Motor and balance performance of adults with hemiplegia of different ambulatory status

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Motor and balance performance of adults with hemiplegia of different ambulatory status

 

Author: Ng, Tze-wan
Title: Motor and balance performance of adults with hemiplegia of different ambulatory status
Degree: M.Sc.
Year: 2000
Subject: Cerebrovascular disease -- Patients -- Rehabilitation
Walking
Hong Kong Polytechnic University -- Dissertations
Department: Multi-disciplinary Studies
Dept. of Rehabilitation Sciences
Pages: ix, 106 leaves : ill. ; 30 cm
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b1543401
URI: http://theses.lib.polyu.edu.hk/handle/200/4237
Abstract: This was an observational study on factors undermining walking status of patients after stroke. The objectives of the study were 1) to compare the balance and motor function of the limbs contralateral to the side of stroke lesion between patients with stroke of different ambulatory status, and 2) to investigate the extent these variables may contribute to the difference in their ambulatory status. Twenty ambulatory patients with stroke and thirteen age-matched healthy individuals were studied. Seven patients had ambulatory status classified by the Functional Independent Measure as 4 (FIM4), i.e., assistive devices and physical assistance were required during walking, and thirteen patients were of FIM6 ambulatory status for their ability to walk independently with some assistive devices. There were four variables being studied. They were the upper and lower limb motor function evaluated with the motor sub-section of the Fugl-Meyer Assessment (FMA), the Berg Balance Scale (BBS) and the Limit of Stability (LOS) test to four directions with the Smart Balance Master to review the functional balance and weight shifting capability of the subjects respectively. Differences in the upper and lower limb FMA motor scores and BBS amongst the three groups were significant. For the LOS test, the FIM4 group performed poorly in weight shifting to all directions and particularly the paretic direction. The FIM6 group showed significant deficit in weight shifting to the backward direction when compared with the control group. The FMA lower limb motor score was identified as the variable to discriminate the two groups of patients with different ambulatory status. The FMA upper limb motor score contributed to the difference between the FIM6 and Control groups. The regression analysis identified the BBS as the outstanding variable in differentiating the ambulatory status amongst the three groups. It can be suggested that both the upper and lower limbs motor function should be the focus of treatment in rehabilitation of the ambulatory function of patients with the FIM4 and FIM6 status. Weight shifting to the paretic direction and the backward direction should be emphasized during the intervention, with the aim to improve walking towards complete independence. Finally, the functional balance, which differentiated the three ambulatory status, should be a prime goal throughout the course of stroke rehabilitation.

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