Research Article
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Hemiplejik Hastalarda Duyusal Parametreler ve Dengenin Karşılaştırılması

Year 2022, Volume: 5 Issue: 2, 67 - 73, 27.06.2022

Abstract

Amaç: Hemiplejik hastalarda duyu ve denge kayıpları meydana gelmektedir. Bazı hastalarda etkilenime bağlı olarak, gördükleri tedavi içeriğine göre duyu ve denge rehabilitasyonları değişebilmektedir. Bu tür hastalarda etkilenen anatomik nöronal bölgelerin internöronal ilişkilerle beraber her kişi için farklı hasarlar doğurabileceği bir gerçektir. Bu çalışmamızda tedavisini tamamlamış ve bağımsız yürüyebilen hemiplejik hastaların anatomik olarak Fasciculus gracilis (FG) ve Fasciculus cuneatus’un (FC) etkilenmesine bağlı olarak özellikle propriyosepsiyon duyularının etkilenme oranını, diğer duyu parametreleri ve denge düzeyleri ile ilişkisini araştırmak amaçlanmıştır.
Yöntem: Çalışmaya hemipleji tanısı konulmuş ve tedavi görmüş 12’si kadın ve 12 erkek olmak üzere toplam 24 hasta dahil edilmiştir. Katılımcılar 12’si dominant ve 12’si non-dominant hemiplejik hastalardan oluşmaktadır. Katılımcıların; ekstremite uzunluk-çevre ölçümleri, vibrasyon duyusunun değerlendirilmesi, iki nokta diskriminasyonun değerlendirilmesi, denge duyusu ve propriyosepsiyon duyusunun değerlendirilmesi (Technobody prokin 252) yapılmıştır.
Bulgular: Denge ile duyu parametreleri arasında yapılan incelemede; propriyosepsiyon ile iki bacak denge arasında pozitif yönlü orta dereceli ilişki ve propriyosepsiyon ile sol hemipleji sol bacak dengesi arasında güçlü ilişki saptanmıştır (p˂0,05).
Sonuçlar: Çalışmamızda elde ettiğimiz sonuçlara göre FC ve FG ‘nin etkilenme oranı propriyosepsiyon duyusunu etkileyeceğinden ve bu duyunun da mobilizasyonun temel parametrelerinden denge ile bir ilişkisi olduğundan bu tür hastalarda iyileşme sürecinde genel vücut dengesiyle duysal bütünlüğün ilişkilendirilmesi gerektiği kanaatine varılmıştır.

References

  • Allum null, Bloem null, Carpenter null, Hulliger null, Hadders-Algra null. Proprioceptive control of posture: a review of new concepts. Gait Posture. 1998;8(3):214-242. doi:10.1016/s0966-6362(98)00027-7
  • 2. Missaoui B, Thoumie P. How far do patients with sensory ataxia benefit from so-called “proprioceptive rehabilitation”? Neurophysiologie Clinique/Clinical Neurophysiology. 2009;39(4):229-233. doi:10.1016/j.neucli.2009.07.002
  • 3. Bolognini N, Russo C, Edwards DJ. The sensory side of post-stroke motor rehabilitation. Restor Neurol Neurosci. 2016;34(4):571-586. doi:10.3233/RNN-150606
  • 4. Chae SH, Kim YL, Lee SM. Effects of phase proprioceptive training on balance in patients with chronic stroke. J Phys Ther Sci. 2017;29(5):839-844. doi:10.1589/jpts.29.839
  • 5. Kristensen OH, Stenager E, Dalgas U. Muscle Strength and Poststroke Hemiplegia: A Systematic Review of Muscle Strength Assessment and Muscle Strength Impairment. Arch Phys Med Rehabil. 2017;98(2):368-380. doi:10.1016/j.apmr.2016.05.023
  • 6. Aman JE, Elangovan N, Yeh IL, Konczak J. The effectiveness of proprioceptive training for improving motor function: a systematic review. Front Hum Neurosci. 2014;8:1075. doi:10.3389/fnhum.2014.01075
  • 7. Song Q, Zhang X, Mao M, et al. Relationship of proprioception, cutaneous sensitivity, and muscle strength with the balance control among older adults. J Sport Health Sci. 2021;10(5):585-593. doi:10.1016/j.jshs.2021.07.005
  • 8. Tong J, Mao O, Goldreich D. Two-Point Orientation Discrimination Versus the Traditional Two-Point Test for Tactile Spatial Acuity Assessment. Front Hum Neurosci. 2013;7:579. doi:10.3389/fnhum.2013.00579
  • 9. Ansems GE, Allen TJ, Proske U. Position sense at the human forearm in the horizontal plane during loading and vibration of elbow muscles. J Physiol. 2006;576(Pt 2):445-455. doi:10.1113/jphysiol.2006.115097
  • 10. Cobo R, García-Piqueras J, García-Mesa Y, Feito J, García-Suárez O, Vega JA. Peripheral Mechanobiology of Touch—Studies on Vertebrate Cutaneous Sensory Corpuscles. Int J Mol Sci. 2020;21(17):6221. doi:10.3390/ijms21176221
  • 11. Rand D. Proprioception deficits in chronic stroke-Upper extremity function and daily living. PLoS One. 2018;13(3):e0195043. doi:10.1371/journal.pone.0195043
  • 12. Wade DT, Langton-Hewer R, Wood VA, Skilbeck CE, Ismail HM. The hemiplegic arm after stroke: measurement and recovery. J Neurol Neurosurg Psychiatry. 1983;46(6):521-524. doi:10.1136/jnnp.46.6.521
  • 13. Harris JE, Eng JJ. Individuals with the dominant hand affected following stroke demonstrate less impairment than those with the non-dominant hand affected. Neurorehabil Neural Repair. 2006;20(3):380-389. doi:10.1177/1545968305284528
  • 14. Gliga AC, Neagu NE, Popoviciu HV, Bataga T. Effects of Adding Aquatic-to-Land-Based Physiotherapy Programs for Shoulder Joint Position Sense Rehabilitation. Healthcare (Basel). 2022;10(2):332. doi:10.3390/healthcare10020332
  • 15. Rosenkranz K, Pesenti A, Paulus W, Tergau F. Focal reduction of intracortical inhibition in the motor cortex by selective proprioceptive stimulation. Exp Brain Res. 2003;149(1):9-16. doi:10.1007/s00221-002-1330-3
  • 16. Jung SM. The effects of vibratory stimulation employed to forearm and arm flexor muscles on upper limb function in patients with chronic stroke. J Phys Ther Sci. 2017;29(9):1620-1622. doi:10.1589/jpts.29.1620
  • 17. Bruyere O, Wuidart MA, Di Palma E, et al. Controlled whole body vibration to decrease fall risk and improve health-related quality of life of nursing home residents. Arch Phys Med Rehabil. 2005;86(2):303-307. doi:10.1016/j.apmr.2004.05.019
  • 18. Tavernese E, Paoloni M, Mangone M, et al. Segmental muscle vibration improves reaching movement in patients with chronic stroke. A randomized controlled trial. NeuroRehabilitation. 2013;32(3):591-599. doi:10.3233/NRE-130881

Comparison of Sensory Parameters and Balance in Patients with Hemiplegia

Year 2022, Volume: 5 Issue: 2, 67 - 73, 27.06.2022

Abstract

Objective: Hemiplegic patients experience loss of sensation and balance. In some patients, sensory and balance rehabilitation may vary depending on the treatment content they receive. It is a fact that the anatomical neuronal regions affected in such patients may cause different damages for each person with interneuronal relationships. In this study, we aimed to investigate the effects of proprioception and other sensory parameters and balance levels of hemiplegic patients who have completed treatment and are able to walk independently due to anatomically affected Fasciculus gracilis (FG) and Fasciculus cuneatus (FC).
Methods: A total of 24 patients were included (12 female and 12 male) who were diagnosed and treated with hemiplegia in this study. Participants consisted of 12 dominant and 12 non-dominant hemiplegic patients. Extremity length-circumference measurements, evaluation of vibration, two-point discrimination, balance and proprioception (Technobody prokin 252) senses of participants were evaluated.
Results: In the examination between balance and sensory parameters; a moderate positive correlation was found between proprioception-bipedal balance. In addition, a strong correlation was found between proprioception-left hemiplegia left leg balance (p˂0.05).
Conclusion: In this study, we concluded that the effect rate of FC and FG will affect the sense of proprioception and that this sense is related to balance, which is one of the main parameters of mobilization, so that the general body balance and sensory integrity should be associated in the recovery process.

References

  • Allum null, Bloem null, Carpenter null, Hulliger null, Hadders-Algra null. Proprioceptive control of posture: a review of new concepts. Gait Posture. 1998;8(3):214-242. doi:10.1016/s0966-6362(98)00027-7
  • 2. Missaoui B, Thoumie P. How far do patients with sensory ataxia benefit from so-called “proprioceptive rehabilitation”? Neurophysiologie Clinique/Clinical Neurophysiology. 2009;39(4):229-233. doi:10.1016/j.neucli.2009.07.002
  • 3. Bolognini N, Russo C, Edwards DJ. The sensory side of post-stroke motor rehabilitation. Restor Neurol Neurosci. 2016;34(4):571-586. doi:10.3233/RNN-150606
  • 4. Chae SH, Kim YL, Lee SM. Effects of phase proprioceptive training on balance in patients with chronic stroke. J Phys Ther Sci. 2017;29(5):839-844. doi:10.1589/jpts.29.839
  • 5. Kristensen OH, Stenager E, Dalgas U. Muscle Strength and Poststroke Hemiplegia: A Systematic Review of Muscle Strength Assessment and Muscle Strength Impairment. Arch Phys Med Rehabil. 2017;98(2):368-380. doi:10.1016/j.apmr.2016.05.023
  • 6. Aman JE, Elangovan N, Yeh IL, Konczak J. The effectiveness of proprioceptive training for improving motor function: a systematic review. Front Hum Neurosci. 2014;8:1075. doi:10.3389/fnhum.2014.01075
  • 7. Song Q, Zhang X, Mao M, et al. Relationship of proprioception, cutaneous sensitivity, and muscle strength with the balance control among older adults. J Sport Health Sci. 2021;10(5):585-593. doi:10.1016/j.jshs.2021.07.005
  • 8. Tong J, Mao O, Goldreich D. Two-Point Orientation Discrimination Versus the Traditional Two-Point Test for Tactile Spatial Acuity Assessment. Front Hum Neurosci. 2013;7:579. doi:10.3389/fnhum.2013.00579
  • 9. Ansems GE, Allen TJ, Proske U. Position sense at the human forearm in the horizontal plane during loading and vibration of elbow muscles. J Physiol. 2006;576(Pt 2):445-455. doi:10.1113/jphysiol.2006.115097
  • 10. Cobo R, García-Piqueras J, García-Mesa Y, Feito J, García-Suárez O, Vega JA. Peripheral Mechanobiology of Touch—Studies on Vertebrate Cutaneous Sensory Corpuscles. Int J Mol Sci. 2020;21(17):6221. doi:10.3390/ijms21176221
  • 11. Rand D. Proprioception deficits in chronic stroke-Upper extremity function and daily living. PLoS One. 2018;13(3):e0195043. doi:10.1371/journal.pone.0195043
  • 12. Wade DT, Langton-Hewer R, Wood VA, Skilbeck CE, Ismail HM. The hemiplegic arm after stroke: measurement and recovery. J Neurol Neurosurg Psychiatry. 1983;46(6):521-524. doi:10.1136/jnnp.46.6.521
  • 13. Harris JE, Eng JJ. Individuals with the dominant hand affected following stroke demonstrate less impairment than those with the non-dominant hand affected. Neurorehabil Neural Repair. 2006;20(3):380-389. doi:10.1177/1545968305284528
  • 14. Gliga AC, Neagu NE, Popoviciu HV, Bataga T. Effects of Adding Aquatic-to-Land-Based Physiotherapy Programs for Shoulder Joint Position Sense Rehabilitation. Healthcare (Basel). 2022;10(2):332. doi:10.3390/healthcare10020332
  • 15. Rosenkranz K, Pesenti A, Paulus W, Tergau F. Focal reduction of intracortical inhibition in the motor cortex by selective proprioceptive stimulation. Exp Brain Res. 2003;149(1):9-16. doi:10.1007/s00221-002-1330-3
  • 16. Jung SM. The effects of vibratory stimulation employed to forearm and arm flexor muscles on upper limb function in patients with chronic stroke. J Phys Ther Sci. 2017;29(9):1620-1622. doi:10.1589/jpts.29.1620
  • 17. Bruyere O, Wuidart MA, Di Palma E, et al. Controlled whole body vibration to decrease fall risk and improve health-related quality of life of nursing home residents. Arch Phys Med Rehabil. 2005;86(2):303-307. doi:10.1016/j.apmr.2004.05.019
  • 18. Tavernese E, Paoloni M, Mangone M, et al. Segmental muscle vibration improves reaching movement in patients with chronic stroke. A randomized controlled trial. NeuroRehabilitation. 2013;32(3):591-599. doi:10.3233/NRE-130881
There are 18 citations in total.

Details

Primary Language English
Subjects Anatomy
Journal Section Research Articles
Authors

Burhan İnan 0000-0002-9676-3429

Tuncay Çolak 0000-0002-9483-3243

Mehmet Deniz Yener 0000-0002-4379-5793

Publication Date June 27, 2022
Submission Date March 10, 2022
Acceptance Date April 14, 2022
Published in Issue Year 2022 Volume: 5 Issue: 2

Cite

AMA İnan B, Çolak T, Yener MD. Comparison of Sensory Parameters and Balance in Patients with Hemiplegia. Acta Med Nicomedia. June 2022;5(2):67-73. doi:10.53446/actamednicomedia.1085728

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