtese, tempo de uso e intervenção cirúrgica nos membros inferiores. Resultados: A órtese foi prescrita para 63,5% dos pacientes e utilizada por 38,1%. A variação do tempo de uso foi de 2 a 4 anos (62,3%). O período noturno foi o mais prescrito para uso da órtese, com 67,2%. Os pacientes que a usaram por mais tempo apresentaram maiores idades na perda da marcha. Crianças que chegaram mais precocemente à primeira consulta tiveram maior frequência de prescrição de órtese e perda da marcha mais tardiamente. Conclusão: O uso de OTP pode ajudar a manter a deambulação por mais tempo em meninos com DMD.
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ABSTRACT Objectives: This study primarily aimed to investigate the clinical determinants of the Modified Incremental Step Test (MIST) in adults with non-cystic fibrosis bronchiectasis (NCFB). A secondary objective was to compare the cardiopulmonary responses after the MIST and Incremental Shuttle Walk Test (ISWT), two commonly adopted symptom-limited maximum field tests in chronic respiratory diseases. Methods: Forty-six patients with clinically stable bronchiectasis participated in this cross-sectional study. MIST and ISWT were performed to determine exercise capacity, while disease severity, fatigue, and quality of life were assessed using the Bronchiectasis Severity Index (BSI), the Fatigue Severity Scale (FSS), and St. George's Respiratory Questionnaire (SGRQ), respectively. Quadriceps muscle strength was evaluated using a hand-held dynamometer, walking speed with a wireless inertial sensing device, and the level of physical activity (steps/day) with a pedometer. Results: The BSI score, quadriceps muscle strength, daily step count, and the SGRQ total score explained 61.9% of the variance in the MIST (p < 0.001, R2 = 0.67, AR2 = 0.619). The BSI score (r = -0.412, p = 0.004), quadriceps muscle strength (r = 0.574, p = 0.001), daily step count (r = 0.523, p < 0.001), walking speed (r = 0.402, p = 0.006), FSS score (r = -0.551, p < 0.001), and SGRQ total score (r = -0.570, p < 0.001) correlated with the MIST. The patients achieved higher heart rates (HR), HR%, desaturation, dyspnea, and leg fatigue in the MIST compared to the ISWT (p < 0.05). Conclusions: Disease severity, quadriceps muscle strength, physical activity level, and quality of life were determinants of MIST. The advantages of the MIST, including higher cardiopulmonary response than ISWT and greater portability, which facilitates its use in various settings, make MIST the preferred choice for investigating symptom-limited exercise capacity in patients with NCFB.
RESUMO Objetivos: Este estudo teve como objetivo principal investigar os determinantes clínicos do Teste do Degrau Incremental Modificado (TDIM) em adultos com bronquiectasia não fibrocística (BNFC). Um objetivo secundário foi comparar as respostas cardiopulmonares após o TDIM e o Teste Graduado de Caminhada (TGC), dois testes de campo máximos amplamente adotados e limitados por sintomas em doenças respiratórias crônicas. Métodos: Quarenta e seis pacientes com bronquiectasia clinicamente estável participaram deste estudo transversal. O TDIM e TGC foram realizados para determinar a capacidade de exercício, enquanto a gravidade da doença, fadiga e qualidade de vida foram avaliadas usando o Índice de Gravidade da Bronquiectasia (BSI), a Escala de Gravidade da Fadiga (FSS) e o Questionário Respiratório de Saint George (SGRQ), respectivamente. A força muscular do quadríceps foi avaliada usando um dinamômetro manual, a velocidade de caminhada com um dispositivo de sensor inercial sem fio e o nível de atividade física (passos/dia) com um pedômetro. Resultados: O escore BSI, a força muscular do quadríceps, a contagem diária de passos e o escore total do SGRQ explicaram 61,9% da variação no TDIM (p < 0,001, R2 = 0,67, AR2 = 0,619). O escore BSI (r = -0,412, p = 0,004), a força muscular do quadríceps (r = 0,574, p = 0,001), a contagem diária de passos (r = 0,523, p < 0,001), a velocidade de caminhada (r = 0,402, p = 0,006), o escore FSS (r = -0,551, p < 0,001) e o escore total do SGRQ (r = -0,570, p < 0,001) correlacionaram-se com o TDIM. Os pacientes atingiram maiores frequências cardíacas (FC), FC%, dessaturação, dispneia e fadiga nas pernas no TDIM em comparação com o TGC (p < 0,05). Conclusões: A gravidade da doença, a força muscular do quadríceps, o nível de atividade física e a qualidade de vida foram determinantes do TDIM. As vantagens do TDIM, incluindo uma resposta cardiopulmonar mais elevada que no TGC e maior portabilidade, que facilita sua utilização em diversos ambientes, fazem do TDIM a escolha preferencial para investigar a capacidade de exercício limitada por sintomas em pacientes com BNFC.
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Objective: Stroke survivors may have residual mobility impairments and an inability to improve walking speed in daily life and can result in falls, one of the most common complications after a stroke. The ability to improve walking speed is determined by the difference between the fast and self-selected walking speed, the walking speed reserve (WRS). So, the objective is to investigate the relationship between the WRS capacity and the fear of falling in stroke survivors. Methods: This is a cross-sectional study with fifty five stroke survivors. The WRS was determined by the 10 meter walk test (10MWT, in m/s), and the fear of falling was assessed by Falls Efficacy Scale International (FES-I in points). Pearson's correlation was used to investigate the association between the WRS and fear of falling. Results: 54.5% were male, with a mean age of 62.5 (SD 14.9) years and 41% were community walkers (≥0.8m/s). The WRS was 0.17±0.17m/s, and the mean FES-I score was 31.79±9.88. A negative and statistically significant association was found, with a reasonable magnitude between the WSR and the FES-I score (r= -0.38; p= 0.005). Conclusion: Stroke survivors who have greater WSR capacity, have a lower score on the FES-i scale, indicating less fear of falling.
Objetivo: Os indivíduos pós AVE podem ter déficits residuais de mobilidade e incapacidade de aumentar a velocidade de caminhada na vida diária e podem resultar em quedas, uma das complicações mais comuns após um AVE. A capacidade de aumentar a velocidade de caminhada é determinada pela diferença entre a velocidade de caminhada máxima e auto-selecionada, a velocidade de reserva (VR). Assim, o objetivo é investigar a relação entre a VR e o medo de cair em indivíduos pós AVE. Métodos: Trata-se de um estudo transversal com cinquenta e cinco indivíduos pós AVE. A VR foi determinada pelo teste de caminhada de 10 metros (TC10m, em m/s), e o medo de cair foi avaliado pela Falls Efficacy Scale International (FES-I em pontos). A correlação de Pearson foi usada para investigar a associação entre a VR e o medo de cair. Resultados: 54,5% eram do sexo masculino, com média de idade de 62,5 (DP 14,9) anos e 41% eram deambuladores comunitários (≥0,8m/s). A VR foi de 0,17±0,17m/s, e o escore médio da FES-I foi de 31,79±9,88. Encontrou-se associação negativa e estatisticamente significativa, com magnitude razoável entre a VR e o escore da FES-I (r= -0,38; p= 0,005). Conclusão: Os indivíduos pós AVE que têm maior VR, apresentam uma pontuação mais baixa na escala FES-i, indicando menor medo de cair.
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Resumen Introducción : Hay información escasa sobre evolución a largo plazo de pacientes hospitalizados por neumo nía COVID-19 moderada (NM) y grave (NG). El objetivo del estudio fue determinar impacto clínico, funcional respiratorio y tomográfico (TACAR) luego del alta a 12 meses del diagnóstico. Métodos : análisis según grupos NM y NG, desatura dores (PD) en prueba de caminata 6 min (PC6M) y patrón tomográfico símil fibrótico (SF). Comparamos resultados a 3 y 12 meses de seguimiento. Resultados : 194 pacientes enrolados, evaluados al año: 103 (53% ): masculinos (62.4%), edad 57.7 ± 10.9 años, comorbilidades (hipertensión arterial 38.8%, dia betes 29.6%, antecedentes respiratorios-AR- 18.4%). Com paramos variables a los 3 y 12 meses (media/DE): CVF 84%(19) a 88(19) (p = 0.01); 27% tuvo CVF<80% al año. En PC6M: 426 metros (108) a 447(92) (p = < 0.01). El 12.8% fue PD al año. NG tuvo mayor SF (40% vs. 27.9% p = 0.021). SF se relacionó con CVF <80% (p = 0.004) en toda la co horte, y NG (p < 0.001). Al año en análisis multivariado se asoció a CVF <80%, AR (OR 4.32, 1.15-16.25), diabetes (OR 2.96, 1.02-8.57) y patrón SF (OR 3.51, 1.25-9.88). PD se asoció a AR (OR 12.2, 2.41-61.85). Discusión : Se observó mejoría en todas las variables al año. Pero al año persisten alteraciones funcionales y tomográficas en <50% de los pacientes. El subgrupo de PD se relacionó a AR. Es importante el seguimiento protocolizado de los pacientes hospitalizados, especial mente los grupos NG, PD y SF.
Abstract Introduction : There is scarce information on longterm evolution of hospitalized patients with moderate (MP) and severe (SP) COVID-19 pneumonia. Objective: to de termine clinical, respiratory function, and tomographic (HRCT) impact after being discharged 12 months after diagnosis. Methods : Analysis according to MP and SP, desatura tor patients (DP) in 6-minute walking test (6MWT) and HRCT fibrotic-like pattern (FLP). Results compared at 3 and 12 months of follow-up. Results : 194 patients enrolled and one year later 103 (53%) were evaluated: gender male (62.4%), age 57.7 ± 10.9 years, comorbidities (arterial hypertension 38.8%, diabetes 29.6%, and respiratory diseases-RD-18.4%). Variables compared 3 months to 12 months (mean/SD): FVC: 84%( 19) to 88%( 19) (p= 0.01). A 27% of patients had FVC<80% at one year. In 6MWT:426 (108) to 447 (92) (p = <0.01). 12.8% are DP in one year. SP had a greater FLP than MP (40% vs. 27.9%, p = 0.021). The FLP group was related to FVC < 80% (p = 0.004) in all patients but only in SP (p < 0.001). After one year, in multivariate analysis, FVC < 80% was associated with RD (OR 4.32, 1.15-16.25), diabetes (OR 2.96, 1.02-8.57) and FLP (OR 3.51, 1.25-9.88). DP were associated with RD (OR 12.2, 2.41-61.85). Discussion : Improvement was observed in all vari ables when comparing 3 to 12 months. However, after one year, functional and tomographic alterations persist in less than 50% of patients. DP subgroup was related to RD. Protocolled follow-up of hospitalized patients is important, especially in SP, DP, and FLP groups.
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Resumen Introducción: La obesidad mórbida se asocia a alteraciones de la capacidad de caminar, sin embargo se desconoce cómo es el comportamiento de la prueba de caminata de 6 minutos en sujetos con incrementos del índice de masa corporal (IMC). Objetivo: Describir el comportamiento de la prueba de caminata de 6 minutos en sujetos con IMC normal hasta la obesidad mórbida. Métodos: Mediante un diseño transversal analítico se estudiaron sujetos de ambos sexos de 18 a 60 años con IMC: normal (18.5-24.9 kg/m2), sobrepeso (25-29.9 kg/m2), obesidad (30-39.9 kg/m2), obesidad mórbida (> 40 kg/m2). Se les realizó prueba de caminata de 6 minutos, se acotaron variables demográficas y antecedentes personales patológicos. Se analizaron las categorías de IMC con ANOVA de una vía y ajuste de Bonferroni y los sexos con prueba t, ambos para grupos independientes y correlaciones de Pearson para las diversas variables. Una p < 0.05 fue considerada estadísticamente significativa. Resultados: Se estudiaron 480 sujetos de ambos sexos en cuatro grupos. Edad: hombres 43 ± 11 y mujeres 45 ± 10 años. Porcentaje diabetes mellitus (6.7%), hipertensión arterial (18.3%). Metros caminados hombres vs. mujeres por IMC (normal: 483 ± 56 vs. 449 ± 61; sobrepeso: 471 ± 55 vs. 441 ± 44; obesidad: 455 ± 70 vs. 421 ± 47; obesidad mórbida: 443 ± 49 vs. 403 ± 54; p < 0.05). Correlación IMC-metros caminados r: -0.446 (p < 0.0001). Conclusiones: Los metros caminados en la prueba de caminata de 6 minutos disminuyeron conforme incrementó el IMC. El sexo masculino caminó más metros en todas las categorías.
Abstract Introduction: Morbid obesity is associated with alterations in the ability to walk, however, the behavior of the 6-minute walk test in subjects with increases in body mass index is unknown. Objective: To describe the behavior of the 6-minute walk test in subjects with normal body mass index to morbid obesity. Methods: Through an analytical cross-sectional design, subjects of both genders from 18 to 60 years old with body mass index were studied: Normal (BMI: 18.5-24.9); overweight (BMI: 25-29.9); obesity (BMI: 30-39.9); morbid obesity (BMI: > 40) kg/m2. A 6-minute walk test was performed, demographic variables and pathological personal history were delimited. BMI categories were analyzed with one-way ANOVA and Bonferroni adjustment, and gender with t-test, both for independent groups, and Pearson's correlations for the various variables. Results: 480 subjects of both genders were studied in four groups. Age: men 43 ± 11 and women 45 ± 10 years old. Percentage diabetes mellitus (6.7%), arterial hypertension (18.3%). Meters walked men vs. women by body mass index (normal: 483 ± 56 vs. 449 ± 61; overweight: 471 ± 55 vs. 441 ± 44; obesity: 455 ± 70 vs. 421 ± 47; morbid obesity: 443 ± 49 vs. 403 ± 54, p < 0.05). Correlation body mass index-meters walked: r: -0.446 (p < 0.0001). Conclusions: Meters walked in the 6-minute walk test decreased as body mass index increased. The male gender walked more meters in all categories.
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ABSTRACT BACKGROUND AND OBJECTIVES: Individuals with osteoarthritis (OA) often have joint pain and are overweight or obese. Thus, the objective of this study was to observe whether there is correlation between body mass index and joint pain intensity with gait performance in individuals with OA. METHODS: Cross-sectional study, which evaluated 60 volunteers, being 30 with clinical diagnosis of knee osteoarthritis and 30 without the disease, of both sexes and aged between 50-82 years. Joint pain intensity was assessed using the Visual Analog Scale, gait-related functional tasks using the Dynamic Gait Index, and the functional mobility using the Timed Up and Go test. RESULTS: There was a correlation between overweight/obesity and high levels of joint pain intensity (p=0.018), with worse performance in gait-related functional tasks (p=0.000) and with worse functional mobility (p=0.034) only for the individuals with OA. High levels of joint pain intensity also correlated with worse performance in the gait-related functional tasks (p=0.000) in the OA group, and also with worse functional mobility in the OA group (p=0.001) and also in the group of individuals without the disease (p=0.032). CONCLUSION: This study identified a correlation between overweight/obesity and high levels of joint pain intensity and worse gait performance in individuals with osteoarthritis. High levels of pain intensity also correlated with worse gait performance in individuals with OA.
resumo JUSTIFICATIVA E OBJETIVOS: Indivíduos com osteoartrite (OA) frequentemente apresentam dor articular e sobrepeso ou obesidade. Assim, o objetivo deste estudo foi observar se existe correlação entre o índice de massa corporal e a intensidade da dor articular com o desempenho da marcha em indivíduos com OA. MÉTODOS: Estudo de corte transversal, que avaliou 60 indivíduos, sendo 30 com diagnóstico clínico de osteoartrite de joelho e 30 sem a doença, de ambos os sexos e com faixa etária entre 50 e 82 anos. A intensidade da dor articular foi avaliada pela Escala Analógica Visual, as tarefas funcionais relacionadas à marcha pelo Dynamic Gait Index e a mobilidade funcional pelo teste Timed Up and Go. RESULTADOS: Houve correlação entre o sobrepeso/obesidade e níveis elevados de intensidade da dor articular (p=0,018), com um pior desempenho nas tarefas funcionais relacionadas à marcha (p=0,000) e com menor mobilidade funcional (p=0,034) apenas para os indivíduos com OA. Os níveis elevados de intensidade de dor articular também mostraram correlação com um pior desempenho nas tarefas funcionais relacionadas à marcha (p=0,000) no grupo com OA, e ainda, com uma menor mobilidade funcional no grupo com OA (p=0,001) e também no grupo de indivíduos sem a doença (p=0,032). CONCLUSÃO: Este estudo identificou correlação entre o sobrepeso/obesidade com níveis elevados de intensidade da dor articular e com um pior desempenho na marcha nos indivíduos com OA. Os elevados níveis de intensidade da dor também mostraram correlação com pior desempenho na marcha nos indivíduos com OA.
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Este estudo objetivou verificar a prática de atividade física ao ar livre durante a pandemia da CO-VID-19 entre os professores da educação básica pública de Minas Gerais. Trata-se de um inquérito epidemiológico do tipo websurvey, realizado com professores da educação básica pública de Minas Gerais. A coleta de dados ocorreu de agosto a setembro de 2020 via formulário digital. A variável de-pendente foi a prática de atividade física ao ar livre durante a pandemia, categorizada em sim vs não. Para a análise dos dados utilizou-se a Regressão de Poisson, com variância robusta. O estudo contou com 15.641 participantes. Entre eles, 30,5% estavam realizando atividade física ao ar livre durante a pandemia. Houve maior prevalência entre os homens (RP = 1,15; IC95%: 1,09 - 1,22), aqueles que trabalhavam na zona rural (RP = 1,07; IC95%: 1,01 - 1,13), que não tiveram diminuição na renda familiar (RP = 1,08; IC95%: 1,03 - 1,13), que viviam com cônjuge (RP = 1,05; IC95%: 1,01 - 1,10), que não aderiram totalmente ao distanciamento social (RP = 1,23; IC95%: 1,17 - 1,29), que aumen-taram o desejo de cuidar da aparência física (RP = 1,47; IC95%: 1,40 - 1,55), com melhor padrão alimentar (RP = 1,45; IC95%: 1,39 - 1,52), que estavam realizando atividades de lazer (RP = 1,33; IC95%: 1,27 - 1,40), aqueles que não apresentaram excesso de peso corporal (RP = 1,05; IC95%: 1,01 - 1,10), que não estavam com muito medo da COVID-19 (RP = 1,07; IC95%: 1,02 - 1,12) e os que não faziam parte do grupo de risco para a COVID-19 (RP = 1,10; IC95%: 1,05 - 1,16). Os resultados indicaram, de modo geral, um perfil positivo com os cuidados em relação à saúde entre os praticantes de atividade física ao ar livre
this study aimed to verify the practice of outdoor physical activity during the COVID-19 pandemic among public basic education teachers in Minas Gerais. This is a websurvey-type epidemiological survey, carried out with adults, public basic education teachers in the state of Minas Gerais. Data collection took place from August to September 2020 using a digital form. The dependent variable was the practice of outdoor physical activity during the pandemic, categorized as yes vs no, and those who practiced other types of exercise were not considered. For data analysis, Poisson regression was used, with robust variance. The study had 15,641 participants. Among them, 30.5% were performing physical activity outdoors during the pandemic. There was a higher prevalence among men (PR = 1.15; 95%CI: 1.09 - 1.22), those who worked in rural areas (PR = 1.07; 95%CI: 1.01 - 1.13), who had no decrease in family income (PR = 1.08; 95%CI: 1.03 - 1.13), who lived with a spouse (PR = 1.05; 95%CI: 1.01 - 1.10), who did not fully adhere to social distancing (PR = 1.23; 95%CI: 1.17 - 1.29), which increased the desire to take care of physical appearance (PR = 1.47; 95%CI: 1.40 - 1.55), with a better dietary pattern (PR = 1.45; 95%CI: 1.39 - 1.52), who were performing leisure activities (PR = 1.33; 95%CI: 1.27 - 1.40) , those who were not overweight (PR = 1.05; 95%CI: 1.01 - 1.10), who were not very afraid of COVID-19 (PR = 1.07; 95%CI: 1.02 - 1.12) and those who were not part of the risk group for COVID-19 (PR = 1.10; 95%CI: 1.05 - 1.16). The results indicated, in general, a positive profile with regard to health care among practitioners of outdoor physical activity
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Humanos , Masculino , Feminino , Exercício Físico , Saúde Pública , Coronavirus , Inquéritos Epidemiológicos , CaminhadaRESUMO
INTRODUCTION: Neurogenic claudication (NC) is the classic clinical presentation of patients with Lumbar Spinal Stenosis (LSS). These patients may or may not present with symptoms of leg pain and difficulty walking. These symptoms are exacerbated while walking and standing and are eased by sitting or bending forward. METHOD: Patients with LSS, having a lumbar canal diameter of ≤12mm, were recruited from a recognized Tertiary care hospital. Each subject's demographic characteristics and anthropometrics were noted, and the testing procedure was explained. The canal diameter was documented with the help of an MRI report. A self-paced walking test was used to assess the walking distance. STATISTICAL ANALYSIS: Depending on the normality of the data, the Pearson correlation coefficient (r) was used to find the correlation between canal diameter at different lumbar levels and walking distance in patients with LSS. RESULT: Pearson correlation coefficient (r) determined a fair positive correlation (r = 0.29) between lumbar canal diameter and walking distance. Stepwise multiple regression analysis was done, and a prediction equation was found for different levels of canal stenosis. CONCLUSION: Findings of our present study suggest a fair positive correlation between walking distance and canal diameter at L5-S1. This study may also be useful in predicting the approximate canal diameter by estimating the walking distance of the patient with symptoms of LSS and vice-versa.
INTRODUÇÃO: A claudicação neurogênica (CN) é a apresentação clínica clássica de pacientes com Estenose Espinhal Lombar (EEL). Esses pacientes podem ou não apresentar sintomas de dor nas pernas e dificuldade para caminhar. Esses sintomas são exacerbados ao caminhar e ficar em pé e são aliviados ao sentar ou inclinar-se para a frente. MÉTODO: Pacientes com EEL, com diâmetro do canal lombar ≤12mm, foram recrutados em um hospital terciário reconhecido. As características demográficas e antropométricas de cada sujeito foram anotadas e o procedimento do teste foi explicado. O diâmetro do canal foi documentado com a ajuda de um relatório de ressonância magnética. Um teste de caminhada individualizado foi usado para avaliar a distância percorrida. ANÁLISE ESTATÍSTICA: Dependendo da normalidade dos dados, o coeficiente de correlação de Pearson (r) foi usado para encontrar a correlação entre o diâmetro do canal em diferentes níveis lombares e a distância percorrida em pacientes com EEL. RESULTADO: O coeficiente de correlação de Pearson (r) determinou uma correlação positiva razoável (r = 0,29) entre o diâmetro do canal lombar e a distância percorrida. Análise de regressão múltipla stepwise foi feita, e uma equação de predição foi encontrada para diferentes níveis de estenose do canal. CONCLUSÃO: Os achados de nosso estudo sugerem uma correlação positiva razoável entre a distância percorrida e o diâmetro do canal em L5-S1. Este estudo também pode ser útil para prever o diâmetro aproximado do canal, estimando a distância percorrida pelo paciente com sintomas de EEL e vice-versa.
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Projetos Piloto , Pacientes , Estenose EspinalRESUMO
Problem: Awareness of children, who experience movement, particularly motor coordination difficulties, has increased dramatically over the last ten years. These motor coordination problems of children with Developmental Coordination Disorder (DCD) or/and Attention-Deficit / Hyperactivity Disorder (ADHD) have been frequently associated with poor visual and spatial eye-vision processing.Background: Motor control difficulties for DCD and ADHD children have been discussed in detail. However, just a little is known about the influence of the natural environment on these disorders. Even more, the built environment’s impact as a spatial cognition and coordination functionality has never been considered.Aim: This pilot and innovative study aim to identify the correlation between and evaluate the visual contribution of the so-called “spatial compound linear geometries” and DCD children’s motor/walking control.Methodology: Twenty children aged 5 to 8 years with DCD difficulties (two intervention groups, one with 10 boys and the other one with 10 girls) were assessed by a statistical structural evaluation in three built environments (two urban parks and one pocket park), under two conditions (rich or not in trees, flora, and PnP linear geometries), and different motor coordination control situations (static balance, dynamic balances, dark condition).Results: The worst performances (regarding movement disorders and motor coordination problems) were observed for both groups with DCD children playing in parks poor in or without trees, flora, and spatial compound linear geometries. Instead, a significant performance (strong statistical correlation) was found for the same intervention group (DCD children’s boys or girls) playing in parks rich in trees, flora, and vegetation (natural environment). The best performance (very strong statistical correlation) was detected in parks rich in a natural environment and linear geometries. Conclusions: While the natural environment contribution is bibliographically known, the best performance finding of the visual contribution of the spatial compound linear geometries, as spatial landmarks enriching the visual-spatial motor/walking functionalities for Children with DCD disorder, could provide new cognitive approaches towards an understanding of children’s Developmental Coordination Disorder and walking physiology. DCD children’s performance, scores, and cues were related to both the natural environment and the spatial compound linear geometries as spatial landmark motor coordination cues and spatio-temporal clues. The significant variability in sensory processing among children with DCD, ADHD, and co-occurring symptoms can contribute to understanding how neurological and social factors correlate across diagnoses. Also, derived observations for stepping errors, Gait analysis (variables), and spatio-temporal clues conclude that visual eye-based processing interrelates with motor coordination problems, performance, inattention, environmental conditions (dark), sex identity (boys, girls), and DCD hyperactivity. Applications: Development of interactive visual applications for (i) human spatial cognition and movement improvement; and (ii) children’s motor control and coordination refinement.
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Diminuições na velocidade da marcha (VM) estão associadas a desfechos adversos na saúde física e mental em idosos. Assim, torna-se relevante identificar fatores que podem associar-se com a VM confortável em idosos, de forma a propor estratégias para prevenção de alterações na mobilidade. Objetivo: verificar a associação entre declínio cognitivo, sintomas depressivos e do medo de cair com a VM confortável em idosos comunitários. Métodos: tratou-se de um estudo transversal, com amostra probabilística, incluindo 308 idosos comunitários. O desfecho do estudo foi a VM confortável, sendo considerado como baixo desempenho VM < 0,8m/s. As variáveis preditoras foram 1) declínio cognitivo avaliado pelo Mini Exame do Estado Mental, 2) sintomas depressivos avaliados com a Escala de DepressaÌo GeriaÌtrica Abreviada e 3) medo de cair avaliado pela Falls Efficacy Scale Brasil. Para analisar a associação entre as variáveis foi utilizada a Regressão Logística Multivariada. Resultados: idosos tiveram chances significativamente maiores de apresentar baixo desempenho na VM confortável quando apresentaram declínio cognitivo (OR: 4,67; IC95%: 1,68; 12,94), sintomas depressivos (OR: 2,90; IC95%: 1,42; 5,92) e medo de cair (OR: 4,08; IC95%: 1,72; 9,71) quando comparados aos que não tiveram essas condições. Conclusão: o declínio cognitivo, sintomas depressivos e medo de cair foram associados ao baixo desempenho na VM confortável nos idosos amostrados. Esses achados podem servir para identificação precoce dos fatores que estão associados a alterações na VM confortável, contribuindo para a proposição de estratégias públicas em saúde e no direcionamento de atividades de promoção em saúde para idosos comunitários.(AU)
Decreases in gait speed (GS) are associated with adverse outcomes in the physical and mental health of the elderly. Thus, it is relevant to identify factors that can be associated with comfortable GS in community-dwelling older adults, to propose strategies to prevent changes in mobility. Objective: To verify the association between cognitive decline, depressive symptoms, and fear of falling with comfortable GS in community-dwelling older adults. Methods: This was a cross-sectional study with a probabilistic sample, including 308 community-dwelling older adults. The study outcome was comfortable GS, being considered as low-performance MV < 0.8m/s. Predictive variables were 1) cognitive decline assessed by the Mini-Mental State Examination, 2) depressive symptoms assessed by the Abbreviated Geriatric Depression Scale, and 3) fear of falling assessed by the Falls Efficacy Scale - Brasil. Multivariate Logistic Regression was used to verify the association between the variables. Results: Community-dwelling older adults were significantly more likely to have poor performance in comfortable GS when they presented cognitive decline (OR: 4.67; 95%CI: 1.68; 12.94), depressive symptoms (OR: 2.90; 95%CI: 1 .42; 5.92), and fear of falling (OR: 4.08; 95%CI: 1.72; 9.71) when compared to those who did not have these conditions. Conclusion: Cognitive decline, depressive symptoms, and fear of falling were associated with poor performance in comfortable GS in the community-dwelling older adults sampled. These findings can serve for early identification of factors that are associated with changes in comfortable GS, contributing to the proposition of public health strategies and in directing health promotion activities for community-dwelling older adults.(AU)
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Idoso , Idoso de 80 Anos ou mais , Envelhecimento , Avaliação Geriátrica , Velocidade de CaminhadaRESUMO
Except for a few stick insects that are economically valuable, most species be considered to be forest pests, so it is extremely important to obtain plant host-use information of more stick insects. In this paper, the plant hosts of three species of stick insects were recorded for the first time. We also discovered these stick insects can feed upon the flowers or leaves of plants. Lopaphus unidentatus (Chen & He, 1995) (Phasmida: Lonchodidae) attacked Hypericum choisianum Wall. ex N. Robson, 1973 (Hypericaceae), Leurophasma dolichocercum Bi, 1995 (Phasmida: Aschiphasmatidae) attacked Antenoron filiforme (Thunb.) Roberty & Vautier, 1964 (Polygonaceae) and Megalophasma granulatum Bi, 1995 (Phasmida: Lonchodidae) attacked Debregeasia orientalis C. J. Chen, 1991 (Urticaceae). Finally, we were lucky enough to also obtain photographs of them mating and feeding.
Exceto por alguns insetos-pau que são economicamente valiosos, a maioria das espécies pode ser considerada praga florestal, por isso é extremamente importante obter informações sobre o uso de hospedeiros de plantas de mais insetos-pau. Neste artigo, as plantas hospedeiras de três espécies de bicho-pau foram registradas pela primeira vez. Também descobrimos que esses bichos-pau podem se alimentar de flores ou folhas de plantas. Lopaphus unidentatus (Chen & He, 1995) (Phasmida: Lonchodidae) atacou a parede de Hypericum choisianum. ex N. Robson, 1973 (Hypericaceae), Leurophasma dolichocercum Bi, 1995 (Phasmida: Aschiphasmatidae) atacou Antenoron filiforme (Thunb.) Roberty & Vautier, 1964 (Polygonaceae) e Megalophasma granulatum Bi, 1995 (Phasmida: Lonchodidae orientaled) atacou Chen, 1991 (Urticaceae). Finalmente, tivemos a sorte de também obter fotos deles se acasalando e se alimentando.
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Animais , Artrópodes/classificação , Hypericum , Insetos/crescimento & desenvolvimento , Polygonaceae , UrticaceaeRESUMO
Abstract Except for a few stick insects that are economically valuable, most species be considered to be forest pests, so it is extremely important to obtain plant host-use information of more stick insects. In this paper, the plant hosts of three species of stick insects were recorded for the first time. We also discovered these stick insects can feed upon the flowers or leaves of plants. Lopaphus unidentatus (Chen & He, 1995) (Phasmida: Lonchodidae) attacked Hypericum choisianum Wall. ex N. Robson, 1973 (Hypericaceae), Leurophasma dolichocercum Bi, 1995 (Phasmida: Aschiphasmatidae) attacked Antenoron filiforme (Thunb.) Roberty & Vautier, 1964 (Polygonaceae) and Megalophasma granulatum Bi, 1995 (Phasmida: Lonchodidae) attacked Debregeasia orientalis C. J. Chen, 1991 (Urticaceae). Finally, we were lucky enough to also obtain photographs of them mating and feeding.
Resumo Exceto por alguns insetos-pau que são economicamente valiosos, a maioria das espécies pode ser considerada praga florestal, por isso é extremamente importante obter informações sobre o uso de hospedeiros de plantas de mais insetos-pau. Neste artigo, as plantas hospedeiras de três espécies de bicho-pau foram registradas pela primeira vez. Também descobrimos que esses bichos-pau podem se alimentar de flores ou folhas de plantas. Lopaphus unidentatus (Chen & He, 1995) (Phasmida: Lonchodidae) atacou a parede de Hypericum choisianum. ex N. Robson, 1973 (Hypericaceae), Leurophasma dolichocercum Bi, 1995 (Phasmida: Aschiphasmatidae) atacou Antenoron filiforme (Thunb.) Roberty & Vautier, 1964 (Polygonaceae) e Megalophasma granulatum Bi, 1995 (Phasmida: Lonchodidae orientaled) atacou Chen, 1991 (Urticaceae). Finalmente, tivemos a sorte de também obter fotos deles se acasalando e se alimentando.
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Abstract Except for a few stick insects that are economically valuable, most species be considered to be forest pests, so it is extremely important to obtain plant host-use information of more stick insects. In this paper, the plant hosts of three species of stick insects were recorded for the first time. We also discovered these stick insects can feed upon the flowers or leaves of plants. Lopaphus unidentatus (Chen & He, 1995) (Phasmida: Lonchodidae) attacked Hypericum choisianum Wall. ex N. Robson, 1973 (Hypericaceae), Leurophasma dolichocercum Bi, 1995 (Phasmida: Aschiphasmatidae) attacked Antenoron filiforme (Thunb.) Roberty & Vautier, 1964 (Polygonaceae) and Megalophasma granulatum Bi, 1995 (Phasmida: Lonchodidae) attacked Debregeasia orientalis C. J. Chen, 1991 (Urticaceae). Finally, we were lucky enough to also obtain photographs of them mating and feeding.
Resumo Exceto por alguns insetos-pau que são economicamente valiosos, a maioria das espécies pode ser considerada praga florestal, por isso é extremamente importante obter informações sobre o uso de hospedeiros de plantas de mais insetos-pau. Neste artigo, as plantas hospedeiras de três espécies de bicho-pau foram registradas pela primeira vez. Também descobrimos que esses bichos-pau podem se alimentar de flores ou folhas de plantas. Lopaphus unidentatus (Chen & He, 1995) (Phasmida: Lonchodidae) atacou a parede de Hypericum choisianum. ex N. Robson, 1973 (Hypericaceae), Leurophasma dolichocercum Bi, 1995 (Phasmida: Aschiphasmatidae) atacou Antenoron filiforme (Thunb.) Roberty & Vautier, 1964 (Polygonaceae) e Megalophasma granulatum Bi, 1995 (Phasmida: Lonchodidae orientaled) atacou Chen, 1991 (Urticaceae). Finalmente, tivemos a sorte de também obter fotos deles se acasalando e se alimentando.
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Animais , Plantas , Insetos , Tibet , Folhas de Planta , FloresRESUMO
Vibration sensation is related to motor function. However, it is unclear which vibration frequencies are associated with motor function. Therefore, in this cross-sectional study, we investigated whether a specific frequency of vibration sensation could explain motor functions. Thirty-two community-dwelling Japanese healthy older adults aged 70 years or older participated in the present study. Grip strength, one-leg standing time, and 10-m walking time were evaluated as indicators of motor function. Vibratory (40, 128, and 256 Hz) and tactile sensory tests were examined as sensory functions. Grip strength per body weight was significantly correlated with sex, body mass index, falls efficacy scale, vibration sensation with 40 and 128 Hz, and 10-m walking time (P < 0.05). Furthermore, one-leg standing time showed a correlation between vibration sensation (128 and 256 Hz) and fall history (P < 0.05). However, 10-m walking time was significantly correlated with only the grip strength to body weight ratio. Multiple regression analysis showed that vibration sensation with 128 Hz (β = 0.427) and sex (β = -0.335) (P < 0.05) were significant independent variables associated with grip strength to body weight ratio. Vibration sensation with 256 Hz (β = 0.465) and age (β = -0.343) (P < 0.05) were significant independent variable associated with one-leg standing time. No significant variables were identified for the 10-m walking time. Vibration sensation associated with motor function shows specific frequency characteristics in community-dwelling older Japanese adults.
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An in-depth understanding of the mechanism of lower extremity muscle coordination during walking is the key to improving the efficacy of gait rehabilitation in patients with neuromuscular dysfunction. This paper investigates the effect of changes in walking speed on lower extremity muscle synergy patterns and muscle functional networks. Eight healthy subjects were recruited to perform walking tasks on a treadmill at three different speeds, and the surface electromyographic signals (sEMG) of eight muscles of the right lower limb were collected synchronously. The non-negative matrix factorization (NNMF) method was used to extract muscle synergy patterns, the mutual information (MI) method was used to construct the alpha frequency band (8-13 Hz), beta frequency band (14-30 Hz) and gamma frequency band (31-60 Hz) muscle functional network, and complex network analysis methods were introduced to quantify the differences between different networks. Muscle synergy analysis extracted 5 muscle synergy patterns, and changes in walking speed did not change the number of muscle synergy, but resulted in changes in muscle weights. Muscle network analysis found that at the same speed, high-frequency bands have lower global efficiency and clustering coefficients. As walking speed increased, the strength of connections between local muscles also increased. The results show that there are different muscle synergy patterns and muscle function networks in different walking speeds. This study provides a new perspective for exploring the mechanism of muscle coordination at different walking speeds, and is expected to provide theoretical support for the evaluation of gait function in patients with neuromuscular dysfunction.
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Humanos , Velocidade de Caminhada , Músculo Esquelético/fisiologia , Eletromiografia , Marcha/fisiologia , Caminhada/fisiologiaRESUMO
ObjectiveTo investigate the effect of self-efficacy-based intelligent walking training on function of lower extremities of stroke patients. MethodsFrom December, 2021 to December, 2022, 44 stroke inpatients from Zhejiang Provincial People's Hospital were randomly divided into control group (n = 22) and experimental group (n = 22). Both groups accepted routine rehabilitation, while the control group accepted routine gait training, and the experimental group accepted self-efficacy-based intelligent walking training on the gait training system (Walker View), for six weeks. They were assessed with Fugl-Meyer Assessment-Lower Extremities, 10-Meter Walk Test, Timed 'Up and Go' Test, stride length and average walking velocity, Functional Ambulation Category and General Self-Efficacy Scale before and after treatment. ResultsThree cases dropped down in the experimental group. All the indexes improved in two groups after treatment (|t| > 5.808, |Z| > 2.961, P < 0.01), and improved more in the experimental group than in the control group (|t| > 2.049, Z = -2.572, P < 0.05). ConclusionThe self-efficacy-based intelligent walking training can promote the recovery of motor function of lower extremities and walking ability in stroke patients.
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ObjectiveTo explore the effects of different intensity of wearable lower limb rehabilitation robot-assisted training on walking function, lower limb motor function, balance function and functional independence of stroke patients. MethodsFrom November, 2021 to December, 2022, 60 stroke patients hospitalized in Beijing Bo'ai Hospital were randomly divided into control group (n = 20), observation group 1 (n = 20) and observation group 2 (n = 20). All the groups received routine rehabilitation, while the control group received routine walking training 30 minutes a day, the observation group 1 received wearable lower limb rehabilitation robot-assisted training 30 minutes a day, and the observation group 2 received wearable lower limb rehabilitation robot-assisted training 60 minutes a day, for four weeks. They were assessed with Functional Ambulation Category scale (FAC), Fugl-Meyer Assessment-Lower Extremities (FMA-LE), Berg Balance Scale (BBS) and Rivermead Mobility Index (RMI) before and after treatment. ResultsOne case in the observation group 1 and three cases in the observation group 2 dropped down. The FAC, FMA-LE, BBS and RMI scores improved in all the three groups after treatment (|Z| > 3.448, |t| > 8.102, P < 0.001), and there was no significant difference in all the indexes among the three groups (|H| < 4.643, F = 1.454, P > 0.05); however, the improvement of BBS score was more in the observation group 1 than in the control group (P < 0.05), and the improvement of all the indexes was more in the observation group 2 than in the control group (P < 0.05). ConclusionThe wearable lower limb rehabilitation robot-assisted training may promote the recovery of walking function, lower limb motor function, balance function and functional independence of stroke patients, and high-intensity training seems to be more effective.
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Objective To analyze the influence of different backpack types and loads on kinematics and plantar pressure of college students during stair climbing, so as to provide references for choosing the appropriate backpack and carrying mode. Methods The Nokov infrared light point motion capture system and Podome plantar pressure system were used to analyze the differences in the range of motion ( ROM) of the trunk and lower limb joints, the kinematic parameters at the peak time, the peak pressure of each plantar partition, the contact time, the maximum pressure of the whole foot, the average pressure and the maximum contact area for 15 male college students during the support period of stair climbing. Results The 5% BW and 10% BW backpack loads reduced ROM of trunk rotation, increased ROM of ankle flexion/ extension and varus / valgus. The 10% BW backpack loads increased the peak pressure of the 1st and 3rd metatarsals bones and the maximum pressure of the whole foot ( P < 0. 05). Single-shoulder bag and handbag reduced ROM of trunk tilting and rotation, and increased ROM of ankle flexion and extension, hip flexion angle, peak pressure of foot arch and medial heel (P<0. 05). The double-shoulder bag loads increased peak pressure in the toe area (P<0. 05). Conclusions During walking on the stairs, the 5% BW and 10% BW backpack loads limited trunk rotation and increased ankle ROM. The 10% BW loads also increased the load in metatarsal area. The unilateral weight-bearing mode would make the trunk tilt to the unload side and rotate to the weight-bearing side. The pressure in toe area was higher when carrying double-shoulder bag, while single-shoulder bag and handbag mainly increased the pressure of arch foot and medial heel. It is suggested that college students choose symmetrical backpack scheme, and wisely allocate back weight to avoid the injury of foot area.
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ObjectiveTo observe the effect of video-based mirror therapy on lower limb motor function, walking ability, and balance of stroke patients at recovery stage. MethodsFrom January to October, 2022, 43 stroke patients in Beijing Bo'ai Hospital were randomly divided into control group (n = 22) and mirror therapy group (n = 21). Both groups received routine rehabilitation, and the mirror therapy group received video-based mirror therapy additionally, for four weeks. They were assessed with Fugl-Meyer Assessment-Lower Extremities (FMA-LE), Functional Ambulation Category (FAC) and Berg Balance Scale (BBS) before and after treatment. ResultsAfter treatment, the scores of FMA-LE, FAC and BBS improved significantly in both groups (|t| > 6.205, P < 0.001), and the scores of FMA-LE and BBS were better in the mirror therapy group than in the control group (|t| > 2.164, P < 0.05). ConclusionCombining with video-based mirror therapy could facilitate to improve the lower limb motor function and balance ability of stroke patients at recovery stage.