Effect of cawthorne-cooksey exercises on balance and gait among individuals with hemiparesis

BACKGROUND

Stroke is the sudden loss of neurological function caused by an interruption of blood flow to the brain. Maintaining balance requires an interaction between sensory (visual, vestibular, somatosensory) and motor systems within the central nervous system. Hemiparesis occurs in stroke inpatients and is a common disability that could restrict joint movement and reduce the ability of muscle contraction. In addition, motor disability can cause imbalance of the left and right sides of the body, reduce balance ability and gait endurance, and induce a fear of falling when performing physical activity. The Cawthorne-Cooksey exercise includes movements of the head, task requiring coordination of eyes with the head, total body movements, and balance tasks.

NEED OF THE STUDY

Balance can be severely affected in individuals with Hemiparesis. As affection in balance is essential component, it is necessary to focus on its rehabilitation.

There is also presence of slow gait cycle and speed, which decreases the walking ability and reduces the endurance level, overall leading to difficulty in activities of daily living of hemiparetic individuals.

Several researches had been done on Cawthorne-Cooksey exercises which showed improvement in balance and gait in Multiple Sclerosis, Cerebral Palsy and Geriatric populations, meanwhile there are few studies on Hemiparetic individuals.

Therefore, the need arises to find out the effect of Cawthorne-Cooksey exercises on balance and gait in individuals with Hemiparesis.

AIM

Aim of the study is to find out the effect of Cawthorne-Cooksey exercises on balance and gait among individuals with Hemiparesis.

OBJECTIVE

·       To evaluate the effect of Cawthorne-Cooksey exercises on balance in individuals with hemiparesis by Timed Up and Go Test.

·       To evaluate the effect of Cawthorne-Cooksey exercises on gait in individuals with hemiparesis by Functional gait assessment.

·       To evaluate the effect of conventional exercise on balance in individuals with hemiparesis by Timed Up and Go Test.

·       To evaluate the effect of conventional exercise on gait in individuals with hemiparesis by Functional Gait Assessment.

·       To compare the effect of Cawthorne-Cooksey exercises and Conventional exercise on balance in individuals with hemiparesis by Timed Up and Go Test.

·       To compare the effect of Cawthorne-Cooksey exercises and Conventional exercise on gait in individuals with hemiparesis by Functional gait assessment.

      PROCEDURE

After being approved by the ethical Commitee, according to inclusion and exclusion criteria 36 subjects will be divided into groups. Informed consent will be taken. In both groups, pre and post data will be measured.

Group A: Experimental Group (Cawthorne-Cooksey Exercise)

Group B: Control Group (Conventional Exercise)

Group A: Experimental Group (Cawthorne-Cooksey Exercise) CONSIST OF:

Eye Movements:

·     Looking up and looking down.

·     Looking alternately left and right.

Head Movements:

·     Bending alternatively forward and backward (eyes opened and eye closed).

·     Turning alternatively to the left then right (eyes opened and closed).

Arm And Body Movements:

·     Shrugging and rotating shoulder.

·     Bending forward and picking up objects from the floor.

·     Turning head and trunk alternatively to the left and then right.

Standing Position:

·     Eye movements (as described above).

·     Head movements (as described above).

·     Arm and body movements (as described above).

·     Switching from sitting to standing.

Walking Position:

·     Walking up and down a flight of stairs.

·     Walking in a circle with head turned left and right.

 The sessions were 5 times a week for 3 weeks (total 15 sessions). each session of 45-60 minutes. In first day of training participants were demonstrated and participants were instructed to perform the procedure. Each exercise was repeated 10 times.

Group B: Control Group (Conventional Exercise) CONSIST OF:

In this group conventional exercise was given. Participants were asked to perform 7 conventional exercises which include,

1.forward walking

2.backward walking

3.tandem standing

4.tandem walking

5.Side walking

6.Stair climbing

7.Stair descending

The sessions were 5 times a week for 3 weeks (15 sessions). On the first day of training participants were demonstrated with a verbal explanation and participants were instructed to perform the procedure. On the second day participants were instructed to perform the procedure. Each step pattern was repeated 10 times.