The Effect of Strengthening of the Upper Limb, on Balance and Gait, in Old People Post-Stroke: Systematic Review

Authors

  • Vânia Figueiredo Escola Superior de Tecnologia da Saúde de Lisboa (ESTeSL) – Instituto Politécnico de Lisboa, Lisboa, Portugal https://orcid.org/0009-0002-9636-4521
  • Andreia Carvalho Escola Superior de Tecnologia da Saúde de Lisboa (ESTeSL) – Instituto Politécnico de Lisboa, Lisboa, Portugal; U Lisboa, Fac Motricidade Humana, CIPER, LBMF, P-1499-002 Lisboa, Portugal
  • Patrícia Mota Escola Superior de Tecnologia da Saúde de Lisboa (ESTeSL) – Instituto Politécnico de Lisboa, Lisboa, Portugal; U Lisboa, Fac Motricidade Humana, CIPER, LBMF, P-1499-002 Lisboa, Portugal; H&TRC- Health & Technology Research Center, ESTeSL- Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, Lisbon, Portugal

DOI:

https://doi.org/10.46531/sinapse/RS/220055/2023

Keywords:

Aged, Gait, Postural Balance, Recovery of Function, Stroke/therapy, Stroke Rehabilitation, Upper Limb

Abstract

Introduction: The occurrence of stroke is higher in the elderly population, and 30% to 60% have upper limb (UL) limitations. The decrease of range of motion on the upper limb joints and pendular movement can lead to changes in gait pattern, risk of falling, and balance. Studies refer that UL strengthening benefits gait and functional capacity in patients with stroke sequels. Our aim was to determine the effect of strengthening of the UL, in adults aged 65 years or over and post-stroke, on gait, falls and standing balance.
Methods: A search of the current literature was performed using PubMed, Cochrane Library and ScienceDirect, including randomized clinical trials, with no date limitation, evaluating the effect of UL strengthening on gait, falls and balance in post-stroke individuals aged 65 years or over. Two blinded reviewers, screened the articles for inclusion, with a third review in case of disagreement. Protocols, presentations, and articles with scores lower than 5 on the PEDro scale were excluded.
Results: Six studies were included, with a total of 468 participants. Strengthening the MS is positively interferes with walking ability, namely at the level of speed, it acts in the prevention of falls, and shows improvements in balance, compared to baseline.   Conclusion: The inclusion of UL strengthening interferes positively in improving gait speed and balance, with the consequent reduction in the risk of falling in this population.

Downloads

Download data is not yet available.

References

Zaslavsky C, Gus I. Idoso. Doença cardíaca e comorbidades. Arq Bras Cardiol. 2002;79:635-9. doi: 10.1590/s0066-782x2002001500011

Instituto Nacional de Emergência Médica (INEM). Dia Nacional do Doente com AVC[acedido jan2022] Disponivel em: https://www.inem.pt/wp-content/uploads/2021/04/2021-03-30-Dia-Nacional-do-Doente-com-AVC.pdf

Lucca LF, Castelli E, Sannita WG. The application of robotics in the functional motor recovery of the paretic upper limb. J Rehabil Med. 2009;41:949-2010. doi: 10.2340/00015555-2.

Lamberti N, Straudi S, Malagoni M, Argiró M, Felisatti M, Nardini E, et al. Effects of low-intensity endurance and resistance training on mobility in chronic stroke survivors: A pilot randomized controlled study. Eur J Phys Rehabi Med. 2017;53:228-39. doi: org/10.23736/S1973-9087.16.04322-7.

Rafsten L, Meirelles C, Danielsson A, Sunnerhagen S. Impaired motor function in the affected arm predicts impaired postural balance after stroke: A cross-sectional study. Front Neurol. 2019;10:1-7. doi: org/10.3389/fneur.2019.00912.

De Bartolo D, Belluscio V, Vannozzi G, Morone G, Antonucci G, Giordani G, et al. Sensorized assessment of dynamic locomotor imagery in people with stroke and healthy subjects. Sensors. 2020;20:1-15. doi: org/10.3390/s20164545.

Lewek M, Poole R, Johnson J, Halawa O, Huang X. Arm Swing Magnitude and Asymmetry During Gait in the Early Stages of Parkinson’s Disease. NIH Public Access. 2008;23:1-7. doi.: org/10.1016/j.gaitpost.2009.10.013. Arm.

Gholizadeh H, Hill A, Nantel J. Effect of arm motion on postural stability when recovering from a slip perturbation. J Biomech. 2019;95:1-9. doi: org/10.1016/j.jbiomech.2019.07.013.

Klarner T, Barss TS, Sun Y, Kaupp C, Loadman PM, Paul ZE. Long-term plasticity in reflex excitability induced by five weeks of arm and leg cycling training after stroke. Brain Sci. 2016;6:1-22. doi: org/10.3390/brainsci6040054.

Dragert K, Zehr EP. High-intensity unilateral dorsiflexor resistance training results in bilateral neuromuscular plasticity after stroke. Exp Brain Res. 2013;225:93-104. doi: org/10.1007/s00221-012-3351-x.

Kaupp C, Pearcey GE, Klarner T, Sun Y, Cullen H, Barss TS, et al. Rhythmic arm cycling training improves walking and neurophysiological integrity in chronic stroke: The arms can give legs a helping hand in rehabilitation. J Neurophysiol. 2018;119:1095-112. doi: org/10.1152/jn.00570.2017.

Morris SL, Dodd KJ, Morris ME. Outcomes of progressive resistance strenght training following stroke: A systematic review. Clin Rehabi. 2004;18:27-39. doi: org/10.1191/0269215504cr699oa.

Collado-Garrido L, Parás-Bravo P, Santibáñez-Margüello M, Calvo-Martín P. Impact of resistance therapy on motor function in children with cerebral palsy: A systematic review and meta-analysis. Int J Environ Res Public Health. 2019;;16:4513. doi: org/10.3390/ijerph16224513.

Moher D, Liberati A, Tetzlaff J. Principais itens para relatar Revisões sistemáticas e Meta-análises: A recomendação PRISMA. Epidemiol Serv Saúde. 2015;24:335-42. doi: org/10.5123/s1679-49742015000200017.

Sampaio RF, Mancini MC. Revisão sistemática: um guia para síntese criteriosa da evidência científica. Rev Brasil Fisioterap. 2007;11:83-9. doi: org/10.1590/S1413-35552007000100013.

Shiwa SR, Costa LO, Moser AD, Aguiar IC, de Oliveira LV. PEDro: A physiotherapy evidence database. Physiotherap Theory Pract. 2011;24:188-79. doi: org/10.1080/09593980802686938.

Costa C. Tradução e adaptação da PEDro Scale para a cultura portuguesa: um instrumento de avaliação de ensaios clínicos em Fisioterapia [tese de mestrado apresentada à Universidade de Lisboa]. Lisboa: Univerisade de Lisboa;2011.

Pang M, Eng J. Determinants of improvement in walking capacity among individuals with chronic stroke following a multi-dimensional exercise program. J Rehabil Mede. 2008;40:284-290. doi:org/10.2340/16501977-0166.

Dean CM, Rissel C, Sherrington C, Sharkey M, Cumming RG, Lord SR, et al. Exercise to enhance mobility and prevent falls after stroke: The community stroke club randomized trial. Neurorehabil Neural Repair. 2012;26:1046-1057. doi: org/10.1177/1545968312441711.

Mead, GE, Greig CA, Cunningham I, Lewis SJ, Dinan S, Saunders DH, et al. Stroke: A randomized trial of exercise or relaxation. J Am Geriatr Soc. 2007; 55:892-9. doi: org/10.1111/j.1532-5415.2007.01185.x.

Lund C, Dalgas U, Grønborg TK, Andersen H, Severinsen K, Riemenschneider M, et al. Balance and walking performance are improved after resistance and aerobic training in persons with chronic stroke. Disabil Rehabil. 2018;40:2408-15. doi: org/10.1080/09638288.2017.1336646.

Kwakkel G, Kollen BJ, Wagenaar RC. Long term effects of intensity of upper and lower limb training after stroke: A randomised trial. J Neurol Neurosurg Psychiatry. 2002;72:473-9. doi.org/10.1136/jnnp.72.4.473.

Langhammer B, Stanghelle, JK, Lindmark B. An evaluation of two different exercise regimes during the first year following stroke: A randomised controlled trial. Physiother Theory Pract. 2009;25:55-68. doi: org/10.1080/09593980802686938.

Hyndman D, Ashburn A, Stack E. Fall events among people with stroke living in the community: Circumstances of falls and characteristics of fallers. Arch Phys Med Rehabil. 2002;83:165-70. doi: org/10.1053/apmr.2002.28030.

Boström KJ, Dirksen T, Zentgraf K, Wagner H. The contribution of upper body movements to dynamic balance regulation during challenged locomotion. Front Hum Neurosci. 2018;12:1-10. doi: org/10.3389/fnhum.2018.00008

Stephenson JL, De Serres SJ, Lamontagne A. The effect of arm movements on the lower limb during gait after a stroke. Gait Posture. 2010; 31:109-15. doi: org/10.1016/j. gaitpost.2009.09.008.

Published

2023-05-19

How to Cite

1.
Figueiredo V, Carvalho A, Mota P. The Effect of Strengthening of the Upper Limb, on Balance and Gait, in Old People Post-Stroke: Systematic Review. Sinapse [Internet]. 2023 May 19 [cited 2024 Apr. 29];23(1):21-8. Available from: https://sinapse.pt/index.php/journal/article/view/30

Issue

Section

Review Article

Most read articles by the same author(s)