Effectiveness of Pronate-Supinate Pipe in Sub-Acute Stroke Patients: A Randomized Controlled Trial
Keywords:
pronation, supination, sub-acute stroke, upper limb functional activityAbstract
Background and Objective: Muscle weakness is the main cause of upper limb functional activity (ULFA) limitation post-stroke. This study aimed to develop a piece of novel equipment, the pronate-supinate pipe, to improve upper limb muscle strength and to investigate the effectiveness of the pronate-supinate pipe
Method: A randomized controlled clinical sixteen sub-acute stroke patients were randomly allocated to experimental (n=8) and control groups(n=8). Both groups received a 45-minute conventional physical therapy program 3-day / week for 4 weeks. The experimental group received a strength training program for pronator and supinator muscles using the pronate-supinate pipe 15 times/ set for 3 sets with a 2-minute rest interval at each set for 30 minutes before the conventional physical therapy. The primary outcome was ULFA as measured by the Streamlined Wolf Motor Function Test for sub-acute stroke patients (SWMFT-Sub-acute). The secondary outcomes were pronate/ supinate active range of motion (AROM), grip muscle strength and upper limb motor recovery as measured by a goniometer, hand grip dynamometer and the Fugl-Meyer assessment for upper extremity (FMA-UE) respectively. Measurements were conducted at baseline and post-intervention.
Results: The result of this study showed that ULFA, pronate/ supinate AROM, grip strength and upper limb motor recovery of the experimental group at post-intervention improved from baseline significantly (p<0.05) but did not differ from the control group.
Conclusions: The pronate supinate pipe training has a superior effect on ULFA than the conventional physical therapy alone.
References
Srisoparb W, Nualnetr N, Sommanochai K, Karinta N, Charungthanakij P. Upper limb functional ability of individuals with chronic Stroke in communities of Naresuan university hospital. Thai J Phys Ther 2562;41(2):60-74.
Sackley C, Brittle N, Patel S, Ellins J, Scott M, Wright C, et al. The prevalence of joint contractures, pressure sores, painful shoulder, other pain, falls, and depression in the year after a severely disabling stroke. Stroke 2008;39(12):3329-34.
Prodbumrung J. Complications following hemiparesis in stroke patients. Buddhachinaraj Med J 2014;31(3):376-84.
Smith MC, Byblow WD, Barber PA, Stinear CM. Proportional recovery from lower limb motor impairment after Stroke. stroke 2017;48(5):1400-3.
Ada L, O'Dwyer N, O'Neill E. Relation between spasticity, weakness and contracture of the elbow flexors and upper limb activity after stroke: an observational study. Disabil Rehabil 2006;28(13-14):891-7.
Kwakkel G, Kollen B, Twisk J. Impact of time on improvement of outcome after stroke. Stroke 2006;37(9):2348-53.
Sun Y, Ledwell NMH, Boyd LA, Zehr EP. Unilateral wrist extension training after stroke improves strength and neural plasticity in both arms. Exp Brain Res 2018;236:2009 – 21.
Harris JE, Eng JJ. Strength training improves upper-limb function in individuals with stroke: a meta-analysis. Stroke 2010;41:136-40.
Kilbreath SL, Heard RC. Frequency of hand use in healthy older persons. Aust J Physiother 2005;51:119-22.
Krebs HI, Volpe BT, Williams D, Celestino J, Charles SK, Lynch D, et all. Robot-aided neurorehabilitation: a robot for wrist rehabilitation. IEEE T Neur Sys Reh 2007;15:327-35.
Hesse S, Werner C, Pohl M, Rueckriem S, Mehrholz J, Lingnau ML. Computerized arm training improves the motor control of the severely affected arm after stroke - A single-blinded randomized trial in two centers. Stroke 2005;36:1960-6.
Takahashi CD, Der-Yeghiaian L, Le V, Motiwala RR, Cramer SC. Robot-based hand motor therapy after stroke. Brain 2008;131:425-37.
Kwakkel G, Kollen B, Twisk J. Impact of time on improvement of outcome after stroke. Stroke 2006;37(9):2348-53.
Arya KN, Verma R, Garg RK, Sharma VP, Agarwal M, Aggarwal GG. Meaningful task-specific training (MTST) for stroke rehabilitation: A randomized controlled trial. Top Stroke Rehabil 2012;19(3):193–21.
Rosner B. Fundamental of Biostatistics. 8 th ed. United States: Cengage Learning; 2016.
Roman N.A, Miclaus RS, Nicolau C, Sechel G. Customized manual muscle testing for post-stroke upper extremity assessment. brain Sci 2022;12(4):457.
Institute of Geriatric Medicine, Department of Medical Services, Ministry of Public Health Thailand. Mini-Mental State Examination-Thai 2002, 2002.
Bogard K, Wolf S, Zhang Q, Thompson P, Morris D, Nichols-Larsen D. Can the Wolf Motor Function Test be streamlined?. NNR 2009;23(5):422-8.
Morris DM, Uswatte G, Crago JE, Cook EW 3rd, Taub E. The reliability of the Wolf Motor Function Test for assessing upper extremity function after stroke. Arch Phys Med Rehabil 2001;82(6):750-5.
Tretriluxana J, Vachalathiti R, Poungvarin N, Emsakul J, Juntrkaew T, Srirugsa P, et al. The reliability and validity of Wolf motor function test (WMFT) for assessing paretic limb of individuals with acute stroke. J Neurol Sci 2009;285:S176-S7.
Chen HF, Wu CY, Lin KC, Chen HC, Chen CP, Chen CK. Rasch validation of the streamlined Wolf Motor Function Test in people with chronic stroke and subacute stroke. Phys Ther 2012;92(8):1017-26.
Wu CY, Fu T, Lin KC, Feng CT, Hsieh KP, Yu HW, et al. Assessing the streamlined Wolf motor function test as an outcome measure for stroke rehabilitation. Neurorehabil Neural Repair 2011;25(2):194-9.
Gladstone DJ, Danells CJ, Black SE. The Fugl-Meyer assessment of motor recovery after stroke: a critical review of its measurement properties. Neurorehabil Neural Repair 2002 Sep;16(3):232-40.
Lambercy O, Dovat L, Yun H, Wee SK, Kuah C, Chua K, et al. Effects of a robot-assisted training of grasp and pronation/supination in chronic stroke: a pilot study. J Neuroeng Rehabil 2011;8:63.doi:10.1186/1743-0003-8-63.
Fasoli SE, Krebs HI, Stein J, Frontera WR, Hogan N. Effects of robotic therapy on motor impairment and recovery in chronic stroke. Arch Phys Med Rehabil 2003;84(4):477-82.
Veldema J, Janse P. Resistance training in stroke rehabilitation: systematic review and meta-analysis. Clin Rehabil 2020;34(9):1173-97.
Kidgell D, Pearce A. Corticospinal properties following short-term strength training of an intrinsic hand muscle. Hum Mov Sci 2010;29(5):631-41.
Ada L, Dorsch S, Canning C. Strengthening interventions increase strength and improve activity after stroke: a systematic review. Aust J Physiother 2006;52(4):241 - 8.
Da Silva PB, Antunes FN, Graef P, Cechetti F, Pagnussat Ade S. Strength training associated with task-oriented training to enhance upper-limb motor function in elderly patients with mild impairment after stroke: a randomized controlled trial. Am J Phys Med Rehabil 2015;94:11-9.
Ada L, O'Dwyer N, O'Neill E. Relation between spasticity, weakness and contracture of the elbow flexors and upper limb activity after stroke: an observational study. Disabil Rehabil 2006;28 (13-14):891-7.
Kwakkel G, Wagenaar RC, Twisk JW, Lankhorst GJ, Koetsier JC. Intensity of leg and arm training after primary middle-cerebral-artery stroke: a randomised trial. Lancet 1999;354:191–6.
Kattenstroth J, Kalisch T, Sczesny-Kaiser M, Greulich W, Tegenthoff M, Dinse H. Daily repetitive sensory stimulation of the paretic hand for the treatment of sensorimotor deficits in patients with subacute stroke: RESET, a randomized, sham-controlled trial. BMC Neurol 2018;18(1):2.
Park M, Ko M, Oh S, Lee J, Ham Y, Yi H, et al. Effects of virtual reality-based planar motion exercises on upper extremity function, range of motion, and health related quality of life: a multicenter, single blinded, randomized, controlle pilot study. J Neuroeng Rehabil 2019;16:122.
Lee H, Kuo F, Lin Y, Liou T, Lin J, Huang S. Effects of robot-assisted rehabilitation on hand function of people with stroke: a randomized, crossover-controlled, assessor-blinded study. Am J Occup Ther 2021;75(1):7501205020.
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