EFFECT OF ROBOTIC TILT TABLE VERSUS CONVENTIONAL EXERCISES ON REHABILITATION OUTCOME IN STROKE PATIENTS: A FOLLOW UP STUDY.
- Associate Professor and Head, Department of Physiotherapy, UPUMS, Saifai, Etawah, UP, India.
- Professor and Head, Department of Neurology, UPUMS, Saifai, Etawah, UP, India.
- Senior Research Fellow, Department of Physiotherapy, UPUMS, Saifai, Etawah, UP, India.
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Background: Stroke is the main cause of long term disability among adults, living survivors with deficits, and one third remain dependant in activities of daily living thus necessitates early mobilization. Purpose: To determine the efficacy of exercises by Robotic tilt table versus the conventional physiotherapy treatment program in rehabilitation of patients with hemiplegia following stroke. Methods: A total of 80 hemiplegic patients (age 50.36 ?8.36 years, 8.43?4.76 days after stroke) were assigned randomly into two groups for 30 days of Conventional physiotherapy or Robotic tilt-table rehabilitation. The National Institutes of Health Stroke Scale (NIHSS), Mini Mental Scale Examination (MMSE), Modified Ashworth Scale, Quality of Life (QOL) and muscle strength of affected upper and lower limb) outcomes were assessed before (day 0), after (day 30) of the rehabilitative protocols and on 90th day of follow up. Results: The Robotic tilt table group improved with time in 0-90 days in QOL=26.6, NIHSS= 9.38, Ashworth= 0.18, MMSE =8.10, muscle strength upper limb =2.08 and lower limb =2.40.Whereas conventional physiotherapy group improved with time within 0-90 days QOL=14.18, NIHSS= 8.30, Ashworth= 0.45, MMSE =8.25, muscle strength upper limb =2.10 and lower limb =2.07. Conclusion: Robotic tilt table group has shown higher improvement than conventional physiotherapy group.
- Basteris A, Nijenhuis SM, Stienen AH, Buurke JH, Prange GB, Amirabdollahian F (2014) Training modalities in robot-mediated upper limb rehabilitation in stroke: A framework for classification based on a systematic review J Neuroeng Rehabil 11: 111.
- Ben M, Harvey L, Denis S, Glinsky J, Goehl G, Chee S, Herbert RD. (2005). Does 12 weeks of regular standing prevent loss of ankle mobility and bone mineral density in people with recent spinal cord injuries? Aust J Physiother; 51(4):251-60.
- Bohannon RW. (1993): Tilt Table Standing for Reducing Spasticity after Spinal Cord Injury. Archives of Physical Medicine Rehabilitation; 74, 1121-1122.
- Calabro, R Salvatore, N Antonino, R Margherita, L Antonino (2015). Do post-stroke patients benefit from robotic verticalization? A pilot-study focusing on?a?novel neurophysiological approach, Journal of Restorative Neurology and Neuroscience, 33, 5, 671-681.
- Chang AT, Boots R, Hodges PW, Paratz J (2004) Standing with assistance of a tilt table in intensive care: A survey of Australian physiotherapy practice, Aust J Physiother 50: 51-54.
- Ciesla N, Dinglas V, Fan E, Kho M, Kuramoto J, Needham D. (2011): Manual Muscle Testing: A method of measuring extremity muscle strength applied to critically ill patients. Journal of Visualized Experiment; 50: 26-32.
- Cumming TB, Thrift AG, Collier JM, Churilov L, Dewey HM, Donnan GA, Bernhardt J (2011) Very early mobilization after stroke fast-tracks return to walking: Further results from the phase II AVERT randomized controlled trial Stroke 42: 153-158.
- Dean E and Ross J. (1992): Oxygen transport: The basis for contemporary cardiopulmonary physical therapy and its optimization with body positioning and mobilization. Physical Therapy Practice; 1: 34?44.
- Duncan J, and Owen A.M. (2000): Common regions of the human frontal lobe recruited by diverse cognitive demands. Trends Neurosci; 23, 475-483.
- Duret C, Courtial O, Grosmaire AG, Hutin E (2014) Use of a robotic device for the rehabilitation of severe upper limb paresis in subacute stroke: Exploration of patient/robot interactions and the motor recovery processBioMed Research Internationalin press.
- Elliot L, Coleman M, Shiel A et al. (2005): Effect of posture on levels of arousal and awareness in vegetative and minimally conscious state patients: a preliminary investigation. J Neurol Neurosurg Psych; 76(2):298?299.
- Gregson J M, Leathley M J, Moore A P, Smith T L. (1999): Reliability of the tone assessment scale and the modified ashworth scale as clinical tools for assessing poststroke spasticity, Physical Medicine and Rehabilitation; 80(9): 1013-1016.
- Gunaydin R, Karatepe A G, Kaya T, Ulutus O. (2011): Determinants of quality of life (QoL) in elderly stroke patients: A short term follow up study, Archives of Gerontology and Geriatrics; 53, 19-23.
- Janice J Eng,Stephen M Levins,?Andrea F Townson,?Dianna Mah-Jones, Joy Bremner?and?Grant Huston (2001). Use of Prolonged Standing for Individuals with Spinal Cord Injuries.Physical Therapy?81?(8),?1392-1399.
- Kim CY, Lee JS, Kim HD, Kim (2015): Lower extremity muscle activation and function in progressive task-oriented training on the supplementary tilt table during stepping-like movements in patients with acute stroke hemiparesis, Journal of Arthroplasty; 25(3) 522?530.
- Kumar S, Sharma V.P., Negi MPS. (2009), ?Efficacy of dynamic muscular stabilization technique (DMST) over conventional technique in rehabilitation of chronic low back pain?. Journal of Sports conditioning and Research December 23 (9), 2651-2659.
- Kuznetsov AN, Rybalko NV, Daminov VD, Luft AR (2013) Early post-stroke rehabilitation using a robotic tilt-table stepper and functional electrical stimulation Stroke Res Treat: 94605-94606.
- Masiero S, Poli P, Rosati G, Zanotto D, Iosa M, Paolucci S, et al. (2014): The value of robotic systems in stroke rehabilitation. Expert Review of Medical Devices; 11: 187?198.
- Odeen I. Knutsson E. (1981): Evaluation of the effects of muscle stretch andweight load in patients with spastic paraplegia. Stand J Rehabil Med; 13:117-21.
- Pellegrino G, Tomasevic L, Tombini M, Assenza G, Bravi M, Sterzi S, Giacobbe V, Zollo L, Guglielmelli E, Cavallo G, Vernieri F, Tecchio F(2012) Inter-hemispheric coupling changes associate with motor improvements after robotic stroke rehabilitation Restor Neurol Neurosci 30: (6) 497-510.
- Pittaccio S, Zappasodi F, Tamburro G et al. (2013): Passive ankle dorsiflexion by an automated device and the reactivity of the motor cortical network. Conf Proc IEEE Eng Med Biol Soc, 6353-6356.
- Poli P, Morone G, Rosati G, Masiero S. (2013): Robotic Technologies and Rehabilitation: New Tools for Stroke Patients? Therapy. BioMed Research International; 2013: 1?8.
- Raethjen J, Govindan R, Binder S et al. (2008): Cortical representation of rhythmic foot movements. Brain Res; 1236, 79-84.
- Reinstrup P, Ryding E, Algotsson L et al. (1994): Effects of nitrous oxide on human regional cerebral blood flow and isolated pial arteries. Anesthesiology; 81, 396-402.
- Riberholt CG, Thorlund JB, Mehlsen J, Nordenbo A. (2013): Patients with severe acquired brain injury show increased arousal in tilt-table training. Dan Med J; 60(12).
- Turner-Bowker, D.M., Bartley, P.J., Ware, J.E., (2000): Jr. SF-36? Health Survey & ?SF? Bibliography: Third Edition. Lincoln, RI: QualityMetric Incorporated.
- Wieser M, Haefeli J, Butler L et al. (2010): Temporal and Spatial patterns of cortical activation during assisted lower limb movement. Exp Brain Res, 203, 181-191.
- Williams L S, Yilmaz E Y, Lopez Yunez A M. (2000): Retrospective Assessment of Initial Stroke Severity with the NIH Stroke Scale, Stroke; 31(4): 858-862.
- Wilson BA, Dhamapurkar S, Tunnard C et al. (2013): The effect of positioning on the level of arousal and awareness in patients in the vegetative state or the minimally conscious state: a replication and extension of the previous findings. Brain Impairment; 14(3):475?479.
- Zwecker M, Levenkrohn S, Fleisig Y, Zeilig G, Ohry A, Adunsky A (2002): Mini-Mental State Examination, cognitive FIM instrument, and the Loewenstein Occupational Therapy Cognitive Assessment: Relation to functional outcome of stroke patients, Physical Medicine and Rehabilitation; 83(3): 342-345.
[Suraj Kumar, Ramakant Yadav and Aafreen. (2018); EFFECT OF ROBOTIC TILT TABLE VERSUS CONVENTIONAL EXERCISES ON REHABILITATION OUTCOME IN STROKE PATIENTS: A FOLLOW UP STUDY. Int. J. of Adv. Res. 6 (Nov). 689-696] (ISSN 2320-5407). www.journalijar.com
Professor and Head, Dept. of Neurology, UPUMS, Saifai, Etawah, UP, 206130