Effects of Upper Limb Control on the Less-Affected Side on Upper Limb Function, Respiration, Balance, and Activities of Daily Living in Stroke
Abstract
:1. Instruction
2. Materials and Methods
2.1. Participants
2.2. Experimental Procedure
Real-Time Feedback
2.3. Training Program
2.4. Outcome Measurements
2.4.1. Upper Limb Function Assessment
2.4.2. Respiratory Assessment
2.4.3. Balance Assessment
2.4.4. Activities of Daily Living
2.5. Data Analysis
3. Results
3.1. General Characteristics of the Participants
3.2. Changes in Upper Limb Function of Affected Side
3.3. Changes in Respiration Function
3.4. Changes in Balance
3.5. Changes in Activities of Daily Living
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Sequence | Intermediate and Finishing Postures |
---|---|
1 | Seat the patient on the mat and stabilize their feet and ankles near the midline. |
2 | Hold the pelvis and grasp the proximal femurs to stabilize them near the midline. Perform steps 1 and 2 bilaterally. |
3 | Place both hands on the table and align the trunk with the midline. |
4 | The therapist stabilizes the pelvis by holding it with both hands. |
5 | The therapist holds the patient’s lower trunk and performs trunk extension. |
6 | The therapist holds the patient’s lower trunk and performs trunk flexion. |
7 | The therapist holds the patient’s trunk and moves toward the affected side. |
8 | Therapist holds the patient’s trunk and moves toward the non-affected side before stabilizing in the center. |
1 | The patient wears the HMD and prepares on the mat. |
2 | Prepare for trunk control exercise program (10 min). |
3 | The therapist holds the patient’s trunk and upper limb on the affected side and waits. |
4 | Play the intervention video with real-time feedback from the HMD connected to the laptop, along with the verbal command from the assistant to “start”. |
5 | The patient follows the movements while watching the video on the HMD, and the therapist conducts treatment while adjusting the posture on the affected side (20 min). |
6 | Treatment focuses on enhancing posture control on the affected side and promoting mobility of the upper limb. This is achieved by adjusting the posture of the trunk and upper limb on the affected side, leading to improved stability on the non-affected side and increased mobility of the upper limb. |
Weeks | Intermediate and Finishing Postures | Picture |
---|---|---|
1st week | A. Stabilize the trunk and secure the paralyzed arm on the assistive table. B. Flex and extend the fingers of the non-paralyzed side to regulate tension. C. Repeat the movement of flexing and then extending the wrist of the non-paralyzed side. D. Repeat the movement of pronating and then supinating the wrist of the non-paralyzed side. E. All movements are performed in collaboration with the therapist, who assists in controlling the patient’s upper limb strength while actively participating. | |
2nd week | A. Stabilize the trunk and secure the paralyzed arm on the assistive table. B. Flex the elbow of the non-paralyzed side and then extend it again. C. Bend the elbow of the non-paralyzed side and then flex the shoulder joint. D. Bend the elbow of the non-paralyzed side and then bring the shoulder joint forward. E. All movements are conducted with a therapist, actively assisting while regulating the patient’s upper limb strength. | |
3rd week | A. Stabilize the trunk and secure the paralyzed arm on the assistive table. B. In a flexed position of the non-paralyzed elbow, move the shoulder joint backward. C. In a bent position of the paralyzed elbow, move the shoulder joint upward. D. In a flexed position of the non-paralyzed elbow, move the shoulder joint downward. E. All movements are conducted with a therapist, actively assisting while regulating the patient’s upper limb strength. | |
4th week | A. Stabilize the trunk and secure the paralyzed arm on the assistive table. B. In the bent position of the non-paralyzed elbow, flex the shoulder joint upward. C. In the bent position of the non-paralyzed elbow, flex and extend the upper limb. D. In the bent position of the non-paralyzed elbow, flex and extend the lower limb. E. All movements are conducted with a therapist, actively assisting while regulating the patient’s upper limb strength. |
Characteristics | ULD-LA Group (n = 14) | ULD-A Group (n = 14) | t (p) |
---|---|---|---|
Sex (M/F) | 9/5 | 6/8 | −1.520 (0.617) |
Age (years) | 61.15 (1.61) | 63.32 (4.21) | 1.886 (0.637) |
Height (cm) | 167.64 (7.92) | 161.42 (5.15) | 2.213 (0.334) |
Weight (kg) | 67.86 (12.60) | 66.54 (2.93) | 1.746 (0.945) |
Lesion sites (Rt/Lt) | 7/7 | 7/7 | 0.366 (1.000) |
Onset period (month) | 10.71 (4.23) | 12.57 (5.15) | 1.325 (0.617) |
ULD-LA (n = 14) | ULD-A (n = 14) | Time F (p) | Group F (p) | Time × Group F (p) | ||
---|---|---|---|---|---|---|
A | 0 w | 70.12 (18.15) a | 60.61 (11.25) | 3.072 (0.091) | 11.426 (0.002) * | 0.296 (0.591) |
4 w | 74.62 (20.14) | 61.62 (13.67) | ||||
6 w | 78.93 (21.66) | 62.63 (10.85) | ||||
B | 0 w | 61.92 (17.18) | 53.48 (20.13) | 10.234 (0.004) * | 9.954 (0.004) * | 0.113 (0.039) * |
4 w | 62.56 (18.53) | 55.04 (18.44) | ||||
6 w | 69.28 (17.94) | 54.47 (16.59) | ||||
C | 0 w | 112.32 (43.58) | 87.43 (51.53) | 2.782 (0.107) | 5.397 (0.028) * | 4.635 (0.041) * |
4 w | 127.42 (45.40) | 88.13 (52.01) | ||||
6 w | 130.32 (41.94) | 89.13 (48.55) | ||||
D | 0 w | 36.14 (17.33) | 32.91 (15.68) | 5.455 (0.027) * | 3.388 (0.077) | 2.343 (0.138) |
4 w | 41.64 (15.22) | 31.21 (31.22)) | ||||
6 w | 50.54 (34.81) | 38.01 (19.83) | ||||
E | 0 w | 17.62 (9.63) | 17.91 (10.22) | 1.064 (0.312) | 0.894 (0.033) * | 1.064 (0.312) |
4 w | 21.21 (8.68) | 18.41 (9.77) | ||||
6 w | 22.42 (8.88) | 17.94 (9.15) |
ULD-LA (n = 14) | ULD-A (n = 14) | Time F (p) | Group F (p) | Time × Group F (p) | ||
---|---|---|---|---|---|---|
A | 0 w | 3.14 (0.43) a | 2.68 (1.78) | 1.180 (0.287) | 0820 (0.374) | 6.007 (0.021) * |
4 w | 3.34 (0.36) | 2.07 (1.65) | ||||
6 w | 3.94 (0.49) | 2.56 (0.24) | ||||
B | 0 w | 1.83 (0.19) | 1.28 (0.24) | 1.465 (0.237) | 3.296 (0.081) | 8.696 (0.007) * |
4 w | 1.84 (0.16) | 1.27 (0.13) | ||||
6 w | 2.13 (0.21) | 1.36 (0.44) | ||||
C | 0 w | 2.61 (0.39) | 2.18 (0.40) | 2.225 (0.148) | 6.813 (0.015) | 2.245 (0.146) |
4 w | 3.11 (0.45) | 2.17 (0.16) | ||||
6 w | 3.41 (0.45) | 2.46 (0.27) |
ULD-LA (n = 14) | ULD-A (n = 14) | Time F (p) | Group F (p) | Time × Group F (p) | ||
---|---|---|---|---|---|---|
A | 0 w | 1057.86 (149.11) a | 1096.11 (171.52) | 12.776 (0.001) * | 5.275 (0.030) * | 12.741 (0.035) * |
4 w | 1010.54 (186.41) | 1183.28 (210.54) | ||||
6 w | 919.22 (155.63) | 1066.21 (191.23) | ||||
B | 0 w | 916.12 (157.71) | 1271.22 (101.64) | 30.504 (0.000) * | 7.753 (0.010) * | 0.273 (0.042) * |
4 w | 793.01 (161.41) | 1216.23 (119.14) | ||||
6 w | 734.09 (161.63) | 1211 (121.16) | ||||
C | 0 w | 19.21 (3.56) | 27.94 (2.05) | 0.767 (0.000) * | 1.168 (0.290) | 1.787 (0.193) |
4 w | 17.99 (27.48) | 64.67 (19.52) | ||||
6 w | 16.64 (23.04) | 58.21 (16.43) |
ULD-LA (n = 14) | ULD-A (n = 14) | Time F (p) | Group F (p) | Time × Group F (p) | ||
---|---|---|---|---|---|---|
KMBI | 0 w | 74.31 (3.58) a | 65.06 (2.64) | 2.747 (0.044) * | 3.003 (0.035) * | 0.277 (0.03) * |
4 w | 77.41 (4.51) | 70.66 (2.27) | ||||
6 w | 79.19 (3.05) | 70.97 (3.19) |
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Kim, J.-O.; Lee, M.-Y.; Lee, B.-H. Effects of Upper Limb Control on the Less-Affected Side on Upper Limb Function, Respiration, Balance, and Activities of Daily Living in Stroke. Medicina 2024, 60, 937. https://doi.org/10.3390/medicina60060937
Kim J-O, Lee M-Y, Lee B-H. Effects of Upper Limb Control on the Less-Affected Side on Upper Limb Function, Respiration, Balance, and Activities of Daily Living in Stroke. Medicina. 2024; 60(6):937. https://doi.org/10.3390/medicina60060937
Chicago/Turabian StyleKim, Ju-O, Mi-Young Lee, and Byoung-Hee Lee. 2024. "Effects of Upper Limb Control on the Less-Affected Side on Upper Limb Function, Respiration, Balance, and Activities of Daily Living in Stroke" Medicina 60, no. 6: 937. https://doi.org/10.3390/medicina60060937