ABSTRACT
(1) Background: Leg length discrepancy (LLD), regardless of its origin, is a very common pathology that can contribute to low back pain. Various authors have pointed out its relationship with the lack of activation of both the gluteus medius (GM) and the ipsilateral erector spinae (ES). The purpose of this study was to identify the activation of the ES and GM with different simulated LLDs, correlating this activation with LBP. In turn, we evaluated whether ES and GM activity has an effect on jumping ability using a CMJ test. (2) Method: A sample of healthy subjects was selected to whom an artificial LLD was applied using 0.5, 1, and 1.5 cm insoles. These three heights were measured using EMG while the subjects walked and performed a counter movement jump (CMJ). The measurements of the insole heights were carried out in random order using a Latin square. Muscle activation patterns were recorded for 30 s at each of the insole heights while the patients walked at 5.7 km/h and they were compared with the maximum voluntary contraction (MVC), both on the ipsilateral and contralateral sides. These muscles were then measured under the same circumstances during the performance of the CMJ. (3) Results: We found statistically significant differences in the flight heights in both the CMJ and DJ. In the comparison, significant differences were found in the flight heights of the CMJ and the DJ using the 5 mm insoles, and in the case of the DJ, also without insoles, with respect to the MVC. We found statistically significant differences in the activation of the GM with the differences in insoles, but not in the activation of the Es in relation to the different insole heights. (4) Conclusions: Insoles of different heights caused activation differences in the medius on the side where the insoles were placed. We can relate this difference in activation to LBP. In relation to the ES, no significant differences were found in the activation of the ipsilateral side of the insole.
Subject(s)
Cerebellar Ataxia , Humans , Electromyography , Muscle, Skeletal/physiology , Thigh , ButtocksABSTRACT
BACKGROUND: Chronicity and lack of motivation often go together during the upper limb rehabilitation process in stroke. Virtual reality is a useful tool in this context, providing safe, intensive, individualised treatments in a playful environment. B-cost, easy-to-use devices with personalised and motivating games for a specific population seem to be the most effective option in the treatment of the upper limbs. METHODS: A randomised clinical study with follow-up was carried out to assess the effectiveness of the Leap Motion Controller® device in improving the functionality of the upper limb in patients with chronic stroke. Patients (n = 36) were randomised into a control group that performed conventional therapy and an experimental group that combined the virtual reality protocol with conventional therapy. The outcome measures used were grip strength; the Block and Box Test; the Action Research Arm Test; the Disabilities of the Arm, Shoulder and Hand; as well as a Technology Satisfaction Questionnaire and adherence to treatment. RESULTS: Inter-group statistical analysis showed no significant differences except in subsection D of the Action Research Arm Test. Intra-group analysis showed significant differences in both groups, but the experimental group reached significance in all long-term variables. Satisfaction and adherence levels were very high. CONCLUSIONS: The Leap Motion Controller® system, as a complementary tool, produces improvements in grip strength, dexterity and motor function in patients with chronic stroke. It is perceived as a safe, motivating, and easy-to-use device. CLINICAL REGISTRATION: NCT04166617 Clinical Trials.
Subject(s)
Stroke , Virtual Reality , Humans , Upper Extremity , Hand , Stroke/therapy , Hand StrengthABSTRACT
BACKGROUND: Improving balance remains a challenge in stroke rehabilitation. The technological development has allowed the design of more accessible and user-friendly systems for assessing postural control. OBJECTIVES: The aim of this review was to analyze portable devices for the instrumental assessment of balance in patients with chronic stroke. METHODS: PRISMA guidelines were used to carry out the systematic review. The literature search was restricted to articles written in English or Spanish published from 2013 to December 2022 in Pubmed, Web of Science, Scopus, PEDro, and CINAHL. Of the 309 search results, 229 unique references were reviewed after duplicates were removed. The PEDro scale was applied to evaluate the methodological quality of the included papers, and the degree of evidence and level of recommendation were determined through the Oxford Centre for Evidence-Based Medicine. RESULTS: A total of seven articles reporting on five different balance testing devices were included in this systematic review; they regarded BIORescue, a smartphone application, and the Biodex-BioSway Balance System for the evaluation of standing balance, and SwayStar Balance and Xsens ForceShoes™ for the evaluation of dynamic balance during walking. CONCLUSIONS: The use of portable devices that assess balance in adult patients with chronic stroke is scarce.
Subject(s)
Stroke Rehabilitation , Stroke , Adult , Humans , Physical Therapy Modalities , Postural Balance , Stroke Rehabilitation/methods , WalkingABSTRACT
BACKGROUND: The objective of the present study was to develop a virtual reality protocol based on activities of daily living and conventional rehabilitation, using Leap Motion Controller to improve motor function in upper extremity rehabilitation in stroke patients. At the same time, the purpose was to explore its efficacy in the recovery of upper extremity motor function in chronic stroke survivors, and to determine feasibility, satisfaction and attendance rate; Methods: A prospective pilot experimental clinical trial was conducted. The outcome measures used were the grip strength, the Action Research Arm Test (ARAT), the Block and Box Test (BBT), the Short Form Health Survey-36 Questionnaire, a satisfaction questionnaire and attendance rate; Results: Our results showed statistically significant changes in the variables grip strength, BBT and ARAT as well as high levels of satisfaction and attendance; Conclusions: This virtual reality platform represents an effective tool in aspects of upper extremity functionality rehabilitation in patients with chronic stroke, demonstrating feasibility and high levels of attendance and satisfaction.
Subject(s)
Stroke Rehabilitation , Stroke , Video Games , Virtual Reality , Activities of Daily Living , Feasibility Studies , Humans , Pilot Projects , Prospective Studies , Recovery of Function , Stroke/therapy , Stroke Rehabilitation/methods , Upper ExtremityABSTRACT
OBJECTIVES: Upper limb impairment is the most common motor impairment in stroke survivors. The use of new technologies in the field of rehabilitation aims to reduce the impact of functional problems. Our objective is to evaluate the effectiveness of using the Leap Motion Controller® virtual reality system in the treatment of upper limb functionality in people with stroke. MATERIALS AND METHODS: PRISMA guidelines were used to carry out the systematic review. The literature search was restricted to articles written in English or Spanish published from 2012 to December 2020 in Pubmed, Web of Science, Scopus, PEDro and Science Direct. Of the 309 search results, 230 unique references were reviewed after duplicates were removed. The Downs and Black and CONSORT scales were applied to evaluate the methodological quality of the included papers and the degree of evidence and level of recommendation were determined through the Oxford Centre for Evidence-Based Medicine. RESULTS: Six papers with a total of 144 participants were included in this review, with heterogeneity of the sample, assessment measures, protocols, number of sessions and diversity of games applied. The main results of the studies show favourable data after using the Leap Motion Controller® system in the improvement of upper limb functionality in people with stroke. CONCLUSIONS: There is a growing trend in the use of the Leap Motion Controller® device as a tool in the treatment of the upper limb in people with stroke. Nevertheless, the limitations encountered suggest the need for future research protocols with greater scientific rigor.
Subject(s)
Stroke Rehabilitation , Upper Extremity , Virtual Reality , Humans , Stroke Rehabilitation/methods , Upper Extremity/physiopathologyABSTRACT
Introducción. Uno de los objetivos principales de la neurorrehablitación en pacientes con ictus es el reentrenamiento del equilibrio. Se ha estudiado la influencia de la función motora del miembro superior en el control postural, pero desconocemos si la estimulación somatosensorial de la mano afecta puede influirlo. Objetivo. Estudiar si un protocolo de estimulación somatosensorial de la mano afecta, podía modificar, en pacientes con ictus crónico, la posición del centro de masa y su desplazamiento en bipedestación. Pacientes y métodos. 5 pacientes con ictus crónico con capacidad de bipedestación autónoma completaron este estudio piloto prospectivo y longitudinal, con valoración pretratamiento, post-primer tratamiento y post-intervención final. La intervención consistió en estimulación somatosensorial de la mano afecta, de 20 minutos de duración durante 5 días consecutivos. Se midieron Timed Up and GO Test (TUG), Performance Oriented Mobility Assessment (POMA), Limits Of Stability (LOS) y Modified Clinical Test of Sensory Interaction on Balance (mCTSIB). Resultados. Se observaron cambios estadísticamente significativos en TUG (p=0,043), en mCTSIB en los máximos desplazamientos del centro de presiones para la condición ojos abiertos (p=0,043) y en LOS para el tiempo de reacción en la diagonal posterior afecta(pê0,043), máximas excursiones en las diagonales anterior menos afecta, afecta y posterior afecta (p=0,043) y el control direccional en la anterior menos afecta y anterior afecta. Conclusiones. La estimulación somatosensensorial propuesta puede ser positiva para el reentrenamiento del equilibrio a la luz de los resultados obtenidos. Son necesarias investigaciones a este nivel a gran escala y a largo plazo con muestras más grandes.
Introduction. One of the main objectives of neurorehablitation in stroke patients is balance retraining. The influence of upper limb motor function on postural control has been studied, but we do not know whether somatosensory stimulation of the affected hand can influence it. Objective. To study whether a protocol of somatosensory stimulation of the affected hand could modify, in patients with chronic stroke, the position of the center of mass and its displacement in standing. Patients and methods. Five patients with chronic stroke who were able to stand independently completed this prospective and longitudinal pilot study, with pre-treatment, post-first treatment and final post-intervention assessment. The intervention consisted of somatosensory stimulation of the affected hand, lasting 20 minutes for 5 consecutive days. Timed Up and GO Test (TUG), Performance Oriented Mobility Assessment (POMA), Limits Of Stability (LOS) and Modified Clinical Test of Sensory Interaction on Balance (mCTSIB) were measured. Results. Statistically significant changes were observed in TUG (p=0.043), in mCTSIB for maximum center of pressures displacements for the eyes open condition (p=0.043) and in LOS for reaction time in the posterior diagonal affect(pê0.043), maximum excursions in the anterior least affect, affect and posterior affect diagonals (p=0.043) and directional control in the anterior least affect and anterior affect. Conclusions. The proposed somatosensory stimulation may be positive for balance retraining in light of the results obtained. Large-scale and long-term investigations at this level with larger samples are necessary.
