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The Effect of Upper Extremity Training with a Focus on Functional Reaching, on Trunk Control and ADL Performance in Post-Stroke Hemiplegic Patients  

Song, Bo-Kyung (Department of Occupational Therapy, Bobath Memorial Hospital)
Publication Information
The Journal of Korean Physical Therapy / v.23, no.3, 2011 , pp. 71-77 More about this Journal
Abstract
Purpose: In this study, we tried to determine the effect of upper extremity training such as functional reaching on improved trunk control and ADL performance in post-stroke hemiplegic patients. Methods: We randomly selected 11 stroke patients in the hospital, who had a problem with the upper extremity, trunk and ADL performance. The patients were divided into the conservative training group and the functional reaching training group. We applied general occupational therapy only in the conservative training group whereas we applied upper extremity training with a focus on functional reaching in the functional reaching training group. To compare the two groups we used several assessment tools such as Modified Barthel Index (MBI), total Trunk Impairment Scale (TIS), static TIS, dynamic TIS and coordinative TIS. Results: The results obtained were as follows: (1) In the functional reaching training group, there was a statistically significant difference in the total TIS score, dynamic TIS score, and MBI. (2) We compared the results obtained before training with the changes in the results obtained after training and found that there was a relation between the assessment outcomes. Especially, static TIS score showed a relation in both groups. Conclusion: Functional reaching training influenced both the trunk control and ADL performance. Especially, the functional reaching training group demonstrated better static trunk control ability than the conservative treatment group.
Keywords
Stroke; Functional reaching; Trunk control; Anticipatory Postural Adjustments; ADL performance;
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Times Cited By KSCI : 4  (Citation Analysis)
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1 Dickstein F, Marcovitz SS, Villa EY. Anticipatory postural adjustment in selected trunk muscles in poststroke hemiparetic patients. Arch Phys Med Rehabil. 2004;85(1):261-267.
2 An SH, Lee SM. Trunk control after stroke and the relationship with balance, activity daily living; PASS, TCT, BBS, FM-B, MBI. The Journal of Korean Society of Occupational Therapy. 2008;16 (4):31-43.
3 Verheyden G, Nieuwber A, Fey H et al. Discriminant ability of the Trunk Impairment Scale: A comparison between stroke patient and health individuals. Disabil Rehabil. 2005;27(17):1023-1028.   DOI   ScienceOn
4 Shah S, Vanclay F, Cooper B. Improving the sensitivity of the Barthel Index of stroke rehabilitation. Clinical epidermiology. 1989;42(8):703-709.   DOI   ScienceOn
5 Smith A. Beware of the Barthel, Physiotherapy. 1993;79:12-13.   DOI
6 Yoo EY, Chun SI, Oh HC et al. the cognitive perceptual performance in relation to activities of daily living in stroke patients. The Journal of Korean Society of Occupational Therapy. 1997;5(1):8-19.
7 Eggers O. Occupational therapy in the treatment of adult hemiplegia. Maryland, William Heinemann, 1984;10-35.
8 Nichols DS. Balance retraining after stroke using force platform biofeedback. Physical Therapy. 1997;77(1):553-558.   DOI
9 Hsieh CL, Sheu CF, Hsueh JP et al. Trunk control as an early predictor of comprehensive activities of daily living function in stroke patients. Stroke. 2002;33(11):2626-2630.   DOI   ScienceOn
10 TG, Zelenin PV, Beloozerova IN et al. Nervous mechanisms controlling body posture. Physiology & Behavior. 2007;92(2):148-154.
11 Jorgensen HS, Nakayama H, Raaschou HO et al. Outcome and time course of recovery in stroke. Part II: time course of recovery. The openhagen Stroke Study. Arch Phys Med Rehabil. 1995;76(5):406-412.   DOI   ScienceOn
12 Seo DK, Oh DW, Lee SH. Effectiveness of Ankle Visuoperceptual‐ Feedback Training on Balance and Gait Functions in Hemiparetic Patients. J Kor Soc Phys Ther 2010;22(4):35-41.
13 Lee DJ, Kim SY, Song CH. The Correlations between the Balance Test, functional movement, Visual Perception Test and Functional Independent Measure in Stroke Patients. J Kor Soc Phys Ther 2009;21(1):39-45.
14 Gilen G. upper extremity function and management. In: Gilen G, Burkhardt A. Stroke rehabilitation: A functional-based approach. 3rd eds, St. Louis, Mosby. 2010;218-275.
15 Wagner JM, Dromerick AW, Sahrmann SA et al. Upper extremity muscle activation during recovery of reaching in subjects with post-stroke hemiparesis, Neurophysiol Clin. 2007; 118(1):164-176.   DOI   ScienceOn
16 Kamper DG, Rymer WZ. Impairment of voluntary control of finger motion following stroke: Role of inappropriate muscle coactivation. Muscle & Nerve. 2001;24(5):673-681.   DOI   ScienceOn
17 Lang CE, Schieber MH. Differential impairment of individual finger movements in humans after damage to the motor cortex or the corticospinal tract. J Neurophysiol. 2003;90(2):1160-1170.   DOI   ScienceOn
18 You YY, Ann CS. The Effects of Symmetrical Scapular Alignment on Weight Bearing of Hemiplegic Patients During Standing Position. J Kor Soc Phys Ther 2009;21(2):23-29.   DOI
19 Dettmann MA, Linder MT, Sepic SB. Relationship among walking performance, postural stability, and functional assessment of the hemiplegic patient. Arch Phys Med Rehabil. 1987;6(2):77-90.
20 Bennis N, Roby-Brami A, Dufosse M et al. Anticipatory responses to self applied load in normal subjects and hemiparetic patients. J Physiol. 1996;90(1):27-42.
21 Shepherd RB. Adaptive motor behaviour in response to perturbations balance. Physiotherapy Theory and Practice. 1992;8(3):137-143.   DOI
22 Franchignoni FP, Tesio L, Ricupero C. Trunk control test as an early predictor of stroke rehabilitation outcome. Stroke. 1997;28(7):1382-1385.   DOI   ScienceOn
23 Neumann DA. Shoulder complex. In: Neumann, DA, Kinesiology of the musculoskeletal system: Foundations for physical rehabilitation 2nd eds, St. Louis, Mosby. 2010;121-167.
24 Ewards, S. Neurological physiotheray: A problem solving approach 2nd eds. London: Churchill Livingstone. 2002;61-63.
25 Song YJ, Kwon JS. The study on physical predictors which affect performance of acute and post-acute stroke patients. The Journal of Korean Society of Occupational Therapy. 2008;16(4):45-53.
26 An SH, Lee JH. Reliability and Validity of the Postural Assessment Scale for Stroke in Chronic Stroke Patients. J Kor Soc Phys Ther 2009;21(1):9-18
27 Fujiwara T, Liu M, Tsuji T et al. Development of a new measure to assess trunk impairment after stroke(Trunk Impairment Scale): Its psychometric roperties. Am J Phys Med Rehabil. 2004;83(9):681-688.   DOI   ScienceOn
28 Verheyden G, Nieuwber A, Mertin J et al. The Trunk Impairment Scale: A new tool to measure motor impairment of the trunk after stroke. Clin Rehabil. 2004;18(3):326-334.   DOI   ScienceOn
29 Uno Y, Kawato M, Suzuki R. Formation and control of optimal trajectory in human multi joint arm movement. Minimum torque change model. Biol Cybern. 1989;61(2):89-101.
30 Jeannerod, M. The timing of natural prehension movements. J Mot Behav. 1984;16(3):235-54.
31 Zatsiorsky VM, Gao F, Latash, ML. Finger force vectors in multi-finger presension. J Biomech. 2003;36(11):1745-9.   DOI   ScienceOn
32 Liaw LJ, Hsieh CL, Lo SK et al. The relative and absolute reliability of two balance performance measures in chronic stroke patients. Disability rehabilitation. 2007;30(9): 656-661.
33 Lippitt S, Matsen F. Mechanisms of glenohumeral joint stability. Clin Orthop Relat Res. 1993;291(1):20-28.
34 Yoshida S, Nakazawa K, Shimizu E et al. Anticipatory postural adjustments modify the movement-related potentials of upper extremity voluntary movement. Gait & Posture. 2008;27:97-02.   DOI   ScienceOn
35 Massion J. Postural control system. Curr Opin Neurobiol. 1994;4(6):877-887.   DOI   ScienceOn
36 Heller A, Wade DT, Wood VA et al. Arm function after stroke: Measurement and recovery over the first three months. J Neurol Neurosurg Psychiatry. 1987;50(6):714-719.   DOI
37 Chae J, Yang G, Park BK et al. Muscle weakness and cocontraction in upper limb hemiparesis: Relationship to motor impairment and physical disability. Neurorehabil Neural Repair. 2002;16(3):241-248.   DOI
38 Frontera WR, Grimby L, Larsson L. Firing rate of the lower motoneuron and contractile properties of its muscle fibers after upper motoneuron lesion in man. Muscle & Nerve. 1997;20(8):938-947.   DOI   ScienceOn
39 Sahrmann SA, Norton BJ. The relationship of voluntary movement to spasticity in the upper motor neuron syndrome. Ann Neurol. 1977;2(6):460-465.   DOI   ScienceOn