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Objective measurements of muscle force in a group of after-stroke patients with hemiparesis

Pasternak-Miłądzka I., Miłądzki Z., Będziński R., Baran B.

Acta of Bioengineering and Biomechanics

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2007

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Vol. 9, nr 1

19-23

EN

The aim of this study was to estimate the strength of spastic muscles using Biodex System 3 within a group of patients with hemiparesis in after-stroke population. Measurements of the moments of force in elbow flexors and extensors of both spastic and non-spastic limbs were conducted under isostatic conditions. We analysed the values obtained for both limbs in order to determine the spasticity level on an Ashworth scale (0–4). The subjects were 10 patients with hemiparesis and varying spasticity selected from an after-stroke population. The analysis showed that spastic muscles activated less force than non-spastic muscles of the same patient. Furthermore, in a spastic limb, higher values of force were noted in the flexors than in the extensors of the elbow. In a non-spastic limb, the values of force were higher in the extensors of the elbow joint than in flexors. It is worth adding that the dynamics of force exposure, defined by a gradient of force, was much lower in spastic muscles than in non-spastic ones. Objective estimation of muscle force can be done by measuring the moments of force in particular groups of muscles upon the isokinetic contraction appearing. The repeatability of measurements may enable the kind of kinesitherapy to be determined as well as the assessment of the effectiveness of exercises in regard to force increase and dynamics of spastic muscles.

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Jakościowa i ilościowa ocena chodu osób po udarze mózgu

Dębiec-Bąk A., Mraz M., Mraz M., Skrzek A.

Acta Bio-Optica et Informatica Medica. Inżynieria Biomedyczna

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2007

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Vol. 13, nr 2

97-100

PL

Udary mózgu, będące dramatycznym powikłaniem chorób układu naczyniowego, stanowią duży problem zdrowotny we współczesnym społeczeństwie, prowadząc do niepełnosprawności, otępienia i depresji, a często też do śmierci. Trudności w chodzeniu stwierdza się u 70% osób przeżywających udar, natomiast u 30% utrzymuje się ciężkie upośledzenie ruchowe, wymagające stałej opieki. Dlatego istotnym zagadnieniem jest problem przywrócenia lokomocji lub jej usprawnienia. Celem pracy była jakościowa i ilościowa ocena chodu osób po udarze mózgu z niedowładem połowiczym prawo- i lewostronnym. U 25 osób (17 osób z niedowładem połowiczym prawostronnym, 8 osób z niedowładem połowiczym lewostronnym) przeprowadzono ocenę funkcjonalną niedowładnej kończyny dolnej, ocenę chodu (wydolność chodu, sprawność chodu) oraz dystans chodu. Analizowano zależność pomiędzy stanem neurologicznym a lokomocją. Wykazano istotną statystycznie zależność między badanymi cechami. Wyniki przeprowadzonych badań wskazują na potrzebę wykonywania neurologicznej i funkcjonalnej oceny chorych po udarze oraz monitorowania postępowania usprawniającego. Brak poprawy może być wskazaniem do dokonania zmian w programie rehabilitacyjnym, szczególnie w pierwszych miesiącach po udarze. Wyniki postępowania fizjoterapeutycznego zależą w dużej mierze od wyboru właściwej strategii leczenia.

EN

Apoplectic stroke is a dramatic complication of the cardiovascular system's diseases and it has become one of the most distressing health problems of contemporary societies. Often it results in handicap, postapoplectic dementia, depression and high death rate. Around 70% of survivors have difficulties in walking, while the remaining 30% suffer from acute motor impairment and require constant medical attention. Therefore, restoration or, at least, improvement of locomotion is the main goal of rehabilitation of the cerebral hemorrhage survivors. Studies on gait pathologies provide valuable clues for planning physiotherapy that would minimize or eliminate the given dysfunction. The aim of this study was qualitative and quantitative evaluation of gait in cerebral hemorrhage survivors with the right- or the left-sided hemiparesis. 25 patients (17 with the right-sided and 8 with the left-sided hemiparesis) were subjected to functional evaluation of the paretic lower limb, gait evaluation (gait efficiency and gait ability) and walking distance assessment. Correlation between the neurological and locomotor status of the patients was evaluated. The analysis showed a statistically signify- cant correlation between the examined traits. It also indicates a necessity for performing neurological and functional evaluation of patients after stroke and monitoring of the rehabilitation progress. Lack of improvement may indicate that the rehabilitation scheme needs to be altered, especially in the first months after the stroke. The final effect of rehabilitation depends, to a large extent, on the choice of appropriate physiotherapeutic strategy.

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The neurological disease recovery monitoring by walk disturbances level analysis

Zbrojkiewicz J. S., Piecha J.

Journal of Medical Informatics & Technologies

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2003

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Vol. 6

IT95--102

EN

This study was based on 27 patients' motor gait disturbances analysis using their pedobarographic records, affected by neurological diseases - hemiparesis or sciatic neuralgia. The evidence comparison concerns the data records collected before and after the rehabilitation processes. The essential conclusions explain a walk characteristics analysis explaining the neurological status of the patient and how to implement the PSW [2, 3] options in clinical practice. This approach can also be used for medical jurisdiction processes as a unique tool for the disease evidence making.