Comparison of the Effects of Johnstone Pressure Splint and Electrical Stimulation Applications on Balance, Functional Independence, and Mobility in Patients with Stroke: A Randomized Study

Abstract

Purpose: To investigate the effects of Johnstone pressure splint and Neuromuscular Electrical Stimulation (NMES) applied to the lower extremity on balance, functional independence and mobility in individuals with stroke. Method: The study was conducted with 33 acute/subacute stroke patients. The patients were randomly divided into two groups by applying Johnstone pressure splint and NMES in addition to conventional neurological rehabilitation training. Both groups were trained for 6 weeks, 5 days a week, 45-60 minutes a day. Fugl Meyer test, Brunnstrom, Functional Independence Scale, Motricity Index, Berg Balance Test, 10 Meter Walk Test and Timed Get Up and Go Test were used in the evaluations. Evaluations were made before treatment, at 3 weeks and 6 weeks. Results: The mean age and BMI of the participants were 63.29±12.63 years and 24.57±4.26 kg/m2. Statistically significant improvements were found in both the 3rd week and 6th week results compared to the pre-treatment period in both groups (p<0.05). In the comparison between the groups after 6 weeks of application, it was found that the Johnstone pressure splint group showed statistically more improvement in all the evaluated parameters compared to the NMES applied group (p<0.05). Conclusion: It was observed that the Johnstone pressure splint, which was applied in addition to the conventional neurological rehabilitation application, improved the motor development, level of independence, trunk control, balance and walking speed of the stroke patients more than the electrical stimulation application.

Keywords

• stroke
• johstone pressure splint
• electrical stimulation
• balance
• walking

İNMELİ HASTALARDA JOHNSTONE BASINÇ SPLİNTİ VE ELEKTRİK STİMÜLASYON UYGULAMASININ DENGE, FONKSİYONEL BAĞIMSIZLIK VE MOBİLİTE ÜZERİNE ETKİSİNİN KARŞILAŞTIRILMASI: RANDOMİZE ÇALIŞMA

Abstract

Amaç: Alt ekstremiteye uygulanan Johnstone basınç splinti ve Nöromusküler Elektrik Stimülasyonu (NMES) uygulamasının inmeli bireylerde denge, fonksiyonel bağımsızlık ve mobilite üzerine etkisini araştırmak. Yöntem: Çalışma akut/subakut 33 inmeli hasta ile yapıldı. Hastalara konvansiyonel nörolojik rehabilitasyon eğitimine ek olarak Johnstone basınç splinti ve NMES uygulaması uygulanarak randomize iki gruba ayrıldı. Her iki grup 6 hafta, haftada 5 gün, günde 45-60 dakika eğitim uygulandı. Değerlendirmelerde Fugl Meyer testi, Brunnstrom, Fonksiyonel Bağımsızlık Ölçeği, Motrisite İndeksi, Berg Denge Testi, 10 Metre Yürüme Testi ve Zamanlı Kalk Yürü Testi kullanıldı. Değerlendirmeler tedavi öncesi, 3. hafta ve 6. hafta yapıldı. Bulgular: Katılımcıların yaş ve VKİ ortalamaları, 63.29±12.63 yıl ve 24.57±4.26 kg/m2 idi. Her iki grupta da tedavi öncesine göre hem 3. hafta hem de 6. hafta sonuçlarında istatistiksel olarak anlamlı gelişmeler saptandı (p<0.05). Altı haftalık uygulama sonrasında gruplar arası karşılaştırılmada Johnstone basınç splinti uygulanan grubun değerlendirilen tüm parametrelerde, NMES uygulanan gruba göre daha fazla anlamlı düzeyde gelişme gösterdiği bulundu (p<0.05). Sonuç: Konvansiyonel nörolojik rehabilitasyon uygulamasına ek olarak uygulanan Johnstone basınç splintinin inmeli hastaların motor gelişimini, bağımsızlık düzeyini, gövde kontrolünü, dengesini ve yürüme hızını elektrik stimülasyon uygulamasına göre daha fazla geliştirdiği görüldü.

Keywords

• inme
• johstone basınç splint
• elektrik stimülasyonu
• denge
• yürüme

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