Effect of Knee Hyperextension on Femoral Cartilage Thickness in Stroke Patients.

OBJECTIVE: Knee hyperextension is one of the most common compensatory mechanisms in stroke patients. The first aim of the study was to measure knee hyperextension and femoral cartilage thickness in stroke patients. The second aim was to compare the femoral cartilage thickness of the paretic and nonparetic limbs in stroke patients with and without knee hyperextension. DESIGN: Forty stroke patients were included in the study. The patients were divided into two groups according to the presence of knee hyperextension based on kinematic analyses performed during walking with a three-dimensional motion analysis system. The medial femoral cartilage, lateral femoral cartilage, and intercondylar cartilage thicknesses of the paretic and nonparetic sides of the patients were measured by ultrasonography. RESULTS: In the study group, medial femoral cartilage, intercondylar, and lateral femoral cartilage thicknesses were less on the paretic side than on the nonparetic side, while the femoral cartilage thicknesses on the paretic and nonparetic sides were similar in the control group. Paretic side medial femoral cartilage and intercondylar thicknesses were less in the study group compared with the control group, and lateral femoral cartilage thickness was similar between the two groups. CONCLUSIONS: Knee hyperextension during walking causes femoral cartilage degeneration in stroke patients.Clinical Trial code: NCT05513157.

Balance and gait in individuals with diabetic peripheral neuropathy.

BACKGROUND: Diabetic Peripheral Neuropathy (DPN) causes various physical problems such as the increased risk of falling, loss of balance and coordination while standing or walking, susceptibility to injuries due to sensory loss. AIMS: The aim of the study was to evaluate and compare the effects of neuropathic pain (NP) in individuals with DPN on balance and gait. METHODS: This prospective controlled study was conducted on 42 adults aged between 40-65 years. The participants were divided into three groups; individuals with DPN and NP (DPN+NP/n = 14), individuals with DPN without NP (DPN-NP/n = 14), and the control group (n = 14), respectively. The Force Plate system and Core Balance System measured static and dynamic postural balance and stability limits. Gait and dynamic plantar pressure distribution analyses were performed with a computerized gait evaluation system. RESULTS: The score of LANSS, and VAS during gait were higher in DPN+NP group than in DPN-NP (p < 0.05). No significant difference was observed between the groups in balance parameters (p > 0.05). The right-left heel maximum forces were lower in both groups with DPN compared to the control group (p < 0.05). In terms of spatiotemporal parameters of the gait, there was a difference between the groups only in step width and left single support line parameters (p < 0.05). CONCLUSIONS: The results of this study indicate that the individuals with DPN have an increased step width, their left single support line was shortened, and the maximum force on the heel decreased. The NP did not cause any change in balance and gait parameters.

The effect of robot-assisted walking in different modalities on cardiorespiratory responses and energy consumption in patients with subacute stroke.

OBJECTIVES: The aim of our study was to evaluate the effect of robot-assisted walking in different modalities on cardiorespiratory responses and energy consumption in subacute stroke patients. METHODS: Our study consisted of 16 individuals between the ages of 18-65 years. Individuals diagnosed with hemiplegia after unilateral ischemic or haemorrhagic stroke constitute the stroke group. Eight subacute stroke individuals were included in the experimental group, and eight healthy individuals were included in the control group. Each participant tested on the Lokomat in three consecutive days in random sequence, with three tests: the first test: 100% guiding strength (GF)and 100% body weight support (BWS); the second test 80% GF, 50% BWS; the third test 60% GF, 30% BWS was achieved. Gas analyzer (Cosmed, Quark CPET, Italy) measurements were made with the help of a mask to evaluate the cardiorespiratory responses of the participants during all tests. RESULTS: In the comparison of the three test results of the two groups separately, the stroke group's oxygen consumption (VO2), carbon dioxide production (VCO2), tidal volume (VT), pulse reserve (HRR), calories burned per hour (EEh), Borg dyspnea values, control group's VO2, VCO2, VE, HR, HRR, and EEh, Borg values were statistically significantly different (p < 0.005). It was seen that the third test results were significantly greater than the first and second test results (p < 0.005). DISCUSSION: By decreasing GF and BWS values during robot-assisted walking, adequate cardio-metabolic and energy response in both subacute stroke patients and healthy individuals could be achieved. These results show us that it is important to consider the cardiorespiratory function of the patient when choosing training protocols.

Effects of freezing of gait on balance in patients with Parkinson's disease.

OBJECTIVES: The aim of the study was to evaluate the effects of freezing of gait (FOG) on static and dynamic balance. METHODS: Twenty patients with Parkinson's disease with and without FOG [PD+FOG (68,6±6,39 years) and PD-FOG group (70,6±4,57 years)] and 10 healthy individuals (68,4±4,92 years) with similar demographic characteristics were included in the study. Balance was compared between the three groups. Balance was evaluated with clinical tests Limits of stability (LoS) and body sway were measured using the E-LINK FP3 Force Plate and the Korebalance Balance Evaluation System, which measure the balance in static and dynamic conditions. Center of pressure (COP) change and average sway velocity were evaluated with the Zebris RehaWalk system. RESULTS: Total and subscale scores of the Unified Parkinson's Disease Rating Scale were significantly higher in the PD+FOG group (p<0.05). The balance test results for both groups were similar (p>0.05). The PD+FOG group performed worse on the computerized static balance tests, the COP analysis, and the dynamic balance total score than the other two groups (p<0.05). The PD+FOG group had significantly greater sustained weight deviation than the healthy controls (p<0.05). Patients with Parkinson's disease had a lower LoS in the posterior direction than healthy controls (p<0.05). DISCUSSION: FOG affects the dynamic balance more negatively than the static balance. In addition, FOG reduces LoS in the posterior direction and increases body sway in the anterior-posterior direction, which can lead to falls.

Comparison of the Effectiveness of Kinesiology Taping and Rigid Taping on Ankle Kinematics During Drop Landing in Individuals with Lateral Ankle Injury.

BACKGROUND: Lateral ankle sprain is an injury that often occurs during sports or daily life activities. Athletic tape and kinesiology tape applications are among the external support treatment options especially for athletes to support the ankle and protect it from recurrent sprains. We sought to compare the kinematic stabilization effects of different ankle taping applications on the ankle joint during drop landing in individuals with a history of unilateral lateral ankle injury. METHODS: In this randomized controlled study, 30 volunteers with unilateral ankle injury were evaluated. The participants were asked to land on one leg on the involved side and the contralateral side from a 30-cm-high platform. The same practice was repeated after applying kinesiology tape and rigid tape to the injured foot. Kinematic analysis of the foot and ankle was performed by recording three-dimensional spatial position information at a speed of 240 frames per second using infrared cameras. RESULTS: The highest inversion angles of the involved foot at initial contact and 150 msec after initial contact were higher than those of the uninvolved side (P = .03 and P = .04, respectively). There was no significant difference in ankle kinematic values in the involved foot among kinesiology taping, athletic taping, and no taping applications (P = .74). CONCLUSIONS: People with lateral ankle sprains show reduced inversion during landing. There were no significant differences among kinesiology taping, athletic taping, and no taping on the injured foot in terms of ankle kinematics. Care should be taken when using taping materials as protective measures for sports activities.