Trunk control and acute-phase multifactorial predictors of community mobility after stroke: a longitudinal observational study.

Introduction: Stroke is a detrimental condition associated with long-term functional impairments that restrict community reintegration, which is an indicator of successful post-stroke functional recovery and rehabilitation. Additionally, trunk control is an understudied factor that may contribute to community mobility and participation after stroke. This study aimed to identify predictors of community mobility among stroke survivors in the acute phase, with a primary focus on trunk control, in addition to exploring the mediating and moderating role of predictive factors. Methods: A longitudinal observational study included 61 participants with acute stroke. Trunk control test (TCT) during sitting, stroke severity, quality of life, fear of falls, depression, and age was assessed during the acute phase as potential predictors. The community mobility outcome measure was assessed 3 months after baseline using the Reintegration to Normal Living Index (RNLI). Statistical analyses included correlation, linear regression, mediation, and moderation analyses. Results: Trunk control test was the strongest predictor of RNLI among all factors (ß = 0.72; 95%CI = 0.004-0.007; p ≤ 0.0001). Stroke severity, quality of life, fear of falls, and age significantly predicted RNLI (p < 0.01). Higher age was a significant moderator of the relationship between TCT and RNLI (ß = 0.002; p < 0.001; 95% CI = 0.0001-0.0003). Discussion: The findings highlight sitting trunk control impairment during the acute stage as a crucial predictor of reduced community mobility after stroke, where age over 60 years can moderate this relationship. The study emphasizes that addressing trunk control during early stroke rehabilitation may enhance community reintegration prospects.

Plantar pressure distribution in the evaluation and differentiation of flatfeet.

BACKGROUND: Although foot diseases are common, only a few studies have detailed the biomechanical and anatomical components of each disorder. The most reliable diagnostic tool for flatfoot is X-ray radiography. Achieving a similar accurate and objective diagnosis using another assessment tool, such as plantar pressure measurements, can be more convenient in clinical practice. RESEARCH QUESTION: To identify foot plantar pressure characteristics that primarily detect flatfoot based on X-ray, which addresses the use of such assessments for flatfoot diagnosis. In addition, to compare between the normal foot, flatfoot with positive Foot Posture Index-6 (FPI), and flatfoot with positive FPI and radiographic measures. METHODS: Sixty-two feet were examined from healthy female subjects aged 20.38 ± 1.10 years. According to the results of FPI and X-ray, each sample was assigned to one of the three groups (normal: negative FPI; FPI+: FPI ≥ +6; X-ray and FPI+: Arch Angle ≥ 165°, CP ≤ 12.3° and FPI ≥ +6) and compared using plantar pressure variables. RESULTS: As per normal group compared to X-ray and FPI+ group, there was a significant difference in the surface area (P-value: 0.01, 95 % CI: -26.58 to -3.62), force (P-value: 0.04, 95 % CI: -10.37 to -0.09), and pressure (P-value: 0.01, 95 % CI: -56.78 to -6.35) in the medial foot. Similarly, the arch index among the normal group and the X-ray and FPI+ group showed significant differences (Static AI; P-value: 0.003, 95 % CI: -0.21 to -0.04). CONCLUSION: There was a significant difference in plantar pressure between the normal feet and flatfeet with positive FPI and X-ray in the medial foot area. SIGNIFICANCE: To attain a consensus among diagnostic approaches to identify flatfoot, the combined comparison of observational, foot pressure, and radiographic methods that have shown considerable reliability can be useful for clinical practice.

Effect of Community Education Program on Stroke Symptoms and Treatment on School and College Students from South India: A Longitudinal Observational Study.

Community awareness regarding stroke signs, risk factors, and actions that help reduce the risk and complications of stroke is poorly addressed, as it is thought to be the best approach to control and prevent stroke. Aim: To establish the awareness of stroke and its management among high school and college students using an educational intervention. A questionnaire was administered to students from five high schools and four colleges with different areas of focus, (arts, science and commerce), types (public, semi-public and private), and economic locations before and after an educational lecture on stroke. The lecture covered the following elements: stroke definition, signs, risk factors, actions, time window for thrombolytic therapy, and types of rehabilitation interventions. This study included 1036 participants, of whom 36.3% were male and 56.4% were high school students, and the mean age was 17.15 ± 1.29 (15-22) years. Before the lecture, 147 participants were unaware of a single sign of stroke, and 124 did not know the risk factors. After the intervention, 439 participants knew four signs of stroke, and 196 knew 12 risk factors. Female students had better knowledge about stroke signs (odds ratio (OR), 3.08; 95% confidence interval (95% CI), 2.15-4.43). Hypertension (52.7%) and weakness (59.85%) were the most known signs and risk factors. The proportion of students who selected traditional medicine as the mode of treatment decreased from 34.75% to 8.59% after the lecture. Other rehabilitation methods (e.g., physical therapy, occupational therapy, speech therapy and counseling) were chosen by more than 80% of the students. The results of the current study showed that the awareness on stroke risk factors and management among the school and college students can be significantly improved with regular educational interventions, and therefore stroke can be prevented to some extent.

Factors affecting foot posture in young adults: a cross sectional study.

OBJECTIVE: Age, Body Mass Index (BMI) and flexibility are factors affecting foot posture, which is poorly understood in young adults. The objective of this study is to discover the relationships among these factors. METHODS: 252 healthy participants (106 males, 146 females) between the ages of 18 and 25 were selected. BMI and the Foot Posture Index - 6 item version (FPI-6) were assessed, a Beighton score was obtained for each participant, and a lunge test was conducted. RESULTS: Pronated feet (indicated by an FPI-6 score of 6+ (had a weak positive correlation with Beighton score (r=0.25, p= 0.05, 95% CI [0.01 to 0.47]) and a weak negative correlation with BMI (r=0.31, p = 0.01, 95% CI [-0.52 to -0.07]). Females had a higher prevalence of pronated feet (81.75%) than males (18.75%). CONCLUSION: There is a mild relationship between ligament laxity and foot pronation, and females are more prone to have pronated feet than males. No correlation was found between body weight and pronated feet.

Physical therapists' perspectives on improving walking capacity in patients with stroke: a cross-sectional study from Saudi Arabia.

OBJECTIVES: Stroke is a serious condition that leads to disability and death, which affects around 16 million people worldwide each year. The considerable loss of function after stroke is likely to impede walking ability. The current study was to understand the practices of physical therapists in Saudi Arabia and their perspectives on treatment to improve walking capacity after stroke. METHODS: This prospective cross-sectional survey was conducted using a 12-item, semistructured questionnaire, which included demographic characteristics and physical therapy practices. The questionnaires were distributed as hard copies to physical therapists working in Saudi Arabia and were asked to return the forms after completion. Totally 191 respondents from 18 institutions in Saudi Arabia completed the survey and were included in the analysis. RESULTS: There was comparable agreement from respondents regarding the use of ankle foot orthosis (84.8%). The use of walking aids was supported more by physical therapists with higher qualifications (post-graduates=40%, doctorates=55.6%), while evidence-based practice showed a higher rate in less-experienced to moderately experienced physical therapists (2-5 years=24.2%, 5-10 years=19.3%). CONCLUSION: Variable responses from different sectors according to qualification, experience, and institution were observed among the physical therapists in Saudi Arabia for improving the walking capacity in patients after Stroke.

Effect of spinal decompression therapy and core stabilization exercises in management of lumbar disc prolapse: A single blind randomized controlled trial.

BACKGROUND: Spinal decompression therapy (SDT) has recently been used as a conservative treatment for lumbar disc prolapse (LDP). The effectiveness of SDT when compared with other conservative techniques with a well-designed randomized controlled trials is lacking. OBJECTIVE: To find the efficacy of SDT and core stabilization exercises (CSE) on pain and functional disability in individuals with chronic LDP, and to compare with CSE alone. METHODS: This single blind randomized controlled trial included thirty-one participants with a mean age of 38.68 ± 8.79 having chronic LDP with or without radiating symptoms were included in the study. The study group received SDT with CSE and control group received CSE alone along with interferential therapy for both groups. Pain and disability were estimated by Numerical Rating Scale (NRS) and Modified Oswestry Questionnaire (mOQ). RESULTS: The results demonstrated significant within-group improvements in all outcomes in both groups, the mean differences between pre to post intervention in SDT with CSE group were (NRS: 4.75, t= 12.81, p⩽ 0.001) and (mOQ: 45.13, t= 29.34, p⩽ 0.001), while in CSE group (NRS: 2.60, t= 13.67, p⩽ 0.001) and (mOQ: 27.67, t= 24.52, p⩽ 0.001). CONCLUSIONS: A combination of SDT with CSE has proven to be more significant when compared with CSE alone to reduce pain and disability in subjects with chronic LDP.