Effects of a physical conditioning program on balance and gait function in stroke patients

Authors

DOI:

https://doi.org/10.33233/fb.v22i5.4714

Keywords:

stroke; exercise; Physical therapy specialty

Abstract

Stroke can lead to decreased levels of physical activity, muscle strength and aerobic capacity, leading to reduced gait velocity and quality. The present study aimed to investigate the impact of aerobic exercises associated with lower limb strengthening on balance and gait functionality in stroke patients. We evaluated patients submitted to a physical conditioning protocol at the Associação de Assitência à Criança Deficiente (AACD). There were improvements in all variables analyzed (6-minute walk test and 10-meter walk test, Timed Up and Go and Mini BEST-test) after the end of the protocol and after 3 months of follow-up. The improvement found in mini BEST-test was statistically significant. The exercise program generated a tendency to improve gait performance and a significant improvement in balance in the group of patients analyzed.

Author Biographies

Sabrina Kyoko de Paula Asa, AACD

Fisioterapeuta de Adultos da Associação de Assistência à Criança com Deficiência

Elaine Menezes de Oliveira, AACD

Mestranda em Neurologia/Neurociências da UNIFESP, Fisioterapeuta da Associação de Assistência à Criança Deficiente

Gabriela da Silva Matuti, AACD

Mestre em Fisioterapia pela Unicid, Fisioterapeuta de Adultos da Associação de Assistência à Criança com Deficiência 

Clarissa Barros de Oliveira, AACD

Fisioterapia de Adultos da Associação de Assistência à Criança com Deficiência (AACD), Mestranda em Neurologia/Neurociências da UNIFESP

References

Pang MYC, Eng JJ, Dawson AS, McKay HA, Harris JE. A community-based fitness and mobility exercise program for older adults with chronic stroke: a randomized, controlled trial. J Am Geriatr Soc 2005;53(10):1667-74. doi: 10.1111/j.1532-5415.2005.53521.x

Elsawy B, Higgins KE. Physical activity guidelines for older adults. Am Fam Physician [Internet]. 2010 [cited 2021 Oct 5];81(1):55-9. Available from: https://pubmed.ncbi.nlm.nih.gov/20052963/

Eng JJ. Fitness and mobility exercise program for stroke. Top Geriatr Rehabil 2010;26(4):310-23. doi: 10.1097/tgr.0b013e3181fee736

Jørgensen HS, Nakayama H, Raaschou HO, Olsen TS. Recovery of walking function in stroke patients: The Copenhagen stroke study. Arch Phys Med Rehabil 1995;76(1):27-32. Available from: doi: 10.1016/s0003-9993(95)80038-7

Billinger SA, Arena R, Bernhardt J, Eng JJ, Franklin BA, Johnson CM, et al. Physical activity and exercise recommendations for stroke survivors. Stroke 2014;45(8):2532-53. doi: 10.1161/str.0000000000000022

Gordon NF, Gulanick M, Costa F, Fletcher G, Franklin BA, Roth EJ, et al. Physical activity and exercise recommendations for stroke survivors. Stroke 2004;35(5):1230-40. doi: 10.1161/01.str.0000127303.19261.19

Ivey FM, Macko RF, Ryan AS, Hafer-Macko CE. Cardiovascular health and fitness after stroke. Top Stroke Rehabil 2005;12(1):1-16. doi: 10.1310/geeu-yruy-vj72-lear

Ovando AC, Michaelsen SM, Carvalho T, Herber V. Avaliação da aptidão cardiopulmonar em indivíduos com hemiparesia após acidente vascular encefálico. Arq Bras Cardiol 2011;96(2):140-7. doi: 10.1590/s0066-782x2011005000001

Severinsen K, Jakobsen JK, Pedersen AR, Overgaard K, Andersen H. Effects of resistance training and aerobic training on ambulation in chronic stroke. Am J Phys Med Rehabil 2014;93(1):29-42. doi: 10.1097/phm.0b013e3182a518e1

Lund C, Dalgas U, Grønborg TK, Andersen H, Severinsen K, Riemenschneider M, et al. Balance and walking performance are improved after resistance and aerobic training in persons with chronic stroke. Disabil Rehabil 2017;40(20):2408–15. doi: 10.1080/09638288.2017.1336646

Borschmann K, Pang MYC, Bernhardt J, Iuliano-Burns S. Stepping towards prevention of bone loss after stroke: a systematic review of the skeletal effects of physical activity after stroke. Int J Stroke 2011;7(4):330-5. doi: 10.1111/j.1747-4949.2011.00645.x

Dobkin BH, Dorsch A. New evidence for therapies in stroke rehabilitation. Curr Atheroscler Rep 2013;15(6). doi: 10.1007/s11883-013-0331-y

Marsden DL, Dunn A, Callister R, Levi CR, Spratt NJ. Characteristics of exercise training interventions to improve cardiorespiratory fitness after stroke. Neurorehabil Neural Repair 2013;27(9):775-88. doi: 10.1177/1545968313496329

Saunders D, Greig C, Young A, Mead G. Physical fitness training for stroke patients. Cochrane Database of Syst Rev 2016;3(3):CD003316. doi: 10.1002/14651858.cd003316

ATS Statement. Guidelines for the Six-Minute Walk Test. Am J Respir Crit Care Med 2002;166(1):111-7. doi: 10.1164/ajrccm.166.1.at1102

Podsiadlo D, Richardson S. The timed “Up & Go”: A Test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 1991;39(2):142-8. doi: 10.1111/j.1532-5415.1991.tb01616.x

Bambirra C, Magalhães L de C, Paula FR. Confiabilidade e validade do BESTest e do MiniBESTest em hemiparéticos crônicos. Rev Neurociências 2015;23(1):30-40. doi: 10.34024/rnc.2015.v23.8044

Hinsongkram B, Chaikeeree N, Saengsirisuwan V, Viriyatharakij N, Horak FB, Boonsinsukh R. Reliability and validity of the balance evaluation systems test (BESTest) in people with subacute stroke. Phys Ther 2014;94(11):1632-43. doi: 10.2522/ptj.20130558

Maia AC, Rodrigues-de-Paula F, Magalhães LC, Teixeira RLL. Cross-cultural adaptation and analysis of the psychometric properties of the Balance Evaluation Systems Test and MiniBESTest in the elderly and individuals with Parkinson's disease: application of the Rasch model. Braz J Phys Ther 2013;17(3):195-217. http://dx.doi.org/10.1590/S1413-35552012005000085.

IBM Corp. Released 2012. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.

R Core Team. R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. 2018. [cited 2021 Oct 7]. Available from: https://www.R-project.org/.

Madhavan S, Bishnoi A. Comparison of the Mini-Balance Evaluations Systems Test with the Berg Balance Scale in relationship to walking speed and motor recovery post stroke. Top Stroke Rehabil 2017;24(8):579-84. doi: 10.1080/10749357.2017.1366097

Noguchi K, Gel YR, Brunner E, Konietschke F. nparLD: An R Software Package for the Nonparametric Analysis of Longitudinal Data in Factorial Experiments. Journal of Statistical Software 2012;50(12):1-23. doi: 10.18637/jss.v050.i12

Powers SK, Howley ET. Fisiologia do exercício: teoria e aplicação aplicada ao condicionamento e ao desempenho. São Paulo: Manole; 2000.

Tiozzo E, Youbi M, Dave K, Perez-Pinzon M, Rundek T, Sacco RL, et al. Aerobic, resistance, and cognitive exercise training poststroke: figure. Stroke 2015;46(7):2012–6. doi: 10.1161/strokeaha.114.006649

Stoller O, Bruin ED, Knols RH, Hunt KJ. Effects of cardiovascular exercise early after stroke: systematic review and meta-analysis. BMC Neurology;12(1). doi: 10.1186/1471-2377-12-45

Mayo NE, Wood-Dauphinee S, Côté R, Durcan L, Carlton J. Activity, participation, and quality of life 6 months poststroke. Arch Phys Med Rehabil 2002;83(8):1035-42. doi: 10.1053/apmr.2002.33984

Patel AT, Duncan PW, Lai S-M, Studenski S. The relation between impairments and functional outcomes poststroke. Arch Phys Med Rehabil 2000;81(10):1357-63. doi: 10.1053/apmr.2000.9397

Wist S, Clivaz J, Sattelmayer M. Muscle strengthening for hemiparesis after stroke: A meta-analysis. Ann Phys Rehabil Med 2016;59(2):114–24. doi: 10.1016/j.rehab.2016.02.001

Boyne P, Welge J, Kissela B, Dunning K. Factors influencing the efficacy of aerobic exercise for improving fitness and walking capacity after stroke. Arch Phys Med Rehabil 2017;98(3):581-95. doi: 10.1016/j.apmr.2016.08.484

Miyamoto ST, Lombardi Junior I, Berg KO, Ramos LR, Natour J. Brazilian version of the Berg balance scale. Braz J Med Biol Res 2004;37(9):1411-21. doi: 10.1590/s0100-879x2004000900017

Published

2021-11-11