Research Report Abstracts - Gesundheit

eS1374
in women, were independently associated with high risk of
malnutrition.
Conclusions: These results suggest that elderly patients
receiving long-term care are at serious risk for malnutrition,
and that appropriate nutritional assessments are therefore
necessary. BMI and body composition parameters correlate
significantly with the results of nutritional screening based
on Alb; it is therefore possible for elderly patients receiving
long-term care to be screened for malnutrition risk through
concurrent BMI and body composition measurement.
Implications: The easy methods used in this study to measure
BMI and body composition is adaptable for patients
who are unable to stand due to decline in their physical
function. The results of this study indicate the possibility
of nutritional screening through BMI and body composition
measurements, which will allow more frequent nutritional
assessment in long-term care settings that lack laboratory
facilities, and reduce the risk of malnutrition during rehabilitation
in such settings.
Keywords: Elderly patients receiving long-term care; Body
mass index; Malnutrition
Funding acknowledgements: None.
Ethics approval: This study has been approved by the
ethics committee of the International University of Health
and Welfare.
Research Report Poster Display
Number: RR-PO-209-28-Tue Tuesday 21 June 12:00
RAI: Exhibit Halls 2&3
THE EFFECT OF FORCED-USE TRAINING OVER
LOWER EXTREMITY ON GAIT, MOBILITY AND
QUALITY OF LIFE IN INDIVIDUALS WITH
STROKE
Yu W.-H. 1,2 , Liu W.-Y. 2 , Wang T.-C. 2,3 , Wong A.M.-K. 2,4 ,
Lien H.-Y. 2
1Chang Gung Medical Foundation-Taoyuan Branch, Physical
therapy, Department of Physical Medicine and
Rehabilitation, Taoyuan, Taiwan, 2Chang-Gung University,
Graduate Institute of Rehabilitation Science, Taoyuan,
Taiwan, 3Tzu Hui Institute of Technology, The Department of
Rehabilitation Technology, Pingtung, Taiwan, 4Chang Gung
Medical Foundation-Taoyuan Branch, Department of Physical
Medicine and Rehabilitation, Taoyuan, Taiwan
Purpose: To investigate the effects of a forced-use training
program on the gait, mobility and quality of life (QoL) in
stroke patients.
Relevance: Forced-use training is an effective technique in
improving hand and arm functions after stroke. However,
owing to the bi-pedal nature of the human locomotion, the
principles are rarely applied in training mobility. Therefore,
this study developed a lower extremity training program
based on forced-use principles and examined its feasibility
and efficacy in clinical setting.
Participants: Twenty-one individuals with unilateral stroke
voluntarily consented to participate in this study. All participants
suffered from the first stroke with post-stroke time of
at least 3 months, Brunnstrom stages between III and V on
affected lower limb, and Functional Ambulation Category
(FAC) greater or equal than 2, were recruited for training.
Methods: A observer-blind, nonequivalent pretest-posttest
control group design with 1 month follow-up was adopted. To
avoid diffusion of the treatment, lower extremity forced-use
training (LEFUT) or intensive conventional physical therapy
(ICPT) were offered in two separate periods of the year in the
same rehabilitation ward. Both groups received 90 minutes a
day, 5 times a week program for 2 weeks. The ICPT program
provides gait correction, treadmill training, and other training
activities prescribed by physical therapists. Participants
in LEFUT group must wear a wedged shoe on unaffected side
to forced-use the affected limb in all floor activities during the
two-weeks period and during a daily, 5-workstations’ circuit
training. Performance on free and maximal walking velocity
(FWV; MWV), spatial and temporal symmetry index (SSI;
TSI) (GAITRite, CIR system Inc., NJ 507012, USA), timed
up and go (TUG) test, Rivermead Mobility Index (RMI)
and Stroke-Specific Quality of Life Scale Taiwan Version
(SSQoLTV) were collected to compare the effects of the
programs.
Analysis: The between-groups comparisons on demographic
characteristics and pretest scores were analyzed by independent
t-test or Mann–Whitney U test. Walking velocities,
TUG test and SSQoLTV scores were converted into gain
scores and analyzed by mixed two-way ANOVA (2 × 2) with
repeated measures. The gait SI were analyzed by mixed twoway
ANOVA (2 × 3) with repeated measures while Friedman
and Kruskal–Wallis tests, were used to compare RMI scores
within or between-groups. All statistical testing were completed
with SPSS version 11.0.
Results: Forced-use group showed greater improvement
than ICPT group in gait and mobility Forced-use group
showed greater improvement than ICPT group in gait and
mobility (FWV, p < 0.001; MWV, p < 0.05; TUG: p < 0.05;
RMI: p < 0.05). Surprisingly, patients in ICPT group walked
faster but more asymmetrically after training (SSI at FWV,
p < 0.05). Both LEFUT and ICPT could not improve QoL
significantly after training (SSQoL; p = 0.62).
Conclusions: Lower extremity forced-use training helps
stroke patients getting greater mobility, walking faster with
symmetrical gait than conventional physical therapy. However,
the effect of both programs on QoL could not be fully
revealed by current setting. Randomized control trial with
multiple follow-ups is warrant to verify the effectiveness of
LEFTU on stroke individuals at different stages of recovery.
Implications: Forced-used principles could be successfully
adopted and implemented clinically to improve gait and functional
mobility for individuals with stroke.
Keywords: Stroke; Forced-use; Mobility