Journal of the Korean Society of Physical Medicine (대한물리의학회지)

The Korean Society of Physical Medicine (대한물리의학회)
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Effects of Combined Functional Electrical Stimulation and Joint Mobilization on Muscle Activation and Mobility of Ankle Joints and Modified Functional Reach Test in Stroke Patient

  • Kim, Su-Jin (Department of Physical Therapy, Graduate School of Health Sciences, Catholic University of Pusan) ;
  • Son, Ho-Hee (Department of Physical Therapy, College of Health Sciences, Catholic University of Pusan)
  • Received : 2019.02.20
  • Accepted : 2019.03.18
  • Published : 2019.05.31
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Abstract

PURPOSE: This study was conducted to investigate the effects of combined Joint Mobilization and Functional Electrical Stimulation on Muscle Activation and Mobility of ankle joints in stroke patients and their Modified Functional Reach Test (MFRT) results. METHODS: A total of 26 patients with stroke were randomly selected for enrollment in this study. (1) Functional Electrical Stimulation (FES) (2) combined Joint Mobilization and FES. An EMG system was used to measure tibialis anterior and gastrocnemius activities. Range Of Motion (ROM) of Ankle Joint and MFRT for Dynamic Balance. Pre and post intervention results were compared by paired-t-tests and differences in changes after intervention between groups were identified by the independent t-test. RESULTS: The muscle activation, ROM, and MFRT differed significantly in the experimental group (p<.05). The ROM was significantly different for the active dorsiflexion pre and post intervention in the group that received FES alone (p<.05). CONCLUSION: The results of this study suggest use of a systematic program of proactive posture control to prevent dysfunction when planning interventions for ankle joints can help stroke patients walk efficiently.

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References

  1. Burridge JH, Wood DE, Taylor PN, et al. Indices to describe different muscle activation patterns, identified during treadmill walking, in people with spastic drop-foot. Med Eng Phys. 2001;23(6):427-34. https://doi.org/10.1016/S1350-4533(01)00061-3
  2. Harlaar J, Becher JG, Snijders CJ, et al. Passive stiffness characteristics of ankle plantar flexors in hemiplegia. Clin Biomech. 2000;15(4):261-70. https://doi.org/10.1016/S0268-0033(99)00069-8
  3. Baker LL, Yeh C, Wilson D et al. Electrical stimulation of wrist and fingers for hemiplegic patients. Phys Ther. 1979;59(12):1495-9. https://doi.org/10.1093/ptj/59.12.1495
  4. Morone G, Fusco A, Capua PD, et al. Walking Training with Foot Drop Stimulator Controlled by a Tilt Sensor to Improve Walking Outcomes: A Randomized Controlled Pilot Study in Patients with Stroke in Subacute Phase. Stroke Res Treat. 2012;(2012):523-64.
  5. Tiebin Yan, CWY Hui-Chan, LSW Li. Functional Electrical Stimulation Improves Motor Recovery of the Lower Extremity and Walking Ability of Subjects With First Acute Stroke. Stroke. 2005;36:80-5. https://doi.org/10.1161/01.STR.0000149623.24906.63
  6. Sabut SK, Sikdar C, Kumar R, et al. Functional electrical stimulation of dorsiflexor muscle: Effects on dorsiflexor strength, plantarflexor spasticity, and motor recovery in stroke patients. NeuroRehabilitation. 2011;29(4):393-400. https://doi.org/10.3233/NRE-2011-0717
  7. Sabut SK, Bhattacharya SD, Manjunatha M. Functional electrical stimulation on improving foot drop gait in poststroke rehabilitation: a review of its technology and clinical efficacy. Crit Rev Biomed Eng. 2013;41(2):149-60. https://doi.org/10.1615/CritRevBiomedEng.2013007621
  8. An CM, Won JI. Effects of Ankle Joint Mobilization with Movement on Lower Extremity Muscle Strength and Spatiotemporal Gait Parameters in Chronic Hemiplegic Patients. Phys Ther Korea. 2012;19(3):20-9. https://doi.org/10.12674/ptk.2012.19.3.020
  9. An CM, Won JI. Effects of ankle joint mobilization with movement and weight-bearing exercise on knee strength, ankle range of motion, and gait velocity in patients with stroke: a pilot study. J Phys Ther Sci. 2016;28(2):689-94. https://doi.org/10.1589/jpts.28.689
  10. Lee J, Kim JO, Lee BH .The effects of posterior talar glide with dorsiflexion of the ankle on mobility, muscle strength and balance in stroke patients: a randomised controlled trial. J Phys Ther Sci. 2017;29(3):452-56. https://doi.org/10.1589/jpts.29.452
  11. Kim K, Lee S, Kim D, et al. The effects of ankle joint muscle strengthening and proprioceptive exercise programs accompanied by functional electrical stimulation on stroke patients' balance. J Phys Ther Sci. 2015;27(9):2971-5. https://doi.org/10.1589/jpts.27.2971
  12. Runge CF, Shupert CL, Horak FB, et al. Ankle and hip postural strategies defined by joint torques. Gait & Posture. 1999;10(2):161-70. https://doi.org/10.1016/S0966-6362(99)00032-6
  13. Park KH. The Effect of Ankle Strategy Exercises on Balance of Patients with Hemiplegia. Master's Degree Daegu University. 2013.
  14. Jeon SN. Impact of Ankle Strategy Exercise on Balancing Ability of Patients with Stroke According to the Existence of Visual Feedback. Master's Degree Namseoul University. 2015.
  15. Mun BM. Effect of Strengthening Exercise with Lower Extremity and Functional Electrical Stimulation on Gait, Balance and Spasticity in Chronic Stroke Patients. Doctor's Degree Daegu University. 2014.
  16. Kang YH, Toon SE, Seo SK, et al. The Effect on Change of Spinal Neuron Excitability during Gait Training of Hemiplegia Patients by the Functional Electrical Stimulation. J Phys Ther Sci. 2007;19(1):11-22.
  17. Jung TW. The Effects of Functional Electrical Stimulation with Progressive Resistance Exercise on Dorsiflexors of Hemiparesis Side for The Patients with Stroke. Master's Degree DanKook University. 2013.
  18. Stewart C, Postans N, Schwartz MH, et al. An exploration of the function of the triceps surae during normal gait using functional electrical stimulation. Gait & Posture. 2007;26(4):482-8. https://doi.org/10.1016/j.gaitpost.2006.12.001
  19. Kaltenborn. Manual Mobilization of the Joints (7th ed). Yeongmun Publisher. Orthopedic Physical Therapy Products. 2011.
  20. Cho MS. The Effect on Ankle Joint Movement by FES Application on Tibialis Anterior Muscle in Chronic Stroke Patients. J Kor Soc Med. 2011;6(3):277-86.
  21. Nam SM. The Effects on Muscle Activation and Reaction Time of The Balance Trainer Controlled Knee-joint Mobility in Functional Ankle Instability Adult Males. Master's Degree Daegu University. 2015.
  22. Moon GS. The kinematic analysis of the ankle joint and EMG analysis of the Lower Limbs muscle for the different walking speed. Sports Biomech. 2005;15(1):177-95.
  23. Park MC, Lee SY. Deltoid Middle Fiber of the Isometric Contraction According to Elastic Band and Dumbbell on Various Shoulder Abduction Angle. J Korean Soc Phys Med 2016;11(2):71-6. https://doi.org/10.13066/kspm.2016.11.2.71
  24. Dean CM, Shepherd R. Task-related training improves performance of seated reaching tasks after stroke: a randomized controlled trial. Stroke. 1997;28(4):722-8. https://doi.org/10.1161/01.STR.28.4.722
  25. Bock C, Gentile AM, Kaminski TR. The coordination between trunk and arm motion during pointing movements. Exp Brain Res. 1995;106(3):457-66.
  26. Mastalerz A, Palczewska IW. The influence of trunk inclination on muscle activity during sitting on forward inclined seats. Acta Bioeng Biomech. 2010;12(4):19-24.
  27. Rapport, LJ, Websster JS, Flemming KL, et al. Predictors of fall among right-hemisphere stroke patients in the rehabilitation setting. Arch Phys Med Rehabil. 1993;74(6):621-6. https://doi.org/10.1016/0003-9993(93)90160-C
  28. Mackintosh SF, Hill KD, Dodd KJ, et al. Balance score and a history of falls in hospital predict recurrent falls in the 6 months following stroke rehabilitation. Arch Phys Med Rehabil. 2006;87(12):1583-9. https://doi.org/10.1016/j.apmr.2006.09.004
  29. Lee HS, Choi JH. Correlation between BBS, FRT, STI, TUG, MBI, and falling in stroke patients. The Journal of Korean Society of Physical Therapy. 2008;20(4):1-6.
  30. Lynch SM, Leahy P, Barker SP. Reliability of measurements obtained with a modified functional reach test in subjects with spinal cord injury. Phys Ther. 1998;78(2):128-33. https://doi.org/10.1093/ptj/78.2.128
  31. Katz-Leurer M, Rotem H, Keren O, et al. Balance abilities and gait characteristics in post-traumatic brain injury, cerebral palsy and typically developed children. Dev Neurorehabil. 2009;12(2):100-5. https://doi.org/10.1080/17518420902800928
  32. Duncan PW, Weiner DK, Chandler J, et al. Functional reach: a new clinical measure of balance. J Gerontol. 1990;45(6):192-7.
  33. Carr JH, Shepherd RB, Nordholm L, et al. Investigation of a new motor assessment scale for stroke patient. Phys Ther. 1985;65(2):175-80. https://doi.org/10.1093/ptj/65.2.175
  34. Welmer AK, Holmqvist LW, Disa K, et al. Hemiplegic limb synergies in stroke patients. Am J Phys Med Rehabil. 2006;85(2):112-9. https://doi.org/10.1097/01.phm.0000197587.78140.17
  35. Hur YG. The Effects on Spasticity, Range of Motion, Balance on Combining Active-Stretching Exercise of Plantarflexor on Ankle with FES in The Patients with Stroke. Master's Degree Yongin University. 2013.
  36. Jin HK, Cho SH. The Effect of Electrical Stimulation Level on Autonomic Nerve System in Normal Adults. Journal of the Korea Academia-Industrial cooperation Society. 2015;16(3):2029-37. https://doi.org/10.5762/KAIS.2015.16.3.2029
  37. Sheffler LR, Chae J. Neuromuscular electrical stimulation in neurorehabilitation. Muscle Nerve. 2007;35(5):562-90. https://doi.org/10.1002/mus.20758
  38. Kim SL. The Effects of Weight Bearing based Mobilization with Movement on Balance and Gait in Stroke Patients. Master's Degree SahmYook University. 2015.
  39. Bower KJ, McGinley JL, Miller KJ, et al. Instrumented Static and Dynamic Balance Assessment after Stroke Using Wii Balance Boards: Reliability and Association with Clinical Tests. PLoS One. 2014;9(12):115-282.
  40. Jeong SB. The Effects of Lower Extremity Muscle Strength Exercise of 8 Weeks on the Balance and Gait in Stroke Patients. Master's Degree Yongin University. 2013.
  41. Winter DA, Paltla AE, Prince F. Stiffness control of balance in quiet standing. J Neurophysiol. 1998;80(3):1121-211.
  42. Almeida GL, Carvalho RL, Talis VL. Postural strategy to keep balance on the seesaw. Gait & posture. 2006;23(1):17-21. https://doi.org/10.1016/j.gaitpost.2004.11.020