Effectiveness of Conventional Rehabilitation Therapy on Postural Stability and Clinic in Stroke Patients with Hemiplegia

Year 2013, Volume: 38 Issue: 3, 446 - 455, 01.09.2013

Ahmet İnanır Sevil Okan Behçet Filiz Emre Kuyucu

Abstract

Objective: The aim of the present study was to determine the effectiviness of conventional rehabilitation in patients with stroke on static and dynamic balance as well as clinical assessment Methods: Twelve patients with stroke, 7 (58.33%) of them being male and 5 (41.66%) female, ranging from 51 to 75 in age who were treated in Physical Medicine and Rehabilitation clinic were involved in this study. The patients were treated with conventional rehabilitation. All individuals were evaluated using balance tests before (Group 1) and after (Group 2) the treatment. Balance level and postural control has been assessed through Berg Balance Scale (BBS), Trunk Control Test (TCT) and Biodex Stability System (BSS), motor level through BMİE, ambulation state through Functional Ambulatory Scale (FAS) and functional state in daily activities through Functional Independence Measure (FIM). The same tests were repeated while the patients were being discharged. Results: The mean age of the study population was 65,83±4,38 years, the average Body Mas Index (BMI) was 30,55±6,94. In the evaluations according to FIM, FAS, TCT and BBS differences between the mean of patients before and after the rehabilitation were significantly higher for the post-treatment (p=0.001, p=0.001, p=0.001 and p=0.001, respectively). In the evaluations according to Overall Stability Index (OSI), Antero-Posterior Stability Index (APSI) and Medio-Lateral Stability Index (MLSI) differences between the mean of patients before and after the rehabilitation were significantly higher for the pre-treatment (p=0.001, p=0.001 and p=0.001, respectively). Conclusion: It can be stated that this approach is effective and useful in restoring static and dynamic balance as well as in obtaining an effective improvement in the treatment of patients with stroke through conventional treatment.

Keywords

Stroke, Rehabilitation, Postural Balance, Biodex Stability System

Hemiplejili Hastalarda Konvansiyonel Rehabilitasyon Tedavisinin Postüral Denge ve Klinik Üzerine Etkinliği

Abstract

Amaç: Bu çalışmada inmeli hastalarda konvansiyonel rehabilitasyonun klinik değerlendirilmesi yanında statik ve dinamik denge üzerine olan etkilerinin araştırılması amaçlanmıştır. Gereç ve yöntem: Çalışmaya yaşları 51 ile 75 yıl aralığında değişen ve Fiziksel Tıp ve Rehabilitasyon kliniğinde yatarak tedavi gören toplam 12 inmeli hasta dahil edildi. Bireyler tedavi öncesi (Grup 1) ve sonrası (Grup 2) denge testine tabi tutuldular. Hastalarımızın hepsine gövde için temel komponentin varolduğu bir problem çözme yaklaşımı olmasından dolayı bir fizyoterapist eşliğinde temel olarak nörogelişimsel amaca da yönelinerek multidisipliner konvansiyonel tedavi uygulandı. Denge düzeyi ve postüral kontrol Berg Denge Skalası (BDS), Gövde Kontrol Testi (GKT) ve Biodex Denge Sistemi (BDS) ile, motor seviye Brunnstrom Motor İyileşme Evrelemesi (BMİE) ile, ambulasyon durumu Fonksiyonel Ambulasyon Skalası (FAS) ile ve günlük yaşam aktivitelerindeki fonksiyonel durum Fonksiyonel Bağımsızlık Ölçeği (FBÖ) ile değerlendirildi. Bireyler taburcu olurken aynı testler tekrarlandı. Bulgular: Çalışmaya dahil edilen hastaların yaş ortalaması 65,83±4,38 yıl ve vücut kitle indeksi ortalaması 30,55±6,94 idi. Fonksiyonel Bağımsızlık ölçeği, Fonksiyonel Ambulasyon Skalası, Gövde Kontrol Testi, Berg Denge Skalası açısından değerlendirildiğinde iki grup arasında istatistiksel olarak anlamlı fark tespit edildi (sırasıyla, p=0.001, p=0.001, p=0.001 ve p=0.002). Ayrıca bireylerin tedavi öncesi ve sonrası denge testleri karşılaştırıldığında genel stabilite indeksi, antero-posterior stabilite indeksi ve medio-lateral stabilite indeksi açısından istatistiksel olarak anlamlı farklılık saptandı (sırasıyla, p=0.001, p=0.012 ve p=0.002). Sonuç: Konvansiyonel tedavi ile stroklu hastaların tedavisinde etkin bir gelişme sağlanması yanında statik ve dinamik dengenin yeniden kazanılmasında etkin bir tedavi yöntemi olarak etkin ve vazgeçilmez olduğu ifade edilebilir

Keywords

İnme, Rehabilitasyon, Postural Denge, Biodex Denge Sistemi

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• Yazışma Adresi / Address for Correspondence: Dr. Ahmet İnanır Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Gaziosmanpaşa Üniversitesi, Tıp Fakültesi, 60100 TOKAT e-mail: [e-mail] geliş tarihi/received :24.09.2012 kabul tarihi/accepted:07.12.2012