AES1320 Impact of Functional Electrical Stimulation on Muscle Recovery in Stroke Patients
- Subject Code :
AES1320
- University :
University of Sydney Exam Question Bank is not sponsored or endorsed by this college or university.
- Country :
Australia
Applied Exercise and Sport Science: Plan (Project Synopsis) 1320 words total (maximum)
Question:
(P) stroke patients with a slight to moderate disability (Modified Rankin Scale [MRS]) and Brunnstrom motion recovery stage 4.
(I) functional electrical stimulation device (FES) in combination of standard care
(C) standard care physiotherapy
(O) muscle strengthening and motor recovery for paralysed limb.
Title (5 marks): In stroke patients, does the use of Functional electrical stimulation with or without standard physio care impacts muscle strength and motor recovery of the paralysed limb.
Character count (with spaces): 172
Section 1: Introduction, aim(s) and hypothesis(es), and methodology (660 words maximum; 65 marks)
Introduction (25 Marks)
Stroke is one of the most common type of neurological condition that has a high social and financial burden worldwide (Cohen & Dimyan 2011). In fact, according to the 2018 review by the Australia Institute of Health and Welfare, stroke was identified to be the 10th primary cause of disease burden in Australia, accounting for 8,400 deaths in that year. Moreover, a recent study estimated that Australia pays a direct economic cost exceeding $6.2 billion and an additional economic loss of $26.0 billion per year, due loss of life and wellbeing, and the required continues support for short to long term disability (Stroke foundation 2020). As such, rehabilitation of motor impairment and accommodation of the patients limitation remains to be the focus in supporting stroke patients.
The effects of rehabilitative training and exercise to the bodys capacity to restore motor function after a neurological injury has long been established (Cohen & Dimyan 2011). As such, this has resulted in the establishment of clinical disciplines for rehabilitative therapy and, more specifically, neurorehabilitation (Bao et al 2020). The Innate physiological and anatomical plasticity are essential mechanisms that underscores the significant gains in muscle activity following a stroke. As such, task-specific therapy along with general aerobic exercise are recognised as the gold-standard procedure for rehabilitation (Cohen & Dimyan 2011). Nevertheless, patients with hemiplegia are often excluded from intensive rehabilitative training and exercise due to the lack of voluntary muscle control (Lee 2020). As a result, novel therapeutic devices that uses electrical stimulation to augment and support neuroplasticity have increasingly become the popular field of research.
Consequently, recent meta-analysis on the Neuromuscular electrical stimulation (NMES) has shown positive result in restoring lower limb muscle control as well as improve posture and gait control (Lin et al 2018). In fact, neuromuscular electrical stimulation (NMES), especially functional electrical stimulation (FES) is already in used to compensate for voluntary motion in some clinical settings, while therapeutic electrical stimulation (TES) is used to strengthen muscles (Takeda et al 2017). Moreover, research on active EMG/ECG triggered (FES) shows significantly greater improvement of (p < 0>
Therefore, with the current and continued innovation in biomechanical and electrical science, it has become evident that the future of stroke care and recovery will involve some form of integration of neuromuscular electrical stimulation and physiotherapy (Bao et al 2020). Nonetheless, the use of (FES) device has not yet become mainstream and the current gold standard remains to be a physiotherapy-based program (Bao et al. 2020; Cohen & Dimyan 2011). Therefore, the purpose of this study is to investigate if functional electronic stimulation (FES) device in conjunction of the standard physiotherapy is more effective at improving muscle strength and motor recovery of the paralytic limb than a typical care.
Aim(s) and (if applicable) hypothesis(es) (5 Marks)
Aim(s): To determine if functional electrical stimulation with standard care is more effective in promoting muscle strength and motor recovery in the paralysed limb than usual care.
Hypothesis(es): It is hypothesised, that there will be significant difference in the muscle strength and motor control between pre-post group, and among intervention and control group due to increase stimulation.
Methodology (~250 words; 30 marks)
Complete the table below using concise, dot-pointed responses. Remember to provide enough detail that a researcher or applied practitioner could replicate your project.
Subsection |
Criteria |
Response |
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Participants |
Describe who the data will be collected in. Notes on ethical consideration is not required. 5 marks |
40 Stroke patients must have a slight to moderate disability (Modified Rankin Scale [MRS]) (Kim et al 2015) Brunnstrom motion recovery stage >4 (Lee 2020) with ability to walk. Age <65> No signs and symptoms of other diseases or impairment, that can affect movement apart from hemiplegia caused by stroke |
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Experimental overview / approach to the experiment / research approach |
Provide a broad but brief description of your methodology/study design. Draw a schematic of your methodology/study design. 5 marks |
For 6 weeks, 40 stroke participants are divided into 2 cohorts, (randomised control design assessor are blinded to clinical data) - muscular strength & motor controlled are measured pre-post. o intervention group = FES device + standard physio program o control standard program the participants are matched in level of disability (Modified Rankin Scale [MRS]) (Kim et al 2015) and Brunnstrom motion recovery stage (Lee 2020). |
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Data collection procedures / processes |
Describe Your treatment(s) / intervention(s) 5 marks The assessment of your outcome measures around those treatments / interventions 5 marks Justify the use of your treatments/interventions and outcome measures 5 marks Validity and reliability You may draw a schematic of your data collection procedures / processes if it assists clarity. |
Both Brunnstrom motion recovery stage (Lee 2020) and Modified Rankin Scale (MRS) (Kim et al 2015) to be used at pre-post measurement to see if a degree of change in muscle strength and motor recovery occur. Further test includes Pre -Post. Motor recovery will be measured using static balance via (BioRescue software program) and dynamic balance via (TUG). BioRescue software and TUG has an intraclass coefficient (ICC of 0.99 and 0.83) respectively (lee 2020). Muscle strength and power is measured using EMG analysis (Sabut et al 2011) EMG power - a high reliability (Kellis & Katis 2006). Lastly, Physiological Cost Index (PCI) of walking PCI=[HR(w)?HR(r)]/S is calculated using Casio heart monitor, measure gait efficiency (Sabut et al 2011) motor control/recovery |
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Statistical analysis |
Describe how your data will be analysed to answer your question. 5 marks |
Analysis: changes on motor control and muscle strength The data within group pre vs post of both controlled and intervention group. Then difference between of controlled vs intervention group |
Template Section 1 word count: 160 (introduction sub-heading to the end of the methodology table)
Total Section 1 word count: 427
Student Section 1 word count (Total Section 1 word count minus 160): 267
Section 2: Exercise science subdisciplines/study areas integration (660 words maximum; 30 marks)
Template Section 2 word count: 58 (integration table headings)
Total Section 2 word count: 484
Student Section 2 word count (Total Section 2 word count minus 58): 426
