Purpose. The goal of this study was to investigate the effects of arm weight support training using the ArmeoSpring for subacute patients after stroke with different levels of hemiplegic arm impairments. Methods. 48 inpatients with subacute stroke, stratified into 3 groups from mild to severe upper extremity impairment, were engaged in ArmeoSpring training for 45 minutes daily, 5 days per week for 3 weeks, in addition to conventional rehabilitation. Evaluations were conducted at three measurement occasions: immediately before training (T1); immediately after training (T2); and at a 3-week follow-up (T3) by a blind rater. Results. Shoulder flexion active range of motion, Upper Extremity Scores in the Fugl-Meyer Assessment (FMA), and Vertical Catch had the greatest differences in gain scores for patients between severe and moderate impairments, whereas FMA Hand Scores had significant differences in gain scores between moderate and mild impairments. There was no significant change in muscle tone or hand-path ratios between T1, T2, and T3 within the groups. Conclusion. Arm weight support training is beneficial for subacute stroke patients with moderate to severe arm impairments, especially to improve vertical control such as shoulder flexion, and there were no adverse effects in muscle tone.
Objective : To investigate the effectiveness of voluntary trunk rotation and half-field eye-patching to treat patients with unilateral neglect in stroke. Design : Pre—post, day 60 follow-up, single-blinded randomized controlled trial. Setting : Single-centre inpatient rehabilitation hospital. Subjects : Sixty subacute patients with right hemisphere stroke having unilateral neglect within eight weeks post stroke consented to participate between November 2003 and July 2005. They were randomly assigned to three comparison groups. Interventions : Nineteen patients received daily experimental training in voluntary trunk rotation (TR) for 1 hour five times a week for 30 days. Twenty patients received the same kind of treatment together with half-field eye-patching (TR + EP). Fifteen patients in the control group received conventional training with the same contact time. Main outcome measures : Patients were assessed on days 0, 30 and 60 using the Behavioural Inattention Test, the Clock Drawing Test, and the Functional Independence Measure. Results : No significant differences between voluntary trunk rotation (TR), voluntary trunk rotation and half-field eye-patching (TR + EP) and controls were found in functional performance and neglect measures at day 30 (P = 0.042—0.994) and follow-up (P = 0.052—0.911) at P = 0.005 using Bonferroni correction. Conclusions : The results of this study do not support the use of voluntary trunk rotation alone or with half-field eye-patching to improve functional performance or reduce unilateral neglect in subacute patients with stroke.
Objective/Background The reliability and validity of the Chinese version of the Kid-KINDL R questionnaire were examined with school-aged children in Hong Kong. Methods A total of 112 healthy children were selected by convenience sampling from two primary schools and 30 children with global developmental delay were selected from an outpatient occupational therapy department of a convalescent hospital. The Kid-KINDL R questionnaire was translated using independent forward and backward translation. The content validity of the translated instrument was evaluated by four experts. Internal consistency, factor analysis, and construct validity were examined in the healthy children group, whereas known-group comparison was performed in the group with global developmental delay. Results The significance value of the Shapiro—Wilk test was greater than 0.05, indicating that the sample displayed a normal distribution. The total score had good internal consistency (Cronbach's alpha = .77); however, the consistency of the subscales varied (Cronbach's alpha ranged from .47 to .70). The children and parent questionnaires did not load onto the six factors originally hypothesized. Instead, seven factors were generated. Evidence supporting the questionnaire's validity included a lack of age and sex bias and positive known-group differentiation (Wilks’ lambda = 0.906, p = .035). Conclusion The Chinese version of the Kid-KINDL R questionnaire exhibited good psychometric properties, but the internal consistency of the translated instrument needs further improvement. It is recommended that practitioners focus on the Kid-KINDL R total score when interpreting the Kid-KINDL R data. Overall, the study findings indicate that the Chinese version of the Kid-KINDL R is an important tool for use in clinical practice.
To compare the effects of contralesional sensory cueing and limb activation with that of sham control in the treatment of unilateral neglect after stroke.A randomized, single-blinded, sham-controlled pilot study.Two rehabilitation hospitals.Forty subacute left hemiplegic stroke inpatients with unilateral neglect.Participants were assigned randomly to 1 of 2 groups. The experimental group wore a wristwatch cueing device over the hemiplegic arm for three hours a day, five days per week, for three weeks, and also underwent conventional rehabilitation. Patients were encouraged to move their hemiplegic arm five consecutive times after each prompt. The sham group underwent the same rehabilitation process, except they wore a sham device.Neglect, arm motor performance, and overall functioning were assessed pre- and posttraining, and at follow-up.There were no significant differences between groups in outcome measures except the neglect drawing tasks (p = 0.034) (the mean gain score from baseline to follow-up assessment was 5.2 (3.7) in the experimental group and 1.9 (3.5) in the sham group), across three time intervals. The experimental group showed greater improvement in arm motor performance than did the sham group.The results did not confirm that sensory cueing and limb activation treatment is effective when compared with those receiving placebo to reduce unilateral neglect, but it might be useful for promoting hemiplegic arm performance in stroke patients.
To study the efficacy of the motor relearning approach in promoting physical function and task performance for patients after a stroke.Matched-pair randomized controlled trial.An outpatient rehabilitation centre in Hong Kong.Fifty-two outpatients with either a thrombotic or haemorrhagic stroke who completed either the study or control group.The patients received 18 2-h sessions in six weeks of either the motor relearning programme or a conventional therapy programme.The Berg Balance Scale, the Timed Up and Go Test, the Functional Independence Measure (FIM), the modified Lawton Instrumental Activities of Daily Living (IADL) test, and the Community Integration Questionnaire.Patients in the motor relearning group showed significantly better performance on all but the Timed Up and Go Test when compared with the control group (F(1,150) = 6.34-41.86, P < or = 0.015). The interactions between group and occasion were significant on all five outcome measures, indicating that the rates of change across time between the motor relearning and control groups differed (F(3,150) = 3.60-33.58, P < 0.015).The motor relearning programme was found to be effective for enhancing functional recovery of patients who had a stroke. Both 'sequential' and 'function-based' concepts are important in applying the motor relearning approach to the rehabilitation of stroke patients.
Mallet finger injury, ligamentous sprain and dislocation of proximal interphalangeal (PIP) joint of fingers are very common types of simple hand injuries. Immediate correction of alignment and protection of the injured area will facilitate early joint movement while maximising functional recovery. This article is to introduce the fabrication of three simple finger splints to tackle these injuries for quick and effective conservative treatment. They are the mallet finger splint, buddy splint and dorsal finger block splint. The indications and functions of the three types of splints are discussed. The fabrication process will be illustrated; including materials needed, pattern drafting and steps of molding. Wearing regime and precautions will be highlighted to ensure effective patient compliance to splinting programme for the finger injuries.
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