Patients with stroke have hypomobility in the facet joint of affected side. Lumbar joint mobilization could be used to maintain function and mobility of the joints.
OBJECTIVE:
This study aimed to investigate the effects of lumbar joint mobilization on trunk function, postural balance, and gait in patients with stroke.
METHODS:
Thirty patients with stroke were randomly assigned to two groups. Lumbar joint mobilization was provided for 15 min, 5 times a week for 6 weeks to patients who were allocated into the experimental group. Patients who were allocated into the control group received a sham intervention. Trunk function (trunk impairment scale), postural balance (weight distribution, Berg balance scale, and timed up and go test), and walking (10 m walk test, functional gait assessment, step length, and stride length) were evaluated before and after the experiment for all the patients.
RESULTS:
Lumbar joint mobilization significantly improved trunk function, postural balance, and gait compared with pre-test values in the experimental group ( 0.05). Significant differences were seen in trunk function, postural balance, and walking between the two groups ( 0.05).
CONCLUSION:
Lumbar joint mobilization might be an effective intervention for trunk function, postural balance, and walking in patients with stroke.
BatchoCSStoquartGThonnardJL. Brisk walking can promote functional recovery in chronic stroke patients. Journal of Rehabilitation Medicine.2013; 45(9): 854-9.
2.
LiuHSongLZhangT. Changes in brain activation in stroke patients after mental practice and physical exercise: a functional MRI study. Neural Regen Res.2014; 9(15): 1474-84.
3.
VerheydenGVereeckLTruijenSTrochMHerregodtsILafosseC, et al. Trunk performance after stroke and the relationship with balance, gait and functional ability. Clinical Rehabilitation.2006; 20(5): 451-8.
4.
FarfanHF. Mechanical disorders of the low back: Lea & Febige, 1973.
5.
AkuthotaVFerreiroAMooreTFredericsonM. Core stability exercise principles. Current Sports Medicine Reports.2008; 7(1): 39-44.
6.
AkuthotaVNadlerSF. Core strengthening. Archives of Physical Medicine and Rehabilitation.2004; 85(3 Suppl 1): 86-92.
7.
DicksteinRDvirZBen JehosuaERoisMPillarT. Automatic and voluntary lateral weight shifts in rehabilitation of hemiparetic patients. Clinical Rehabilitation.1994; 8(2): 91-9.
8.
GibbonsPTehanP. Spinal manipulation: indications, risks and benefits. Journal of Bodywork and Movement Therapies.2001; 5(2): 110-9.
9.
SuterEMcMorlandG. Decrease in elbow flexor inhibition after cervical spine manipulation in patients with chronic neck pain. Clinical Biomechanics (Bristol, Avon).2002; 17(7): 541-4.
10.
ReimanMPMathesonJW. Restricted hip mobility: clinical suggestions for self-mobilization and muscle re-education. International Journal of Sports Physical Therapy.2013; 8(5): 729-40.
11.
SlavenEJGoodeAPCoronadoRAPooleCHegedusEJ. The relative effectiveness of segment specific level and non-specific level spinal joint mobilization on pain and range of motion: results of a systematic review and meta-analysis. The Journal of Manual & Manipulative Therapy.2013; 21(1): 7-17.
12.
ChoKHParkSJ. Effects of joint mobilization and stretching on the range of motion for ankle joint and spatiotemporal gait variables in stroke patients. J Stroke Cerebrovasc Dis.2020; 29(8): 104933.
13.
NotenSMeeusMStassijnsGVan GlabbeekFVerborgtOStruyfF. Efficacy of Different Types of Mobilization Techniques in Patients With Primary Adhesive Capsulitis of the Shoulder: A Systematic Review. Archives of Physical Medicine and Rehabilitation.2016; 97(5): 815-25.
14.
KoppenhaverSLFritzJMHebertJJKawchukGNParentECGillNW, et al. Association between history and physical examination factors and change in lumbar multifidus muscle thickness after spinal manipulation in patients with low back pain. Journal of Electromyography and Kinesiology: Official Journal of the International Society of Electrophysiological Kinesiology.2012; 22(5): 724-31.
ChenJCShawFZ. Progress in sensorimotor rehabilitative physical therapy programs for stroke patients. World J Clin Cases.2014; 2(8): 316-26.
17.
VerheydenGNieuwboerAMertinJPregerRKiekensCDe WeerdtW. The Trunk Impairment Scale: a new tool to measure motor impairment of the trunk after stroke. Cinical Rehabilitation.2004; 18(3): 326-34.
18.
BergKWood-DauphineeSWilliamsJI. The Balance Scale: reliability assessment with elderly residents and patients with an acute stroke. Scandinavian Journal of Rehabilitation Medicine.1995; 27(1): 27-36.
19.
PodsiadloDRichardsonS. The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. Journal of the American Geriatrics Society.1991; 39(2): 142-8.
20.
DobkinBH. Short-distance walking speed and timed walking distance: redundant measures for clinical trials? Neurology.2006; 66(4): 584-6.
21.
GlatthornJFGougeSNussbaumerSStauffacherSImpellizzeriFMMaffiulettiNA. Validity and reliability of Optojump photoelectric cells for estimating vertical jump height. Journal of Strength and Conditioning Research.2011; 25(2): 556-60.
22.
ThiemeHRitschelCZangeC. Reliability and validity of the functional gait assessment (German version) in subacute stroke patients. Archives of Physical Medicine and Rehabilitation.2009; 90(9): 1565-70.
23.
HarleyCBoydJECockburnJCollinCHaggardPWannJP, et al. Disruption of sitting balance after stroke: influence of spoken output. Journal of Neurology, Neurosurgery, and Psychiatry.2006; 77(5): 674-6.
24.
Mohseni-BandpeiMACritchleyJStauntonTRichardsonB. A prospective randomised controlled trial of spinal manipulation and ultrasound in the treatment of chronic low back pain. Physiotherapy.2006; 92(1): 34-42.
25.
LalanneKLafondDDescarreauxM. Modulation of the flexion-relaxation response by spinal manipulative therapy: a control group study. Journal of Manipulative and Physiological Therapeutics.2009; 32(3): 203-9.
26.
KarthikbabuSSolomonJMManikandanNRaoBKChakrapaniMNayakA. Role of trunk rehabilitation on trunk control, balance and gait in patients with chronic stroke: a pre-post design. Neuroscience and Medicine.2011; 2(2): 61-7.
27.
RyersonSLevitK. Functional movement reeducation: a contemporary model for stroke rehabilitation: Churchill Livingstone, 1997.
28.
VerheydenGNieuwboerAFeysHThijsVVaesKDe WeerdtW. Discriminant ability of the Trunk Impairment Scale: A comparison between stroke patients and healthy individuals. Disability and Rehabilitation.2005; 27(17): 1023-8.
29.
LeeJHChoiJD. The effects of upper extremity task training with symmetric abdominal muscle contraction on trunk stability and balance in chronic stroke patients. Journal of Physical Therapy Science.2017; 29(3): 495-7.
30.
GongW. The influence of lumbar joint mobilization on joint position sense in normal adults. Journal of Physical Therapy Science.2014; 26(12): 1985-7.
31.
LeeMEslerMAMildrenJHerbertR. Effect of extensor muscle activation on the response to lumbar posteroanterior forces. Clinical Biomechanics (Bristol, Avon).1993; 8(3): 115-9.
32.
KamelDMRaoofNATantawySA. Efficacy of lumbar mobilization on postpartum low back pain in Egyptian females: A randomized control trial. Journal of Back and Musculoskeletal Rehabilitation.2016; 29(1): 55-63.
33.
PanjabiMM. Clinical spinal instability and low back pain. Journal of Electromyography and Kinesiology: Official Journal of the International Society of Electrophysiological Kinesiology.2003; 13(4): 371-9.
34.
KimEJLeeKBHwangBY. Effects of upper extremity training in a standing position on trunk alignment in stroke patients. Journal of Physical Therapy Science.2016; 28(9): 2426-9.
35.
VerheydenGRuesenCGorissenMBrumbyVMoranRBurnettM, et al. Postural alignment is altered in people with chronic stroke and related to motor and functional performance. Journal of Neurologic Physical Therapy: JNPT.2014; 38(4): 239-45.
36.
HyongIHHaMS. Effect of Immediate Dynamic Balance Ability of Chronic Low Back Pain on Maitland’s Manual Therapy. The Korea Contents Society.2009; 9(6): 207-15.
37.
McGorryRWHsiangSMFathallahFAClancyEA. Timing of activation of the erector spinae and hamstrings during a trunk flexion and extension task. Spine.2001; 26(4): 418-25.
38.
HenrikssonMHirschfeldH. Physically active older adults display alterations in gait initiation. Gait & Posture.2005; 21(3): 289-96.
39.
PeuralaSHTarkkaIMPitkanenKSiveniusJ. The effectiveness of body weight-supported gait training and floor walking in patients with chronic stroke. Archives of Physical Medicine and Rehabilitation.2005; 86(8): 1557-64.
40.
MoonSJKimTH. Effect of three-dimensional spine stabilization exercise on trunk muscle strength and gait ability in chronic stroke patients: A randomized controlled trial. NeuroRehabilitation.2017; 41(1): 151-9.
41.
GarlandSJWillemsDAIvanovaTDMillerKJ. Recovery of standing balance and functional mobility after stroke. Archives of Physical Medicine and Rehabilitation.2003; 84(12): 1753-9.
42.
SchmidtRALeeTD. Motor learning and performance. Champaign, IL: Human Kinetics, 2013.
