Effect of Trunk Support on Upper Extremity Function in People With Chronic Stroke and People Who Are Healthy

Wee, Seng Kwee; Hughes, Ann‐Marie; Warner, Martin; Brown, Simon; Cranny, Andy; Mazomenos, Evangelos B.; Burridge, Jane

doi:10.2522/ptj.20140487

Cited by 31 publications

(32 citation statements)

References 39 publications

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“…Limiting compensatory trunk movement, while performing reaching movement, has been shown to be effective in improving movement quality in stroke survivors 36,37 . Our set-up prevented trunk flexion and rotation and minimised shoulder girdle movement, permitting only elbow and shoulder movement for the performance of the reaching movement.…”

Section: Reducing Movement Variabilitymentioning

confidence: 99%

Chronic Stroke Survivors Improve Reaching Accuracy by Reducing Movement Variability at the Trained Movement Speed

Hammerbeck

Yousif

Hoad³

et al. 2017

Neurorehabil Neural Repair

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Abstract:Background: Recovery from stroke is often said to have "plateaued" after 6-12 months. Yet training can still improve performance even in the chronic phase. Here we investigate the biomechanics of accuracy improvements during a reaching task and test whether they are affected by the speed at which movements are practised. Method: We trained 36 chronic stroke survivors (57.5 years, SD ±11.5; 10 females) over four consecutive days to improve endpoint accuracy in an arm-reaching task (420 repetitions/day). Half of the group trained using fast and the other half slow movements. The trunk was constrained allowing only shoulder and elbow movement for task performance. Results: Before training, movements were variable, tended to undershoot the target and terminate in contralateral workspace (flexion bias). Both groups improved movement accuracy by reducing trial-to-trial variability; however, change in endpoint bias (systematic error) was not significant. Improvements were greatest at the trained movement speed and generalised to other speeds in the fast training group. Small but significant improvements were observed in clinical measures in the fast training group. Conclusions: The reduction in trial-to-trial variability without an alteration to endpoint bias suggests that improvements are achieved by better control over motor commands within the existing repertoire. Thus, 4 days' training allows stroke survivors to improve movements that they can http://mc.manuscriptcentral.com/nnr Neurorehabilitation & Neural Repair F o r P e e r R e v i e w already make. Whether new movement patterns can be acquired in the chronic phase will need to be tested in longer-term studies. We recommend that training needs to be performed at slow and fast movement speeds to enhance generalisation. AbstractBackground: Recovery from stroke is often said to have "plateaued" after 6-12months. Yet training can still improve performance even in the chronic phase. Here we investigate the biomechanics of accuracy improvements during a reaching task and test whether they are affected by the speed at which movements are practised. Method:We trained 36 chronic stroke survivors (57.5 years, SD ±11.5; 10 females) over four consecutive days to improve endpoint accuracy in an arm-reaching task (420 repetitions/day). Half of the group trained using fast and the other half slow movements. The trunk was constrained allowing only shoulder and elbow movement for task performance.Results: Before training, movements were variable, tended to undershoot the target and terminate in contralateral workspace (flexion bias). Both groups improved movement accuracy by reducing trial-to-trial variability; however, change in endpoint bias (systematic error) was not significant. Improvements were greatest at the trained movement speed and generalised to other speeds in the fast training group. Small but significant improvements were observed in clinical measures in the fast training group. Conclusions:The reduction in trial-to-trial variability without an alterati...

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Section: Reducing Movement Variabilitymentioning

confidence: 99%

Chronic Stroke Survivors Improve Reaching Accuracy by Reducing Movement Variability at the Trained Movement Speed

Hammerbeck

Yousif

Hoad³

et al. 2017

Neurorehabil Neural Repair

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“…Kelumpuhan fisik pasca Stroke disebabkan oleh gangguan postural tubuh yang dapat mempengaruhi keseimbangan, kemampuan berjalan dan meningkatkan risiko jatuh klien serta gangguan aktivitas fungsional sehari-hari yang terkait dengan peran vital fungsi ekstremitas atas. (Weerdesteyn et al 2008;Saeys et al 2012;Aprile et al 2006;Wee et al 2015). Truncal control exercise memperbaiki dan memelihara postural tubuh yang baik dalam melakukan gerak serta menjadi dasar untuk semua gerakan pada lengan dan tungkai.…”

Section: Pendahuluanunclassified

“…Keterlambatan aktifitas otot dan pembentukan gerakan pada ekstremitas atas-bawah mempengaruhi stabilitas tubuh dalam merespon keseimbangan yang menyebabkan klien pasca Stroke mengalami gangguan postural hingga klien dapat terjatuh saat memulai gerakan berdiri dan berjalan serta gangguan aktivitas fungsional sehari-hari akibat penurunan kemampuan fungsi ekstremitas atas klien (Irfan 2012;Saeys et al 2012;Wee et al 2015). Kemampuan kontrol postural dibutuhkan dalam seluruh aspek gerakan fungsional tubuh dan terkait dengan peran dasar dalam keseimbangan postur sehingga gerak ekstremitas atas-bawah menjadi terkontrol dan efisien (Lalonde & Strazielle 2007;Karthikbabu et al 2011).…”

Section: Pendahuluanunclassified

“…Hasil penelitian yang ditemukan peneliti hanya terkait penguatan kontrol otot trunk dengan pemberian restrain dalam peningkatan fungsi ekstremitas atas, yaitu penelitian yang dilakukan Wee et al (2015) dengan desain cross sectional study, didapatkan bahwa klien pascastroke dengan hemiplegia yang mendapatkan penguatan terhadap kontrol trunk, melalui pengukuran the streamlined wolf motor function test dtemukan terjadi penurunan waktu performance sebesar 1,83 detik dan peningkatan kemampuan fungsional ekstremitas atas sebesar 0,1 poin (Wee et al, 2015). Hasil penelitian ini menunjukkan bahwa setengah klien pascastroke mempunyai manifestasi klinis yang sama yaitu hemiparesis kanan-kiri atas-bawah.…”

Section: Pembahasanunclassified

“…Secara teori, truncal control exercise dapat memperkuat otot-otot trunk yang akan melatarbelakangi stabilisasi otot inti dari tubuh sehingga dapat meningkatkan pergerakan segmen proksimal dan distal dari ekstremitas atas (Gjelsvik 2014;Wee et al, 2015). Latihan stabilisasi otot trunk didapatkan memiliki efek pada stabilisasi bahu yang diikuti peningkatan gerakan siku, pergelangan tangan dan jari.…”

Section: Pembahasanunclassified

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The Effectiveness of Nursing Interventions Truncal Control Exercise Against the Upper Limb Function, Balance, and Gait on the Client Post Stroke

Kusnanto

Ardiansyah

Harmayetty³

2016

Nursing

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ABSTRAK:Pendahuluan: Klien pascastroke akan mengalami gangguan postural tubuh yang dapat mempengaruhi keseimbangan, kemampuan berjalan dan fungsi ekstremitas atas. Truncal control exercise memperbaiki dan memelihara postural tubuh yang baik. Rehabilitasi pascastroke masih berfokus pada latihan tungkai atas dan bawah hemiplegia dibandingkan perbaikan postural tubuh. Metode: Jenis penelitian menggunakan Quasy eksperimental dengan desain control group pretest -postest. Besar sampel didapatkan dengan tehnik consequetive sampling terdiri dari 20 responden (n-perlakuan = 10 dan n-kontrol = 10). Variabel independen adalah truncal control exercise. Variabel dependen adalah fungsi ekstremitas atas, keseimbangan, dan berjalan. Data dikumpulkan dengan menggunakan lembar observasi dan ceklist. Analisa data menggunakan independent t-test dan paired t-test dengan α = 0,05. Hasil: Hasil uji statistik kelompok perlakuan dan kontrol didapatkan p-value kemampuan fungsional ekstremitas atas = 0,270 dan p-value performance fungsi ekstremitas atas = 0,289. Hasil uji statistik kelompok perlakuan dan kontrol didapatkan p-value keseimbangan = 0,017. Hasil uji statistik kelompok perlakuan dan kontrol didapatkan p-value berjalan = 0,026. Diskusi: Intervensi keperawatan truncal control exercise kurang efektif terhadap perubahan fungsi ekstremitas atas, tetapi efektif terhadap keseimbangan dan berjalan klien pascastroke. Intervensi keperawatan truncal control exercise dapat dilanjutkan sebagai bentuk tindakan kolaboratif bagi perawat medikal bedah dengan fisioterapi untuk mengoptimalkan program rehabilitasi klien pascastroke dengan masalah keseimbangan dan berjalan di klinik maupun rumah klien. The number of samples obtained with consecutive sampling techniques that appropriate criteria research consists of 20 respondents (n = 10 treatment-and n-control = 10). The independent variable is the truncal control exercise. The dependent variable is the function of the upper limb, balance, and gait. Data were collected by using observation and checklist sheets. Data were analyzed using independent t-test and paired t-test with α = 0,05. Results: The results of statistical tests performed in the treatment group and the control was obtained p-value of the functional capabilities of the upper limb = 0.270 and p-value of performance of upper limb function = 0.289. The results of statistical tests performed in the treatment group and the control was obtained p-value of balance = 0.017. The results of statistical tests performed in the treatment group and the control was obtained p-value of gait = 0.026. Discussion: Nursing interventions truncal control exercise have less effective results to changes in upper limb function, but it is effective to balance and walk clients pascastroke. Nursing interventions truncal control exercise can be continued as a form of collaborative action for medical-surgical nurse with physiotherapy to optimize rehabilitation programs of posstroke clients with balance and gait problems in clinic or home's client.

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Trunk training for improving activities in people with stroke

Thijs

Denissen

Mehrholz

et al. 2020

Cochrane Database of Systematic Reviews

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Effect of Trunk Support on Upper Extremity Function in People With Chronic Stroke and People Who Are Healthy

Cited by 31 publications

References 39 publications

Chronic Stroke Survivors Improve Reaching Accuracy by Reducing Movement Variability at the Trained Movement Speed

Chronic Stroke Survivors Improve Reaching Accuracy by Reducing Movement Variability at the Trained Movement Speed

The Effectiveness of Nursing Interventions Truncal Control Exercise Against the Upper Limb Function, Balance, and Gait on the Client Post Stroke

Trunk training for improving activities in people with stroke

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