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Gait velocity as a tool for evaluating the effects of gait training in patients with chronic stroke

100%
Agnieszka Guzik A., Mariusz Drużbicki M., Andrzej Kwolek A., Grzegorz Przysada G., Agnieszka Brzozowska-Magoń A.
Medical Review
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2016
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issue 2
183-192
EN
Background. Gait velocity is a simple but very essential parameter which may be applied as an indicator of functional efficiency. Gait of stroke patients is characterized by reduced speed. As a result, the patients have significantly limited functioning capabilities, including walking independently outside home. The study was designed to assess selected temporal gait parameters, including gait velocity, stride velocity and swing phase velocity in patients with chronic stroke following a rehabilitation program with the use treadmill. Material and method. The study was conducted in a group of 50 patients with hemiparesis in the late period after stroke. Temporal gait parameters such as: gait velocity, stride velocity and swing velocity were examined. Additionally, 10-metre walk test was measured. Results. While analyzing 10-metre walk test results it was shown that after rehabilitation gait velocity increased by an average of 0.15 m/s (p = 0.0000). Similar results were obtained in terms of gait velocity which had been assessed using a 3-dimensional gait analysis, the average gait velocity increased by 0,14m/s (p = 0.0000). Analyzing stride velocity, both the paretic and non-paretic side it was noted that after rehabilitation this particular parameter increased by an average of 0.05 m/s (p = 0.0019) and 0.06 m/s (p = 0.0052). Similar results were achieved in terms of swing velocity of the paretic side - p = 0.0017. Conclusions. It was demonstrated that rehabilitation program with the use of treadmill enabled significant improvement in gait velocity, stride velocity and swing phase velocity in patients with chronic stroke. Gait velocity is a practical and simple tool to be applied for monitoring of progress in rehabilitation and for assessing effects of gait re-education in patients with hemiplegia in a chronic stage after stroke.
PL
Wstęp. Prędkość chodu jest prostym, a zarazem bardzo istotnym parametrem, który może być stosowany jako wyznacznik sprawności funkcjonalnej. Chód pacjentów po udarze mózgu charakteryzuje się zmniejszoną prędkością. W efekcie pacjenci mają znacznie ograniczone możliwości funkcjonowania, w tym samodzielnego chodu poza domem. Celem pracy jest ocena wybranych czasowych parametrów chodu, w tym prędkości chodu, prędkości cyklu chodu oraz prędkości fazy przenoszenia u pacjentów w okresie późnym po udarze mózgu, po programie rehabilitacji z wykorzystaniem bieżni ruchomej. Materiał i metoda. Badanie przeprowadzono w grupie 50 pacjentów z niedowładem połowiczym w okresie późnym po udarze mózgu. Analizowano czasowe parametry chodu: prędkość chodu, prędkości cyklu chodu oraz prędkości fazy przenoszenia. Dodatkowo wykonano test drogi na 10 metrach. Wyniki. Analizując wyniki testu drogi wykazano, że po zakończeniu programu rehabilitacji prędkość chodu wzrosła średnio o 0,15 m/s (p = 0,0000). Podobne wyniki uzyskano w zakresie prędkości chodu ocenionej z wykorzystaniem 3-wymiarowej analizy chodu, średnia prędkość chodu wzrosła o 0,14m/s (p = 0,0000). Analizując prędkość cyklu chodu zarówno po stronie niedowładnej jak i zdrowej zanotowano, iż w wyniku rehabilitacji nastąpił wzrost tego parametru średnio o 0,05 m/s (p = 0,0019) i 0,06 m/s (p = 0,0052). Zbliżone wyniki uzyskano również w zakresie prędkości fazy przenoszenia po stronie niedowładnej – p = 0,0017. Wnioski. Program rehabilitacji z wykorzystaniem bieżni ruchomej wpłynął na istotną poprawę w zakresie prędkości chodu, prędkości cyklu chodu oraz prędkości fazy przenoszenia u pacjentów w okresie późnym po udarze mózgu. Prędkość chodu jest przydatnym narzędziem umożliwiającym ocenę efektów reedukacji chodu pacjentów z niedowładem połowiczym w okresie późnym po udarze mózgu.
2
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Assessment of manual abilities in children with infantile cerebral palsy

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Grzegorz Przysada G., Agnieszka Guzik A., Andżelina Wolan-Nieroda A., Magdalena Przybyło M., Mariusz Drużbicki M., Artur Mazur A.
European Journal of Clinical and Experimental Medicine
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2019
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issue 2
136-141
EN
Introduction. Cerebral palsy (CP) is a problem presenting multiple issues and the prevalence of this condition is quite significant. CP risk factors are mainly observed in prematurely born children as well as those affected by complications around the time of birth or during the period of mother’s pregnancy. Quite frequently CP is manifested by abnormal muscle tone, contractures and deformities, and consequently impaired fine and gross motor functions. Aim. The study was designed to examine the level of hand function, i.e. fine motor skills and to investigate whether there is a correlation between development of fine motor and gross motor functions. Material and methods. The study group included 80 children with infantile CP. In the group there were 24 cases with spastic diplegia, 36 with spastic hemiplegia, and 20 with bilateral hemiplegia. During the study the children performed Box and Blocks test, and their parents filled in Manual Ability Classification System (MACS) describing the level of fine motor function development in their children. The children were additionally asked to perform two motor tasks. The first one involved an attempt to assume position on all fours, and the other one checked the ability to assume and maintain standing position. Results. The best scores in the conducted tests were found in children with CP taking the form of spastic diplegia, and the poorest scores in MACS, Box and Blocks test as well as in motor tasks assessing gross motor function were observed in children with bilateral hemiplegia. Conclusion. The form of infantile CP affects the level of manual abilities. There is a correlation between the level of gross motor and fine motor functions development.
3
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Cervical spine injuries in Poland – epidemiology, divisions, and causes

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Andżelina Wolan-Nieroda A., Andrzej Maciejczak A., Agnieszka Guzik A., Grzegorz Przysada G., Justyna Wyszyńska J., Ewa Szeliga E.
European Journal of Clinical and Experimental Medicine
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2017
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issue 1
66-70
EN
Aim. The aim of the study was to review the literature on the prevalence of cervical spine injuries divided between the level of the injury and the causes of fractures. Material and methods. A review of Polish and foreign literature was performed. The following databases were searched: PubMed, Medline, Science Direct, Termedia, and Polish Medical Bibliography. Literature analysis. In Poland the incidence of spinal injuries, including damage to the cord, is estimated at the level of 25–35 persons per one million of the population, half of these being cervical spine injuries. More than one in three of all spinal injuries affect the atlantoaxial and occipital area. It is estimated that axis fractures occur in up to 40% of the cases involving cervical spine injury. Odontoid fractures constitute 10–15% of all cervical spine fractures. Hangman fractures account for 20% of vertebral fractures. Cervical spine injuries more frequently occur in males than in females, and the relevant rates for males are from 1.5 to 2.7 times higher. The most common causes of cervical spine injuries include road traffic accidents, accounting for 33 to 75% of the cases, falls from heights (15–44%) and sports injuries (4–18%). Cervical spine injuries are most often diagnosed in subjects over thirty years of age. Such injuries most commonly are related to the second, fifth and sixth cervical vertebrae. On the other hand damage to the first and second cervical vertebrae is often observed in the same patients who are found with injury to lower cervical vertebrae (approx. 9% of the cases). In the group of advanced age subjects the most frequent cervical spine injuries are axial fractures and they are diagnosed in 15% of adult patients with cervical spine fractures.
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