Application of Isokinetic Muscle Training in Stroke Rehabilitation

Stroke has the characteristics of high morbidity, high disability rate and high mortality rate. About 70%-80% of the surviving patients have varying degrees of dysfunction, which seriously affects patients‘ living quality and brings heavy burden to patients’ families and the society.  

Patients with hemiplegia are easy to form abnormal gait because it is hard for them to coordinate balance, weight bearing and stride organically. Recovery of walking ability is one of the important goals of rehabilitation training for stroke patients with hemiplegia.  

1. Isokinetic Muscle Strength Training

Isokinetic motion is a special motion mode in which the angular velocity is constant and resistance is variable. It needs special isokinetic equipment to realize it. Once the angular velocity of constant velocity movement is set, no matter how much force the subject uses, the angular velocity of joint movement always remains at the pre-set speed. Subjective force can only increase muscle tension and output power, but cannot produce acceleration. It is considered as the best way to evaluate muscle function and study muscle mechanical properties at present.

Isokinetic muscle strength training has two major characteristics: constant speed and compliant resistance:  It can not only preset the movement speed as required, but also ensure that the muscle activity at any point during the movement can bear the maximum resistance. These two basic characteristics ensure the best application of muscle strength training.   

In terms of effectiveness, the muscles can bear the maximum load at every angle within whole range of motion during isokinetic training, producing the maximum torque output and improving the training efficiency.  In terms of safety, the speed of isokinetic training is relatively stable and there’s no explosive acceleration, so that muscle and joint injury can be avoided.

 

2. Isokinetic Muscle Strength Assessment

The training system can not only provide patients with high quality rehabilitation training, but also provide effective rehabilitation evaluation.  PT is the maximum force output of flexor and extensor muscle group in muscle testing, which has high accuracy and repeatability. It is regarded as the gold index and reference value in isokinetic muscle strength testing.  TW is the sum of the amount of work done by the contraction, the product of the force and distance under the torque curve.  The above indicators are representative indicators in isokinetic muscle strength training, which basically reflect the muscle strength size and muscle endurance of the tested muscle group, making the evaluation of trunk muscle strength of patients more visual.  

 

3. Isokinetic Trunk Strength Training

Isokinetic trunk muscle strength training ensures that the trunk muscles can withstand the maximum resistance at every angle and produce the maximum torque output in the training process, which is very important for enhancing the trunk muscle strength and the stability of the human core. It is also the necessary criteria for improving walking ability and strengthening balance.  Similarly, trunk control ability, core stability and balance ability and walking ability were highly correlated in stroke patients with hemiplegia.

 

4. Isokinetic Lower Limb Function Training

Isokinetic muscle strength training can not only improve the muscle strength of knee flexor and extensor muscle group, but also significantly coordinate the normal ratio of active and antagonistic muscles, which is of great significance in the stability of joint.  Isokinetic muscle strength training plays an important role in enhancing the muscle strength of knee flexor and extensor muscle, improving the control ability of the affected lower limb, preventing knee hyperextension, improving the load-bearing ability of the affected lower limb, improving weight shifting and balance ability, and improving lower limb function and ability of daily living.  

Isokinetic muscle strength testing and training technology has been considered as the best method for muscle function evaluation and muscle mechanics training. In muscle function evaluation and muscle strength training, this method is objective, efficient, safe and repeatable. Moreover, due to its compliance resistance, it can be applied even in the condition of weak muscle strength.  In addition, isokinetic technology can be used to evaluate patients’ muscle spasm, establish quantitative evaluation index for spastic hemiplegia, and judge the effect of spasm treatment, which has a good application prospect in clinical neurological rehabilitation.

Limb Function Training for Stroke Hemiplegia

 

Limb Function Training for Stroke Hemiplegia
— Passive Upper Limb Movement

 

Stroke is a common Neurological disease, and hemiplegia is a common symptom of stroke. For hemiplegia, in addition to drug treatment, functional training is also a very important means of treatment. Here we introduce one of the ways of limb function training for hemiplegia – passive upper limb movement.

1. What are the purposes of passive upper limb movement?

A. Accelerate limb function recovery, improve limb function recovery degree of hemiplegia, and prevent deformity and contracture of hemiplegia limbs. 

B. Avoid joint stiffness caused by long-term disuse, relax muscles, stretch the contracted muscles and ligaments, and promote the recovery of neurological function.

 

2. What are the basic principles of passive upper limb movement?

a. Need to include every joint involved in the movement

b. It is necessary to include all physiological activity directions of involved joint

c. The joint movement ROM (range of motion) in each direction should reach maximum physiological limit as much as possible

d. Follow the sequence of upper limbs to lower limbs and then to the trunk

e. Maintain antispasmodic position in the whole process

f. Avoid or reduce exercise of the dominant muscles

g. Avoid violence

 

3. Timing of upper limb passive movement exercise

For both cerebral infarction and cerebral hemorrhage cases, exercise can be performed 48 hours after vital signs are stable.

 

Rehab Equipment for Passive Upper Limb Movement Exercise

1.Hand Rehabilitation Robotics A5

Passive training hand rehabilitation robotics is A5 for finger and wrist rehabilitation training. It works with real-time simulation of human finger and wrist movement rules. Composite passive training is available for single fingers, multiple fingers, all fingers, wrists, fingers and wrists. Patients can perform comprehensive rehabilitation training in a computer virtual environment with the help of robotic exoskeleton.

2.Arm Rehabilitation and Assessment Robotics A6

The arm rehabilitation and assessment robotics can realize passive and active movement of arms in multiple dimensions. Moreover, integrated with situational interaction, feedback training and a powerful evaluation system, A6 enables patients to train under zero muscle strength. The rehab robot offer patients passive upper limb training in the early period of rehabilitation, thus shortening rehab process.

3.Rehab Bike for Upper and Lower Limbs SL4

SL4 enables passive, assist, and active (resistance) training on patients’ upper and lower limbs. The bike helps to improve the function of limb joints and muscles and promote the recovery of limb neuromuscular control function. The system has built-in sports programs including standard, relaxation, strength and endurance, and coordination modes, so that it’s applicable to patients in different stages of functional recovery.

Can Stroke Patients Restore Self-Care Ability?

Yikang Medical

After stroke, around 70% to 80% stroke patients are unable to take care of themselves due to the sequelae, causing great pressure on patients and their families. How can they quickly restore self-care ability through rehabilitation treatment has become a problem of great concern. Occupational therapy is gradually known as an important part of rehabilitation medicine.

 

1.Introduction to Occupational Therapy

Occupational therapy (OT for short) is a rehabilitation treatment method that applies purposeful and selected occupational activities (various activities such as work, labor, and recreational activities) to help patients obtain functional exercise so that their physical, mental, and social participation functions can be recovered to the maximum extend. It is a process of evaluation, treatment and training for patients who have lost their self-care and working ability to varying degrees due to physical, mental and developmental dysfunction or disability. This method focuses on helping patients to restore their abilities of daily living and work as much as possible. It is an important way for patients to return to their families and society.

The goal is to recover or enhance patient’s ability to live and work independently to the maximum extend so that he or she can lead a meaningful life as a member of the family and society. This therapy is of great value for the rehabilitation of patients with functional disabilities, which can help patients recover from functional disorders, change abnormal movement patterns, improve self-care ability, and shorten the process of returning to family and society.

 

2.Occupational Therapy Assessment

A.Occupational therapy for motor dysfunction:

Adjust patient’s nervous system function through occupational activities, improve muscle strength and joint mobility, enhance motor function recovery, improve coordination and balance ability, and gradually restore patient’s self-care ability.

B.Occupational therapy for mental disorders:

In occupational exercises, patients not only have to put in energy and time, but also need to enhance their sense of independence and rebuild their confidence in life. Problems such as distraction, inattention, and memory loss can be solved through occupational activities. Through collective and social activities, patients’ awareness of social participation and reintegration is cultivated.

C.Occupational therapy for activity and social participation disorders:

In the recovery period, patient’s psychological state may change. Social activities  can help patients improve their sense of social participation, increase their confidence, feel connected to the society, adjust their psychological state, and actively participate in rehabilitation training.

 

3.Classification of Occupational Therapy Activities

A.Daily Activity Training

Train patients’ self-care ability, such as dressing, eating, walking, hand function training, etc. Restore their self-care ability through repeated training.

B.Therapeutic Activities

Improve patients’ dysfunction problems using carefully selected specific activities or tools. Take hemiplegic patients with upper limb movement disorders as an example, we can train their lifting, rotation and grasping functions with activities like pinching plasticine and screwing nuts so as to improve their upper limb motion function.

C.Productive Labor Activities

This type of activity is suitable for patients who have recovered to a certain extent, or patients whose functional impairment is not particularly severe. They also create economic value while performing occupational activity treatment (such as woodworking and other manual occupational activities).

D.Psychological and Social Activities

The patient’s psychological state will change to some extent during the postoperative period or recovery period. Through such activities, patients can adjust their psychological state and maintain a positive mental attitude.

 

4.Advanced Equipment for Occupational Therapy

Compared to traditional occupational therapy equipment, robotic rehabilitation equipment can provide a certain degree of weight support so that patients with weaker muscle strength can also lift their arms for occupational training. Moreover, the interactive games in the system can attract patients’ attention and improve their training initiatives.

 

Arm Rehabilitation Robotics A2

It accurately simulates the law of arm movement in real time. Patients can complete multi-joint or single-joint training actively. The arm rehab machine supports both weight-bearing and weight-reducing training on arms. And in the meanwhile, it has intelligent feedback function, three-dimensional space training and a powerful assessment system. 

 

Arm Rehabilitation and Assessment Robotics A6

The arm rehabilitation and assessment robotics A6 can simulate the arm movement in real time according to computer technology and rehabilitation medicine theory. It can realize passive and active movement of arms in multiple dimensions. Moreover, integrated with situational interaction, feedback training and a powerful evaluation system, A6 enables patients to train under zero muscle strength. The rehab robot helps to train patients passively in the early period of rehabilitation, thus shortening rehab process.

Robotic Tilt Tables

Introduction of the Robotic Tilt Table

The robotic tilt table uses new rehabilitation concept to overcome the shortcomings of the traditional rehabilitation training. It changes the patient's position under the suspension state with binding. With support from the bind, the tilt table helps patients to do stepping training. By simulating normal physiological gait, this equipment helps to restore patients' walking ability and suppress abnormal gait.

The rehab machine is suitable for the rehabilitation of patients suffer from disorders of the nervous system related to a stroke or traumatic brain injury or incomplete spinal cord injuries.  Using the rehab robot is really an effective solution especially to those in the early stages of rehabilitation.

Robotic Tilt Table Features

The distance between the feet the angle of the toe flexion and extension are completely adjustable. The two-sided pedal can be used for active or assisted walking training according to patients’ need.

The 0-80 degree progressive standing robotic tilt table with the special suspension bind can effectively protect legs. The spasm monitoring system can make sure training safety and the best training results.

1, enable patients who do not have the standing ability to walk in the lying position;

2, standing in bed at different angles;

3, standing and walking under the suspension state to restrain spasm;

4, gait training at early stages could help with rehabilitation a lot;

5, anti-gravity suspension bind makes it easy for patients to make steps by reducing body weight;

6, reduce the labor intensity of the therapist;

7, combine standing, stepping and suspension;

8, easy to apply.

Treatment Effect of the Robotic Tilt Table

1, gait training at the early stage of rehabilitation can shorten the recovery time of patients to walk again;

2, strengthen the afferent sensory stimulation of the legs to improve the excitability, flexibility and coordination of the nervous system.;

3, improve and maintain the leg joints mobility, improve muscle strength and endurance;

4, relief muscle spasm of legs by exercise and training;

5, improve the patient's body function, prevent orthostatic hypotension, pressure ulcers and other complications;

6, enhance the patient's metabolic level and cardiopulmonary function;

7, a large number of repeat physical movements can relief the muscle spasm of some patients;

8, support patients’ movement

9, strengthen the cardiovascular system

10, strengthen the incoming sensory stimulation

Gait control---Adopt servo motor control system, three shifting programs of initial speed, acceleration and deceleration are completed during the movement, effectively imitating the physiological gait of normal people.

Stepping under biological load can stimulate the proprioception of legs, increase the input of proprioception and promote the growth of nerve synapses.

Feel free to inquire and contact, and if you have any doubt, leave us a message. Check other rehabilitation robotics if you have interest.

Arm rehabilitation robotics

Gait training robotics

Hand rehabilitation and assessment robotics