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      Effects of the Bad Ragaz Ring Method on muscle activation of the lower limbs and balance ability in chronic stroke: A randomised controlled trial

      research-article
      , PT, PhD a , , PT, MS b , , PT, PhD b , *
      Hong Kong Physiotherapy Journal
      Elsevier (Singapore) Pte Ltd
      Bad Ragaz Ring method, balance, stroke

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          Abstract

          Background:

          Recovery of balance and walking abilities is important for the rehabilitation of stroke patients.

          Objectives:

          To evaluate the effects of the Bad Ragaz Ring method on functional recovery in chronic stroke patients.

          Methods:

          Twenty-two chronic stroke patients were randomly assigned to two groups: a Bad Ragaz Ring method group (the experimental group) or a control group. Stroke patients in the experimental group underwent Bad Ragaz Ring exercise and comprehensive rehabilitation therapy, whereas patients in the control group underwent comprehensive rehabilitation therapy alone. The participants in both groups received therapy 3 days per week for 6 weeks. Muscle activations, balance indices, and Timed Up and Go test results were assessed before and after the 6-week therapy period.

          Results:

          The experimental group showed significant improvements in activations of tibialis anterior and gastrocnemius muscles, balance index, and Timed Up and Go test results as compared with preintervention results ( p < 0.05), whereas the control group showed significant improvement in Timed Up and Go test ( p < 0.05). Significant differences in posttraining gains in the activations of tibialis anterior and gastrocnemius muscles and in balance index were observed between the experimental and control groups ( p < 0.05). Effect sizes for gains in the experimental and control groups were strong for tibialis anterior and gastrocnemius muscles (effect sizes, 1.04 and 1.45 respectively).

          Conclusion:

          The Bad Ragaz Ring method may be beneficial for improving balance and leg muscle activation of chronic stroke patients.

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          Most cited references29

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          Aquatic therapy: scientific foundations and clinical rehabilitation applications.

          The aquatic environment has broad rehabilitative potential, extending from the treatment of acute injuries through health maintenance in the face of chronic diseases, yet it remains an underused modality. There is an extensive research base supporting aquatic therapy, both within the basic science literature and clinical literature. This article describes the many physiologic changes that occur during immersion as applied to a range of common rehabilitative issues and problems. Because of its wide margin of therapeutic safety and clinical adaptability, aquatic therapy is a very useful tool in the rehabilitative toolbox. Through a better understanding of the applied physiology, the practitioner may structure appropriate therapeutic programs for a diverse patient population.
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            Balance Disability After Stroke

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              • Article: not found

              The incidence and consequences of falls in stroke patients during inpatient rehabilitation: factors associated with high risk.

              To determine the incidence of falls on a stroke rehabilitation unit; to assess the frequency and nature of injuries; and to identify risk factors predictive of falls, functional outcomes, and impairments. Retrospective cohort study. An inpatient stroke rehabilitation unit. Two hundred thirty-eight consecutive stroke patient admissions. Incident reports completed on patients who experienced a fall while on the unit were reviewed and resultant injuries categorized (abrasions, lacerations, fractures). Stroke impairments and admission functional assessments, FIM instrument, Berg Balance Scale (BBS), and Chedoke-McMaster (CM) Stroke Impairment Inventory of fallers were compared with nonfallers. Of the 238 patients, 88 (37%) experienced at least 1 fall, and almost half of these (45 patients [19%]) experienced at least 2 falls. A total of 180 falls were reported over the 5-year period. Of the 180 reported falls, 33% occurred when patients were using their wheelchairs. Injuries occurred in 22% of the reported falls. These consisted of contusions (49%) and abrasions (41%), primarily of the upper (30.8%) and lower (25.6%) extremities. Only 1 fracture was reported. Fallers tended to have lower admission BBS scores (50% of patients with a score 30, P <.01) and a lower score on the admission arm, leg, and foot components of the CM (P <.05). Patients who fell were also more likely to be apraxic (P <.014) and suffer from cognitive deficits (P <.01). Repeat fallers had lower admission FIM scores (P <.01) when compared with nonfallers. Although patients undergoing stroke rehabilitation experienced a significant number of falls, the incidence of serious injury was small. Patients who experienced at least 1 fall had significantly lower BBS, FIM, and CM arm, leg, and foot scores compared with nonfallers. These data suggest that groups of stroke patients who are at risk for falls within the rehabilitation setting can be identified by using a variety of impairment and functional assessments. This information may be potentially useful for designing interventions directed at reducing fall frequency among stroke survivors. Copyright 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation
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                Author and article information

                Journal
                Hong Kong Physiother J
                Hong Kong Physiother J
                HKPJ
                Hong Kong Physiotherapy Journal
                Elsevier (Singapore) Pte Ltd
                1013-7025
                1876-441X
                December 2017
                21 April 2017
                : 37
                : 39-45
                Affiliations
                [a ]Department of Physical Therapy, College of Tourism and Health Science, Joongbu University, Republic of Korea
                [b ]Department of Physical Therapy, Daegu University, Daegudae-ro, Gyeongsan-si, Gyeongsangbuk-do, Republic of Korea
                Author notes
                [*] [* ] Corresponding author. Department of Physical Therapy, Daegu University, 201, Daegudae-ro, Gyeongsan-si, Gyeongsangbuk-do, Republic of Korea. E-mail address: skybird-98@ 123456hanmail.net (M.-K. Kim).
                Article
                10.1016_j.hkpj.2017.02.001
                10.1016/j.hkpj.2017.02.001
                6385153
                30931045
                d20c8349-8930-4a4b-925d-d08ebf5cea23
                © 2017, Hong Kong Physiotherapy Association

                This is an open access article under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Page count
                Pages: 7
                Categories
                Research Paper

                bad ragaz ring method,balance,stroke
                bad ragaz ring method, balance, stroke

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