Effect of crossed-education using a tilt table task-oriented approach in subjects with post-stroke hemiplegia: A randomized controlled trial
Chang-Yong Kim, Hyeong-Dong Kim
Facilities and Equipment Management Team, National Research Facilities & Equipment Center, Korea Basic Science Institute, 169-148, Gwahak-ro, Yuseong-gu, Daejeon, 34133, South Korea. E-mail: email@example.com
Objective: To determine the effect of crossed-education, using task-related training on a tilt table, on upper extremity function and grip strength in subjects with post-stroke hemiplegia.
Design: Double-blind, randomized controlled, pilot study.
Patients: A total of 45 patients between 6 and 12 months post-stroke.
Methods: Subjects were randomly allocated to the control group, or experimental group I or II. All subjects received conventional upper limb training for 30 min, 3 times a week for 6 weeks, and training on 3 different tilt table applications for 20 min a day. The outcome was evaluated using the Fugl-Meyer scale, Wolf Motor Function Test, and measurements of grip strength using a hydraulic hand dynamometer, prior to and 6 weeks post-intervention.
Results: There was a significantly greater increase, post-test, in the Fugl-Meyer scale (p = 0.003), maximal grip strength of the affected hand (p = 0.04), and grip strength, compared with the less-affected hand (p = 0.03), in subjects who underwent supplementary task-oriented training on a tilt table compared with those in the control group. There was also a significantly greater increase in Wolf Motor Function score (p = 0.001), post-test, in subjects who underwent task-oriented training on a tilt table compared with those in the 2 experimental groups.
Conclusion: Compared with tilt table or conventional training alone, crossed-education using task-oriented training on a tilt table may result in improvements in arm function and maximal grip strength in persons with chronic hemiplegia post-stroke.
Most patients who survive chronic stroke experience persistent impairment of upper limb movement. The ability of such patients to exercise the affected upper limb independently may be restricted by postural instability due to reduced lower limb functioning. A tilt table, which is commonly used in performing upper limb tasks in the clinical setting, was modified for safe and independent use in upper limb rehabilitation. Training on the modified tilt table was found to improve upper limb functioning and maximal grip strength following stroke. This novel therapeutic approach may be a potential neuro-rehabilitation strategy for stroke patients with various severities of upper limb impairment.
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