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COMPLEXITIES IN MEASURING HEMISPATIAL NEGLECT: A CASE REPORT COMPARISON OF OBJECTIVE MEASURES IN A PROFESSIONAL BODY BUILDER POST-STROKE
Title
COMPLEXITIES IN MEASURING HEMISPATIAL NEGLECT: A CASE REPORT COMPARISON OF OBJECTIVE MEASURES IN A PROFESSIONAL BODY BUILDER POST-STROKE.
Creator
Golde, Tyler C., Marieb College of Health & Human Services
Abstract / Description
It is known that the presence of hemispatial neglect is one complication of stroke that causes a greater functional impairment and burden on the patient. Objective measurement of this deficit is an important part of the process of identifying the level of impairment, and being able to then dig deeper for an assessment measure to better realize the level of the deficit. This case report comparison of the line cancellation test and the star cancellation test aims to provide insight on how the...
Show moreIt is known that the presence of hemispatial neglect is one complication of stroke that causes a greater functional impairment and burden on the patient. Objective measurement of this deficit is an important part of the process of identifying the level of impairment, and being able to then dig deeper for an assessment measure to better realize the level of the deficit. This case report comparison of the line cancellation test and the star cancellation test aims to provide insight on how the clinician may tailor their choice of the most appropriate screening tool for neglect. Methods. The Case Report is based on a patient that was seen at Naples Community Hospital, all information was obtained during a single treatment session. He was a middle-aged Croatian male, professional bodybuilder. He presented post right MCA embolus with left sided deficits, and a left hemispatial neglect. During the session, he completed 3 different objective measures in varying testing positions, with uniform verbal directions and prompts. Results. All objective measures were able to be completed. The results of the line cancellation test were abnormal when compared with the previous test scenarios on patients with similar deficits. The difference was that this patient performed better on the line cancellation when in standing (considered the more challenging, i.e. multitasking position). Discussion. A normal response for many patients, on all 3 shown outcome measures, was to perform more poorly (by crossing less items, or marking off further from midline) in the standing position. The assumption for this response was that a patient is more comfortable in a seated position, and can focus more attention to the task, or measure, at hand. It was thought that standing would be difficult, enhancing the patients neglected visual field, causing them to perform more poorly. This patients’ interesting case has given rise to considerations for more detailed talks on how concepts in neuroplasticity, specifically salience and specificity, can affect performance on these measures.
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Date Issued
2017
Identifier
Golde_fgcu_1743_10220
Format
Document (PDF)
Effects of Underwater Treadmill Training with Real-Time Visual Feedback on Ambulation of a Person Who Has Experienced a Stroke
Title
Effects of Underwater Treadmill Training with Real-Time Visual Feedback on Ambulation of a Person Who Has Experienced a Stroke.
Creator
Pagkanlungan, Emmanuel
Abstract / Description
Introduction: Stroke is a leading cause of disability in the United States and it occurs when blood supply to part of the brain is interrupted or severely reduced, depriving brain tissue of oxygen and nutrients. Around 50-80% of people who have experienced a stroke typically recover their ability to walk, but still have many difficulties associated with their gait. This can negatively impact their body composition, physical fitness, and ability to interact in the community. Prior research has...
Show moreIntroduction: Stroke is a leading cause of disability in the United States and it occurs when blood supply to part of the brain is interrupted or severely reduced, depriving brain tissue of oxygen and nutrients. Around 50-80% of people who have experienced a stroke typically recover their ability to walk, but still have many difficulties associated with their gait. This can negatively impact their body composition, physical fitness, and ability to interact in the community. Prior research has shown that using partial body weight support training, as well as visual biofeedback, has been helpful in improving gait and balance for people who have experienced a stroke. Therefore, the purpose of this research is to examine the use of underwater treadmill training with use of real-time visual feedback for improving ambulation in people who have experienced a stroke. Research Design: This research was a single subject design study examining outcomes of underwater treadmill training of a 58 year-old male who sustained a right cerebellar stroke 12 months ago. The participant underwent pre- and post intervention measures for balance and gait: GAITRite© system walking, Timed-Up-and-Go, and Dynamic Gait Index. The intervention of underwater treadmill training using real-time visual feedback was applied for 8 sessions of about 45 minutes each session, which included warm-up exercises and a cool-down period. Outcomes: The participant showed slight trends towards improved balance in his gait analysis and functional outcome measures. Specifically, his average time spent on each leg was closer to equal, average step length of each foot increased, the length of stride increased, and his overall step width decreased from pre-intervention to post-intervention. For the functional tests of balance, his Timed-Up-and-Go score improved (9.0 sec to 8.2 sec). Furthermore, the participant was able to improve his DGI score by 4 points from pre-test to post-test, which indicates a clinically important difference was made for his overall dynamic standing balance. Conclusion: The changes in outcome measures, in conjunction with subjective statements made by the participant, suggest that underwater treadmill training with real-time visual feedback may be beneficial for patients who have experienced a stroke up to a year ago. Further research should be conducted performing a longer randomized controlled study with more participants to determine if these results may be generalized. Furthermore, the participants of the study should demonstrate higher levels of impairments, as the participant in this study had minimal impairments. This would allow for potentially larger gains in outcomes.
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Date Issued
2017
Identifier
Pagkanlungan_fgcu_1743_10221
Format
Document (PDF)
THE CORRELATION BETWEEN ACTIVITY LEVELS AND THE FUNCTIONAL OUTCOMES OF PATIENTS AFFECTED BY STROKE AT AN INPATIENT REHABILITATION CENTER
Title
THE CORRELATION BETWEEN ACTIVITY LEVELS AND THE FUNCTIONAL OUTCOMES OF PATIENTS AFFECTED BY STROKE AT AN INPATIENT REHABILITATION CENTER.
Creator
Victoria, Veronica Valencia, Franks, Steven, Marieb College of Health & Human Services
Abstract / Description
Background: Strokes are one of the most disabling neurologic conditions of adult life. Early intensive rehabilitation, as well as higher levels of mobility and physical activity, have been associated with better outcomes after a stroke. Given the correlation between activity levels and all-cause mortality, the average amount of physical activity that survivors of stroke partake in during the earliest stages of recovery is a variable of interest for physical therapy professionals. Purpose: The...
Show moreBackground: Strokes are one of the most disabling neurologic conditions of adult life. Early intensive rehabilitation, as well as higher levels of mobility and physical activity, have been associated with better outcomes after a stroke. Given the correlation between activity levels and all-cause mortality, the average amount of physical activity that survivors of stroke partake in during the earliest stages of recovery is a variable of interest for physical therapy professionals. Purpose: The purpose of this study was to track and analyze the activity levels of patients affected by a stroke at The Brookdale Center for Healthy Aging & Rehabilitation (Brookdale), and to correlate this to the patients’ scores on the Functional Independence Measure (FIM), and the Timed Up & Go (TUG). Methods: Patients admitted to Brookdale following stroke meeting the inclusion criteria were considered for this study. Participants were evaluated by a physical therapist and given activity monitors to wear continuously during their stay. Functional outcome measures were scored at evaluation and discharge. Activity levels were compared to key outcome measures. Results: 5 participants were included in this study. One participant was excluded from the data analysis due to inconsistencies in their data occurring during a natural disaster that struck Brookdale at the time of the study. The average admission FIM score for the participants was 69.25 (SD = 13.91), and the average FIM score at time of discharge was 103.5 (SD = 10.25). The average change in FIM score among those participants included in this study was 34.25 (SD = 5.68). The average minutes of vigorous physical activity per day were 65.60 (SD = 65.96), whereas the average minutes of moderate physical activity per day were 102.6 (SD = 40.80). Conclusion: Although conclusions from this study are limited, there is a trend with longer lengths of stay (LOS) and more total therapy minutes with greater positive changes in FIM. Further research is necessary with larger sample sizes to further test this correlation. Also, future research needs to focus on the correlation between functional outcomes and type of therapy received.
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Date Issued
2018-05-01
Identifier
fgcu_ETD_0234
Format
Document (PDF)
The Use of Kinesio Tape for the Treatment of Foot Drop in a Patient with Sub-Acute Stroke: A Case Report
Title
The Use of Kinesio Tape for the Treatment of Foot Drop in a Patient with Sub-Acute Stroke: A Case Report.
Creator
Lazarus, Catherine
Abstract / Description
Gait deficits are among the leading impairments in persons with stroke. The purpose of this case report is to describe and demonstrate the use of Kinesio® tape as an intervention for the treatment of foot drop in a patient with sub-acute stroke. The case patient presented with right hemiparesis and impaired functional ambulation, specifically limited by a right foot drop. The patient's intervention consisted of four weeks of conventional physical therapy, focusing on lower extremity...
Show moreGait deficits are among the leading impairments in persons with stroke. The purpose of this case report is to describe and demonstrate the use of Kinesio® tape as an intervention for the treatment of foot drop in a patient with sub-acute stroke. The case patient presented with right hemiparesis and impaired functional ambulation, specifically limited by a right foot drop. The patient's intervention consisted of four weeks of conventional physical therapy, focusing on lower extremity strengthening, balance training, and gait training, combined with the application of Kinesio® tape over the right ankle using the spring-assist technique. The results of the case report revealed improvements in both functional gait measures and in ankle dorsiflexor strength, specifically increasing from 1/5 to 2-/5 strength. Improvements in functional mobility were observed with a decrease in the Timed-Up-and-Go (TUG) score by 10.5 seconds as well as a 2-point increase in the Dynamic Gait Index (DGI). The results of the case report support the use of Kinesio® tape as an adjunct intervention for the treatment of foot drop in sub-acute stroke patients with hemiparesis. Further research should investigate the amount of influence the Kinesio® tape had towards progress as compared to the conventional physical therapy intervention.
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Date Issued
2013
Identifier
Lazarus_fgcu_1743_10006
Format
Document (PDF)