Effects of the Abdominal Drawing-in Maneuver and the Abdominal Expansion Maneuver on Grip Strength, Balance and Pulmonary Function in Stroke Patients원문보기
Purpose: The purpose was to determine whether the application of the abdominal drawing-in maneuver (ADIM) and abdominal expansion maneuver (AEM) to stroke patients would affects their trunk stability, balance, pulmonary function, and grip strength. Methods: The subjects were 36 stroke patients who w...
Purpose: The purpose was to determine whether the application of the abdominal drawing-in maneuver (ADIM) and abdominal expansion maneuver (AEM) to stroke patients would affects their trunk stability, balance, pulmonary function, and grip strength. Methods: The subjects were 36 stroke patients who were randomly and equally assigned to an ADIM group (n=12), an AEM group (n=12), and a control group (n=12). The intervention was applied to each group three times per week, 30 minutes each time, for four weeks. Outcome measures were grip strength, modified functional reach test (mFRT) and pulmonary function. Pulmonary function were measured force expiratory volume at one second (FEV1), forced vital capacity (FVC), FEV1/FVC and peak expiratory flow (PEF) values. Results: The results of the three groups showed statistically significant improvements in grip strength. The AEM group showed significantly greater differences in grip strength than either the ADIM group or the control group. In the anterior mFRT, the ADIM group showed significantly improvements than the control group. The ADIM and AEM groups were showed statistically significant greater improvements in PEF between the baseline and post-intervention and the post-analysis revealed that the AEM group showed significantly greater improvements than the control group. Conclusion: The results of this study indicate that the ADIM and AEM were effective in improving the PEF of pulmonary function. The ADIM was more effective than AEM in trunk stabilization.
Purpose: The purpose was to determine whether the application of the abdominal drawing-in maneuver (ADIM) and abdominal expansion maneuver (AEM) to stroke patients would affects their trunk stability, balance, pulmonary function, and grip strength. Methods: The subjects were 36 stroke patients who were randomly and equally assigned to an ADIM group (n=12), an AEM group (n=12), and a control group (n=12). The intervention was applied to each group three times per week, 30 minutes each time, for four weeks. Outcome measures were grip strength, modified functional reach test (mFRT) and pulmonary function. Pulmonary function were measured force expiratory volume at one second (FEV1), forced vital capacity (FVC), FEV1/FVC and peak expiratory flow (PEF) values. Results: The results of the three groups showed statistically significant improvements in grip strength. The AEM group showed significantly greater differences in grip strength than either the ADIM group or the control group. In the anterior mFRT, the ADIM group showed significantly improvements than the control group. The ADIM and AEM groups were showed statistically significant greater improvements in PEF between the baseline and post-intervention and the post-analysis revealed that the AEM group showed significantly greater improvements than the control group. Conclusion: The results of this study indicate that the ADIM and AEM were effective in improving the PEF of pulmonary function. The ADIM was more effective than AEM in trunk stabilization.
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제안 방법
The ADIM and AEM group performed 4 weeks of training thrice a week for 30 minutes. All subjects, including those in the control group, underwent a traditional physical treatment 15 times a week, for 60 minutes per session, over the course of 4 weeks. After 4 weeks, the final evaluation was performed, and each measurement was evaluated respectively.
This study was a single-blind randomized controlled trial and was conducted with stroke patients for 4 weeks. All the enrolled patients were randomly assigned by the selection of an opaque closed envelope from envelopes in which the group assignment was written. General surveys of a subject and pre-tests were conducted.
All the enrolled patients were randomly assigned by the selection of an opaque closed envelope from envelopes in which the group assignment was written. General surveys of a subject and pre-tests were conducted. The ADIM and AEM group performed 4 weeks of training thrice a week for 30 minutes.
Pulmonary function tests were performed by the researchers at least three times for each subject in a sitting position; Spirobank G (Medical International Research, Rome, Italy) spirometer and with a different mouthpiece for each subject. A practical presentation about the test and the way it is done was performed for the subjects before the test.
This study compares the effects of the ADIM and AEM on the balance, the pulmonary function, and upper extremity function of stroke patients. The before-after intervention study, after four-week application of ADIM and AEM, shows that the improvement of mFRT in the ADIM group, the improvement of hand grip force and PEF in the AEM group are observed.
This study is carried out to suggest an efficient method for intervention of improving trunk stabilization, upper limb function, and pulmonary function. However, fifteen minutes as a duration of exercise is short to check the effects of the exercise, and there was a limitation in terms of accuracy in the breathing exercise through the AEM, while the breathing exercise using visual feedback through ADIM has been quantified.
This study was a single-blind randomized controlled trial and was conducted with stroke patients for 4 weeks. All the enrolled patients were randomly assigned by the selection of an opaque closed envelope from envelopes in which the group assignment was written.
대상 데이터
This study was performed in the neurorehabilitation center in Deajeon, Republic of Korea. Thirty-six hospitalized stroke patients agreed to participate in this study after learning about the context of this study. The selection criteria were those older than 6 months, were diagnosed with stroke, could stand independently, and who had no cognitive impairment based on Mini-Mental State Examination (MMSE) results.
This study was performed in the neurorehabilitation center in Deajeon, Republic of Korea. Thirty-six hospitalized stroke patients agreed to participate in this study after learning about the context of this study.
데이터처리
A one-way ANOVA was used to discover the differences in the changes before and after interventions.
Tests of homogeneity were performed using a Chi-square test. A paired t-test was used to discover the periodic measurement change of the before and after for each group. A one-way ANOVA was used to discover the differences in the changes before and after interventions.
Means and standard deviations were calculated for the general characteristics of the study subjects using technical analysis. Tests of homogeneity were performed using a Chi-square test. A paired t-test was used to discover the periodic measurement change of the before and after for each group.
When differences were found, the Scheffe’s method was used as a posteriori test.
이론/모형
A practical presentation about the test and the way it is done was performed for the subjects before the test. The tests were performed according to the test procedure of The American Thoracic Society. Force expiratory volume at one second (FEV1), forced vital capacity (FVC), FEV1/FVC and peak expiratory flow (PEF) values were measured three times and the best result of the three measurements was recorded.
성능/효과
However, the ADIM and AEM groups were showed statistically significant improvements in PEF between the baseline and post-intervention (p < 0.05) and the post-analysis revealed that the AEM group showed significantly greater improvements than the control group (p < 0.05) (Table 3).
However, they showed that other indices of pulmonary function have nothing to do with trunk control, except the significant correlation between TIS and PEF. In this study, the change in the anterior mFRT in the groups of AEM and ADIM who do the breathing exercise is larger than the change of control group, and the change in the ADIM group shows statistically larger improvements compared with the control group. In addition, the change of PEF in the ADIM and AEM groups is larger compared with control group, which is following the results in the previous studies.
No significant differences were observed among the three groups in terms of age, gender, body weight, height, time since stroke, affected side, and MMSE (p> 0.05).
Results of the pulmonary function tests, all three groups were not showed statistically significant improvements in FVC, FEV1, and FEV1/FVC between the baseline and post-intervention (p > 0.05).
The affected anterior mFRT showed statistically significant increases in all three groups after the intervention (p < 0.05), and the ADIM group showed significantly greater improvements than the control group (p < 0.05).
The results of ADIM, AEM, and control groups showed statistically significant improvements in affected and non-affected side grip strength between the baseline and post-intervention (p < 0.05).
후속연구
Furthermore, there has not been a study applying the AEM as a respiration exercise to stroke patients although AEM has been studied for athletes or back pain patients.17Therefore, this research is going to study how the application of the ADIM and AEM to stroke patients would affect the trunk stability, balance, pulmonary function, and grip strength.
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