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Efficacy of Isokinetic Strength Training and Balance Exercises on Lower Limb Muscles in Subjects with Stroke
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AIM: To evaluate the efficacy of isokinetic strength training and balance exercises on lower limb muscles with subjects with stroke.
Objectives:
1. To evaluate the efficacy of isokinetic strength training through isokinetc device in subjects with stroke.
2. To evaluate the efficacy of balance exercises through berg balance scale in subjects with stroke.
Methodology: 40 stroke subjects were divided into two groups, Experimental group received Isokinetic strength training and balance exercises (n=20) and Control group received conventional physiotherapy.
Research Design: Prospective randomized experimental control study.
Setting: College of Physiotherapy, svims, Tirupati, A.P, India
Sampling Method: Simple Random sampling
Sample Size: 40 subjects divided into two groups.
Inclusion Criteria:
• Age: 40-60 years.
• Gender: both male and female.
• Side: Both right and left hemiplegics.
• Subjects with first time onset of stroke.
• Subjects with Modified Ashworth scale of 1+, 2.
Exclusion Criteria:
• Subjects with hemianopsia.
• Contractures in lower limb.
• Any cognitive or sensory deficits are stroke patients.
• Other neurological and musculoskeletal conditions.
• People with cardiovascular diseases.
• Recurrent stroke.
• Participants who cannot comprehend and obey verbal commands.
Intervention: Subjects who fulfilled inclusion criteria are randomly selected into 2 groups and each group has 20 subjects.
GROUP I: (The experimental group underwent Isokinetic strengthening and balance exercises) A 6 week program which includes 5 min warm-up on stationary bicycle at low resistance followed by 65seconds stretches for hamstrings and quadriceps group of muscles on effected side. Strength training with knee extensors on isokinetic machine. 3 Sets of 6 to 8 repetition of maximum efforts followed by cool down section of 5 min of cycling, followed by balance exercises they are as follows:
The Balance Exercises Include Static Balance Exercises:
I Sitting Balance
II Standing Balance
Dynamic Balance
GROUP II: (The control group underwent conventional training)
Conventional Physiotherapy Treatment: A 6 weeks program which includes Active exercises for all groups of muscles in lower limb on effected side, Pelvic bridging followed by Modified pelvic bridging, resistance exercises for all group of muscles in lower limb with one kg weight cuff and manual resistance, weight bearing exercise in quadripod position, kneeling, half kneeling, standing, standing with single limb support, manual perturbations with wider base of support in forward, backward, sideways and finally progressing manual perturbations to narrow base of support.
Outcome Scale: Isokinetic device to measure peak torque of knee extensors on paretic leg. Berg balance scale to measure balance.
Statistical Analysis: Paired T-test has been carried out to observe the treatment impact between the groups before and after the treatment.
Results: After a 6 week treatment period, the subjects in the Group I (strength training and balance exercise) compared with the subjects in the Group II (conventional physiotherapy) had shown a statistically significant improvement with the outcome measures at 0.05 level.
Conclusion: Isokinetic strength training and balance exercise was found much effective in improving strength of quadriceps lower limb and balance in subjects with stroke.
Keywords
- Richard W Bohannon, PT, University of Connecticut, Neag School of Education, Department of Physical Therapy, U-2101, Storrs, CT 06269-2101, USA. Submitted October 3, 2006; accepted November 8, 2006
- Scelsi R, Lotta S, Lommi G, Poggi P, Marchetti C, Hemiplegia atorpy. Morphology findings in the anterior tibial muscles of patients with cerebral vascular accidents. Acta Neuropathol1984; 62:324-31.
- Dietz V, Ketelsen UP, Berger W, Quintern J. Motor unit involvement in spastic paresis. Relationship between leg muscle activation and histochemistry. J Neurol 1993; 33:109-14.
- Dattola R, Girlanda p, Vita G, et al: an electrophysiological and morphological study.Eur Neyrol 1993; 33:109-14.
- Hachisuka K, Umezu Y, Ogata H. Disuse muscle atrophy of lower limbs in hemiplegic patients. Arch Phys Med Rehabil 1997; 78:13-18.
- Lamb SE, Ferrucci L, Volapto S, Fried LP, Guralnik JM, Women’s Health and ging Study. Risk factors for falling in home-dwelling older women with stroke: The Women’s Health and Aging Study. Stroke. 2003;34(2):494–501.[PMID: 12574566]
- Harris JE, Eng JJ, Marigold DS, Tokuno CD, Louis CL.Relationship of balance and mobility to fall incidence in people with chronic stroke. Phys Ther. 2005;85(2):150–58.[PMID: 15679466]
- Belgen B, Beninato M, Sullivan PE, Narielwalla K. The association of balance capacity and falls self-efficacy with history of falling in communitydwelling people with chronic stroke. Arch Phys Med Rehabil. 2006;87(4):554–61. [PMID: 16571397]
- Chen IC, Cheng PT, Hu AL, Liaw MY, Chen LR, Hong WH, Wong MK. Balance evaluation in hemiplegic stroke patients. Chan Gung Med J. 2000;23(6):339–47. [PMID: 10958036]
- Tyson SF, Hanley M, Chillala J, Selley A, Tallis RC. Balance disability after stroke. Phys Ther. 2006;86(1):30–38.[PMID: 16386060] Erratum in: Phys Ther. 2006;86(3):463.
- Nashner LM, Black FO, Wall C 3rd. Adaptation to altered support and visual conditions during stance: Patients withvestibular deficits. J Neurosci. 1982;2(5):536– 44.[PMID: 6978930]
- Rode G, Tiliket C, Boisson D. Predominance of postural imbalance in left hemiparetic patients. Scand J RehabilMed. 1997;29(1):11–16. [PMID: 9084100]
- Shigematsu R, Rantanen T, Saari P, et al. Motor speed and lower extremity strength as predictors of fall-related bone fractures in elderly individuals, Aging Clin Exp Res;2006;18:320-4.
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