[Purpose] There have been no investigations into the improvement of activities of daily living among patients suffering from post-stroke depression on admission to convalescent rehabilitation wards in Japan. This study aimed to assess the improvement of activities in daily living in patients with or without post-stroke depression at the time of admission to a convalescent rehabilitation ward. [Subjects and Methods] This retrospective study included 108 stroke patients divided into two groups according to their Geriatric Depression Scale 15-item short form scores. Activities of daily living were assessed using the Functional Independence Measure. The degree of improvement on the Functional Independence Measure was defined as the difference between scores on admission and at discharge. [Results] The Functional Independence Measure gain score was significantly different from the Functional Independence Measure total score. There was a significant interaction between time period and post-stroke depression factors for the Functional Independence Measure total score. A multiple regression analysis revealed a significant association between Geriatric Depression Scale score and Functional Independence Measure total score. [Conclusion] The present study suggests that post-stroke depression has a negative impact on recovery of activities of daily living and on rehabilitation outcomes in a convalescent rehabilitation ward setting.
[Purpose] The trunk muscles frequently become weak after stroke, thus impacting overall activities of daily living. However, activities of daily living items closely related with trunk strength remain unclear. This study aimed to clarify the influence of trunk muscle weakness on activities of daily living items. [Subjects] The subjects were 24 stroke patients who fulfilled the following inclusion criteria: first stroke and the absence of severe paralysis, marked cognitive function deterioration, unilateral spatial neglect or apathy. [Methods] According to abdominal strength, the 24 patients were divided into a nonweakness group and a weakness group. For the assessment, we used the stroke impairment assessment set, the Berg balance scale, a simple test for evaluating hand function, grip strength, and functional independence measure scale scores and the results were compared between the groups. [Results] The Berg balance scale score and scores for dressing, toilet use, transfer to bed, and walk items of the functional independence measure were significantly lower in the weakness group than in the nonweakness group. [Conclusion] Our results suggest that weakness of the abdominal muscles adversely impacts the balance of patients with mild stroke as well as their ability to dress, use a toilet, transfer, and walk. Trunk training, including abdominal muscle exercises, can effectively improve the performance of these activities of daily living items.
PurposeAlthough acute bouts of exercise reportedly have beneficial effects on executive function, inactive people may find it difficult to start exercising. In this study, we focused on housework activities (HAs) that generate a sense of accomplishment and require a mild intensity of physical activity. We examined the impact of an acute bout of HA on executive function and oxygenated hemoglobin (oxy-Hb) flow to related cortical regions.Materials and methodsTwenty-five participants (age, 18–21 years; mean, 19.88±0.60 years; six males and 19 females) underwent two experiments, ie, HA and control experiments, which were conducted on different days. Participants vacuumed a dirty floor in the HA experiment and mimicked the same motion with an unplugged vacuum cleaner on a clean floor in the control experiment.ResultsHeart rate recorded during the experiments showed no significant difference in the intensity of physical activity between control and HA groups. A questionnaire revealed a sense of accomplishment after completing the HA experiment. Participants performed the Stroop color–word task (SCWT) pre- and post-experiments; cortical hemodynamic changes were simultaneously monitored using functional near-infrared spectroscopy. Variation in Stroop interference scores for SCWT total response between pre- and post-experiments was signifi-cantly higher in the HA group than in the control group, and that for SCWT correct response showed a similar trend. Variation in the Stroop interference score for oxy-Hb flow to the right ventrolateral prefrontal cortex (R-VLPFC) showed the same trend.ConclusionThus, HAs may have a greater beneficial effect on executive function than other physical activities through the activation of PFC, including R-VLPFC.
[Purpose] This study aimed to clarify the independent impact of the affected upper and lower limb, trunk, and unaffected side motor functions on activities of daily living in stroke patients using partial correlation analysis. [Subjects and Methods] This retrospective study included 77 stroke patients. Motor functions were assessed using the Stroke Impairment Assessment Set, and the activities of daily living performance was assessed using the Barthel index or Functional Independence Measure. Further, simple and partial correlation analyses were conducted between each motor function and activities of daily living parameter. [Results] Simple correlation analysis identified significant positive correlations for each pair. In contrast, partial correlation analysis only identified significant positive correlations between the affected lower limb or unaffected side functions and the Barthel index or Functional Independence Measure. This discrepancy between the two tests was explained by the significant interaction between the affected upper and lower limb functions and between the trunk and unaffected side functions. [Conclusion] The present study identified the affected lower limb and unaffected side motor functions as the major determinants of activities of daily living performance in stroke patients. These findings suggest that rehabilitation programs can be improved by targeting these areas.
Motion and force produced by electrical neuromuscular stimulation (ENS) to each of the extensor carpi radialis longus (ECRL) and brevis (ECRB), and extensor carpi ulnaris (ECU) with the prone (P), semiprone (SP), and supine forearm (S) were studied in ten normal human subjects. Abduction (AB), extension (E), adduction (AD), and flexion (F) directions were represented by, respectively, 0°, 90°, 180°, and 270°. ENS to ECRL, ECRB, and ECU produced motion in direction of, respectively, 60° (mean), 87°, and 205° with P, 66°, 83°, and 166° with SP, and 47°, 66°, and 116° with S to maximal range. Direction/strength (Nm) of force by ENS to ECRL, ECRB, and ECU were, respectively, 54°/1.75, 74°/1.78, and 184°/1.49 with P, 34°/1.65, 63°/1.66, and 152°/1.43 with SP, and 32°/1.66, 70°/1.49, and 147°/1.25 with S. ENS to ECRL exhibited force of 15-20% of maximal E (15-20%Max-E) and 19-29%Max-AB, that to ECRB 24-32%Max-E, and that to ECU 17-30%Max-AD. The force study results suggest that ECRL is an abductor and extensor and ECRB is an extensor rather than an abductor. ECU should be an adductor rather than an extensor with SP and S and an adductor with P. The data must contribute to reconstruct motor functions of paralyzed hands.
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