This study evaluated the effect of context on the reaching performance of the unaffected arm and postural control while standing in patients with right cerebral vascular accidents (RCVA) and in healthy adults. Fifteen subjects with RCVA and sixteen healthy subjects performed tasks with the right hand under two conditions while standing. One condition involved moving coins forward on a table as far as possible (concrete task) and the other reaching forward without a target (abstract task). Forward reaching distance, forward displacement and lateral shift of center of pressure (CoP), and weight distribution were the dependent variables. The RCVA and control groups achieved significantly greater reaching distances in the concrete task than in the abstract one. The RCVA group showed significantly less lateral shift of the CoP and placed more weight on the affected leg in the concrete than the abstract task, whereas the control group made a greater lateral shift in the concrete task and had a similar mean ratio of weight distribution during both tasks. The results demonstrate that a functional application of task targets may favorably modulate both reaching and posture performance and exert various positive affects on postural control. Such applications may have a place in the therapeutic recovery efforts for patients afflicted with stroke.
Hsieh-ching Chen, Keh-chung Lin, Chia-ling Chen and Ching-yi Wu
Wei-Cheng Chao, Jui-Chi Shih, Kuan-Chung Chen, Ching-Lin Wu, Nai-Yuan Wu and Chien-Sheng Lo
Objectives: To evaluate the effect of functional movement screen (FMS)-based functional exercise in patients after anterior cruciate ligament reconstruction (ACLR). Design: Randomized, controlled, single-blind trial. Setting: Institutional, single center. Patients: A total of 38 patients who underwent ACLR were recruited and randomly assigned to group 1 (n = 19) or group 2 (n = 19). Interventions: Both groups received 6-month routine rehabilitation immediately after surgery. From the postoperative fourth to sixth month, group 1 received FMS-based functional exercise plus routine rehabilitation and group 2 received routine rehabilitation only. The FMS-based functional exercise was individualized and customized functional corrective exercise, which was designed based on the 3-month postoperative FMS results. The frequency of rehabilitation was 1 hour per session, twice a week, for a total duration of 6 months. Main Outcome Measures: At 3 and 6 months postoperatively, patients were evaluated by FMS scoring, Lysholm Knee Score, and International Knee Documentation Committee 2000 Score. Results: After the intervention, both groups had significantly increased FMS, Lysholm Knee Score, and International Knee Documentation Committee 2000 score. Group 1 had significantly greater changes in FMS (median: 4 vs 3, P < .001), Lysholm Knee Score (median: 24 vs 16, P = .001), and International Knee Documentation Committee 2000 Score (median: 22 vs 8, P < .001) than group 2. Conclusion: The application of FMS-based functional exercise to patients after ACLR resulted in significant improvement in knee function and movements. The authors suggested integrating FMS evaluation and FMS-based training into routine post-ACLR rehabilitation programs.