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      The effect of Monkey Chair and Band exercise system on shoulder range of motion and pain in post-stroke patients with hemiplegia

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          Abstract

          [Purpose] A simple rehabilitation device system for strengthening upper limb muscles in hemiplegic patients was developed. This system, which stimulates active exercise while accounting for intensity, time, and frequency, was examined in the present pilot study. [Subjects and Methods] Patients had shoulder pain and limited shoulder movement. Changes in range of motion (ROM) and scores of a visual analog scale (VAS) for pain were evaluated in the experimental and control groups every four weeks for twelve weeks. The modified motor assessment scale (MMAS) was used before and after experiments. [Results] Significant differences between experimental times in ROM for shoulder flexion, abduction, and adduction on the paralyzed side were observed in the experimental group at every time point. Pain VAS scores in the experimental group improved progressively and significantly with time, indicating a consistently increasing effect of exercise. There were significant differences between the MMAS scores before and after completion of the program in the experimental group. [Conclusion] Muscle strengthening is important in hemiplegic patients, and active exercise was more efficient than passive exercise in this regard. Rehabilitation with the Monkey Chair and Band system may represent an efficient and important tool in upper limb training and comprehensive modern rehabilitation therapy.

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          Most cited references13

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          Randomized clinical trial of therapeutic exercise in subacute stroke.

          Rehabilitation care after stroke is highly variable and increasingly shorter in duration. The effect of therapeutic exercise on impairments and functional limitations after stroke is not clear. The objective of this study was to determine whether a structured, progressive, physiologically based exercise program for subacute stroke produces gains greater than those attributable to spontaneous recovery and usual care. This randomized, controlled, single-blind clinical trial was conducted in a metropolitan area and 17 participating healthcare institutions. We included persons with stroke who were living in the community. One hundred patients (mean age, 70 years; mean Orpington score, 3.4) consented and were randomized from a screened sample of 582. Ninety-two subjects completed the trial. Intervention was a structured, progressive, physiologically based, therapist-supervised, in-home program of thirty-six 90-minute sessions over 12 weeks targeting flexibility, strength, balance, endurance, and upper-extremity function. Main outcome measures were postintervention strength (ankle and knee isometric peak torque, grip strength), upper- and lower-extremity motor control (Fugl Meyer), balance (Berg and functional reach), endurance (peak aerobic capacity and exercise duration), upper-extremity function (Wolf Motor Function Test), and mobility (timed 10-m walk and 6-minute walk distance). In the intention-to-treat multivariate analysis of variance testing the overall effect, the intervention produced greater gains than usual care (Wilk's lambda=0.64, P=0.0056). Both intervention and usual care groups improved in strength, balance, upper- and lower-extremity motor control, upper-extremity function, and gait velocity. Gains for the intervention group exceeded those in the usual care group in balance, endurance, peak aerobic capacity, and mobility. Upper-extremity gains exceeded those in the usual care group only in patients with higher baseline function. This structured, progressive program of therapeutic exercise in persons who had completed acute rehabilitation services produced gains in endurance, balance, and mobility beyond those attributable to spontaneous recovery and usual care.
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            Muscle strength and muscle training after stroke.

            R Bohannon (2006)
            For many individuals who have experienced a stroke, muscle weakness is the most prominent impairment. Both the theoretical and statistical relationships between muscle weakness and performance at functional activities suggest that weakness may be an appropriate target for therapeutic interventions. Researchers investigating the outcomes of strengthening regimens after stroke have routinely shown that resistance exercise leads to increased muscle strength, but that strength is typically measured using the same maneuvers that were used in training. Evidence supporting the use of strengthening regimens to reduce limitations in functional activity is equivocal.
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              A community-based upper-extremity group exercise program improves motor function and performance of functional activities in chronic stroke: a randomized controlled trial.

              To assess the effects of a community-based exercise program on motor recovery and functional abilities of the paretic upper extremity in persons with chronic stroke. Randomized controlled trial. Rehabilitation research laboratory and a community hall. A sample of 63 people (> or =50y) with chronic deficits resulting from stroke (onset > or =1y). The arm group underwent an exercise program designed to improve upper-extremity function (1h/session, 3 sessions/wk for 19wk). The leg group underwent a lower-extremity exercise program. The Wolf Motor Function Test (WMFT), Fugl-Meyer Assessment (FMA), hand-held dynamometry (grip strength), and the Motor Activity Log. Multivariate analysis showed a significant group by time interaction (Wilks lambda=.726, P=.017), indicating that overall, the arm group had significantly more improvement than the leg group. Post hoc analysis demonstrated that gains in WMFT (functional ability) (P=.001) and FMA (P=.001) scores were significantly higher in the arm group. The amount of improvement was comparable to other novel treatment approaches such as constraint-induced movement therapy or robot-aided exercise training previously reported in chronic stroke. Participants with moderate arm impairment benefited more from the program. The pilot study showed that a community-based exercise program can improve upper-extremity function in persons with chronic stroke. This outcome justifies a larger clinical trial to further assess efficacy and cost effectiveness.
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                Author and article information

                Journal
                J Phys Ther Sci
                J Phys Ther Sci
                JPTS
                Journal of Physical Therapy Science
                The Society of Physical Therapy Science
                0915-5287
                2187-5626
                31 August 2016
                August 2016
                : 28
                : 8
                : 2232-2237
                Affiliations
                [1) ] Department of Dance, Hanyang University, Republic of Korea
                [2) ] Korea Institute of Industrial Technology, Republic of Korea
                [3) ] Department of Mechanical and Aerospace Engineering, Seoul National University, Republic of Korea
                [4) ] The Graduate School of Industry, Sejong University, Republic of Korea
                [5) ] Department of Physical Medicine and Rehabilitation, College of Medical School, Hanyang University, Republic of Korea
                Author notes
                [* ]Corresponding author. Kyu Hoon Lee, Department of Physical Medicine and Rehabilitation, College of Medical School, Hanyang University: 222-1 Wangsimni-ro, Seongdong-gu, Seoul 04763, Republic of Korea. (E-mail: dumitru1@ 123456hanyang.ac.kr )
                Article
                jpts-2016-190
                10.1589/jpts.28.2232
                5011567
                5ebab872-f871-4c1e-b7b0-d9338c7d28f9
                2016©by the Society of Physical Therapy Science. Published by IPEC Inc.

                This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (by-nc-nd) License.

                Categories
                Original Article

                monkey chair and band system,upper extremity,stroke
                monkey chair and band system, upper extremity, stroke

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