F-2-17-02
CORRELATION OF TRUNK MUSCLE STRENGTH AND AMBULATION
Toshiya Koida, Mitsuru Osada (Yugawara Kousei Nenkin Hospital, Kanagawa, Japan), Shigenobu Ishigami (National Defense Medical College, Saitama, Japan)
Trunk balance is important for stable ambulation of stroke patients. We measured trunk muscle strength (TMS), one of the important factors for trunk balance and examined the correlation of TMS and ambulation and so on. Method: 20 stroke patients with good sitting balance participated in this study. Trunk flexion strength was measured with a hand-held dynamometer (Hoggan Health, MICROFET) while subjects were seated upright with their feet unsupported. Subjects were asked to take a second or two to come to maximum effect and push as hard as possible into MICROFET until asked to stop during test of lateral trunk flexion strength and forward trunk flexion strength. We used trunk flexion strength / body weight (N/Kg) as an index of TMS. Results: Lateral trunk flexion strength toward paretic side was correlative with Brunstrom stage of upper extremity, but not with that of lower extremity. The value of TMS to several direction were higher in good standing balance group than in poor group. The value of TMS were higher to several direction in independent ambulation group than in other groups (unable to walk or supervised). Lateral flexion toward non paretic side was greater than toward paretic side in all groups. Conclusion: The results show that TMS is important for standing and ambulation. In future we want to examine the change of TMS as ambulation improves in individuals.
F-2-17-03
IMPAIRED VESTIBULAR CONTROL IN POORLY AMBULATING STROKE PATIENTS: A STUDY OF SENSORY ORGANISATION PATTERN
I.K.Ibrahim; MD, M. El-Abd;MD, A.Helal;MD
Faculty of Medicine, University of Alexandria, EGYPT.
Purpose: To assess the type and pattern of sensory inputs that contribute to poor stance and locomotion in stroke patients.
Methods: Sensory organisation test was conducted in 20 stroke patients with delayed and poor walking, 20 stroke patients with good walking and 15 apparently healthy volunteers. The study included determination of the equilibrium score, centre of gravity (COG) alignment, and strategy analysis under 6 different postural conditions during standing on a dual force platform. Sway referencing of the platform and visual surround was done to deliver inaccurate orientation to the eyes (visual input) and lower limbs (somatosensory input).
Results: COG alignment was shifted to the unaffected side in poorly ambulating stroke patients, while this shift was not significant in patients showing good walking. Abnormal increase in body sway and/or a complete loss of balance was exhibited in sway referenced conditions for poorly walking patients. Their sensory analysis showed decreased ability to maintain balance using only vestibular cues (vestibular pattern) in 11 patients (55 %), and in using vestibular and visual cues (vestibular/visual pattern) in 4 patients (20%). A slight decrement in the ability to use somatosensory cues (somatosensory pattern) was demonstrated in 2 patients (10%). Three patients (15 %) showed visual preference.
Conclusion: It is concluded that impairment of the corticovestibular function contributes to poor stance and locomotion in stroke patients.
