Temporal characteristics of laryngeal penetration and aspiration in stroke patients.
This study aimed to investigate the temporal characteristics of PA in post-stroke patients in terms of the timing of the PA event and hyolaryngeal incoordination. METHODS: Fifty-eight swallows (38 stroke patients), showing PA when swallowing a thin liquid, were included. The timing of PA was classified kinematically as before or during the swallow. The movement sequence of vertical laryngeal elevation, horizontal hyoid excursion, and epiglottic rotation were compared with healthy controls. Spatiotemporal measurements, videofluoroscopic dysphagia scale parameters were compared between subgroups. RESULTS: Thirteen swallows (22.4%) were classified as PA before the swallow and 45 were classified as PA during the swallow (77.6%). Among the PA during the swallow, 26 (57.8%) swallows exhibited abnormal sequences of hyolaryngeal movements and 19 (42.2%) swallows showed normal sequences of hyolaryngeal movements compared with healthy controls. The onset time of horizontal hyoid excursion (P = 0.028), the time to maximal horizontal hyoid excursion (P = 0.010), and maximal epiglottic rotation (P = 0.030) were significantly more delayed in the PA during the swallow group than in the PA before the swallow group. In the swallows with abnormal sequential movements, the onset of horizontal hyoid excursion occurred significantly later than the onset of epiglottic rotation (P
This study determines acute changes in start-up wheelchair propulsion biomechanics at the end of a fatiguing propulsion protocol. DESIGN: Quasi-experimental one-group pretest-postest design. SETTING: Biomechanics laboratory. PARTICIPANTS: Twenty-six wheelchair users with spinal cord injury (age: 35.5 ± 9.8 years, sex: 73% males and 73% with a paraplegia). INTERVENTIONS: Protocol of 15 min including maximum voluntary propulsion, right- and left turns, full stops, start-up propulsion, and rests. OUTCOME MEASURES: Maximum resultant force, maximum rate of rise of applied force, mean vel...
Results of this study indicate that adults with history of stroke had higher odds of not engaging in healthy behaviors than their counterparts without a history of stroke.Preventing Chronic Disease
CONCLUSIONS: Both the tablet-based tool and the custom PMDD performed better than manual assessment. The PMDD may be useful when the deficit is mild or assessment of dynamic proprioception is desired. As the tablet-based measure does not have the ceiling effect that is associated with the PMDD, it may be useful with any level of proprioceptive impairment, and may be preferable if testing or clinician training time needs to be minimized, or pain or spasticity is present.Video Abstract available for more insights from the authors (see the Video, Supplementary Digital Content 1, available at: http://links.lww.com/JNPT/A256). ...
Commentary on: "Practice Structure and Locomotor Learning After Stroke". J Neurol Phys Ther. 2019 Apr;43(2):94-95 Authors: Leech KA, Holleran CL PMID: 30883496 [PubMed - in process]
CONCLUSIONS: The results suggest that variable practice utilizing alternating belt speed ratios does not influence the ability of those with chronic stroke to adapt and retain a novel locomotor pattern. The effects of other forms of variable practice within other locomotor learning paradigms should be explored in those with chronic hemiparesis after stroke.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A257). PMID: 30883495 [PubMed - in process]
Oh Young Bang, Byung Moon Kim, Woo-Keun Seo, Pyoung Jeon
Angelos Sharobeam, Dennis John Cordato, Nathan Manning, Andrew Cheung, Jason Wenderoth, Cecilia Cappelen-Smith
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