Effects of Extensor Digitorum Longus and Tibialis Anterior Taping on Balance and Gait Performance in Patients Post Stroke.

The purpose of this study was to investigate the effects of extensor digitorum longus taping (EDLT) and tibialis anterior taping (TAT) on balance and gait performance in patients post-stroke. The study included 40 stroke patients randomly assigned to two intervention groups: the EDLT group and the TAT group. Therapeutic taping was applied to the extensor digitorum in the EDLT group and applied to the tibialis anterior in the TAT group. Balance variables were measured using BioRescue equipment, and gait variables were measured using G-walk equipment. Balance and gait variables were significantly increased in both the EDLT and TAT groups after the intervention, but there were no significant differences between the two groups. Therefore, we concluded that eversion (EDLT) or inversion (TAT) through taping did not affect the outcome. Only dorsiflexion affects gait speed increase post-stroke. As a result of this study, extensor digitorum longus taping and tibialis anterior taping were taping methods with no difference in the improvement of balance ability and gait performance.

The Immediate Effects of Lumbar Rotational Mobilization on Trunk Control and Gait Parameter in Patients with Stroke.

OBJECTIVES: Improved gait performance in patients with stroke requires trunk control. This study investigated the effect of lumbar rotational mobilization on improving trunk control and gait parameters. MATERIALS AND METHODS: This study recruited 42 patients with stroke who were randomly assigned to the grade III (experimental group, n=21) and grade I (control group, n=21) lumbar rotational mobilization groups. Grade III lumbar mobilization with right and left rotation was performed in the experimental group with patients lying on their sides. The control group performed grade I rotation mobilization using the same method. Among outcome measurements, the trunk impairment scale was used for trunk control, while gait parameters were measured using the BTS G-WALK. RESULTS: The trunk impairment scale score and gait performance were significantly higher in the experimental group than those in the control group. CONCLUSIONS: Grade III lumbar rotational mobilization improved trunk control and increased gait performance in patients with stroke.

Changes in Ankle Range of Motion, Gait Function and Standing Balance in Children with Bilateral Spastic Cerebral Palsy after Ankle Mobilization by Manual Therapy.

The aim of this study was to investigate the effect of ankle joint mobilization in children with cerebral palsy (CP) to ankle range of motion (ROM), gait, and standing balance. We recruited 32 children (spastic diplegia) diagnosed with CP and categorized them in two groups: the ankle joint mobilization (n = 16) group and sham joint mobilization (n = 16) group. Thus, following a six-week ankle joint mobilization, we examined measures such as passive ROM in ankle dorsiflexion in the sitting and supine position, center of pressure (COP) displacements (sway length, area) with eyes open (EO) and closed (EC), and a gait function test (timed up and go test (TUG) and 10-m walk test). The dorsiflexion ROM, TUG, and 10-m walk test significantly increased in the mobilization group compared to the control group. Ankle joint mobilization can be regarded as a promising method to increase dorsiflexion and improve gait in CP-suffering children.

Effects of joint mobilization and stretching on the range of motion for ankle joint and spatiotemporal gait variables in stroke patients.

BACKGROUND AND PURPOSE: Stroke patients have limited ranges of motion and gait disturbances due to neurological deficits and connective tissue changes. We assessed the effects of joint mobilization and active stretching on ankle joint range of motion and gait in stroke patients. METHODS: In total, 45 stroke patients were evenly divided into three groups: joint mobilization, active stretching, and combination (joint mobilization and active stretching) groups. Patients in each group received the corresponding interventions in a non-simultaneous manner for 6 weeks in total (3 days per week, 15 min per day). The range of motion of the ankle joint was measured using a goniometer, and spatiotemporal gait variables were measured using G-walk. All measurements were taken immediately before and after the 6-week intervention. RESULTS: The joint mobilization group exhibited significantly increased range of motion for ankle joint after the intervention (p < 0.05), while the spatiotemporal gait variables were unchanged. In the active stretching group, both the range of motion of the ankle joint in the supine position and the spatiotemporal gait variables (cadence, speed, stride length) were significantly increased (p < 0.05). In the combination group, both the range of motion of the ankle joint and spatiotemporal gait variables (cadence, speed, stride length) were significantly increased (p < 0.05). CONCLUSION: Combination therapy of joint mobilization and active stretching improves the range of motion of the ankle joint and spatiotemporal gait variables in stroke patients, suggesting that ankle rehabilitation of stroke patients should include limited joint structure and muscles shortness.

Effects of Neuromuscular Electrical Stimulation (NMES) Plus Upper Cervical Spine Mobilization on Forward Head Posture and Swallowing Function in Stroke Patients with Dysphagia.

After a stroke, forward head posture occurs, resulting in swallowing dysfunction. Neuromuscular electrical stimulation (NMES) combined with upper cervical spine mobilization has demonstrated enhanced recovery of the swallowing function in stroke patients. This study investigated the therapeutic effects of NMES in conjunction with upper cervical mobilization in stroke patients with dysphagia. Thirty-four stroke patients were recruited (in a randomized controlled clinical trial) and divided into an experimental group (n = 17; NMES plus upper cervical spine mobilization) and a control group (n = 17; NMES plus sham mobilization). Forward head posture was measured by craniocervical flexion test (CCFT) and craniovertebral angle (CVA). Swallowing function was measured by variations in video fluoroscopic dysphagia scale (VDS) and penetration-aspiration scale (PAS) scores using the video fluoroscopic swallowing study (VFSS). All measurements were done at baseline and after four weeks of NMES plus mobilization. A significant increase was observed in CCFT, CVA, VDS (total VDS score, oral stage score, pharyngeal stage score), and PAS score in all variations in the experimental group. The CCFT, CVA, pharyngeal stage score, total VDS, and PAS score were significantly higher in the experimental group when compared to the control group. NMES plus upper cervical spine mobilization can be regarded as a promising method to improve swallowing function and forward head posture changes in stroke patients with dysphagia.

Effects of trunk rehabilitation with kinesio and placebo taping on static and dynamic sitting postural control in individuals with chronic stroke: A randomized controlled trial.

Background: Impaired trunk postural control is common after stroke. Combining kinesio taping with trunk rehabilitation has been shown to enhance the recovery of postural control ability in patients with stroke.Objective: We investigated whether the combination of kinesio taping with trunk rehabilitation would improve dynamic and static sitting stability after stroke.Methods: Twenty-eight patients with stroke were recruited and randomly assigned to one of the two 8-week trunk rehabilitation programs with kinesio (experimental group) or placebo taping (control group). Outcome measures were dynamic forward, dynamic backward, affected-side, and unaffected-side sway areas, static sway area and length, and the total limit of stability (LOS) area. The variables were measured using the BioRescue analysis system. All outcome measures were assessed at baseline and after 8 weeks of trunk rehabilitation.Results: Significant increases were observed in the dynamic forward, dynamic backward, affected-side, and unaffected-side sway areas, and the total LOS area, in the experimental and control groups, whereas decreases were observed in the static sway area and length. The dynamic forward sway area was significantly higher in the experimental group than in the control group, but there were no significant differences between the groups in the other variables.Conclusions: Trunk rehabilitation is effective for improving dynamic and static sitting stability after stroke. The addition of kinesio taping to the back muscles further increases forward mobility.

The effect of chest expansion exercise with TENS on gait ability and trunk control in chronic stroke patients.

[Purpose] The purpose of this study was to investigate the effect of chest expansion exercise with transcutaneous electrical nerve stimulation (TENS) on gait ability and trunk control of patient with stroke. [Subjects and Methods] The subjects were divided into 7 in the chest expansion exercise with TENS group (experimental group) and 7 in the chest expansion exercise with placebo TENS (control group). The gait ability and trunk contol were measured using Six-Minute Walk Test, Tinetti gait index and Trunk impairment scale (TIS). [Results] Both the experimental group and the control group showed significant improvement in the Six-Minute Walk Test, Tinetti gait index, and TIS total score. The dynamic sitting balance and coordination of TIS showed significant improvement only in the experimental group. In comparison between the two groups, the experimental group showed a more significant improvement in Tinetti gait index and TIS total score than the control group. [Conclusion] This study showed that chest expansion exercise with TENS was an effective method for improving gait ability and trunk control in chronic stroke patients.

The immediate effect of diaphragm taping with breathing exercise on muscle tone and stiffness of respiratory muscles and SpO2 in stroke patient.

[Purpose] This study aimed to examine the immediate effects of diaphragm taping with breathing exercise on the tone and stiffness in the respiratory muscles of patient with stroke. [Subjects and Methods] A total of 28 subjects, 14 in the diaphragm taping with breathing exercise group and 14 in the breathing exercise group, were administered respective intervention methods. Subsequently, the muscle tone and stiffness in upper trapezius, scalene, external oblique abdominal and ractus abdominis muscle of both the respiratory muscles were measured. [Results] The comparison of respiratory muscles on the affected and non-affected sides in stroke patients showed statistically significant declines in the muscle tone and stiffness of all measured muscles but not in the stiffness of the external oblique abdominal muscle and rectus abdominis muscles. After intervention, the diaphragm taping with breathing exercise group exhibited statistically significant increases in the muscle tone of all measured muscles and in the stiffness of the upper trapezius and scalene muscles, and statistically significant declines in the saturation of peripheral oxygen. However, the breathing exercise group showed statistically significant increases only in the muscle tone of the upper trapezius and external oblique abdominal muscles. [Conclusion] This study demonstrated that diaphragm taping with breathing exercise had positive effects of immediately increasing the muscles tone and stiffness in the respiratory muscles.

Heterogeneity of early-onset and ketosis-resistant diabetes in Korean subjects--is it possible to determine cut-off age of early-onset type 2 diabetes?

OBJECTIVE: To investigate the heterogeneity of early-onset and ketosis-resistant diabetes and to define a not-arbitrary cut-off age for early-onset diabetes based on its clinical and metabolic characteristics, and diabetes complications. METHODS: We classified 1015 early-onset diabetes subjects aged 21-40 into four groups (group I, age at diagnosis 21-25 years; group II, 26-30; group III, 31-35; group IV, 36-40). Familial and diabetic history, statue of insulin secretion, metabolic parameters, and diabetes complications were analyzed. RESULTS: No significant difference in family history or the rate of diabetic complication was found in the four groups. Subjects with a 21 to a 25-year-old diabetes onset had the lowest serum C-peptide levels, with 50% of the cumulative 24-h urine C-peptide levels of the other three groups (p<0.0001). This group also had the lowest prevalence of hyperlipidemia and arterial hypertension (p<0.01 and <0.0001, respectively). Group III was found to have a higher prevalence of insulin insufficiency and hypertension than group IV. CONCLUSION: Our data based on insulin secretory function and metabolic factors might suggest that a cut-off age of 26 years might be warranted in Korean patients. Korean early-onset type 2 diabetes patients tend to be non-obese and insulin secretory dysfunction.