![]() ![]() Mobility of the upper limbs is vital for daily activities, functional activities, and quality of life upper limb paresis following stroke leads to limitations of daily activities, functional activities, and social roles. The last phase is the chronic stroke that continues from months to years following stroke and the patient may complete his life with this phase. The next phase is subacute stroke that continues for many months up to 6 months following stroke. Stroke is subdivided into three phases, the initial phase or acute stroke that starts immediately following cerebrovascular accident and continues for 2 weeks. Stroke survivors can suffer some neurological impairments such as hemiparesis, communication disorders, cognitive deficits, or disorders in visuospatial perception. Stroke is a common nervous system disorder. ConclusionĬore muscle training is similar to conventional physical therapy program in improving upper limb function in hemiparetic patients, and has beneficial effect on improving trunk balance. In post treatment assessment, there was no statistical significant difference between group A and group B in all the outcome measures, except for trunk impairment subscale (dynamic sitting balance) the statistical significant difference was in favor of group B. There was no statistical significant difference between two groups in pretreatment assessment using wolf motor function test, trunk impairment scale, and shoulder range of motion. All measurement outcomes were assessed before and after applying the treatment program. The upper limb function was assessed using Wolf motor function test with subscales (function ability scale, time, and grip strength), the range of motion of shoulder flexion and abduction was measured by using goniometer, trunk balance was assessed using the trunk impairment scale with subscales (static sitting balance, dynamic sitting balance, and coordination). Patients received 18 sessions for 6 weeks, three sessions/week. They were assigned into two equal groups, the control group, Group A: with 15 patients who received only conventional physical therapy program the study group, Group B: with 15 patients who received conventional physical therapy program and additional core muscle training. ![]() Thirty patients with hemiparesis, with age between 45 and 60 years, and with illness duration of more than 6 months. ![]() To determine the effect of core stability exercises on upper limb function and trunk balance in hemiparetic patients. Note that some muscles are not usually involved in these synergy patterns and include the lattisimus dorsi, teres major, serratus anterior, finger extensors, and ankle evertors.Upper limb paresis is a common problem in patients with stroke. The extension synergy for the lower extremity includes hip extension, adduction and internal rotation, knee extension, ankle plantar flexion and inversion, and toe plantar flexion. The flexion synergy for the lower extremity includes hip flexion, abduction and external rotation, knee flexion, ankle dorsiflexion and inversion and toe dorsiflexion. The extension synergy for the upper extremity includes scapular protraction, shoulder adduction and internal rotation, elbow extension, forearm pronation, and wrist and finger flexion. ![]() The flexion synergy for the upper extremity includes scapular retraction and elevation, shoulder abduction and external rotation, elbow flexion, forearm supination, and wrist and finger flexion. Obligatory synergy patterns are observed when a patient tries to make a minimal voluntary movement, or as a result of stimulated reflexes. Careful thought should, therefore, be considered in deciding which muscle groups to stretch at specific times during recovery. Some aspects of the obligatory synergy patterns however, can be cleverly used to increase function relative to the movement available to the individual. This interferes with normal activities of daily living. When these patterns occur in a patient, he or she is unable to move a limb segment in isolation of the pattern. They are described as either a flexion synergy or an extension synergy and affect both the upper and lower extremity (see below). It manifests in abnormal and stereotypical patterns across multiple joints called obligatory synergies. In medicine, obligatory synergies occur when spasticity appears, such as following a stroke. Please help improve this article by introducing citations to additional sources.įind sources: "Obligatory synergies" – news Relevant discussion may be found on the talk page. This article relies largely or entirely on a single source. ![]()
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