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Critical Reviews™ in Physical and Rehabilitation Medicine
SJR: 0.121 SNIP: 0.228 CiteScore™: 0.17

ISSN Печать: 0896-2960
ISSN Онлайн: 2162-6553

Выпуски:
Том 31, 2019 Том 30, 2018 Том 29, 2017 Том 28, 2016 Том 27, 2015 Том 26, 2014 Том 25, 2013 Том 24, 2012 Том 23, 2011 Том 22, 2010 Том 21, 2009 Том 20, 2008 Том 19, 2007 Том 18, 2006 Том 17, 2005 Том 16, 2004 Том 15, 2003 Том 14, 2002 Том 13, 2001 Том 12, 2000 Том 11, 1999 Том 10, 1998 Том 9, 1997 Том 8, 1996 Том 7, 1995

Critical Reviews™ in Physical and Rehabilitation Medicine

DOI: 10.1615/CritRevPhysRehabilMed.2018028519
pages 135-146

A Top-Down versus Bottom-Up Approach to Lower-Extremity Motor Recovery and Balance Following Acute Stroke: A Pilot Randomized Clinical Trial

Vidyasagar Pagilla
Department of Physiotherapy, Kasturba Medical College, Mangaluru, Manipal Academy of Higher Education, Karnataka, India
Vijaya Kumar
Department of Physiotherapy, Kasturba Medical College, Mangaluru, Manipal Academy of Higher Education, Karnataka, India
Abraham Joshua
Department of Physiotherapy, Kasturba Medical College, Mangaluru, Manipal Academy of Higher Education, Karnataka, India
Chakrapani M
Department of Medicine, Kasturba Medical College, Mangaluru, Manipal Academy of Higher Education, Karnataka, India
Z. K. Misri
Department of Neurology, Kasturba Medical College, Mangaluru, Manipal Academy of Higher Education, Karnataka, India
Prasanna Mithra
Department of Community Medicine, Kasturba Medical College, Mangaluru, Manipal Academy of Higher Education, Karnataka, India

Краткое описание

Neuromuscular electrical stimulation (NMES) uses electric current to produce contractions of paralyzed or paretic muscles. Mirror therapy (MT) is a cognitively induced intervention that introduces visual illusion of the paretic limb through movements of the healthy limb with external feedback that is communicated with a mirror. Both NMES and MT have been found to be effective adjuvant treatments for motor and functional recovery in stroke rehabilitation. The present study compares the efficacy of NMES and MT for lower-extremity (LE) motor recovery and balance among stroke survivors. We studied 30 stroke patients who were referred for rehabilitation (onset < 3 wk) and used Brunnstrom LE recovery stages 3 and higher. Subjects were randomized into two groups, and each received an eclectic approach for 30 min/d for 6 d to remediate LE recovery. In addition, group A (n = 15) received 30 min of surface NMES training for six major LE paretic muscle groups, and group B (n = 15) received 30 min of MT sessions. NMES had greater change scores compared to those of the MT group, as follows: LE subscale of the Fugl-Meyer Assessment (FMA-LE), 25.12 ± 3.01 vs. 23.31 ± 2.38; Berg Balance Scale (BBS), 35.12 ± 4.61 vs. 34.68 ± 5.42; and Barthel Index (BI), 40.00 ± 10.32 vs. 37.18 ± 7.73. Among groups, no significance was found for FMA-LE (p = 0.09), BBS (p = 0.80), or BI (p = 0.39). We conclude that an eclectic approach is an effective adjunct treatment in very early phases of poststroke rehabilitation, regardless of NMES or MT use.

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