Does Upper Extremity Proprioceptive Training Have an Impact on Functional Outcomes in Chronic Stroke Patients?
Yıl: 2020 Cilt: 35 Sayı: 2 Sayfa Aralığı: 91 - 98 Metin Dili: İngilizce DOI: 10.5222/MMJ.2020.48752 İndeks Tarihi: 24-11-2020
Does Upper Extremity Proprioceptive Training Have an Impact on Functional Outcomes in Chronic Stroke Patients?
Öz: Objective: We aimed to investigate the effect of upper extremity proprioceptive training on spasticity and functional motor skills in patients with chronic hemiplegia occurring after stroke.Method: Thirty chronic hemiplegic patients (17 females, mean age: 66.47±12.55 years) admitted tothe Research Center with a diagnosis of chronic hemiplegia developed after stroke were included inthe study. Patients were divided into two groups. The first group received a conventional physiotherapy program (PTR) for 5 days a week and the second group additionally received a proprioceptivetraining program (PTR-PT) for 5 days a week. Before and 6 weeks after the treatment modified Ashworth scale (MAS), Fugl-Meyer upper extremity motor evaluation scale (FMA) and action-researcharm-test (ARAT) and motor activity log-28 scale (MAL-28) were applied. SSPS-22.0 program wasused for statistical evaluation and p <0.05 was considered as the level of statistical significanceResults: There was no difference in MAS scores before and after treatment in the groups (p>0.05).There was a statistically significant improvement in both PTR (p<0.05) and PTR-PT groups (p<0.001)for the FMA, ARAT and MAL-28. scale scores. Although the results obtained in the PTR, and PTgroups were more improved, there was a significant result in favor of PTR-PT only regarding theMAL-28 scale scores (p<0.05). It was determined that adding proprioception-based exercises hadthe greatest effect on FMA, ARAT and MAL-28 in the evaluation of the effect size (>0.3).Conclusion: It was observed that upper extremity proprioceptive training yielded better results inpatients with chronic hemiplegia developed after stroke than conventional therapy in increasingthe frequency and quality of movement in upper extremity. This result shows that proprioceptivetraining programs should be added to stroke rehabilitation methods
Anahtar Kelime: Kronik İnme Hastalarında Üst Ekstremite Proprioseptif Eğitimin Fonksiyonel Sonuçlara Etkisi Var mıdır?
Öz: Amaç: İnme sonrası, kronik hemipleji olan hastalarda üst ekstremite proprioseptif eğitimin spastisite, fonksiyonel motor beceriler ve günlük yaşam aktivitesi üzerine etkisini araştırmak amaçlanmıştır. Yöntem: Araştırma Merkezine inme sonrası, kronik hemipleji tanısı ile başvuran 30 kronik hemiplejik birey (17 kadın, 66.47±12,55 yaş) çalışmaya dahil edildi. Hastalar iki guba ayrıldı. Birinci gruba haftada 5 gün konvansiyonel fizyoterapi programı (FTR), ikinci gruba ise bu programa ek olarak haftada 5 gün proprioseptif eğitim programı (PE) eklenmiştir. Hastaların tedavi öncesi ve 6 hafta sonrasında; modifiye ashworth ölçeği (MAÖ), Fugl-Meyer Üst Ekstremite Motor Değerlendirme Ölçeği (FÜM), Action-Research-Arm-Testi (ARAT), Motor Aktivite Günlüğü-28 Ölçeği (MAG-28) uygulandı. İstatiksel olarak SSPS-22,0 programı kulanıldı ve p<0,05 anlamlı kabul edildi. Bulgular: Hastaların grup içinde tedavi öncesi ve sonrası değerlerinde MAÖ üzerine bir fark görülmezken (p>0,05), FÜM, ARAT ve MAG-28 ölçeklerinde istatiksel olarak hem FTR (p<0,05) hem de FTR-PE grubunda (p<0,001) iyileşme yönünde anlamlılık vardı. Gruplar arasında FTR ve PE grubunun sonuçları; FTR grubuna göre daha iyi çıkmasına rağmen, sadece MAG-28 ölçeğinde FTR ve PE lehine anlamlı sonuç vardı (p<0,05). Etki büyüklüğünün değerlendirilmesinde, propriyosepsiyonu temel alan egzersizlerin tedaviye eklenmesinin FMA, ARAT ve MAL-28 üzerinde en büyük etkiye sahip olduğu belirlenmiştir (> 0.3). Sonuç: İnme sonrası, kronik hemipleji olan hastalarda üst ekstremite proprioseptif eğitiminin üst ekstremitede hareket sıklığı ve kalitesini artırmada konvansiyonel tedaviye göre daha iyi sonuç gösterdiği görülmüştür. Bu sonuç inme rehabilitasyon yöntemlerine proprioseptif eğitim programlarının da eklenmesi gerektirdiğini bize göstermektedir
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
- 1. Yavuzer G, Atay MB, Bussmann JB, et al. Mirror therapy improves hand function in subacute stroke: a randomized controlled trial. Arch Phys Med Rehabil. 2008;89:393-8. [CrossRef]
- 2. Bonita R. Epidemiology of Stroke. Lancet. 1992;239:342-4. [CrossRef]
- 3. Roth EJ, Heinemann AW, Lovell LL, Harvey RL, Mcguire JR, Diaz S. Impairment and disability: their relation during stroke rehabilitation. Arch Phys Med Rehabil. 1998;79:329-35. [CrossRef]
- 4. Urton ML, Kohia M, Davis J, Neill MR. Systematic literature review of treatment interventions for upper extremity hemiparesis following stroke. Occup Ther Int. 2007;14:11-27. [CrossRef]
- 5. Dalyan AM, Cakcı A. İnme Rehabilitasyonu. In: Oguz H, Dursun E, Dursun N, editors. Tıbbi Rehabilitasyon. 2rd ed. İstanbul: Nobel Tıp Kitabevleri; 2004. p. 589-619.
- 6. Ward NS, Cohen LG. Mechanisms underlying recovery of motor function after stroke. Arch Neurol. 2004;61:1844-8. [CrossRef]
- 7. Dimyan MA, Cohen LG. Neuroplasticity in the context of motor rehabilitation after stroke. Nat Rev Neurol. 2011;7:76-85. [CrossRef]
- 8. Otman S, Aksu S, Aras Ö, Karaduman A, Kerem M, Köse N, Meriç A, Livanelioğlu A, Hemipleji Rehabilitasyonunda Nörofizyolojik Yaklaşımlar. 1rd ed. Ankara: Hipokrat Kitapevi; 2001.
- 9. Hsieh YW, Chang WH, Chen CC, et al. Predicting clinically significant changes in motor and functional outcomes after robot- assisted stroke rehabilitation. Arch Phys Med Rehabil. 2014;95(2):316-21. [CrossRef]
- 10. Rand D. Proprioception deficits in chronic stroke upper extremity function and daily living. PLoS ONE. 2018;13(3):e0195043. [CrossRef]
- 11. Kiper P, Agostini M, Baba A, Turolla A, Proprioceptive Based Training for stroke recovery. Proposal of new treatment modality for rehabilitation of upper limb in neurological diseases. Arch Phy Ther. 2015;5(1):6. [CrossRef]
- 12. Stern PH, McDowell F, Miller SM, Robinson M. Factors influencing stroke rehabilitation. Stroke. 1971;3:213-8. [CrossRef]
- 13. Wade DT, Wood VA, Langton-Hewer R. Recovery after stroke. J Neurol Neurosurg Psychiatry. 1985;48(1):7-13. [CrossRef]
- 14. Smith DL, Akhtar AJ, Garraway WM. Proprioception and spatial neglect after stroke. Age Ageing. 1983;12(1):63-9. [CrossRef]
- 15. Gottlieb D, Kipnis M, Sister E, Medvedev V, Brill S, Vardi Y. Classification of stroke rehabilitation patients with a simple impairment scale. Neurorehabil Neural Repair. 1997;11(4):239-43. [CrossRef]
- 16. Wade DT, Langton-Hewer R, Wood VA, Skilbeck CE, Ismail HM. The hemiplegic arm after stroke: Measurement and recovery. J Neurol Neurosurg Psychiatry. 1983;46:521-4. [CrossRef]
- 17. Chalsen GG, Fitzpatrick KA, Navia RA, Bean SA, Reding MJ. Prevalence of shoulder-hand syndrome in an inpatient stroke rehabilitation population: A quantitative cross-sectional study. J Neurol Rehabil. 1987;1:137-41. [CrossRef]
- 18. Rand D, Weiss PL, Gottlieb D. Does proprioceptive loss influence recovery of the upper extremity after stroke? Neurorehabil Neural Repair. 1999; 3:15-2. [CrossRef]
- 19. Rand D, Gottlieb D, Patrice L. Weiss T. Recovery of Patients with a Combined Motor and Proprioception Deficit During the First Six Weeks of Post Stroke Rehabilitation. Phys Occup Ther Geriatr. 2001;18(3):69-87. [CrossRef]
- 20. Stone JA, Partın NB, Lueken JS, Tımm KE, Ryan EJ. Upper Extremity Proprioceptive Training. J Athl Training. 1994;29:1.
- 21. Bohannon RW, Smith MB. Interrater Reliability of a Modified Ashworth Scale of Muscle Spasticity. Ardsley, NY: Geigy Pharmaceuticals, Div of CIBA-GEIGY Corp; 1987.
- 22. Sullıvan KJ, Cen S, Correa A, Duncan PW, Gallıchıo J, Hershberg J, et al. Fugl-Meyer Assessment of Sensorimotor Function After Stroke. Stroke. 2011;42:427-32. [CrossRef]
- 23. Lyle RC, A performance test for assessment of upper limb function in physical rehabilitation treatment and research. Int J Rehab Research. 1981;4(4):483-92. [CrossRef]
- 24. Ersöz Hüseyinsinoğlu B, Razak Özdinçler A, Oğul E, Krespi Y. Reliability And Validity Of Turkish Version Of Motor Activity Log-28. Turk J Neurol. 2011;17(2):83-9.
- 25. Cohen J. Statistical power analysis for the behavioural sciences. New York: Academic Press; 1977.
- 26. Hsieh YW, Chang WH, Chen CC, Chen JL, Lin KC, Lien HY. Predicting clinically significant changes in motor and functional outcomes after robot-assisted stroke rehabilitation. Arch Phys Med Rehabil. 2014;95(2):316-21. [CrossRef]
- 27. Coupar F, Pollock A, van Wijck F, Morris J, Langhorne P. Simultaneous bilateral training for improving arm function after stroke. Cochrane Database Syst Rev. 2010;14(4):CD006432. [CrossRef]
- 28. Whitall J, Waller SM, Silver KH, Macko RF. Repetitive bilateral arm training with rhythmic auditory cueing improves motor function in chronic hemiparetic stroke. stroke. 2000;31(10):2390-5. [CrossRef]
- 29. Wu CY, Yang CL, Chen MD, Lin KC, Wu LL. Unilateral versus bilateral robot assisted rehabilitation on arm-trunk control and functions post stroke: a randomized controlled trial. J Neuroeng Rehabil. 2013;10(1):35. [CrossRef]
- 30. Cho S, Ku J, Cho JC, et. al. Development of virtual reality proprioceptive rehabilitation system for stroke patients. Comput Methods Programs Biomed. 2014;113(1):258- 65. [CrossRef]
| APA | Öcal N, Alaca N, canbora m (2020). Does Upper Extremity Proprioceptive Training Have an Impact on Functional Outcomes in Chronic Stroke Patients?. , 91 - 98. 10.5222/MMJ.2020.48752 |
| Chicago | Öcal Numan Melik,Alaca Nuray,canbora mehmet kerem Does Upper Extremity Proprioceptive Training Have an Impact on Functional Outcomes in Chronic Stroke Patients?. (2020): 91 - 98. 10.5222/MMJ.2020.48752 |
| MLA | Öcal Numan Melik,Alaca Nuray,canbora mehmet kerem Does Upper Extremity Proprioceptive Training Have an Impact on Functional Outcomes in Chronic Stroke Patients?. , 2020, ss.91 - 98. 10.5222/MMJ.2020.48752 |
| AMA | Öcal N,Alaca N,canbora m Does Upper Extremity Proprioceptive Training Have an Impact on Functional Outcomes in Chronic Stroke Patients?. . 2020; 91 - 98. 10.5222/MMJ.2020.48752 |
| Vancouver | Öcal N,Alaca N,canbora m Does Upper Extremity Proprioceptive Training Have an Impact on Functional Outcomes in Chronic Stroke Patients?. . 2020; 91 - 98. 10.5222/MMJ.2020.48752 |
| IEEE | Öcal N,Alaca N,canbora m "Does Upper Extremity Proprioceptive Training Have an Impact on Functional Outcomes in Chronic Stroke Patients?." , ss.91 - 98, 2020. 10.5222/MMJ.2020.48752 |
| ISNAD | Öcal, Numan Melik vd. "Does Upper Extremity Proprioceptive Training Have an Impact on Functional Outcomes in Chronic Stroke Patients?". (2020), 91-98. https://doi.org/10.5222/MMJ.2020.48752 |
| APA | Öcal N, Alaca N, canbora m (2020). Does Upper Extremity Proprioceptive Training Have an Impact on Functional Outcomes in Chronic Stroke Patients?. Medeniyet Medical Journal, 35(2), 91 - 98. 10.5222/MMJ.2020.48752 |
| Chicago | Öcal Numan Melik,Alaca Nuray,canbora mehmet kerem Does Upper Extremity Proprioceptive Training Have an Impact on Functional Outcomes in Chronic Stroke Patients?. Medeniyet Medical Journal 35, no.2 (2020): 91 - 98. 10.5222/MMJ.2020.48752 |
| MLA | Öcal Numan Melik,Alaca Nuray,canbora mehmet kerem Does Upper Extremity Proprioceptive Training Have an Impact on Functional Outcomes in Chronic Stroke Patients?. Medeniyet Medical Journal, vol.35, no.2, 2020, ss.91 - 98. 10.5222/MMJ.2020.48752 |
| AMA | Öcal N,Alaca N,canbora m Does Upper Extremity Proprioceptive Training Have an Impact on Functional Outcomes in Chronic Stroke Patients?. Medeniyet Medical Journal. 2020; 35(2): 91 - 98. 10.5222/MMJ.2020.48752 |
| Vancouver | Öcal N,Alaca N,canbora m Does Upper Extremity Proprioceptive Training Have an Impact on Functional Outcomes in Chronic Stroke Patients?. Medeniyet Medical Journal. 2020; 35(2): 91 - 98. 10.5222/MMJ.2020.48752 |
| IEEE | Öcal N,Alaca N,canbora m "Does Upper Extremity Proprioceptive Training Have an Impact on Functional Outcomes in Chronic Stroke Patients?." Medeniyet Medical Journal, 35, ss.91 - 98, 2020. 10.5222/MMJ.2020.48752 |
| ISNAD | Öcal, Numan Melik vd. "Does Upper Extremity Proprioceptive Training Have an Impact on Functional Outcomes in Chronic Stroke Patients?". Medeniyet Medical Journal 35/2 (2020), 91-98. https://doi.org/10.5222/MMJ.2020.48752 |
