Journal of International Academy of Physical Therapy Research (국제물리치료학회지)

International Academy of Physical Therapy Research (국제물리치료연구학회)
권호 표지
DOI QR코드

DOI QR Code

Effect of Bridge Exercise Combined with Functional Electrical Stimulation on Trunk Muscle Activity and Balance in Stroke Patients

  • Kang, Jeongil (Department of Physical Therapy, Sehan University) ;
  • Jeong, Daekeun (Department of Physical Therapy, Sehan University) ;
  • Heo, Sinhaeng (Department of Physical Therapy, Sehan University)
  • Received : 2021.02.20
  • Accepted : 2021.03.25
  • Published : 2021.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

Background: Stroke patients have weak trunk muscle strength due to brain injury, so a single type of exercise is advised for restoring functionality. However, even after intervention, the problem still lies and it is suggested that another intervention method should be applied with exercise in order to deal with such problem. Objectives: To Investigate the effect of bridge exercise combined with functional electrical stimulation (FES) on trunk muscle activity and balance in stroke patients. Design: Randomized controlled trial. Methods: From July to August 2020, twenty stroke patients was sampled, ten patients who mediated bridge exercises combined with functional electrical stimulation were assigned to experiment group I, and ten patients who mediated general bridge exercises were assigned to experiment groupII. For the pre-test, using surface EMG were measured paralyzed rectus abdominis, erector spinae, transverse abdominis/internal oblique muscle activity, and using trunk impairment scale were measured balance. In order to find out immediate effect after intervention, post-test was measured immediately same way pre-test. Results: Change in balance didn't show significant difference within and between groups, but muscle activity of trunk was significant difference rectus abdominis and erector spinae within groups I (P<.01), also between groups was significant difference (P<.05). Conclusion: Bridge exercise combined with FES could improve trunk function more effectively than general bridge exercise due to physiological effect of functional electrical stimulation.

Keywords

Acknowledgement

This study was supported by the Sehan University Research Fund in 2021.

References

  1. Najafi Z, Rezaeitalab F, Yaghubi M, Manzari ZS. The effect of biofeedback on the motor - muscular situation in rehabilitation of stroke patients : A randomized controlled trial. J Caring Sci. 2018;7(2):89-93. https://doi.org/10.15171/jcs.2018.014
  2. Karatas M, Cetin N, Bayramoglu M, Dilek A. Trunk muscle strength in relation to balance and functional disability in unihemispheric stroke patients. Am J Phys Med Rehabil. 2004;83(2):81-87. https://doi.org/10.1097/01.PHM.0000107486.99756.C7
  3. Raine S, Meadows L, Lynch-Ellerington M. Bobath concept: theory and clinical practice in neurological rehabilitation. UK: Wiley-Backwell; 2013.
  4. Choi HS, Shim YJ, Shin WS. Comparison on postural control between abdominal draw-in maneuver and abdominal expansion maneuver in persons with stroke. Phys Ther Rehabil Sci. 2016;5(3):113-119. https://doi.org/10.14474/ptrs.2016.5.3.113
  5. Chung EJ, Lee JS, Kim SS, Lee BH. The relationships among trunk control ability, dynamic balance and gait in stroke patients. J Korean Med. 2012;33(1):148-159.
  6. Kim JW, Park MC. Effects of the abdominal hollowing technique applied during plank exercises at different angles between ground and the humerus on abdominal stabilization muscle activity. J Kor Phys Ther. 2020;32(2):94-100. https://doi.org/10.18857/jkpt.2020.32.2.94
  7. Akuthota V, Nadler SF. Core strengthening. Arch Phys Med Rehabil. 2004;3(1):86-92. https://doi.org/10.1053/j.apmr.2003.12.005
  8. McGill SM. Low back stability: from formal description to issues for performance and rehabilitation. Exerc Sport Sci Rev. 2001;29(1):26-31. https://doi.org/10.1097/00003677-200101000-00006
  9. Hubley-Kozey CL, Vezina MJ. Muscle activation during exercises to improve trunk stability in men with low back pain. Arch Phys Med Rehabil. 2002;83(8):1100-1108. https://doi.org/10.1053/apmr.2002.33063
  10. Jeon HY. The effects of a bridging exercise on body shape changes and foot pressure distribution. [Doctoral thesis]. Gyeongsan: Daegu University; 2010.
  11. Lehman GJ, Hoda W, Oliver S. Trunk muscle activity during bridging exercises on and off a swissball. Chiropr Osteopat. 2005;13(1):1-8. https://doi.org/10.1186/1746-1340-13-1
  12. Kisner C, Colby LA, Borstad J. Therapeutic exercise: foundations and techniques. Philadelphia: Fa Davis; 2017.
  13. Boyd BS, Wanek L, Gray AT, Topp KS. Mechanosensitivity during lower extremity neurodynamic testing is diminished in individuals with Type 2 Diabetes Mellitus and peripheral neuropathy: a cross sectional study. BMC neurology. 2010;10(1):1-14. https://doi.org/10.1186/1471-2377-10-1
  14. Robson N, Faller II KJ, Ahir V, Ferreira ARDM, Buchanan J, Banerjee A. Creating a virtual perception for upper limb rehabilitation. Int J Biol Biomed Eng. 2017;11(4):152-157.
  15. Alawieh A, Zhao J, Feng W. Factors affecting post-stroke motor recovery: implications on neurotherapy after brain injury. Behav Brain Res. 2018;340:94-101. https://doi.org/10.1016/j.bbr.2016.08.029
  16. Glanz M, Klawansky S, Stason W, Berkey C, Chalmers TC. Functional electrostimulation in poststroke rehabilitation: a meta-analysis of the randomized controlled trials. Arch Phys Med Rehabil. 1996;77(6):549-553. https://doi.org/10.1016/S0003-9993(96)90293-2
  17. Martin R, Sadowsky C, Obst K, Meyer B, McDonald J. Functional electrical stimulation in spinal cord injury: from theory to practice. Top Spinal Cord Inj Rehabil. 2012;18(1):28-33. https://doi.org/10.1310/sci1801-28
  18. Rushton DN. Functional electrical stimulation and rehabilitation-an hypothesis. Med eng phy. 2003;25(1):75-78. https://doi.org/10.1016/S1350-4533(02)00040-1
  19. Ho CH, Triolo RJ, Elias AL, et al. Functional electrical stimulation and spinal cord injury. Phys Med Rehabil Clin N Am. 2014;25(3):631-654. https://doi.org/10.1016/j.pmr.2014.05.001
  20. Bustamante C, Brevis F, Canales S, Millon S, Pascual R. Effect of functional electrical stimulation on the proprioception, motor function of the paretic upper limb, and patient quality of life: A case report. J Hand Ther. 2016;29(4):507-514. https://doi.org/10.1016/j.jht.2016.06.012
  21. Criswell E. Cram's introduction to surface electromyography. Burlington: Jones & Bartlett Publishers; 2010.
  22. Yun JH, Kim TS, Lee BK. The effects of combined complex exercise with abdominal drawing-in maneuver on expiratory abdominal muscles activation and forced pulmonary function for post stroke patients. J Korean Soc Phys Med. 2013;8(4):513-523. https://doi.org/10.13066/kspm.2013.8.4.513
  23. Kwon G. The effect of applying different bridge exercise after abdominal drawing-In maneuver on trunk muscles activation and balance for chronic stroke patients. [Master's thesis]. Yongin: Yongin University; 2016.
  24. Verheyden G, Nieuwboer A, De Wit L, et al. Trunk performance after stroke: an eye catching predictor of functional outcome. J Neurol Neurosurg Psychiatry. 2007;78(7):694-698. https://doi.org/10.1136/jnnp.2006.101642
  25. Stevens VK, Coorevits PL, Bouche KG, Mahieu NN, Vanderstraeten GG, Danneels LA. The influence of specific training on trunk muscle recruitment patterns in healthy subjects during stabilization exercises. Man Ther. 2007;12(3):271-279. https://doi.org/10.1016/j.math.2006.07.009
  26. Park RJ, Oh JL. The effect of functional electrical stimulation on sitting balance in cerebral palsy. J Kor Soc Phys Ther. 2002;14(4):204-213.
  27. Verheyden G, Vereeck L, Truijen S, et al. Trunk performance after stroke and the relationship with balance, gait and functional ability. Clin Rehabil. 2006;20(5):451-458. https://doi.org/10.1191/0269215505cr955oa
  28. Eraifej J, Clark W, France B, Desando S, Moore D. Effectiveness of upper limb functional electrical stimulation after stroke for the improvement of activities of daily living and motor function: a systematic review and meta-analysis. Syst Rev. 2017;6(1):1-21. https://doi.org/10.1186/s13643-016-0385-3
  29. Mun DJ, Lee SH. Effect of body stabilization training on trunk muscle activity in adults. J Korean Soc Neurother. 2019;23(3):1-7.
  30. Park YS. The Effect Of Affected side Trunk Muscle Activity In Hemiplegia During Asymmetrical Bridging Exercise With Each Differnt Knee Joint Angles. [Master's thesis]. Gyeongsan: Deagu Catholic University; 2012.
  31. Kahanovitz N, Nordin M, Verderame R, et al. Normal trunk muscle strength and endurance in women and the effect of exercises and electrical stimulation. Part 2: Comparative analysis of electrical stimulation and exercises to increase trunk muscle strength and endurance. Spine. 1987;12(2):112-118. https://doi.org/10.1097/00007632-198703000-00006
  32. Newsam CJ & Baker LL. Effect of an electric stimulation facilitation program on quadriceps motor unit recruitment after stroke. Arch Phys Med Rehabil. 2004;85(12):2040-2045. https://doi.org/10.1016/j.apmr.2004.02.029
  33. Jung JW. The Effects of Neuromuscular Electrical Stimulation on Sitting and Trunk Muscle Activity in Children with Cerebral Palsy. [Master's thesis]. Cheonan: Dankook University; 2011.
  34. Song GB, Heo JY. The effects of bridge exercise with abdominal drawing-in on balance in patients with stroke. J Kor Phy Ther. 2016;28(1):1-7. https://doi.org/10.18857/jkpt.2016.28.1.1
  35. Shim JH. Effects of Therapist vs. EMG-triggered Functional Electrical Stimulation during Trunk Pattern in Proprioceptive Neuromuscular Facilitation on Balance and Gait Performance in Person with Stroke. [Master's thesis]. Cheonan: Baekseok University; 2019.