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http://dx.doi.org/10.13066/kspm.2019.14.4.63

Effects of Cross Training with Bilateral Ankle Dorsiflexor Strengthening Exercise on the Muscle Activity of the Paralytic Tibialis Anterior, Balancing Ability, and Gait Function in Patients with Chronic Stroke: A Preliminary Randomized, Controlled Study  

Park, Sung-Chan (Department of Physical Therapy, Daejeon Rehabilitation Hospital)
Ryu, Jun-Nam (Department of Physical Therapy, Yeoju University)
Park, Jae-Man (Department of Physical Therapy, Daejeon Rehabilitation Hospital)
Seo, Byoung-Do (Department of Physical Therapy, Kyungwoon University)
Ryu, In-Tae (Department of Physical Therapy, Daejeon Rehabilitation Hospital)
Cha, Yong-Jun (Department of Physical Therapy, College of Health and Medical Science, Dajeon University)
Publication Information
Journal of the Korean Society of Physical Medicine / v.14, no.4, 2019 , pp. 63-70 More about this Journal
Abstract
PURPOSE: This study examined the effects of bilateral ankle dorsiflexors-strengthening exercise on the paralytic tibialis anterior activity, balance ability, and gait function of patients with chronic stroke. METHODS: Nineteen patients with chronic stroke were assigned randomly to the experimental and control groups. All participants received general physical therapy for 60-minutes per session, five times a week, for 6 weeks. In addition, the experimental group (n = 9) performed bilateral ankle dorsiflexion muscle-strengthening training three times a week, 30 minutes per session, for six weeks. The control group (n=10) performed the paraplegic ankle dorsiflexion muscle- strengthening training in the same manner. Before and after the intervention, the paralytic tibialis anterior muscle activity, timed up and go test (TUG), and 10m walking test (10 MWT) were performed. RESULTS: Both groups showed significant improvement in the post-intervention muscle activity of the paralytic tibialis anterior, TUG, and 10MWT compared to that before the intervention (p<.05), but the differences between the two groups were not significant (p >.05). CONCLUSION: Bilateral ankle dorsiflexors strengthening exercise is an effective cross-training method to improve the muscle activity of the paraplegic tibialis anterior, balance ability, and walking function in chronic stroke patients.
Keywords
Ankle dorsiflexor; Cross-education; Electromyography; Stroke;
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1 Sprigg N, Selby J, Fox L, et al. Very low quality of life after acute stroke: data from the efficacy of nitric oxide in stroke trial. Stroke. 2013;44(12):3458-62.   DOI
2 Kim DG, Choi YR, Cha YJ. Comparison of exercise intensity of strengthening exercise program for stroke patients with type II diabetes melitus. J Korean Soc Phys Med. 2018;13(4):105-12.   DOI
3 Park JH, Lee SG. Effect of bilateral arm movement on brain and muscle activity in chronic stroke patients. J Korean Soc Phys Med. 2018;13(1):1-9.   DOI
4 Dorsch S, Ada L, Canning CG. Lower Limb Strength Is Significantly Impaired in All Muscle Groups in Ambulatory People With Chronic Stroke: A Cross-Sectional Study. Arch Phys Med Rehabil. 2016;97(4):522-7.   DOI
5 Dorsch S, Ada L, Canning CG, et al. The strength of the ankle dorsiflexors has a significant contribution to walking speed in people who can walk independently after stroke: an observational study. Arch Phys Med Rehabil. 2012;93(6):1072-6.   DOI
6 Dragert K, Zehr EP. High-intensity unilateral dorsiflexor resistance training results in bilateral neuromuscular plasticity after stroke. Exp Brain Res. 2013;225(1):93-104.   DOI
7 Moreland JD, Goldsmith CH, Huijbregts MP, et al. Progressive resistance strengthening exercises after stroke: a single-blind randomized controlled trial. Arch Phys Med Rehabil. 2003;84(10):1433-40.   DOI
8 Song GB. Effects of indirect cross training on strengthening, balance, gait and depression in patients with stroke. Doctor's Degree. Daegu. 2015.
9 Stromberg BV. Contralateral therapy in upper extremity rehabilitation. Am J Phys Med. 1986;65(3):135-43.
10 Yasuda Y, Miyamura M. Cross transfer effects of muscular training on blood flow in the ipsilateral and contralateral forearms. Eur J Appl Physiol Occup Physiol. 1983; 51(3):321-9.   DOI
11 Hortobagyi T, Scott K, Lambert J, et al. Cross-education of muscle strength is greater with stimulated than voluntary contractions. Motor Control. 1999;3(2):205-19.   DOI
12 Zhou S. Chronic neural adaptations to unilateral exercise: mechanisms of cross education. Exerc Sport Sci Rev. 2000;28(4):177-84.
13 Lee M, Carroll TJ. Cross education: possible mechanisms for the contralateral effects of unilateral resistance training. Sports Med. 2007;37(1):1-14.   DOI
14 Sun Y, Ledwell NMH, Boyd LA, et al. Unilateral wrist extension training after stroke improves strength and neural plasticity in both arms. Exp Brain Res. 2018;236(7):2009-21.   DOI
15 Kim CY, Lee JS, Kim HD, et al. The effect of progressive task-oriented training on a supplementary tilt table on lower extremity muscle strength and gait recovery in patients with hemiplegic stroke. Gait Posture. 2015;41(2):425-30.   DOI
16 Tyson SF, Hanley M, Chillala J, et al. Balance disability after stroke. Phys Ther. 2006;86(1):30-8.   DOI
17 Ramas J, Courbon A, Roche F, et al. Effect of training programs and exercise in adult stroke patients: literature review. Ann Readapt Med Phys. 2007;50(6):438-44, 0-7.   DOI
18 Kisner C, Colby LA. Therapeutic exercise: foundations and techniques Philadelphia. F. A. Davis Company. 2013.
19 Feigin VL, Krishnamurthi RV, Parmar P, et al. Update on the Global Burden of Ischemic and Hemorrhagic Stroke in 1990-2013: The GBD 2013 Study. Neuroepidemiology. 2015;45(3):161-76.   DOI
20 Hendrickson J, Patterson KK, Inness EL, et al. Relationship between asymmetry of quiet standing balance control and walking post-stroke. Gait Posture. 2014;39(1):177-81.   DOI
21 Bird SP, Tarpenning KM, Marino FE. Designing resistance training programmes to enhance muscular fitness: a review of the acute programme variables. Sports Med. 2005;35(10):841-51.   DOI
22 Kendall FP, McCreary EK, Provance PG. Muscles testing and function, with posture and pain. Baltimore. Lippincott Williams & Wilkins. 2005.
23 Criswell E. Cram's introduction to surface electromyography. Sudbury. :Jones & Bartlett Publishers. 2010.
24 Lehman GJ, McGill SM. The importance of normalization in the interpretation of surface electromyography: a proof of principle. J Manipulative Physiol Ther. 1999;22(7):444-6.   DOI
25 Ng SS, Hui-Chan CW. Ankle dorsiflexor, not plantarflexor strength, predicts the functional mobility of people with spastic hemiplegia. J Rehabil Med. 2013;45(6):541-5.   DOI
26 Ng SS, Hui-Chan CW. The timed up & go test: its reliability and association with lower-limb impairments and locomotor capacities in people with chronic stroke. Arch Phys Med Rehabil. 2005;86(8):1641-7.   DOI
27 Geroin C, Picelli A, Munari D, et al. Combined transcranial direct current stimulation and robot-assisted gait training in patients with chronic stroke: a preliminary comparison. Clin Rehabil. 2011;25(6):537-48.   DOI
28 Mehrholz J, Wagner K, Rutte K, et al. Predictive validity and responsiveness of the functional ambulation category in hemiparetic patients after stroke. Arch Phys Med Rehabil. 2007;88(10):1314-9.   DOI
29 Mentiplay BF, Adair B, Bower KJ, et al. Associations between lower limb strength and gait velocity following stroke: a systematic review. Brain Inj. 2015;29(4):409-22.   DOI
30 Moon SH, Kim YM. Effects of close kinetic chain resistant exercise of lower extremity on the gait with stroke. J Korean Soc Phys Med. 2014;9(4):475-83.   DOI
31 Jeon HJ, Hwang BY. Effect of bilateral lower limb strengthening exercise on balance and walking in hemiparetic patients after stroke: a randomized controlled trial. J Phys Ther Sci. 2018;30(2):277-81.   DOI
32 Sousa AS, Silva A, Santos R. Ankle anticipatory postural adjustments during gait initiation in healthy and post-stroke subjects. Clin Biomech (Bristol, Avon). 2015;30(9):960-5.   DOI