Effect of Scapular Stabilization Exercise during Standing on Upper Limb Function and Gait Ability of Stroke Patients

J O Kim, J Lee, B H Lee, J O Kim, J Lee, B H Lee

Abstract

Background: The purpose of this study was to determine the effect of scapular stabilization exercise during standing on a paretic side on upper limb function and gait ability of stroke patients.

Methods: This study was a hospital-based, randomized controlled trial with a blinded assessor. A total of 17 patients with hemiplegic diagnosis after stroke were divided into two groups (9 patients in a study group and 8 patients in a control group). The study group received physical therapy and scapular stabilization exercise on a paretic side. Participants were subjected to initial evaluation before the treatment. Subjects were subsequently re-evaluated 4 and 8 weeks later to compare the changes. Measurements of hand function and gait ability were performed.

Results: Based on multivariate analysis of variance for repeated-measures, there was a significant time effect for Timed Up and Go test (TUG) (F = 13.816, P = 0.000), Functional Gait Assessment (FGA) (F = 18.613, P = 0.000), and manual function test (MFT) (F = 16.777, P = 0.000). The group × time interaction effect was also significant for FGA (F = 4.966, P = 0.024) and MFT (F = 6.946, P = 0.003), but not for TUG test (F = 3.343, P = 0.069).

Conclusion: Results of the present study indicated that scapular stabilization exercise during standing on a paretic side for 8 weeks had an effect on hand function and gait ability of hemiplegic patients after stroke. Further studies are needed to find the most proper exercise for stroke patients who have gait disability and upper limb dysfunction.

Keywords: Gait; scapular stabilization exercise; stroke; upper limb function.

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Flow of participants through the exercise program

References

    1. Davies PM. Steps to Follow: A Guide to the Treatment of Adult Hemiplegia: Based on the Concept of K. and B. Bobath Berlin, New York: Springer-Verlag; 1985.
    1. Woodson C, Bandy WD, Curis D, Baldwin D. Relationship of isokinetic peak torque with work and power for ankle plantar flexion and dorsiflexion. J Orthop Sports Phys Ther. 1995;22:113–5.
    1. Basmajian JV. The 38th annual John Stanley Coulter lecture. The Winter of Our Discontent: Breaking intolerable time locks for stroke survivors. Arch Phys Med Rehabil. 1989;70:92–4.
    1. Cromwell RL, Aadland-Monahan TK, Nelson AT, Stern-Sylvestre SM, Seder B. Sagittal plane analysis of head, neck, and trunk kinematics and electromyographic activity during locomotion. J Orthop Sports Phys Ther. 2001;31:255–62.
    1. Winter DA, Patla AE, Frank JS, Walt SE. Biomechanical walking pattern changes in the fit and healthy elderly. Phys Ther. 1990;70:340–7.
    1. Pozzo T, Berthoz A, Lefort L, Vitte E. Head stabilization during various locomotor tasks in humans. II. Patients with bilateral peripheral vestibular deficits. Exp Brain Res. 1991;85:208–17.
    1. Mottram SL. Dynamic stability of the scapula. Man Ther. 1997;2:123–31.
    1. MacKay-Lyons M. Central pattern generation of locomotion: A review of the evidence. Phys Ther. 2002;82:69–83.
    1. Olney SJ, Griffin MP, Monga TN, McBride ID. Work and power in gait of stroke patients. Arch Phys Med Rehabil. 1991;72:309–14.
    1. Winter DA. Biomechanical motor patterns in normal walking. J Mot Behav. 1983;15:302–30.
    1. Balasubramanian CK, Bowden MG, Neptune RR, Kautz SA. Relationship between step length asymmetry and walking performance in subjects with chronic hemiparesis. Arch Phys Med Rehabil. 2007;88:43–9.
    1. Michaelsen SM, Dannenbaum R, Levin MF. Task-specific training with trunk restraint on arm recovery in stroke: Randomized control trial. Stroke. 2006;37:186–92.
    1. Mackintosh SF, Hill K, Dodd KJ, Goldie P, Culham E. Falls and injury prevention should be part of every stroke rehabilitation plan. Clin Rehabil. 2005;19:441–51.
    1. Ebaugh DD, McClure PW, Karduna AR. Three-dimensional scapulothoracic motion during active and passive arm elevation. Clin Biomech (Bristol, Avon) 2005;20:700–9.
    1. Lin JJ, Hanten WP, Olson SL, Roddey TS, Soto-quijano DA, Lim HK, et al. Functional activity characteristics of individuals with shoulder dysfunctions. J Electromyogr Kinesiol. 2005;15:576–86.
    1. You YY, Her JG, Woo JH, Ko T, Chung SH. The effects of stretching and stabilization exercise on the improvement of spastic shoulder function in hemiplegic patients. J Phys Ther Sci. 2014;26:491–5.
    1. Yang J, Lee J, Lee B, Jeon S, Han B, Han D, et al. The effects of active scapular protraction on the muscle activation and function of the upper extremity. J Phys Ther Sci. 2014;26:599–603.
    1. Awad A, Shaker H, Shendy W, Fahmy M. Effect of shoulder girdle strengthening on trunk alignment in patients with stroke. J Phys Ther Sci. 2015;27:2195–200.
    1. Patterson SL, Forrester LW, Rodgers MM, Ryan AS, Ivey FM, Sorkin JD, et al. Determinants of walking function after stroke: Differences by deficit severity. Arch Phys Med Rehabil. 2007;88:115–9.
    1. Dunsky A, Dickstein R, Marcovitz E, Levy S, Deutsch JE. Home-based motor imagery training for gait rehabilitation of people with chronic poststroke hemiparesis. Arch Phys Med Rehabil. 2008;89:1580–8.
    1. Pang MY, Eng JJ, Dawson AS. Relationship between ambulatory capacity and cardiorespiratory fitness in chronic stroke: Influence of stroke-specific impairments. Chest. 2005;127:495–501.
    1. Kottink AI, Hermens HJ, Nene AV, Tenniglo MJ, van der Aa HE, Buschman HP, et al. A randomized controlled trial of an implantable 2-channel peroneal nerve stimulator on walking speed and activity in poststroke hemiplegia. Arch Phys Med Rehabil. 2007;88:971–8.
    1. Ada L, Dorsch S, Canning CG. Strengthening interventions increase strength and improve activity after stroke: A systematic review. Aust J Physiother. 2006;52:241–8.
    1. Podsiadlo D, Richardson S. The timed “Up & amp; go”: A test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39:142–8.
    1. Leddy AL, Crowner BE, Earhart GM. Functional gait assessment and balance evaluation system test: Reliability, validity, sensitivity, and specificity for identifying individuals with Parkinson disease who fall. Phys Ther. 2011;91:102–13.
    1. Miyamoto S, Kondo T, Suzukamo Y, Michimata A, Izumi S. Reliability and validity of the manual function test in patients with stroke. Am J Phys Med Rehabil. 2009;88:247–55.
    1. Horstmann S, Koziol JA, Martinez-Torres F, Nagel S, Gardner H, Wagner S, et al. Sonographic monitoring of mass effect in stroke patients treated with hypothermia. Correlation with intracranial pressure and matrix metalloproteinase 2 and 9 expression. J Neurol Sci. 2009;276:75–8.
    1. Park JH, Hwangbo G, Kim JS. The effect of treadmill-based incremental leg weight loading training on the balance of stroke patients. J Phys Ther Sci. 2014;26:235–7.
    1. Eng JJ, Chu KS. Reliability and comparison of weight-bearing ability during standing tasks for individuals with chronic stroke. Arch Phys Med Rehabil. 2002;83:1138–44.
    1. Jette AM. Toward a common language for function, disability, and health. Phys Ther. 2006;86:726–34.
    1. Hsu AL, Tang PF, Jan MH. Analysis of impairments influencing gait velocity and asymmetry of hemiplegic patients after mild to moderate stroke. Arch Phys Med Rehabil. 2003;84:1185–93.
    1. Patterson SL, Rodgers MM, Macko RF, Forrester LW. Effect of treadmill exercise training on spatial and temporal gait parameters in subjects with chronic stroke: A preliminary report. J Rehabil Res Dev. 2008;45:221–8.
    1. Hill TR, Gjellesvik TI, Moen PM, Tørhaug T, Fimland MS, Helgerud J, et al. Maximal strength training enhances strength and functional performance in chronic stroke survivors. Am J Phys Med Rehabil. 2012;91:393–400.
    1. Trombly CA, Wu CY. Effect of rehabilitation tasks on organization of movement after stroke. Am J Occup Ther. 1999;53:333–44.
    1. Nakayama H, Jørgensen HS, Raaschou HO, Olsen TS. Compensation in recovery of upper extremity function after stroke: The copenhagen stroke study. Arch Phys Med Rehabil. 1994;75:852–7.
    1. Oujamaa L, Relave I, Froger J, Mottet D, Pelissier JY. Rehabilitation of arm function after stroke. Literature review. Ann Phys Rehabil Med. 2009;52:269–93.
    1. Hsieh CL, Sheu CF, Hsueh IP, Wang CH. Trunk control as an early predictor of comprehensive activities of daily living function in stroke patients. Stroke. 2002;33:2626–30.
    1. Hardwick DD, Lang CE. Scapular and humeral movement patterns of people with stroke during range-of-motion exercises. J Neurol Phys Ther. 2011;35:18–25.

Source: PubMed

Sponsorer og samarbeidspartnere

Medisinsk tilstand

Legemiddelintervensjoner

3
Abonnere