Improvement In Performance Of Activities Research Articles

Effects of acupuncture combined with rehabilitation training on unilateral spatial neglect

Objective To explore the effect of acupuncture combined with rehabilitation training on unilateral spatial neglect (USN). Methods One hundred stroke patients with USN were randomly divided into a treatment group (n=50) and a control group (n=50). Both groups were treated with routine rehabilitation training for 4 weeks, while the treatment group was additionally treated with acupuncture. Before and after the treatment, the degree of USN was evaluated in both groups along with the Fugl-Meyer assessment, the modified Barthel index and the incidence of shoulder pain. Results No significant differences were found between the 2 groups in any of the measurements before the treatment. After the treatment the incidence of shoulder pain in the treatment group was significantly lower than that in the control group. All the other measurements were significantly higher in the treatment group than in the control group. Conclusion Acupuncture combined with rehabilitation training can significantly improve the symptoms of unilateral spatial neglect, improve motor function in a hemiplegic limb and improve performance in the activities of daily living. Key words: Acupuncture; Stroke; Unilateral spatial neglect; Rehabilitation

Restoration of Upper Limb Function in an Individual with Cervical Spondylotic Myelopathy using Functional Electrical Stimulation Therapy: A Case Study

Non-traumatic spinal cord pathology is responsible for 25–52% of all spinal cord lesions. Studies have revealed that spinal stenosis accounts for 16–21% of spinal cord injury (SCI) admissions. Impaired grips as well as slow unskilled hand and finger movements are the most common complaints in patients with spinal cord disorders, such as myelopathy secondary to cervical spondylosis. In the past, our team carried out couple of successful clinical trials, including two randomized control trials, showing that functional electrical stimulation therapy (FEST) can restore voluntary reaching and/or grasping function, in people with stroke and traumatic SCI. Motivated by this success, we decided to examine changes in the upper limb function following FEST in a patient who suffered loss of hand function due to myelopathy secondary to cervical spondylosis. The participant was a 61-year-old male who had C3–C7 posterior laminectomy and instrumented fusion for cervical myelopathy. The participant presented with progressive right hand weakness that resulted in his inability to voluntarily open and close the hand and to manipulate objects unilaterally with his right hand. The participant was enrolled in the study ~22 months following initial surgical intervention. Participant was assessed using Toronto Rehabilitation Institute’s Hand Function Test (TRI-HFT), Action Research Arm Test (ARAT), Functional Independence Measure (FIM), and Spinal Cord Independence Measure (SCIM). The pre–post differences in scores on all measures clearly demonstrated improvement in voluntary hand function following 15 1-h FEST sessions. The changes observed were meaningful and have resulted in substantial improvement in performance of activities of daily living. These results provide preliminary evidence that FEST has a potential to improve upper limb function in patients with non-traumatic SCI, such as myelopathy secondary to cervical spondylosis.

WARM-UP PROTOCOLS FOR HIGH SCHOOL STUDENTS.

The study compared the acute effects of three warm-up protocols on change-of-direction speed, reaction time, and movement time of upper extremities. Participants were 27 Greek high school students from an urban area (M age=17.2 yr., SD=0.2, range=16.5-18.0). All participants performed the following warm-up protocols on three different days: (a) 3 min. jogging followed by 5 min. static stretching, (b) 3 min. jogging followed by 5 min. dynamic stretching, and (c) 3 min. jogging followed by 5 min. of rest without stretching. At the end of each protocol, participants performed sprints of moderate to submaximal intensity. After the warm-up protocols, participants performed the following tests: "505-change-of-direction-speed," reaction time, and movement time (arm movements). There was no significant effect of protocols on the performance tests. Pre-exercise stretching may not be required for performance improvement in activities involving change-of-direction speed, reaction, and movement time if the final part of the warm-up involves sprinting. The advantage of a short duration warm-up is that it offers students more time to play in physical education lessons. However, it is generally important for students to learn the benefits of stretching and how to stretch for lifelong fitness.

Theatre Arts for Improving Cognitive and Affective Health

This article presents, for the first time, the methodological details of a theatrical intervention designed to enhance the mental/emotional health and psychological well-being of older adults. A step-by-step plan is offered for health care professionals and activity directors who might wish to carry out this program in their own facilities. The authors’ supporting research documented significant improvements in performance of activities of daily living, as well as on standard measures of memory, comprehension, problem-solving ability, and personal growth through this unique intervention.

Effect of home-based hand exercises in women with hand osteoarthritis: a randomised controlled trial

BackgroundHand exercises are recommended for patients with hand osteoarthritis (HOA), though evidence for their effect is conflicting.ObjectiveTo evaluate, in a randomised controlled trial, the effect of HOA information plus home-based...

Effects of muscle energy technique combined with joint mobilization in the management of frozen shoulder

Objective To observe the therapeutic effects of muscle energy technique combined with joint mobilization on frozen shoulder.Methods Thirty-six patients with frozen shoulder were randomly assigned to:group A (treated with muscle energy technique plus joint mobilization),group B (treated with passive stretching with joint mobilization),and group C (treated with joint mobilization merely),and each had 12 patients.All the patients were treated accordingly for 3 times a week,totally for 4 weeks.The American Shoulder and Elbow Surgeons evaluation system (ASES) was adopted to evaluate clinical effects before and at the end of treatment.Results After 4 weeks of treatment,all patients' ASES scores were improved significantly (P ＜ 0.05).The improvement in the shoulder score index and shoulder range of motion were to a significantly better extent in group A than in the other two groups.Conclusion Muscle energy technique plus joint mobilization could effectively relieve pain increase the shoulder ROM and improve performance in activities of daily living in patients suffering from frozen shoulder. Key words: Frozen shoulder; Muscle energy technique; Passive stretch; Arthrogryposis; Joint mobilization

A multi‐site study of functional outcomes following a themed approach to hand–arm bimanual intensive therapy for children with hemiplegia

This study investigated the effects of a theme-based ('magic') variation of the hand-arm bimanual intensive therapy programme, in two different countries, in improving activity performance for children with hemiplegia, including those with severe movement restrictions. Twenty-three children with spastic hemiplegia (13 males, 10 females; mean age 10y 7mo, range 7-15y; Manual Ability Classification System level I, two; level II, 13; level III, eight), participated in one of three, 2-week, summer camps. A within-participant experimental design was used with the Assisting Hand Assessment and Children's Hand Experience Questionnaire as primary outcome measures. Evaluations occurred immediately before the first day, on the last day, and 3months after intervention. Two groups underwent additional assessments 2weeks before the camp. Significant intervention effects were seen on the Assisting Hand Assessment (p=0.002) and on the Children's Hand Experience Questionnaire (p<0.001), the latter maintained at follow-up. The affected hand was reported to be used in 25% of bimanual activities before the camp, progressing to 93% after camp, and decreasing to 86% at follow-up. Severity of impairment did not influence progress. This themed approach to intensive intervention showed positive results in bimanual use, with improvements in independence sustained at follow-up. Although children across camps and motor severity made progress, some questions remain about intensity and duration of intervention to optimize longer-term outcomes.

Is Occupational Therapy Adequately Meeting the Needs of People With Chronic Pain?

Is Occupational Therapy Adequately Meeting the Needs of People With Chronic Pain?

Scapular fixation in muscular dystrophy

Winging of the scapula is caused by weakness of the thoracoscapular muscles, which allows the scapula to lift off the chest wall during shoulder movements. In facioscapulohumeral muscular dystrophy (and occasionally in other muscular dystrophies) there is selective weakness of the thoracoscapular muscles which may spare other shoulder muscles such as the deltoid muscle. This imbalance results in significant winging and loss of shoulder function. Historically, a number of different surgical and non-surgical interventions have been used to achieve scapular stability. This review examines the evidence available for the use of all scapular fixation techniques in muscular dystrophy, especially facioscapulohumeral muscular dystrophy. To examine the evidence for the relative efficacy of scapular fixation techniques in muscular dystrophy (especially facioscapulohumeral muscular dystrophy) in improving upper limb function. We searched the Cochrane Neuromuscular Disease Group Trials Specialized Register (20 July 2009), The Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 3, 2009) Medline (1966 to July 2009) and EMBASE (1980 to July 2009) for randomised trials. We also contacted authors of trials and other experts in the field. All reports of scapular fixation for muscular dystrophy, including quasi-randomised or randomised controlled trials, comparing any form of scapular fixation (surgical and non-surgical) in people (of all ages and of all severity) with scapular winging due to muscular dystrophy. Our primary outcome measure was objective improvement in shoulder abduction. Our secondary outcome measures were: patient-perceived improvement in performance of activities of daily living, cosmetic results, subjective improvement in pain and proportion of patients with significant postoperative complications. We collated and summarised studies on the treatment of scapular winging in muscular dystrophy. No randomised trials were identified. We therefore present a review of the non-randomised literature available. There is no evidence from randomised trials to support the suggestion from observational studies that operative interventions produce significant benefits. However, these have to be balanced against postoperative immobilisation, need for physiotherapy and potential complications. We conclude that a randomised trial would be difficult, but a register of cases and the use of a standardised assessment protocol would allow more accurate comparison of the disparate techniques.

A randomized trial of novel upper limb rehabilitation in children with congenital hemiplegia

A randomized trial of novel upper limb rehabilitation in children with congenital hemiplegia

Scapular fixation in muscular dystrophy.

Winging of the scapula is caused by weakness of the thoracoscapular muscles, which allows the scapula to lift off the chest wall during shoulder movements. In facioscapulohumeral muscular dystrophy (and occasionally in other muscular dystrophies) there is selective weakness of the thoracoscapular muscles which may spare other shoulder muscles such as the deltoid muscle. This imbalance results in significant winging and loss of shoulder function. Historically, a number of different surgical and non-surgical interventions have been used to achieve scapular stability. This review examines the evidence available for the use of all scapular fixation techniques in muscular dystrophy, especially facioscapulohumeral muscular dystrophy. To examine the evidence for the relative efficacy of scapular fixation techniques in muscular dystrophy (especially fascioscapulohumeral muscular dystrophy) in improving upper limb function. We searched the Cochrane Neuromuscular Disease Group trials register (search updated March 2003) for randomised trials and other reports, and made enquiries from authors of trials and other experts in the field. All reports of scapular fixation for muscular dystrophy, including quasi-randomised or randomised controlled trials, comparing any form of scapular fixation (surgical and non-surgical) in people (of all ages and of all severity) with scapular winging due to muscular dystrophy. Our primary outcome measure was objective improvement in shoulder abduction. Our secondary outcome measures were: patient-perceived improvement in performance of activities of daily living, cosmetic results, subjective improvement in pain and proportion of patients with significant postoperative complications. We collated and summarised studies on the treatment of scapular winging in muscular dystrophy. No randomised trials were identified. We therefore present a review of the non-randomised literature available. Operative interventions appear to produce significant benefits, though these have to be balanced against postoperative immobilisation, need for physiotherapy and potential complications. We conclude that a randomised trial would be difficult, but a register of cases and the use of a standardised assessment protocol would allow more accurate comparison of the disparate techniques.

Virtual Reality Promotes Visual and Cognitive Function in Rehabilitation

The purpose of this study is to evaluate the effectiveness of virtual reality (VR) in cognitive and perceptual dysfunction. Patients who have suffered cerebro-vascular accidents may exhibit visual field and auditory processing deficits, which may pose a challenge for clinicians in the rehabilitation setting. Visual neglect and auditory processing can greatly interfere with a person's ability to perform activities of daily living. These can include reading, writing, dressing, self care activities, communicating, and establishing eye contact during conversational exchanges. Occupational therapists and speech-language pathologists coordinate their treatment goals to address these cognitive and visual perceptual deficits for improved communication skills and performance of daily functional activities. Our focus is to demonstrate how VR can be used in conjunction with traditional therapeutic techniques to facilitate a patient's ability to follow multi-unit commands and increase visual attention to the affected side. The VR technology used in this particular procedure is nonimmersive, which allows for full body movement and immediate feedback. Future efforts to determine the feasibility of VR in other aspects of rehabilitation are currently being explored.

Vertical Banded Gastroplasty for Sleep Apnea Syndrome Associated with Morbid Obesity.

We report a case of morbid obesity accompanied by obstructive sleep apnea syndrome (SAS) and obesity hypoventilation syndrome (OHS). Satisfactory weight control was obtained without significant surgical complications after vertical banded gastroplasty. With the reduction in weight, the symptoms of SAS and OHS, as well as several other complications caused by the severe obesity, disappeared. Quality of life also improved remarkably, as exhibited by improved activity performance and disappearance of irritability at waking. Thus, it appears that vertical banded gastroplasty is efficacious in the treatment of morbid obesity with sleep apnea and hypoventilation.