Araştırma Makalesi
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Comparison of the efficiency of exercise, electrical muscle stimulation, electromyographic biofeedback and robotic rehabilitation in tibialis anterior muscle activation of hemiplegic patients

Yıl 2021, , 1 - 13, 23.04.2021
https://doi.org/10.30569/adiyamansaglik.799520

Öz

Aim: The comparison of the efficiency of Classical Physical Therapy and Rehabilitation (CPTR), Electrical Muscle Stimulation (EMS), Electromyographic Biofeedback (EMG-BF) and Robotic Rehabilitation (RR) on tibialis anterior (mTA) muscle activation and functions of hemiplegic patients was aimed.
Materials and Methods: Thirty hemiplegic patients aged 40-86 years were participated. The range of motion (ROM), 10 meters walk test, Modified Ashworth Scale (MAS), strength measurements, and Visual Analog Scale (VAS) were performed.
Results: In the measurements including dorsi flexion ROM, EMG-BF, NMMT (right and left), a significant difference was found in all Groups. Also, the significant difference in dorsi flexion ROM was higher in Group 3 than Group 2 and Group 1. Additionally, the plantar flexion ROM was higher in Group 1 than Group 3 and Group 2.
Conclusion: There were the positive effects of three different treatment methods on ROM, walking time, spasticity and mTA muscle strength. Also, three treatment modalities contributed to recovery level of hemiplegic patients. 

Kaynakça

  • Hankey GJ. Stroke. Lancet. 2017; 389: 641–654.
  • D´iaz I, Gil JJ, S´anchez E. Lower-limb robotic rehabilitation: Literature review and challenges. Hindawi Publishing Corporation Journal of Robotics. 2011;1-12.
  • Stuart M, Dromerick AW, Macko R, et al. Adaptive physical activity for stroke: An early-stage randomized controlled trial in the United States. Neurorehabil Neural Repair. 2019 August; 33(8): 668–680.
  • Marganska VK, Blanco J, Campen K, et al. Three-dimensional, task-specifi c robot therapy of the arm after stroke: a multicentre, parallel-group randomised tria. Lancet Neurol,2014;13(2):159-166.
  • Serra MC, Accardi CJ, Ma C, et al. Metabolomics of Aerobic Exercise in Chronic Stroke Survivors: A Pilot Study. J Stroke Cerebrovasc. Dis., 2019; 28 (12):1-9.
  • Etoh S, Noma T, Miyata R, Shimodozono M. Effects of repetitive facilitative exercise on spasticity in the upper paretic limb after subacute stroke. J Stroke Cerebrovasc Dis., 2018; 27 (10): 2863-2368.
  • Swinnen E, Beckwée D, Meeusen R, Baeyens JP, Kerckhofs E. Does robot-assisted gait rehabilitation improve balance in stroke patients? A systematic review. Top Stroke Rehabil. 2014; 21(2): 87-100.
  • Belas dos Santos M, Barros de Oliveira C, Dos Santos A, Pires CG, Dylewski V, Arida RM. A Comparative Study of Conventional Physiotherapy versus Robot-Assisted Gait Training Associated to Physiotherapy in Individuals with Ataxia after Stroke. Behavioural Neurology 2018:1-6.
  • Bezerre Dos Santos Cardozo L, Moreira MC, Monteiro UM, Salvetti A, Paula A, Rodrigues MC. Spasticity reduction through EMG Biofeedback relaxation in post-stroke patients: a pilot study. Montreal QC; International Conference on Virtual Rehabilitation, 2017; 1-3.
  • Baricich A, Picelli A, Carda S, et al. Electrical stimulation of antagonist muscles after botulinum toxin type A for post-stroke spastic equinus foot. A randomized single-blind pilot study. Ann Phys Rehabil Med. 2019; 62: 214–19.
  • Kaji R, Osako Y, Suyama K, Maeda T. Botulinum toxin type A in post-stroke lower limbspasticity: a multicenter, double-blind, placebo-controlled trial. J Neurol. 2010; 257 (8): 1330-1337.
  • Burbaud P, Wiart L, Dubos JL, et al. A randomised double blind plasebo controlled trial ofbotulinum toxin in the treatment of spastic foot in hemiparetic patients. J Neurol Neurosurg Psychiatry. 1996; 61: 265-269.
  • Van Gelder LMA, Barnes A, Wheat JS, Heller BW. The use of biofeedback for gait retraining: A mapping review. Clin Biomech. 2018;59:159-166.
  • Bakhtiary AH, Fatemy E. Does electrical stimulation reduce spasticity after stroke? A randomized controlled study. Clin Rehabil, 2008; 22: 418–425.
  • Uzunca K. İnmeli Hastalarda EMG Biofeedback Kullanımı. Tıp Rehab Derg, 2007;53(Özel sayı 1):26-29.
  • Hammami N, Coroian FO, Julia M, et al. Isokinetic muscle strengthening after acquired cerebral damage: a literature review. Ann Phys Rehabil Med. 2012; 55 (4):279-291.
  • Otman AS, Köse N. Tedavi Hareketlerinde Temel Değerlendirme Prensipleri. 10th ed. Ankara: Pegem Akademi; 2016;1-202.
  • Shubert TE, Schrodt LA, Mercer VS, Busby Whitehead J, Giuliani CA. Are Scores on Balance Screening Tests Associated with Mobility in Older Adults?. J Geriatr Phys Ther, 2006;29(1):35-39.
  • Polat SÖ, Yücel AH, Ince G. The effects of an eight-week multi-model sport activity home programme on function of children with cerebral palsy. Biomed Hum Kinet. 2020;12, 105–114.
  • Tsaih PL, Chiu MJ, Luh JJ, Yang YR, Lin JJ, Hu MH. Practice Variability Combined with Task-Oriented Electromyographic Biofeedback Enhances Strength and Balance in People with Chronic Stroke. Hindawi Behav Neurol. 2018;1-9.
  • Bohannon RW, Smith MB. Interrater reliability of a modified Ashworth scale of muscle spasticity. Phys ther. 1987;67(2): 206-207.
  • Krause DA, Neuger MD, Lambert KA, Johnson AE, Devinny HA, Hollman JH. Effects of examiner strength on reliability of hip strength testing using a handheld dynamometer. J Sport Rehabil. 2014; 23:56-64.
  • Arnold CM, Warkentin KD, Chilibeck PD, Magnus CRA. The reliability and validity of handheld dynamometry for the measurement of lower extremity muscle strength in older adults. J Strength Cond Res. 2010; 24(3):815-824.
  • Bohannon RW. Reference values for extremity muscle strength obtained by hand held dynamometry from adults aged 20 to 79 years. Arch Phys Med Rehabil. 1997;78:26-32.
  • Moss CL, Wright PT. Comparison of three methods of assessing muscle strength and imbalance ratios of the knee. J Athl Train. 1993; 28(1): 55-58.
  • Dunn JC, Iversen MD. Interrater reliability of knee muscle forces obtained by hand-held dynamometer from elderly subjects with degenerative back pain. J Geriatr Phys Ther. 2003; 26: 3(3): 23-29.
  • Aras Ö, Aras B, Yilmaz I, Kabay SC. Parkinson’lu olgularda kas kuvvet değerlendirmelerinin test-tekrar test güvenilirliği. TUBAV Bilim Dergisi. 2009; 2(1): 122-125.
  • Klimek L, Bergmann KC, Biedermann T, et al. Visual analogue scales (VAS): Measuring instruments for the documentation of symptoms and therapy monitoring in cases of allergic rhinitis in everyday health care. Allergo J Int. 2017;26: 16-24.
  • Aguiar LT, Nadeau S, Britto RR, et al. Effects of aerobic training on physical activity in people with stroke: protocol for a randomized controlled trial. Trials. 2018;19 (1):446-453.
  • Lawrence ES, Coshall C, Dundas R, et al. Estimates of the prevalence of acute stroke impairments and disability in a multiethnic population. Stroke. 2001;32:1279-84.
  • Bohannon RW. Muscle strength and muscle training after stroke. J Rehabil Med. 2017;39 (1):14-20.
  • Dragert K, Zehr EP. High-intensity unilateral dorsi flexor resistance training results in bilateral neuromuscular plasticity after stroke. Exp Brain Res. 2013;225(1):93-104.
  • Candan SA İnmeli hastalarda modifiye kısıtlayarak zorlayıcı hareket tedavisinin alt ekstremite fonksiyonları, denge, ambulasyon ve yaşam kalitesi üzerine etkileri [Dissertation].Ankara, Turkey: Hacettepe University;2015.
  • Yang YR, Wang RY, Lin KH, Chu MY, Chan RC. Task-oriented progressive resistance strength training improves muscle strength and functional performance in individuals with stroke. Clin Rehabil. 2006; 20: 860-870.
  • Krishnan C, Kotsapouikis D, Dhaher YY, Rymer WZ. Reducing robotic guidance during robot-assisted gait training improves gait function: a case report on a stroke survivor. Arch Phys Med Rehabil. 2013; 94 (6):1202-1206.
  • Tefertiller C, Pharo B, Evans N, Winchester P. Effica of rehabilitation robotics for walking training in neurological disorders: a review. J Rehabil Res Dev. 2011;48 (4): 387-416.
  • Yeung LF, Ockenfeld C, Pang MK, Wai HW, Soo OY, Li SW, Tong KY. Randomized controlled trial of robot assisted gait training with dorsiflexion assistance on chronic stroke patients wearing ankle-foot-orthosis. J Neuroeng Rehabil. 2018 Jun; 19;15(1):51-62.
  • Bogataj U, Gros N, KiJajic M, Acimovic R, Malezic M. The rehabilitation of gait in patients with hemiplegia: A Comparison Between Conventional Therapy and multichannel Functional Electrical Stimulation Therapy. Phys Ther. 1995;75(6):490-502.
  • Bradley L, Hart BB, Mandana S, Flowers K, Riches M, Sanderson P. Electromyographic biofeedback for gait training after stroke. Clin Rehabil. 1998;12:11-22.

Egzersiz, elektriksel kas stimülasyonu, elektromyografik biofeedback ve robotik rehabilitasyonun hemiplejik hastaların tibialis anterior kas aktivasyonu üzerine etkileri

Yıl 2021, , 1 - 13, 23.04.2021
https://doi.org/10.30569/adiyamansaglik.799520

Öz

Amaç: Klasik Fizik Tedavi ve Rehabilitasyon (KFTR), Elektriksel Kas Stimülasyonu (EKS), Elektromyografik Biyofeedback (EMG-BF) ve Robotik Rehabilitasyon’un (RR) hemipleji hastalarının tibialis anterior kas (mTA) aktivitesi ve fonksiyonları üzerine etkinliğini karşılaştırma amaçlandı.
Gereç ve Yöntem: Yaşları 40-86 arasında değişen otuz hemiplejik hasta çalışmaya katıldı. Eklem hareket açıklığı (EHA), 10 metre yürüme testi, Modifiye Ashworth Skalası (MAS), kuvvetlendirme ölçümleri ve Görsel Analog Skalası (GAS) uygulandı.
Bulgular: Dorsi fleksiyon EHA, EMG-BF ve NMMT (sağ-sol) ölçümlerinde bütün gruplarda anlamlı farklılık bulundu. Dorsi fleksiyon EHA'da anlamlı farklılık Grup 3'te Grup 2 ve Grup 1'den daha yüksekti. Ayrıca, plantar fleksiyon EHA artışı ise Grup 1'de Grup 3 ve Grup 2'den daha yüksekti.
Sonuç: Uygulanan üç farklı tedavi metodunun EHA, yürüme zamanı, spastisite ve tibialis anterior kas kuvvetini içeren parametreler üzerine olumlu etkileri vardı. Ayrıca, üç tedavi yöntemi hemiplejik hastaların iyileşme düzeylerine katkı sağladı.

Kaynakça

  • Hankey GJ. Stroke. Lancet. 2017; 389: 641–654.
  • D´iaz I, Gil JJ, S´anchez E. Lower-limb robotic rehabilitation: Literature review and challenges. Hindawi Publishing Corporation Journal of Robotics. 2011;1-12.
  • Stuart M, Dromerick AW, Macko R, et al. Adaptive physical activity for stroke: An early-stage randomized controlled trial in the United States. Neurorehabil Neural Repair. 2019 August; 33(8): 668–680.
  • Marganska VK, Blanco J, Campen K, et al. Three-dimensional, task-specifi c robot therapy of the arm after stroke: a multicentre, parallel-group randomised tria. Lancet Neurol,2014;13(2):159-166.
  • Serra MC, Accardi CJ, Ma C, et al. Metabolomics of Aerobic Exercise in Chronic Stroke Survivors: A Pilot Study. J Stroke Cerebrovasc. Dis., 2019; 28 (12):1-9.
  • Etoh S, Noma T, Miyata R, Shimodozono M. Effects of repetitive facilitative exercise on spasticity in the upper paretic limb after subacute stroke. J Stroke Cerebrovasc Dis., 2018; 27 (10): 2863-2368.
  • Swinnen E, Beckwée D, Meeusen R, Baeyens JP, Kerckhofs E. Does robot-assisted gait rehabilitation improve balance in stroke patients? A systematic review. Top Stroke Rehabil. 2014; 21(2): 87-100.
  • Belas dos Santos M, Barros de Oliveira C, Dos Santos A, Pires CG, Dylewski V, Arida RM. A Comparative Study of Conventional Physiotherapy versus Robot-Assisted Gait Training Associated to Physiotherapy in Individuals with Ataxia after Stroke. Behavioural Neurology 2018:1-6.
  • Bezerre Dos Santos Cardozo L, Moreira MC, Monteiro UM, Salvetti A, Paula A, Rodrigues MC. Spasticity reduction through EMG Biofeedback relaxation in post-stroke patients: a pilot study. Montreal QC; International Conference on Virtual Rehabilitation, 2017; 1-3.
  • Baricich A, Picelli A, Carda S, et al. Electrical stimulation of antagonist muscles after botulinum toxin type A for post-stroke spastic equinus foot. A randomized single-blind pilot study. Ann Phys Rehabil Med. 2019; 62: 214–19.
  • Kaji R, Osako Y, Suyama K, Maeda T. Botulinum toxin type A in post-stroke lower limbspasticity: a multicenter, double-blind, placebo-controlled trial. J Neurol. 2010; 257 (8): 1330-1337.
  • Burbaud P, Wiart L, Dubos JL, et al. A randomised double blind plasebo controlled trial ofbotulinum toxin in the treatment of spastic foot in hemiparetic patients. J Neurol Neurosurg Psychiatry. 1996; 61: 265-269.
  • Van Gelder LMA, Barnes A, Wheat JS, Heller BW. The use of biofeedback for gait retraining: A mapping review. Clin Biomech. 2018;59:159-166.
  • Bakhtiary AH, Fatemy E. Does electrical stimulation reduce spasticity after stroke? A randomized controlled study. Clin Rehabil, 2008; 22: 418–425.
  • Uzunca K. İnmeli Hastalarda EMG Biofeedback Kullanımı. Tıp Rehab Derg, 2007;53(Özel sayı 1):26-29.
  • Hammami N, Coroian FO, Julia M, et al. Isokinetic muscle strengthening after acquired cerebral damage: a literature review. Ann Phys Rehabil Med. 2012; 55 (4):279-291.
  • Otman AS, Köse N. Tedavi Hareketlerinde Temel Değerlendirme Prensipleri. 10th ed. Ankara: Pegem Akademi; 2016;1-202.
  • Shubert TE, Schrodt LA, Mercer VS, Busby Whitehead J, Giuliani CA. Are Scores on Balance Screening Tests Associated with Mobility in Older Adults?. J Geriatr Phys Ther, 2006;29(1):35-39.
  • Polat SÖ, Yücel AH, Ince G. The effects of an eight-week multi-model sport activity home programme on function of children with cerebral palsy. Biomed Hum Kinet. 2020;12, 105–114.
  • Tsaih PL, Chiu MJ, Luh JJ, Yang YR, Lin JJ, Hu MH. Practice Variability Combined with Task-Oriented Electromyographic Biofeedback Enhances Strength and Balance in People with Chronic Stroke. Hindawi Behav Neurol. 2018;1-9.
  • Bohannon RW, Smith MB. Interrater reliability of a modified Ashworth scale of muscle spasticity. Phys ther. 1987;67(2): 206-207.
  • Krause DA, Neuger MD, Lambert KA, Johnson AE, Devinny HA, Hollman JH. Effects of examiner strength on reliability of hip strength testing using a handheld dynamometer. J Sport Rehabil. 2014; 23:56-64.
  • Arnold CM, Warkentin KD, Chilibeck PD, Magnus CRA. The reliability and validity of handheld dynamometry for the measurement of lower extremity muscle strength in older adults. J Strength Cond Res. 2010; 24(3):815-824.
  • Bohannon RW. Reference values for extremity muscle strength obtained by hand held dynamometry from adults aged 20 to 79 years. Arch Phys Med Rehabil. 1997;78:26-32.
  • Moss CL, Wright PT. Comparison of three methods of assessing muscle strength and imbalance ratios of the knee. J Athl Train. 1993; 28(1): 55-58.
  • Dunn JC, Iversen MD. Interrater reliability of knee muscle forces obtained by hand-held dynamometer from elderly subjects with degenerative back pain. J Geriatr Phys Ther. 2003; 26: 3(3): 23-29.
  • Aras Ö, Aras B, Yilmaz I, Kabay SC. Parkinson’lu olgularda kas kuvvet değerlendirmelerinin test-tekrar test güvenilirliği. TUBAV Bilim Dergisi. 2009; 2(1): 122-125.
  • Klimek L, Bergmann KC, Biedermann T, et al. Visual analogue scales (VAS): Measuring instruments for the documentation of symptoms and therapy monitoring in cases of allergic rhinitis in everyday health care. Allergo J Int. 2017;26: 16-24.
  • Aguiar LT, Nadeau S, Britto RR, et al. Effects of aerobic training on physical activity in people with stroke: protocol for a randomized controlled trial. Trials. 2018;19 (1):446-453.
  • Lawrence ES, Coshall C, Dundas R, et al. Estimates of the prevalence of acute stroke impairments and disability in a multiethnic population. Stroke. 2001;32:1279-84.
  • Bohannon RW. Muscle strength and muscle training after stroke. J Rehabil Med. 2017;39 (1):14-20.
  • Dragert K, Zehr EP. High-intensity unilateral dorsi flexor resistance training results in bilateral neuromuscular plasticity after stroke. Exp Brain Res. 2013;225(1):93-104.
  • Candan SA İnmeli hastalarda modifiye kısıtlayarak zorlayıcı hareket tedavisinin alt ekstremite fonksiyonları, denge, ambulasyon ve yaşam kalitesi üzerine etkileri [Dissertation].Ankara, Turkey: Hacettepe University;2015.
  • Yang YR, Wang RY, Lin KH, Chu MY, Chan RC. Task-oriented progressive resistance strength training improves muscle strength and functional performance in individuals with stroke. Clin Rehabil. 2006; 20: 860-870.
  • Krishnan C, Kotsapouikis D, Dhaher YY, Rymer WZ. Reducing robotic guidance during robot-assisted gait training improves gait function: a case report on a stroke survivor. Arch Phys Med Rehabil. 2013; 94 (6):1202-1206.
  • Tefertiller C, Pharo B, Evans N, Winchester P. Effica of rehabilitation robotics for walking training in neurological disorders: a review. J Rehabil Res Dev. 2011;48 (4): 387-416.
  • Yeung LF, Ockenfeld C, Pang MK, Wai HW, Soo OY, Li SW, Tong KY. Randomized controlled trial of robot assisted gait training with dorsiflexion assistance on chronic stroke patients wearing ankle-foot-orthosis. J Neuroeng Rehabil. 2018 Jun; 19;15(1):51-62.
  • Bogataj U, Gros N, KiJajic M, Acimovic R, Malezic M. The rehabilitation of gait in patients with hemiplegia: A Comparison Between Conventional Therapy and multichannel Functional Electrical Stimulation Therapy. Phys Ther. 1995;75(6):490-502.
  • Bradley L, Hart BB, Mandana S, Flowers K, Riches M, Sanderson P. Electromyographic biofeedback for gait training after stroke. Clin Rehabil. 1998;12:11-22.
Toplam 39 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makalesi
Yazarlar

Mustafa Al Haddad Bu kişi benim 0000-0003-2294-6617

Sema Özandaç Polat 0000-0003-4695-0514

Emir İbrahim Işık 0000-0002-8219-6013

Yayımlanma Tarihi 23 Nisan 2021
Gönderilme Tarihi 24 Eylül 2020
Kabul Tarihi 11 Aralık 2020
Yayımlandığı Sayı Yıl 2021

Kaynak Göster

AMA Al Haddad M, Özandaç Polat S, Işık Eİ. Comparison of the efficiency of exercise, electrical muscle stimulation, electromyographic biofeedback and robotic rehabilitation in tibialis anterior muscle activation of hemiplegic patients. ADYÜ Sağlık Bilimleri Derg. Nisan 2021;7(1):1-13. doi:10.30569/adiyamansaglik.799520