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.

Immediate Effects of Diaphragmatic Breathing with Cervical Spine Mobilization on the Pulmonary Function and Craniovertebral Angle in Patients with Chronic Stroke.

Background and Objectives: Patients with stroke have a forward neck posture due to neurological damage and often have impaired pulmonary function. This study investigated the effect of diaphragmatic breathing with cervical mobilization to improve pulmonary function cervical alignments. Materials and Methods: This study used a one-group pre-test-post-test design including 20 patients with stroke. Two types of cervical joint mobilization techniques, consisting of left and right lateral glide mobilization and posterior-anterior mobilization, were utilized. During joint mobilization, the patients performed diaphragmatic breathing. The measurements were performed immediately after the intervention. Pulmonary function was evaluated using a spirometer to measure the forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and peak expiratory flow (PEF). The craniovertebral angle (CVA) was measured using lateral photographs. Results: After diaphragm breathing with cervical joint mobilization, subjects had significantly increased FEV1, FVC, PEF and CVA. Conclusion: Diaphragm breathing with cervical joint mobilization are possible interventions to increase pulmonary function and improve the craniovertebral angle in patients with stroke. However, a complete conclusion can be reached only after a follow-up study has been conducted with a comparison of more subjects and controls.

Effects of Animal-Assisted Therapy on Gait Performance, Respiratory Function, and Psychological Variables in Patients Post-Stroke.

BACKGROUND: Animal-assisted therapy using dogs is being administered to patients post-stroke for the purpose of recovering psychological and physical activity. OBJECTIVE: This study was conducted to confirm the effect of animal-assisted therapy using dogs on gait performance, pulmonary function, and psychological variables in patients post-stroke. All outcomes were analyzed using two-way repeated-measure analysis. METHODS: In total, 30 post-stroke patients were divided into an experimental group (gait training by animal-assisted activity, n = 15) and a control group (gait training, n = 15). Gait performance (cadence, gait speed, stride length, symmetric index), respiratory pulmonary function (forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), peak expiratory flow (PEF), maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP)), and psychological variables (rehabilitation motivation and depression assessment) were measured before and after eight weeks of intervention. RESULTS: Gait performance, respiratory pulmonary function, and psychological variables significantly increased in the experimental group compared to the control group. CONCLUSION: Based on this study, it was found that animal-assisted therapy using dogs is an effective intervention for recovery of psychological and physical activity in patients post-stroke.

Effects of Cervical Spine Mobilization on Respiratory Function and Cervical Angles of Stroke Patients: A Pilot Study.

The forward head posture (FHP) of stroke patients has a negative impact on respiratory function. Cervical spine mobilization is a manual therapy technique that used to prevent and treat FHP and respiratory function. This pilot study investigated whether cervical spine mobilization can effectively improve outcomes following FHP and respiratory function of stroke patients. Twenty-four patients participated in our assessor-blinded randomized controlled trial. All the participants received neurodevelopmental treatments (gait training and trunk rehabilitation). The experimental group additionally received 15-min sessions of cervical spine mobilization three times per week for 4 weeks. The control group received cervical spine sham mobilization during the same period. For the cervical angles, the cranial vertebral angle (CVA) and cranial rotation angle (CRA) were measured. A respiratory function test was performed to measure the forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), peak expiratory flow (PEF), maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), and chest circumferences (upper and lower chest sizes). Except for MIP, there was no significant difference between the experimental group and the control group. The CVA and CRA were significantly increased in the experimental group only. Cervical spine mobilization improved cervical angles and inspiratory function of the stroke patients in this study. However, a comparative study with a larger number of patients is needed to confirm this finding from our pilot study, which had a small sample size.

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 Thoracic Mobilization and Extension Exercise on Thoracic Alignment and Shoulder Function in Patients with Subacromial Impingement Syndrome: A Randomized Controlled Pilot Study.

Introduction: Thoracic kyphosis commonly occurs in subacromial impingement syndrome. This pilot study investigated the effect of thoracic joint mobilization and extension exercise on improving thoracic alignment and shoulder function. Methods: In total, 30 patients with subacromial impingement syndrome were recruited and randomly assigned to three groups, the joint mobilization group (n = 10), exercise group (n = 10), and combination group (n = 10). After four weeks of treatment, the measured outcomes included thoracic kyphosis using a manual inclinometer; pectoralis major (PM) and upper trapezius (UT) muscle tone and stiffness using the MyotonPRO®; affected side passive range of motion (ROM) using the goniometer (flexion, abduction, medial rotation, and lateral rotation); and shoulder pain and disability index (SPADI). Results: All three groups had significant improvements in all variables (p < 0.05). Thoracic kyphosis; UT muscle tone; and flexion, medial rotation, and lateral rotation ROM and SPADI were all significantly improved in the combination group compared to the mobilization and exercise groups (p < 0.05). Conclusions: The combination therapy of thoracic mobilization and extension exercise can be regarded as a promising method to improve thoracic alignment and shoulder function in patients with subacromial impingement syndrome.

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.

Immediate Effects of Tibialis Anterior and Calf Muscle Taping on Center of Pressure Excursion in Chronic Stroke Patients: A Cross-Over Study.

Stroke patients often have muscles spasticity, difficulty with posture control, and tend to fall. This study investigated the use of kinesiology tape for patients with spasticity of ankle muscles after stroke. This study had a randomized, repeated measures design, and evaluated the immediate effect of kinesiology tape on the center of pressure (COP) excursion when applied to the calf and tibialis anterior muscles in stroke survivors. We determined that the taping attachment direction affects the COP movement. Twenty subjects were randomly assigned to the tibialis anterior taping condition, calf taping condition, or nontaping condition. Condition excursion was assessed. The measured variables included the paretic side area, nonparetic side area, forward area, and backward area of COP. All evaluations were conducted immediately after taping. COP excursion for chronic stroke survivors improved after tibialis anterior and calf taping (p < 0.05). Calf taping conditions increased significantly in the forward area (p < 0.05), and tibialis anterior taping conditions increased significantly in the backward area (p < 0.05). Kinesiology tape immediately increased the forward and backward COP excursion for patients with stroke.

Changes in Gait Performance in Stroke Patients after Taping with Scapular Setting Exercise.

The purpose of this study was to investigate the effects of combined taping with scapular setting exercise on the gait performance of stroke patients. Twenty stroke patients were randomly allocated to two groups: the taping with scapular setting exercise (TSSE) group (n = 10) and scapular setting exercise (SSE) group (n = 10). Intervention was performed for one week, and pre- and postintervention results for TSSE and SSE were compared. Outcomes were determined using the inertia measurement unit, which can measure spatiotemporal gait parameters, and using the timed up-and-go test. Two-way repeated analysis was used to compare pre- and postintervention results. In the TSSE group, intervention significantly improved cadence, gait speed, stride length, step length, gait cycle, swing phase duration, double support duration, and timed up-and-go test results more than in the SSE group. TSSE was found to improve all spatiotemporal gait parameters examined; thus, we recommend TSSE be considered as an intervention to improve gait parameters in stroke patients.

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 immediate effects of rib cage joint mobilization and chest wall stretch on muscle tone and stiffness of respiratory muscles and chest expansion ability in patients with chronic stroke.

[Purpose] The main purpose of this study was to identify the impact of rib cage joint mobilization and chest wall stretch on respiratory muscle tone and stiffness and chest expansion in stroke patients and to compare the effects of both interventions. [Subjects and Methods] Subjects were randomly assigned to a rib cage joint mobilization group (n=15) or a chest wall stretch group (n=15). Respiratory muscle tone and stiffness were measured using a myotonometer, and the chest expansion was gauged using a measuring tape. [Results] A significant difference was found on comparing the respiratory muscle tone and stiffness on the affected and sound side before intervention. Although both groups showed an increase in respiratory muscle tone and stiffness after intervention, no significant difference was found. A significant increase in chest expansion was observed; however, no significant difference was observed in the variations between the groups. [Conclusion] This study suggests that rib cage joint mobilization and chest wall stretch exercises can be used to increase chest expansion potential and respiratory muscle tone in patients with chronic stroke.

The immediate effects of proprioceptive neuromuscular facilitation with taping on gait parameters in patients with chronic stroke.

[Purpose] The purpose of the present study was to examine the immediate effects of simultaneous application of proprioceptive neuromuscular facilitation (PNF) and elastic taping (T), and the removal of the elastic tape, on the gait parameters of stroke patients. [Subjects and Methods] Twenty stroke patients were divided into a proprioceptive neuromuscular facilitation group (PNFG, n=7), a taping group (TG, n=6), and a proprioceptive neuromuscular facilitation with taping group (PNFTG, n=7). Relevant interventions were applied for 30 minutes, the tape was removed, and gait parameters were evaluated. [Results] Only the intervention of the PNFTG yielded significant differences in patient cadence, speed, and stride length. [Conclusion] The simultaneous application of PNF and taping for 30 minutes has carryover effects that can improve stroke patients' gait ability, even after the removal of the tape.

Comparison of the effects of core stabilization and chest mobilization exercises on lung function and chest wall expansion in stroke patients.

[Purpose] The main purpose of this study was to compare the effects of core stabilization and chest mobilization exercises on pulmonary function and chest expansion in chronic stroke patients. [Subjects and Methods] Thirty stroke patients were randomly divided into two groups: a core stabilization exercise group (n=15) and a chest mobilization exercise group (n=15). Each exercise was performed 3 times per week for 30 minutes for 4 weeks, and pulmonary function and chest expansion when breathing were measured for both groups. [Results] There were significant increases in both forced vital capacity and forced expiratory volume in 1 second before and after intervention. Core stabilization exercise resulted in a significant increase in peak expiratory flow, and significant increases in upper and lower chest expansion were detected with chest mobilization exercise. However, no significant difference was revealed between the two groups. [Conclusion] This study suggested that both exercises were effective in some aspects of pulmonary function while core stabilization can help increase peak expiratory flow and chest mobilization can assist with chest expansion.

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.

The immediate effect of FES and TENS on gait parameters in patients after stroke.

[Purpose] This study was conducted to compare the immediate effects of different electrotherapies on the gait parameters for stroke patients. [Subjects and Methods] Thirty patients with stroke were randomly assigned either to the functional electrical stimulation group or the transcutaneous electrical nerve stimulation group, with 15 patients in each group. Each electrotherapy was performed for 30 minutes simultaneously with the therapeutic exercise, and the changes in the spatial and temporal parameters of gait were measured. [Results] After the intervention, a significant, immediate improvement in cadence and speed was observed only in the functional electrical stimulation group. [Conclusion] Based on this study, functional electrical stimulation that stimulates motor nerves of the dorsiflexor muscles on the paretic side is recommended to achieve immediate improvement in the gait ability of stroke patients.