The clinical effect of Kinesio taping and modified constraint-induced movement therapy on upper extremity function and spasticity in patients with stroke: a randomized controlled pilot study.

BACKGROUND: Spasticity and impaired hand function are common complication in patients with stroke, and it pose negative impact on quality of life. AIM: We aimed to assess the effect of the combined administration of kinesio taping (KT) and modified constraint-induced movement therapy (mCIMT) on upper extremity function and spasticity in hemiplegic patients with stroke. DESIGN: A randomized controlled pilot study. SETTING: A hospital center. POPULATION: Patient of stroke with hemiplegia for 3-12 months. METHODS: Thirty-five patients were enrolled and allocated into three groups, including the sham KT and mCIMT group, KT group, or KT and mCIMT group. The KT, sham KT, and mCIMT serve as additional therapies (5 days/week for 3 weeks) besides regular rehabilitation (5 days/week for 6 weeks). KT was applied over the dorsal side of the affected hand, while mCIMT was applied to restrain the unaffected upper extremity. The outcomes included the modified Tardieu scale (mTS), Brunnstrom stage, Box and Block Test (BBT), Fugl-Meyer assessment for the upper extremity (FMA-UE), and Stroke Impact Scale version 3.0. Measurements were taken at baseline, immediately after intervention (third week), and 3 weeks later (sixth week). RESULTS: Between baseline and the third week, within-group comparisons yielded significant improvement in the wrist and hand parts of the FMA and BBT of the Sham KT and mCIMT group (P=0.007-0.035); in the hand part of the FMA, BBT, and mTS degree (P=0.005-0.024) of the KT group; and in the Brunnstrom stage of the wrist, FMA-UE, BBT, and mTS degrees (P=0.005-0.032) of the KT and mCIMT group. Between baseline and the sixth week, there was significant difference in the proximal part of the FMA and mTS degree in groups with KT, but an additional improvement on the Brunnstrom stage of the wrist was noted in the KT and mCIMT group. CONCLUSIONS: KT benefits patients with stroke in spasticity reduction and upper extremity function. The combination of KT and mCIMT provides extra benefit in motor performance with a more long-lasting effect. CLINICAL REHABILITATION IMPACT: Kinesio taping could act as potential adjuvant therapy in patient of stroke with hemiplegia.

Associations Between Cognitive Functions and Physical Frailty in Patients With Parkinson's Disease.

Background: Parkinson's disease (PD) is a neurodegenerative disease manifested by both motor and non-motor dysfunctions and co-existence of cognitive impairment and physical frailty is common. Given that research in this area is limited, a better understanding of associated factors with physical frailty could provide a focused screening method and facilitate early intervention in PD. Methods: Seventy-six patients with idiopathic PD were recruited and Fried's criteria of physical frailty were used to group all participants. Comprehensive cognitive tests and clinical characteristics were measured, and univariate and multivariate analysis was performed to explore the relationship between clinical factors or neuropsychological functions. Results: Twenty-nine patients with PD (38%) exhibited physical frailty. Compared to PD patients without frailty, PD patients with frailty were older in age and demonstrated worse disease severity and poorer cognitive functions, including attention, executive function, memory, speech and language, and visuospatial function (p < 0.05). Further, stepwise logistic regression analysis revealed that disease severity by the Unified Parkinson's Disease Rating Scale (UPDRS) total score (OR: 1.065; 95% CI: 1.033-1.099) and executive function (OR: 0.724; 95% CI: 0.581-0.877) were independent risk factors for predicting physical frailty (p = 0.003 and 0.002). The best cut-off points are 46 in UPDRS (sensitivity: 62.1%; specificity: 91.5%). Conclusions: Executive function impairment is an independent risk factor for the development of physical frailty with disease progression. Awareness of such comorbidity might provide a screening tool to facilitate investigation in their underlying etiology and early intervention for frailty prevention.

The Sonography and Physical Findings on Shoulder after Selective Neck Dissection in Patients with Head and Neck Cancer: A Pilot Study.

The aim of this study is to investigate soft tissue disorders of affected shoulders after nerve-sparing selective neck dissection (SND) in patients with head and neck cancers (HNCs) by sonography. Eighteen HNCs patients with shoulder disability after SND were enrolled. Shoulder motions, pain, and the sonographic findings were measured and analyzed. Significantly decreased flexion, abduction, and increased pain were found on affected shoulders compared with normal shoulders. There were significant decrease in thickness of trapezius muscle (p=0.001), abnormal findings of supraspinatus tendon (p=0.022), and subdeltoid bursa (p=0.018) on surgical side. The ratio of trapezius muscle atrophy was related to shoulder pain (p=0.010). Patients with subdeltoid abnormalities had significant limitation on shoulder flexion and abduction. Abnormalities of supraspinatus tendon and subdeltoid bursa on sonography and trapezius muscle atrophy may play a key role in shoulder pain and shoulder flexion and abduction limitations.

Effects of kinesio taping on hemiplegic hand in patients with upper limb post-stroke spasticity: a randomized controlled pilot study.

BACKGROUND: Post-stroke spasticity is a common complication in patients with stroke and a key contributor to impaired hand function after stroke. AIM: The purpose of this study was to investigate the effects of kinesio taping on managing spasticity of upper extremity and motor performance in patients with subacute stroke. DESIGN: A randomized controlled pilot study. SETTING: A hospital center. POPULATION: Participants with stroke within six months. METHODS: Thirty-one participants were enrolled. Patients were randomly allocated into kinesio taping (KT) group or control group. In KT group, Kinesio Tape was applied as an add-on treatment over the dorsal side of the affected hand during the intervention. Both groups received regular rehabilitation 5 days a week for 3 weeks. The primary outcome was muscle spasticity measured by modified Ashworth Scale (MAS). Secondary outcomes were functional performances of affected limb measured by using Fugl-Meyer assessment for upper extremity (FMA-UE), Brunnstrom stage, and the Simple Test for Evaluating Hand Function (STEF). Measures were taken before intervention, right after intervention (the third week) and two weeks later (the fifth week). RESULTS: Within-group comparisons yielded significant differences in FMA-UE and Brunnstrom stages at the third and fifth week in the control group (P=0.003-0.019). In the KT group, significant differences were noted in FMA-UE, Brunnstrom stage, and MAS at the third and fifth week (P=0.001-0.035), and in the proximal part of FMA-UE between the third and fifth week (P=0.005). Between-group comparisons showed a significant difference in the distal part of FMA-UE at the fifth week (P=0.037). CONCLUSIONS: Kinesio taping could provide some benefits in reducing spasticity and in improving motor performance on the affected hand in patients with subacute stroke. CLINICAL REHABILITATION IMPACT: Kinesio taping could be a choice for clinical practitioners to use for effectively managing post-stroke spasticity.

The long-term effects of hyaluronic acid on hemiplegic shoulder pain and injury in stroke patients: A randomized controlled study.

BACKGROUND: Hemiplegic shoulder pain (HSP) is one common complication after stroke. The interferes with the functionality of the affected shoulder in patients with stroke during rehabilitation. Hyaluronic acid (HA) could have positive effects on pain relief and shoulder motion in stroke patients with hemiplegic shoulders. We investigated long-term benefits of HA injection in stroke patients with HSP and rotator cuff injury. METHODS: A randomized, double-blinded controlled trial was conducted in one medical center. The stroke patients with HSP and rotator cuff injury were randomized and allocated to the control (n = 9) and experimental (n = 18) groups. The control and the experimental groups received ultrasound-guided subacromial 0.9% sodium chloride and HA injections, respectively. All injections were performed once per week for 3 weeks. The associated upper extremity functional assessments, shoulder pain scale, and sonography findings on affected shoulders were measured before interventions and at the 4th and 12th week after local injections. RESULTS: The visual analog scale (VAS) scores of HSP were significantly reduced in the control and experimental groups at the 4th week following intervention. Additionally, the VAS score at the 12th week was also significantly reduced in the experimental group. Significant differences were found in the hyperemia occurrence in the subscapularis tendon at the 12th week after intervention (P = .018) and in the severity of hyperemia in the long head of the biceps tendon (P = .042) and the subscapularis tendon after intervention (P = .014). CONCLUSION: Subacromial HA injections might provide longer HSP reduction and decrease in hyperemia reactions at the long head of biceps tendon and subscapularis tendon in stroke patients with HSP and tendon injury.