The Investigation of Relationship Between Functional Balance Tests and Activities of Daily Living in Patients with Stroke

Öz

Purpose: To examine the relationship between two functional balance tests, which are frequently used in stroke rehabilitation, with activities of daily living. Material and Method: Fifty-nine patients who had a stroke were included in the study. Descriptive features of the cases were recorded. The Barthel Index was used to evaluate the activities of daily living of the patients, and the Functional Reach Test and the Timed Up&Go Test were used to evaluate their functional balance. Results: The mean age of the patients was 48.42±12.38 years. While there was a moderate correlation (r=0.502) between the Timed Up & Go Test and the Barthel Index, there was a weak correlation (r=0.333) between the Functional Reach Test and the Barthel Index (p<0.05). Conclusion: Although both balance tests were associated with activities of daily living, the Timed Up&Go Test showed stronger correlation. These two tests, which are reliable and valid measurements in the evaluation of post-stroke balance disorder, are easy to apply and can be performed in a short time. In our study, we think that we have contributed to the advantageous aspects of these tests in terms of research and clinical use by revealing the relationships with daily life activities.

Anahtar Kelimeler

• Stroke Rehabilitation
• Activities of Daily Living
• Postural Balance

İnmeli Hastalarda Fonksiyonel Denge Testlerinin Günlük Yaşam Aktiviteleri ile İlişkisinin İncelenmesi

Öz

Amaç: İnmeli bireylerde denge değerlendirilmesinde sıklıkla kullanılan 2 fonksiyonel denge testinin günlük yaşam aktiviteleri ile ilişkisini incelemektir. Gereç ve Yöntem: Çalışmaya inme geçiren 59 olgu dahil edildi. Olguların tanımlayıcı özellikleri kaydedildi. Olguların günlük yaşam aktivitelerini değerlendirmek için Barthel İndeksi, fonksiyonel dengelerini değerlendirmek için de Fonksiyonel Uzanma Testi ve Zamanlı Kalk ve Yürü Testi uygulandı. Sonuçlar: Olguların yaş ortalaması 48,42±12,38 yıldı. Zamanlı Kalk ve Yürü Testi ile Barthel İndeksi arasında orta derecede ilişki (r= 0,502) bulunurken, Fonksiyonel Uzanma Testi ile Barthel İndeksi arasında ise zayıf derecede ilişki (r= 0,331) bulundu (p<0,05). Tartışma: Kullanılan iki denge testi de günlük yaşam aktiviteleri ile ilişkili bulunmasına rağmen, Zamanlı Kalk ve Yürü Testi ile daha kuvvetli korelasyon göstermiştir. İnme sonrası denge bozukluğunun değerlendirilmesinde güvenilir ve geçerli ölçümler olan bu iki testin, kolay uygulanmaları ve kısa sürede yapılabilmeleri en büyük avantajlarıdır. Biz de çalışmamızda bu testlerin günlük yaşam aktiviteleri ile ilişkilerini ortaya koyarak, araştırma ve klinik kullanım açısından avantajlı yönlerine katkı sağladığımızı düşünüyoruz.

Anahtar Kelimeler

• İnme Rehabilitasyonu
• Günlük Yaşam Aktiviteleri
• Postural Denge

Kaynakça

1. Allison, L., Fuller, K. (2001). Balance and vestibular disorders. In: Umphred D. (Ed.) Neurological Rehabilitation. St. Louis, Mosby.
2. Bennie, S., Bruner, K., Dizon, A., Fritz, H., Goodman, B., Peterson, S. (2003). Measurements of balance: comparison of the Timed" Up and Go" test and Functional Reach test with the Berg Balance Scale. Journal of Physical Therapy Science, 15(2), 93-97. https://doi.org/10.1589/jpts.15.93
3. Berg, K., Norman, K. E. (1996). Functional assessment of balance and gait. Clinics in geriatric medicine, 12(4), 705-723. https://doi.org/10.1016/S0749-0690(18)30197-6
4. Blum, L., Korner-Bitensky, N. (2008). Usefulness of the Berg Balance Scale in stroke rehabilitation: a systematic review. Physical therapy, 88(5), 559-566. https://doi.org/10.2522/ptj.20070205
5. Bohannon, R. W., Leary, K. M. (1995). Standing balance and function over the course of acute rehabilitation. Archives of Physical Medicine and Rehabilitation, 76(11), 994-996. https://doi.org/10.1016/S0003-9993(95)81035-8
6. Carr, J. H., Shepherd, R. B. (2010). Neurological Rehabilitation: optimizing motor performance. 2. edition. Edinburgh: Churchill Livingstone Elsevier.
7. de Oliveira, C. B., de Medeiros, Í. R. T., Ferreira, N. A., Greters, M. E., Conforto, A. B. (2008). Balance control in hemiparetic stroke patients: main tools for evaluation. Journal of Rehabilitation Research & Development, 45(8), 1215-1226. https://doi.org/10.1682/JRRD.2007.09.0150
8. Desrosiers, J., Noreau, L., Rochette, A., Bravo, G., Boutin, C. (2002). Predictors of handicap situations following post-stroke rehabilitation. Disability and rehabilitation, 24(15), 774-785. https://doi.org/10.1080/09638280210125814

9. Duncan, P. W., Weiner, D. K., Chandler, J., Studenski, S. (1990). Functional reach: a new clinical measure of balance. Journal of gerontology, 45(6), 192-197. https://doi.org/10.1093/geronj/45.6.M192
10. Flansbjer, U.-B., Holmbäck, A. M., Downham, D., Patten, C., Lexell, J. (2005). Reliability of gait performance tests in men and women with hemiparesis after stroke. Journal of rehabilitation medicine, 37(2), 75-82. https://doi.org/10.1080/16501970410017215
11. Giorgetti, M. M., Harris, B. A., Jette, A. (1998). Reliability of clinical balance outcome measures in the elderly. Physiotherapy Research International, 3(4), 274-283.https://doi.org/10.1002/pri.150
12. Greenhalgh, J., Tyson, S., Long, A., Flynn, R. (2006). How do multidisciplinary teams use clinical outcome measures in clinical practice. Paper presented at the Proceedings of the Society for Research in Rehabilitation Summer Meeting 2006, London.
13. Herman, T., Giladi, N., Hausdorff, J. M. (2011). Properties of the ‘timed up and go’test: more than meets the eye. Gerontology, 57(3), 203-210. https://doi.org/10.1159/000314963
14. Horak, F. B. (1997). Clinical assessment of balance disorders. Gait & posture, 6(1), 76-84.https://doi.org/10.1016/S0966-6362(97)00018-0
15. Hsieh, C. L., Sheu, C. F., Hsueh, I. P., Wang, C. H. (2002). Trunk control as an early predictor of comprehensive activities of daily living function in stroke patients. Stroke, 33(11), 2626-2630.https://doi.org/10.1161/01.STR.0000033930.05931.93
16. Hsueh, I.P., Chen, J. H., Wang, C. H., Chen, C. T., Sheu, C. F., Wang, W. C., Hou, W.H., Hsieh, C. L. (2010). Development of a computerized adaptive test for assessing balance function in patients with stroke. Physical therapy, 90(9), 1336-1344. https://doi.org/10.2522/ptj.20090395
17. Knorr, S., Brouwer, B., Garland, S. J. (2010). Validity of the Community Balance and Mobility Scale in community-dwelling persons after stroke. Archives of Physical Medicine and Rehabilitation, 91(6), 890-896. https://doi.org/10.1016/j.apmr.2010.02.010
18. Kucukdeveci, A., Yavuzer, G., Tennant, A., Suldur, N., Sonel, B., Arasil, T. (2000). Adaptation of the modified Barthel Index for use in physical medicine and rehabilitation in Turkey. Scandinavian journal of rehabilitation medicine, 32(2), 87-92. https://doi.org/10.1080/003655000750045604
19. Mahoney, F. I., Barthel, D. W. (1965). Functional evaluation: the Barthel Index: a simple index of independence useful in scoring improvement in the rehabilitation of the chronically ill. Maryland state medical journal, 14, 61–65.
20. Mancini, M., Horak, F. B. (2010). The relevance of clinical balance assessment tools to differentiate balance deficits. European journal of physical and rehabilitation medicine, 46(2), 239.
21. Mao, H. F., Hsueh, I. P., Tang, P. F., Sheu, C. F., Hsieh, C.L. (2002). Analysis and comparison of the psychometric properties of three balance measures for stroke patients. Stroke, 33(4), 1022-1027.https://doi.org/10.1161/01.STR.0000012516.63191.C5
22. Podsiadlo, D., Richardson, S. (1991). The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. Journal of the American Geriatrics Society, 39(2), 142-148. https://doi.org/10.1111/j.1532-5415.1991.tb01616.x
23. Pollock, C., Eng, J., Garland, S. (2011). Clinical measurement of walking balance in people post stroke: a systematic review. Clinical Rehabilitation, 25(8), 693-708. https://doi.org/10.1177/0269215510397394
24. Shumway-Cook, A., Brauer, S., Woollacott, M. (2000). Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Physical therapy, 80(9), 896-903.https://doi.org/10.1093/ptj/80.9.896
25. Tuncay, F. O., Mollaoglu, M. (2006). The effect of a self-care education program on cerebrovascular disease patients' activities of daily living. Neurology Psychiatry and Brain Research, 13(2):83–8.
26. Tyson, S., Connell, L. (2009). How to measure balance in clinical practice. A systematic review of the psychometrics and clinical utility of measures of balance activity for neurological conditions. Clinical Rehabilitation, 23(9), 824-840. https://doi.org/10.1177/0269215509335018
27. Tyson, S. F., DeSouza, L. H. (2004). Reliability and validity of functional balance tests post stroke. Clinical Rehabilitation, 18(8), 916-923. https://doi.org/10.1191/0269215504cr821oa
28. Weerdesteijn, V., Niet, M. d., Van Duijnhoven, H., Geurts, A. C. (2008). Falls in individuals with stroke. J Rehabil Res Dev, 45:1195–1213. https://doi̇.org/10.1682/JRRD.2007.09.0145
29. Weiner, D. K., Duncan, P. W., Chandler, J., Studenski, S. A. (1992). Functional reach: a marker of physical frailty. Journal of the American Geriatrics Society, 40(3), 203-207. https://doi.org/10.1111/j.1532-5415.1992.tb02068.x
30. Weiss, A., Herman, T., Plotnik, M., Brozgol, M., Maidan, I., Giladi, N., Gurevich, T., Hausdorff, J. M. (2010). Can an accelerometer enhance the utility of the Timed Up & Go Test when evaluating patients with Parkinson's disease? Medical engineering & physics, 32(2), 119-12. https://doi.org/10.1016/j.medengphy.2009.10.015