Original Article : Effects of elastic band orthosis (aider) on balance and gait in chronic stroke patients

( Noha Daher ),( Seung Jun Lee ),( You Jin Yang ) 물리치료재활과학회 2013 Physical therapy rehabilitation science Vol.2 No.2

Objective: The objective of this study was to investigate the feasibility and effects of balance training using a newly developed elastic band orthosis (aider) for improvement of mobility and balance in chronic stroke patients. Design: Cross-sectional study. Methods: Ten patients with chronic hemiplegia participated in this study. There were six males and four females; two patients had right hemiplegia and eight had left hemiplegia. This study investigated the effect of the elastic band orthosis on balance and gait ability compared with bare foot condition. Gait parameters were measured using the opto-gait system for analysis of the spatial and temporal parameters of walking in stroke patients. In addition, balance ability in stroke patients was evaluated using the Timed Up and Go (TUG) and Berg Balance Scale (BBS). Results: This study investigated the effect of the elastic band orthosis on balance compared with bare foot condition. The TUG and BBS showed significant improvement with use of the elastic band orthosis (p<0.05). Use of the Elastic band orthosis resulted in significantly improved velocity, cadence, less-affected step length, less-affected stride length, and less-affected single limb support in stroke patients (p<0.05). Conclusions: We demonstrated a significant improvement in dynamic balance and gait ability in chronic stroke patients using the elastic band orthosis. This orthosis may aid in prevention of spastic foot drop, leading to improvement of walking ability.

Effects of elastic band orthosis (aider) on balance and gait in chronic stroke patients

Daher, Noha,Lee, Seungjun,Yang, You Jin korean Academy of Physical Therapy Rehabilitation 2013 Physical therapy rehabilitation science Vol.2 No.2

Objective: The objective of this study was to investigate the feasibility and effects of balance training using a newly developed elastic band orthosis (aider) for improvement of mobility and balance in chronic stroke patients. Design: Cross-sectional study. Methods: Ten patients with chronic hemiplegia participated in this study. There were six males and four females; two patients had right hemiplegia and eight had left hemiplegia. This study investigated the effect of the elastic band orthosis on balance and gait ability compared with bare foot condition. Gait parameters were measured using the opto-gait system for analysis of the spatial and temporal parameters of walking in stroke patients. In addition, balance ability in stroke patients was evaluated using the Timed Up and Go (TUG) and Berg Balance Scale (BBS). Results: This study investigated the effect of the elastic band orthosis on balance compared with bare foot condition. The TUG and BBS showed significant improvement with use of the elastic band orthosis (p<0.05). Use of the Elastic band orthosis resulted in significantly improved velocity, cadence, less-affected step length, less-affected stride length, and less-affected single limb support in stroke patients (p<0.05). Conclusions: We demonstrated a significant improvement in dynamic balance and gait ability in chronic stroke patients using the elastic band orthosis. This orthosis may aid in prevention of spastic foot drop, leading to improvement of walking ability.

Original Article : Stress and language recovery in individuals with aphasia: constraint induced aphasia therapy

( Brian Sharpa ),( Paige Shaughnessya ),( Berk Lee ),( Noha Daher ) 물리치료재활과학회 2013 Physical therapy rehabilitation science Vol.2 No.2

Objective: Constraint induced aphasia therapy (CIAT) is a more intensive form of language treatment for aphasia as compared to traditional treatments. This study examined whether there are differences in cortisol stress levels between the two methods of aphasia treatment as well as effects on language skills. Design: Randomized controlled trial. Methods: A total of 20 participants with expressive aphasia were randomly placed into one of the two treatment groups. The CIAT group received 10 days of intensive treatment over two weeks. The traditional therapy group received 6 days of treatment over 2 weeks. All participants in each group provided salivary cortisol samples before treatment, at the mid-point of treatment, and at the conclusion of treatment. Language skills were assessed before treatment and at the conclusion of treatment. Results: A significantly higher proportion of individuals in the CIAT treatment group had increased salivary cortisol stress levels when compared to the traditional treatment group at the mid-point of the program (80% versus 30% respectively, p<0.05). There was no significant difference in the proportion of individuals with increased cortisol stress by the end of the treatment. Language scores for word repetition and overall aphasia quotient significantly improved for the CIAT group when compared to the traditional group (p<0.05). Conclusions: The CIAT treatment appears to initially create increased psychophysiological stress as compared to the traditional treatment. In spite of the initial increases in psychophysiological stress, participants appear to become conditioned to the challenge and ultimately have enhanced benefit from CIAT treatment.

Correlation Between Functional Movement Screen Scores, Lower Limb Strength, Y-Balance Test, Grip Strength, and Vertical Jump and Incidence of Injury Due to Musculoskeletal Injury Among Abu Dhabi Police Recruits

Hamad Alkaabi,Everett Lohman,Mansoor Alameri,Noha Daher,Aleksandar Cvorovic,Hatem Jaber 물리치료재활과학회 2023 Physical therapy rehabilitation science Vol.12 No.3

Objective: Training-related injuries and attrition put an additional burden on police and military institutions. Preventing and minimizing musculoskeletal injuries is the primary concern of the Abu Dhabi Police. Therefore, this study aimed to evaluate the correlation between functional movement screen, lower-limb strength, Y-balance test, grip strength and vertical jump and the incidence of musculoskeletal injuries among Abu Dhabi police recruits. Design: Observational analytical study. Methods: An observational study was conducted on 400 male police recruits of Abu Dhabi Police Academy. Physical performance was assessed before the 16-weeks basic police training. Spearman’s correlation evaluated the correlation between the performance parameters and the outcome measures and logistic regression predicted the risk factors associated with musculoskeletal injuries. Results: 149 (34.4%) participants reported at least one injury during the basic police training. Comparison between injured and non-injured participants showed significant difference in mean right Y-balance, back-leg-chest dynamometer, and vertical jump (p=0.02, p=0.02, and p=0.04, respectively). Spearman’s correlation showed a significant negative correlation between risk of injury and back-leg-chest dynamometer and right Y balance (ρ= -0.11, p=0.03). Logistic regression showed that back-leg-chest dynamometer and right Y balance were significant predictors of injury (p =.036 and p=0.037; Odds ratio=0.96; 95% CI (0.92, 0.99) and Odds ratio=0.99; 95% CI (0.98,0.99). Conclusions: Our findings suggest functional movement screen and grip strength may not independently predict injury rates, balance and lower-limb strength needs to be considered in injury prevention strategies to reduce musculoskeletal injuries.

Examination of trunk muscle co-activation during prolonged sitting in healthy adults and adults with non-specific chronic low back pain based on the O'Sullivan Classification System

Alameri, Mansoor,Lohman, Everett III,Daher, Noha,Jaber, Hatem korean Academy of Physical Therapy Rehabilitation 2019 Physical therapy rehabilitation science Vol.8 No.4

Objective: Non-specific chronic low back pain (NS-CLBP) has been related to abnormal trunk muscle activations, but literature reported considerable variability in muscle amplitudes of NS-CLBP patients during prolonged sitting periods. Therefore, the purpose of this study was to examine the differences among homogenous NS-CLBP subgroups in muscle activity, using muscle co-contraction indices as a more objective approach, and their roles on pain development during a 1-hour period of prolonged sitting. Design: Cross-sectional study. Methods: Twenty NS-CLBP subjects with motor control impairment (MCI) [10 classified as having flexion pattern disorder, and 10 with active extension pattern disorder], and 10 healthy controls participated in the study. Subjects followed a 1-hour sitting protocol on a standard office chair. Four trunk muscle activities including amplitudes and co-contraction indices were recorded using electromyography over the 1-hour period. Perceived back pain intensity was recorded using a numeric pain rating scale every 10 minutes throughout the sitting period. Results: All study groups presented with no significantly distinctive trunk muscle activities at the beginning of sitting, nor did they change over time when pain increased to a significant level. Both MCI subgroups reported a similarly significant increase in pain behavior through mid-sitting (p<0.001). However, after mid-sitting, they significantly differed from each other in pain (p<0.01) but did not differ in the levels of muscle activation. Conclusions: This study was the first to highlight the similarities in trunk muscle activities among homogenous NS-CLBP patients related to MCI and compared them to healthy controls while sitting for an extended period of time, and the significant increase in pain over the 1-hour sitting might not be attributed to trunk muscle activation.

Examination of trunk muscle co-activation during prolonged sitting in healthy adults and adults with non-specific chronic low back pain based on the O’Sullivan Classification System

Mansoor Alameri,Everett Lohman III,Noha Daher,Hatem Jaber 물리치료재활과학회 2019 Physical therapy rehabilitation science Vol.8 No.4

Objective: Non-specific chronic low back pain (NS-CLBP) has been related to abnormal trunk muscle activations, but literature reported considerable variability in muscle amplitudes of NS-CLBP patients during prolonged sitting periods. Therefore, the purpose of this study was to examine the differences among homogenous NS-CLBP subgroups in muscle activity, using muscle co-contraction indices as a more objective approach, and their roles on pain development during a 1-hour period of prolonged sitting. Design: Cross-sectional study. Methods: Twenty NS-CLBP subjects with motor control impairment (MCI) [10 classified as having flexion pattern disorder, and 10 with active extension pattern disorder], and 10 healthy controls participated in the study. Subjects followed a 1-hour sitting protocol on a standard office chair. Four trunk muscle activities including amplitudes and co-contraction indices were recorded using electromyography over the 1-hour period. Perceived back pain intensity was recorded using a numeric pain rating scale every 10 minutes throughout the sitting period. Results: All study groups presented with no significantly distinctive trunk muscle activities at the beginning of sitting, nor did they change over time when pain increased to a significant level. Both MCI subgroups reported a similarly significant increase in pain behavior through mid-sitting (p<0.001). However, after mid-sitting, they significantly differed from each other in pain (p<0.01) but did not differ in the levels of muscle activation. Conclusions: This study was the first to highlight the similarities in trunk muscle activities among homogenous NS-CLBP patients related to MCI and compared them to healthy controls while sitting for an extended period of time, and the significant increase in pain over the 1-hour sitting might not be attributed to trunk muscle activation.

Reliability and validity of the patellofemoral disability index as a measure of functional performance and subjective pain in subjects with patellofemoral pain syndrome

Mastour Saeed Alshaharani,Everett Bernell Lohman,Khaled Bahjri,Travis Harp,Mansoor Alameri,Noha S. Daher 물리치료재활과학회 2018 Physical therapy rehabilitation science Vol.7 No.2

Objective: Patellofemoral pain syndrome (PFPS) is a condition that is characterized by patellar discomfort or pain that is aggravated during certain activities such as ascending/descending stairs. The Patellofemoral Disability Index (PDI) was developed to assess the effect of pain on functional activities in individuals with PFPS. The objectives of the current study were to determine the internal consistency, test-retest reliability, and validity of this index. Design: Cross-sectional study. Methods: Forty-one subjects who had PFPS with a mean age of 28.8±5.0 years and a mean body mass index of 25.6±4.7 kg/m2 participated in the study. All subjects were concurrently enrolled in a clinical trial for which they were instructed to complete hamstring- resistance exercises for 4 weeks. Over the course of the intervention, they completed both the PDI and the Oswestry Disability Index (ODI) at baseline after two weeks, and after four weeks. Pearson correlation coefficient was used to assess the criterion validity. Cronbach’s α was used to examine the internal consistency. Intraclass correlation coefficients with 95% confidence interval were computed to examine test-retest reliability. Results: Subjects’ responses within both the PDI and the ODI yielded Pearson correlation coefficient values that were positive and highly significant (range, 0.73-0.97; p<0.001). There was a high level of internal consistency (Cronbach’s α≥0.8), with the exception of stair climbing (Cronbach’s α=0.65). Intraclass correlation ranged from 0.87 to 0.92, indicating high levels of test-retest reliability. Conclusions: The PDI is a valid, reliable, and feasible method of assessing pain and functional ability in patients with PFPS.

Reliability and validity of the patellofemoral disability index as a measure of functional performance and subjective pain in subjects with patellofemoral pain syndrome

Alshaharani, Mastour Saeed,Lohman, Everett Bernell,Bahjri, Khaled,Harp, Travis,Alameri, Mansoor,Daher, Noha S. korean Academy of Physical Therapy Rehabilitation 2018 Physical therapy rehabilitation science Vol.7 No.2

Objective: Patellofemoral pain syndrome (PFPS) is a condition that is characterized by patellar discomfort or pain that is aggravated during certain activities such as ascending/descending stairs. The Patellofemoral Disability Index (PDI) was developed to assess the effect of pain on functional activities in individuals with PFPS. The objectives of the current study were to determine the internal consistency, test-retest reliability, and validity of this index. Design: Cross-sectional study. Methods: Forty-one subjects who had PFPS with a mean age of $28.8{\pm}5.0years$ and a mean body mass index of $25.6{\pm}4.7kg/m^2$ participated in the study. All subjects were concurrently enrolled in a clinical trial for which they were instructed to complete hamstring-resistance exercises for 4 weeks. Over the course of the intervention, they completed both the PDI and the Oswestry Disability Index (ODI) at baseline after two weeks, and after four weeks. Pearson correlation coefficient was used to assess the criterion validity. Cronbach's ${\alpha}$ was used to examine the internal consistency. Intraclass correlation coefficients with 95% confidence interval were computed to examine test-retest reliability. Results: Subjects' responses within both the PDI and the ODI yielded Pearson correlation coefficient values that were positive and highly significant (range, 0.73-0.97; p<0.001). There was a high level of internal consistency (Cronbach's ${\alpha}{\geq}0.8$), with the exception of stair climbing (Cronbach's ${\alpha}=0.65$). Intraclass correlation ranged from 0.87 to 0.92, indicating high levels of test-retest reliability. Conclusions: The PDI is a valid, reliable, and feasible method of assessing pain and functional ability in patients with PFPS.

Home exercise program adherence strategies in vestibular rehabilitation: a systematic review

Gaikwad, Shilpa B.,Mukherjee, Tatri,Shah, Parita V.,Ambode, Oluwaseun I.,Johnsonb, Eric G.,Daher, Noha S. korean Academy of Physical Therapy Rehabilitation 2016 Physical therapy rehabilitation science Vol.5 No.2

Objective: The aim of this systematic review was to investigate for effective strategies to improve home exercise program (HEP) adherence in vestibular rehabilitation (VR). Design: Systematic review. Methods: A systematic review was conducted to identify effective strategies used to improve HEP adherence of patients in VR. Six databases, Academic Search Premier, Cochrane Library, CINAHL, PUBMED, PsycINFO, and Web of Science were searched from their inception to December 31, 2015. The keywords used for search were 'home program', 'home intervention', 'compliance', 'adherence', 'vestibular rehabilitation', 'motion sickness', and 'motion sensitivity'. Results: A total of eight studies were selected to be included in the review. There was 95.2% agreement between the two reviewers who reviewed the studies using a quality assessment tool. The overall inter-rater agreement (${\kappa}$=0.73) showed good agreement between the reviewers. Strong evidence was identified for 3 major categories of effective HEP adherence strategies, 1) providing patient with written summary of HEP; 2) asking patient to maintain a record of HEP and symptoms; and 3) providing tele-rehabilitation in form of email and/or telephone support along with in person treatment sessions. Also, based on strong evidence, computerized technology was not found to be superior to other strategies for improving patients' HEP adherence in VR. Conclusions: The effective strategies for improving HEP in VR include written summary of exercise, maintenance of log of HEP and symptoms and tele-rehabilitation along with in person treatment sessions.

Home exercise program adherence strategies in vestibular rehabilitation: a systematic review

( Shilpa Bgaikwad ),( Tatri Mukherjee ),( Parita V Shah ),( Oluwaseun I Ambode ),( Eric G Johnson ),( Noha S Daher ) 물리치료재활과학회 2016 Physical therapy rehabilitation science Vol.5 No.2

Objective: The aim of this systematic review was to investigate for effective strategies to improve home exercise program (HEP) adherence in vestibular rehabilitation (VR). Design: Systematic review. Methods: A systematic review was conducted to identify effective strategies used to improve HEP adherence of patients in VR. Six databases, Academic Search Premier, Cochrane Library, CINAHL, PUBMED, PsycINFO, and Web of Science were searched from their inception to December 31, 2015. The keywords used for search were `home program`, `home intervention`, `compliance`, `adherence`, `vestibular rehabilitation`, `motion sickness`, and `motion sensitivity`. Results: A total of eight studies were selected to be included in the review. There was 95.2% agreement between the two reviewers who reviewed the studies using a quality assessment tool. The overall inter-rater agreement (κ=0.73) showed good agreement between the reviewers. Strong evidence was identified for 3 major categories of effective HEP adherence strategies, 1) providing patient with written summary of HEP; 2) asking patient to maintain a record of HEP and symptoms; and 3) providing tele-rehabilitation in form of email and/or telephone support along with in person treatment sessions. Also, based on strong evidence, computerized technology was not found to be superior to other strategies for improving patients` HEP adherence in VR. Conclusions: The effective strategies for improving HEP in VR include written summary of exercise, maintenance of log of HEP and symptoms and tele-rehabilitation along with in person treatment sessions.