EFFECTIVENESS OF HOME EXERCISE PROGRAM WITH MODIFIED ROOD’S APPROACH ON MUSCLE STRENGTH IN POST CEREBRAL HAEMORRHAGIC INDIVIDUALS OF ASSAM: A RANDOMIZED TRIAL
DOI:
https://doi.org/10.15621/ijphy/2019/v6i5/186846Keywords:
Rood’s approach, home exercise program (HEP), physiotherapy, intracerebral haemorrhage, stroke, muscle strengthAbstract
Background: Physical therapists are integral to the rehabilitation of patients of stroke, and home exercise program (HEP) prescription is a routine part of physical therapy care. Strength training is imperative in interventions for stroke patients. Various components of Rood’s Approach are effective in stroke rehabilitation, an aspect that has not been thoroughly explored as yet.
Methods: A randomized controlled trial study was done at Gauhati Medical College & Hospital, Assam. The subjects were 236 hemorrhagic stroke patients who were randomly assigned into two groups. Both the groups were given a HEP consisting of routine physiotherapy exercises. Additionally, one group out of the two was also taught exercises based on the Rood’s approach, consisting of facilitation and inhibition techniques with the help of sensory stimulation and repetitive task-specific activity. The output was evaluated in terms of muscle strength using Manual Muscle Testing (MMT) after three months of intervention.
Results: It was observed that HEP with Rood’s approach significantly improved (p<0.05) the muscle strength in shoulder flexors (p=0.038), shoulder extensors (p=0.003), shoulder abductors (p=0.033), shoulder adductors (p=0.018), elbow flexors (p=0.009), wrist flexors (p=0.044), finger flexors (p=0.011), hip flexors (p=0.007), hip extensors (p=0.015), hip adductors (p=0.00), knee flexors (p=0.00), ankle plantar flexors (p=0.00) and dorsi flexors (p=0.039). However, no improvements were observed for elbow extensors, wrist extensors, finger extensors, hip abductors and knee extensors.
Conclusion: Although it was observed that both the Groups improving their muscle strength, but HEP with Rood’s approach was found to be more effective in improving muscle strength.
References
Donnan GA, Fisher M, Macleod M, Davis SM. Stroke. Lancet. 2008; 371(9624): 1612–23.
Dalal PM. Strokes in young and elderly: Risk factors and strategies for stroke prevention. J Assoc Physician India. 1997; 45:125-131.
Henderson A, Korner-Bitensky N, Levin M. Virtual reality in stroke rehabilitation: a systematic review of its effectiveness for upper limb motor recovery. Topics in stroke rehabilitation. 2007; 14(2): 52-61.
Langhorne P, Coupar F, Pollock A. Motor recovery after stroke: a systematic review. The Lancet Neurology, 2009; 8(8): 741-754.
Mikoajewska E. Neurorehabilitation in pediatric stroke. J Health Sci, 2012; 2(3): 23-31.
Dam M, Tonin P, Casson S, Ermani M, Pizzolato G, Iaia V, Battistin L. The effects of long-term rehabilitation therapy on poststroke hemiplegic patients. Stroke. 1993; 24:1186–1191.
Werner RA, Kessle S. Effectiveness of an intensive outpatient rehabilitation program for postacute stroke patients. Am J Phys Med Rehabil.1996; 75:114–120.
Rodriquez AA, Black PO, Kile KA, Sherman J, Stellberg B, McCormick J, Roszkowski J, Swiggum E. Gait training efficacy using a home-based practice model in chronic hemiplegia. Arch Phys Med Rehabil. 1996; 77:801–805.
Green J, Forster A, Bogle S, Young J. Physiotherapy for patients with mobility problems more than 1 year after stroke: a randomised controlled trial. Lancet. 2002; 359:199–203.
Bordoloi K. Stroke. In: Sharma KN, Bordoloi K. Physiotherapeutic Approach to Neuro Care. O.B. Publications, U.P. (India); 2011: Chapter 7.
Chatterjee S, Arumugam N, Midha D, Goyal M, Arora A, Sharma S, Kumar SP. Effect of California Tri-Pull Taping Method on Shoulder Subluxation, Pain, Active Range of Motion and Upper Limb Functional Recovery After Stroke – A Pretest Post Test Design. Am J Psychiatry Neurosci 2015;3(5):98-103.
Digra PK, Deshmukh MK, Midha D, Samuel AJ, Kumar SP. Effect of Dual Task Cognitive Performance along with Conventional Physiotherapy Treatment on Gait Parameters in Patients with Ischemic Stroke: A Study Protocol of Randomized Clinical Trial. Int J Neurol Neurosurg 2015;7(2):55-9.
Wade DT, Hewer L. Functional abilities after stroke: measurement, natural history and prognosis. J Neurol Neurosurg Psychiatry. 1987; 50:177–182.
Duncan PW, Goldstein LB, Matchar D, Divine GW, Feussner J. Measurement of motor recovery after stroke: outcome assessment and sample size requirements. Stroke. 1998; 29:1084–1089.
Anderson C, Rubenach S, Mhurchu, CN. Home or hospital for stroke rehabilitation? Results of a randomized controlled trial: I, Health outcomes at 6 months. Stroke. 2000; 31:1024-31.
Alon G, Sunnerhagen KS, Geurts AC, Ohry A. A home-based, self-administered stimulation program to improve selected hand functions of chronic stroke. Neuro Rehabilitation. 2003; 18 (3):215-25.
Chaiyawat P, Kulkantrakorn K. Effectiveness of home rehabilitation program for ischemic stroke upon disability and quality of life: a randomized controlled trial, Clin Neurol Neurosurg. 2012; 114(7): 866-70.
Lang CE, MacDonald JR, Gnip C. Counting repetitions: an observational study of outpatient therapy for people with hemiparesis post-stroke. Journal of Neurologic Physical Therapy. 2007; 31(1): 3-10.
Eng JJ. Strength training in individuals with stroke. Physio ther Can. 2004; 56: 189–201.
Riolo L, Fisher K. Clinical question? Is there evidence that strength training could help improve muscle function and other outcomes without reinforcing abnormal movement patterns or increasing reflex activity in a man who has had a stroke? Phys Ther. 2003; 83: 844–851.
DeBolt LS, McCubbin JA. The effects of home-based resistance exercise on balance, power, and mobility in adults with multiple sclerosis. Arch Phys Med Rehabil. 2004; 85:290–297.
Brunnstrom S. Movement therapy in hemiplegia. A neurophysiological approach. 1970: 113-122.
Voss DE, Ionta MK, Myers BJ, Knott M. Proprioceptive neuromuscular facilitation: patterns and techniques. Philadelphia, PA: Harper & Row; 1985.
Sharma KN. Handbook of Proprioceptive Neuromuscular Facilitation: Basic Concepts and Techniques. LAP Lambert Academic Publishing; 2012.
Bobath, B. Adult Hemiplegia: Evaluation and Treatment, 2nd Edition. London: Heinemann Medical Books; 1970.
Rood MS. The treatment of neuromuscular dysfunction: Rood approach. Notes taken by C. Trombly at lecture delivered in Boston. 1976 Jul.
Sharma KN. Advanced Techniques in Physiotherapy and Occupational Therapy 1st Edition. Jaypee Brothers Medical Pub; 2019
Trombly C, Levit K, Myers BJ. Remediating motor control and performance through traditional therapeutic approaches. Occupational Therapy for Physical Dysfunction, 4th ed. Philadelphia: Williams & Wilkins. 1997; 437-446.
Rood MS. Neurophysiological reactions as a basis for physical therapy. Physical Therapy Review. 1954; 34:444-449.
Rood MS. Neurophysiological mechanisms utilized in the treatment of neuromuscular dysfunction. American Journal of Occupational Therapy. 1956; 10:220-225.
Metcalfe AB, Lawes N. A modern interpretation of the Rood Approach. Physical therapy reviews. 1998; 3(4): 195-212.
Stillman BC. The activation or de-activation of receptors for the purpose of developing somatic, autonomic, and mental functions: introduction. Part i—philosophy. Australian Journal of Physiotherapy. 1968; 14(3):86-92.
Stockmeyer SA. An interpretation of the approach of Rood to the treatment of neuromuscular dysfunction. American Journal of Physical Medicine & Rehabilitation. 1967; 46(1): 900-956.
Goff B. The application of recent advances in neurophysiology to Miss M. Rood's concept of neuromuscular facilitation. Physiotherapy. 1972; 58(12): 409.
Coolen AC, Kühn R, Sollich P. Theory of Neural Information Processing Systems. Oxford (UK): Oxford University Press; 2005.
Grassi C, Passatore M. Action of the sympathetic system on skeletal muscle. The Italian Journal of Neurological Sciences. 1988; 19(1):23-28.
Riganello F, Cortese MD, Arcuri F, Quintieri M, Dolce G. How can music influence the autonomic nervous system response in patients with severe disorder of consciousness? Frontiers in Neuroscience. 2015; 9(461):1-9.
Brauchli P, Rüegg PB, Etzweiler F, Zeier H. Electrocortical and autonomic alteration by administration of a pleasant and an unpleasant odor. Chemical Senses. 1995; 20(5):505-515.
Sayorwan W, Siripornpanich V, Piriyapunyaporn T, Hongratanaworakit T, Kotchabhakdi N, Ruangrungsi N. The effects of lavender oil inhalation on emotional states, autonomic nervous system, and brain electrical activity. J Med Assoc Thai. 2012; 95(4):598-606.
Bensafi M, Rouby C, Farget V, Bertrand B, Vigouroux M, Holley A. Autonomic nervous system responses to odours: the role of pleasantness and arousal. Chemical Senses. 2002; 27(8):703-709.
Yates BJ. Vestibular influences on the autonomic nervous system. Annals of the New York Academy of Sciences. 1996; 781(1): 458-473.
Ross MJ, Guthrie P, Dumont JC. The Impact of Modulated Color Light on the Autonomic Nervous System. Advances in Mind-Body Medicine. 2013; 27(4):7-16.
Kunkel CF. Effect of “standing” on spasticity, contracture, and osteoporosis in paralyzed males. Arch. Phys. Med. Rehabil. 1993; 74:73-78.
Johnson MH. Developmental Cognitive Neuroscience. Cambridge: Blackwell Publishers Ltd. 1997.
Thelen, E. Motor development: A new synthesis. American Psychologist. 1995; 50(2):79.
Bordoloi K, Deka RS. Scientific reconciliation of the concepts and principles of rood approach. Int J Health Sci Res. 2018; 8(9):225-234.
Duncan, P. W. Stroke disability. Physical Therapy. 1994; 74(5):399-407.
Ciesla N, Dinglas V, Fan E, Kho M, Kuramoto J, Needham D. Manual muscle testing: a method of measuring extremity muscle strength applied to critically ill patients. JoVE (Journal of Visualized Experiments). 2011; 12(50):e2632.
Glasgow Augmented Physiotherapy Study (GAPS) Group. Can augmented physiotherapy input enhance recovery of mobility after stroke? A randomized controlled trial. Clinical rehabilitation. 2004 Aug;18(5):529-37
Liu‐Ambrose T, Taunton JE, MacIntyre D, McConkey P, Khan KM. The effects of proprioceptive or strength training on the neuromuscular function of the ACL reconstructed knee: a randomized clinical trial. Scandinavian Journal of Medicine & Science in Sports. 2003; 13(2):115-123.
Moitra M, Rehal S, Kumar SP. Effects of proprioceptive training on Muscle Strength, Functional Ability and Joint Position Sense in Patients with Knee Osteoarthritis – a randomized clinical trial. Physiother Occup Ther J 2016;9(2):41-5.
Hunter SM, Crome P, Sim J, Pomeroy VM. Effects of mobilization and tactile stimulation on recovery of the hemiplegic upper limb: a series of replicated single-system studies. Archives of Physical Medicine and Rehabilitation. 2008; 89(10):2003-2010.
Gibb RL, Gonzalez CL, Wegenast W, Kolb BE. Tactile stimulation promotes motor recovery following cortical injury in adult rats. Behavioural Brain Research. 2010; 214(1):102-107.
Kolb B, Gibb R. Tactile stimulation after frontal or parietal cortical injury in infant rats facilitates functional recovery and produces synaptic changes in adjacent cortex. Behavioural Brain Research. 2010; 214(1):115-120.
Da Silva PB, Antunes FN, Graef P, Cechetti F, De Souza Pagnussat A. Strength training associated with task-oriented training to enhance upper-limb motor function in elderly patients with mild impairment after stroke: a randomized controlled trial. American Journal of Physical Medicine & Rehabilitation. 2015; 94(1):11-19.
Deekshita B, Srikumari V, Madhavi K. Effect of task-oriented exercises on standing balance in subjects with stroke. International journal of physiotherapy. 2014 Dec 1;1(5):242-7.
Bütefisch C, Hummelsheim H, Denzler P, Mauritz KH. Repetitive training of isolated movements improves the outcome of motor rehabilitation of the centrally paretic hand. Journal of the Neurological Sciences. 1995; 130(1):59-68.
de Sousa DG, Harvey LA, Dorsch S, Glinsky JV. Interventions involving repetitive practice improve strength after stroke: a systematic review. Journal of physiotherapy. 2018 Sep 21.
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