THERAPEUTIC EFFECTS OF WHOLE BODY PERIODIC ACCELERATION FOR STROKE

• Main Author: Bulganchimeg Khaltar
• Other Authors: Chia-Hsin Chen
• Format: Others
• Language: en_US
• Published: 2015
• Online Access: http://ndltd.ncl.edu.tw/handle/52129992365119548824

碩士 === 高雄醫學大學 === 醫學研究所碩士班 === 103 === Background and Aim: Stroke is the second most common cause of mortality and the third most common cause of disability. Eighty percent of stroke survivors with post stroke impairments suffer from mobility impairment and motor coordination deficits. Whole Body Periodic Acceleration (WBPA) is the motion of the supine body in the head to foot axis (z-axis) in a sinusoidal fashion using a motion platform. The acceleration and deceleration produced by the motion of WBPA adds small pulses as a function of frequency to the native pulse rate thereby increasing pulsatile shear stress to the vascular endothelium.WBPA therapy has shown potential neuro-protective and neuro-therapeutical effects in normal and with stroke animal studies. The aim of this study was to compare outcomes following rehabilitation therapy with or without WBPA therapy in patients with post stroke mobility impairment by using assessment of balance and functional testing and level of interleukin 6 (IL-6) and high-sensitivity C-reactive protein (hs-CRP) in serum. Method:Twenty patients with chronic stroke were recruited and randomized to control or WBPA group. In the control group, patients received regular conventional rehabilitation programs. In the WBPA group, patients also received regular rehabilitation programs, and in addition, received intervention with WBPA exercise 5 times per week for 8 weeks. The intensity of WBPA was at frequency of 140 times per minute, 2 cm amplitude for 30 minutes each time. Clinical assessments were evaluated at 3 time points: before intervention (W0), after 4-week WBPA (W4), and upon completion of WBPA (W8). The outcome measures included balance test using Biodex Balance SD system, functional test using timed 10-meter walk test (TMWT) and timed-up-and-go test (TUGT), and blood test for specific inflammatory cytokines, IL-6 and hs-CRP in serum. Results:Twenty subjects (11 in WBPA group, and 9 in control group) were enrolled in study. The average age of the study population was 57.1 years old and 65% were male gender. Half of the included population had ischemic stroke, and the average time post stroke onset was 30.95 months. When evaluating proportional changes in balance and functional mobility between follow-up testing periods, results in rightward limits of stability testing indicated significant improvement in WBPA group (P=0.003). There were also improvement in FRI in both WBPA and control groups, indicating statistically significant differences (P=0.010, P=0.031) between follow-up periods. Conclusion:Our study demonstrated that WBPA therapy combined with conventional physical therapy enhanced the effects of conventional physical therapy on balance in patients with chronic stroke by indicating a tendency toward improved balance and control. WBPA treatment combined with conventional physical therapy did not increase inflammatory cytokines level comparing to physical therapy alone, indicating safety treatment to use in subjects with disability following stroke as well as other conventional physical treatments. WBPA therapy may be applied in patients with chronic stroke for improved balance and functional mobility.