Kinesthetic Brain Exercise in Hemiplegic Individuals With Stroke

The success of conventional physical therapy in the rehabilitation of stroke patients is demonstrated in the light of studies. In this study, the effects of kinesthetic brain exercises, which is a new exercise approach to be applied together with conventional physiotherapy and rehabilitation, on fall risk, balance, and quality of life will be investigated in hemiplegic individuals who have had a stroke. Thus, it is thought that the effectiveness of kinesthetic brain exercises applied together with conventional physiotherapy and rehabilitation will contribute to the literature for the creation of rehabilitation programs.

Stroke is a clinically defined syndrome characterized by rapidly developing symptoms or signs of cerebral dysfunction with no apparent cause other than vascular causes. Symptoms last more than 24 hours and can lead to death. Findings after stroke; upper and lower extremity motor dysfunctions, spasticity, loss of balance and coordination, walking, swallowing, vision, and communication problems. It has been reported that the disability rate ranges from 13-66% and the disability rate varies between 12-64% due to these functional losses that occur after stroke.

In stroke patients, hemiplegic picture occurs depending on the size and location of the damage in the brain. hemiplegia: It is a paralysis that affects the upper and lower extremities of one side of the body. A decrease in muscle strength, loss of sensation and dysfunction occur on the affected side.

After stroke, the lower extremities are severely affected in hemiplegic individuals. Instability of ankle and knee joints is seen in hemiplegic lower extremities. However, due to instability, the center of gravity shifts towards the unaffected side, which causes balance and coordination disorders. Balance and coordination disorders in hemiplegic individuals cause poor performance in activities and an increased incidence of falls.

Kinesthetic brain exercises: Studies investigating the effects of movement, physical activity and exercises on learning and cognitive development have shown that increased attention span, better focus, better behavioral method, and physical activity that contributes to better learning are supported. Conceptually, brain exercises are expressed by the formula: Physical activity + Brain Activity = Better cognitive function.

Neuroplasticity is the basis of kinesthetic brain exercises. In the light of research, it has been found that the brain is in a state of re-activating the activity that cannot be done by using other ways. In rehabilitation sessions, it is aimed to reconstruct these pathways by transforming daily activities into purposeful exercises. According to Dennison, the founder of kinesthetic brain exercises, brain exercises; It is a combination of physical and mental training with a series of physical movements that activate the whole body in turn, improving the neural connections between the two cerebral hemispheres to enhance learning. Kinesthetic brain training consists of twenty-six simple movements combined with deep breathing. Most of these movements are done diagonally. These diagonal movements result in stimulation and integration of different parts of the brain, especially the corpus callosum, which enables faster and more integrated communication between the two hemispheres in the long run. It is claimed that this situation supports the formation of new neural connections between the two hemispheres of the brain. Drabben et al. In their study, they suggest that brain exercises may be considered a useful physical therapy strategy for older adults, as they can have a positive effect on brain functioning.

The aim of this study is to investigate the effects of kinesthetic brain exercises on lower extremity coordination and balance in hemiplegic individuals who have had a stroke. Thus, it is thought that the effectiveness of kinesthetic brain exercises applied together with conventional physiotherapy and rehabilitation will contribute to the literature for the creation of rehabilitation programs.

Study Hypothesis as follows; Kinesthetic brain exercises have an effect on fall risk, balance and quality of life in hemiplegic individuals who have had a stroke.

Eligibility Criteria:
Inclusion Criteria:

* Being in the 30-60 age range
* Being in the subacute/chronic period (6 months and above).
* Having unsupported sitting balance.
* Having the ability to ambulate with and without support
* Not having botox application for the lower extremities in the last 6 months
* Being at least 3 and above according to the Functional Ambulation Scale
* At least level 3 or higher according to Bruunstrom Lower Extremity Motor Staging.

Exclusion Criteria:

* Having a rheumatological, orthopedic or cardiopulmonary disease that prevents participation in exercises
* Having secondary diseases (MS, Parkinson's, spinal cord injuries, contractures, and post-fracture deformities, etc.)
* Having cognitive, visual, and auditory problems that prevent communication
* Having vestibular system disorders.