Search results for: life balance

Authors: Mostafa Sarabzadeh, Masoumeh Helalizadeh, Seyyed Mahmoud Hejazi

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Multiple Sclerosis is considered as diseases related to central nerve system, the chronic and progressive disease impress on sensory and motor function of people. Due to equilibrium problems in this patients that related to disorder of nerve conduction transmission from central nerve system to organs and the nature of elastic bands that can make changes in neuromuscular junctions and momentary actions, the aim of this research is evaluate elastic training effect by reactionary ropes on nerve conduction velocity (in lower and upper limb) and functional balance in female patients with Multiple Sclerosis. The study was a semi-experimental study that was performed based on pre and post-test method, The statistical community consisted of 16 women with MS in the age mean 25-40yrs, at low and intermediate levels of disease EDSS 1-4 (Expanded Disability Status Scale) that were divided randomly into elastic and control groups, so the training program of experimental group lasted six weeks, 3 sessions per week of elastic exercises with reactionary ropes. Electroneurography parameters (nerve conduction velocity- latency) of Upper and lower nerves (Median, Tibial, Sural, Peroneal) along with balance were investigated respectively by the Electroneurography system (ENG) and Timed up and go (TUG) functional test two times in before and after the training period. After that, To analyze the data were used of Dependent and Independent T-test (with sig level p<0.05). The results showed significant increase in nerve conduction velocity of Sural (p=0.001), Peroneal (p=0.01), Median (p=0.03) except Tibial and also development Latency Time of Tibial (p= 0), Peroneal (p=0), Median (p=0) except Sural. The TUG test showed significant decreases in execution time too (p=0.001). Generally, based on what the obtained data can indicate, modern training with elastic bands can contribute to enhanced nerve conduction velocity and balance in neurosis patients (MS) so lead to reduce problems, promotion of mobility and finally more life expectancy in these patients.

Keywords: balance, elastic bands, multiple sclerosis, nerve conduction, velocity

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Authors: Hasan Ziari, Hassan Fazaeli, Seyed Javad Vaziri Kang Olyaei, Asma Sadat Dabiri

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The presence of cracks in concrete pavements is a place for the ingression of corrosive substances, acids, oils, and water into the pavement and reduces its long-term durability and level of service. One of the causes of early cracks in concrete pavements is the plastic shrinkage. This shrinkage occurs due to the formation of negative capillary pressures after the equilibrium of the bleeding and evaporation rates at the pavement surface. These cracks form if the tensile stresses caused by the restrained shrinkage exceed the tensile strength of the concrete. Different climate conditions change the rate of evaporation and thus change the balance time of the bleeding and evaporation, which changes the severity of cracking in concrete. The present study examined the relationship between the balance time of bleeding and evaporation and the area of cracking in the concrete slabs using the standard method ASTM C1579 in 27 different environmental conditions by using continuous video recording and digital image analyzing. The results showed that as the evaporation rate increased and the balance time decreased, the crack severity significantly increased so that by reducing the balance time from the maximum value to its minimum value, the cracking area increased more than four times. It was also observed that the cracking area- balance time curve could be interpreted in three sections. An examination of these three parts showed that the combination of climate conditions has a significant effect on increasing or decreasing these two variables. The criticality of a single factor cannot cause the critical conditions of plastic cracking. By combining two mild environmental factors with a severe climate factor (in terms of surface evaporation rate), a considerable reduction in balance time and a sharp increase in cracking severity can be prevented. The results of this study showed that balance time could be an essential factor in controlling and predicting plastic shrinkage cracking in concrete pavements. It is necessary to control this factor in the case of constructing concrete pavements in different climate conditions.

Keywords: bleeding and cracking severity, concrete pavements, climate conditions, plastic shrinkage

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Authors: Canan Gunay Yazici, Zubeyir Sarı, Devrim Tarakci

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Background: Hippotherapy considered as global techniques used in rehabilitation of children with cerebral palsy as it improved gait pattern, balance, postural control, balance and gross motor skills development but it encounters some problems (such as the excess of the cost of horses' care, nutrition, housing). Hippotherapy simulator is being developed in recent years to overcome these problems. These devices aim to create the effects of hippotherapy made with a real horse on patients by simulating the movements of a real horse. Objectives: To evaluate the efficacy of hippotherapy simulator on gross motor functions, sitting postural control and dynamic balance of children with cerebral palsy (CP). Methods: Fourteen children with CP, aged 6–15 years, seven with a diagnosis of spastic hemiplegia, five of diplegia, two of triplegia, Gross Motor Function Classification System level I-III. The Horse Riding Simulator (HRS), including four-speed program (warm-up, level 1-2-3), was used for hippotherapy simulator. Firstly, each child received Neurodevelopmental Therapy (NDT; 45min twice weekly eight weeks). Subsequently, the same children completed HRS+NDT (30min and 15min respectively, twice weekly eight weeks). Children were assessed pre-treatment, at the end of 8th and 16th week. Gross motor function, sitting postural control, dynamic sitting and standing balance were evaluated by Gross Motor Function Measure-88 (GMFM-88, Dimension B, D, E and Total Score), Trunk Impairment Scale (TIS), Pedalo® Sensamove Balance Test and Pediatric Balance Scale (PBS) respectively. Unit of Scientific Research Project of Marmara University supported our study. Results: All measured variables were a significant increase compared to baseline values after both intervention (NDT and HRS+NDT), except for dynamic sitting balance evaluated by Pedalo®. Especially HRS+NDT, increase in the measured variables was considerably higher than NDT. After NDT, the Total scores of GMFM-88 (mean baseline 62,2 ± 23,5; mean NDT: 66,6 ± 22,2; p < 0,05), TIS (10,4 ± 3,4; 12,1 ± 3; p < 0,05), PBS (37,4 ± 14,6; 39,6 ± 12,9; p < 0,05), Pedalo® sitting (91,2 ± 6,7; 92,3 ± 5,2; p > 0,05) and Pedalo® standing balance points (80,2 ± 10,8; 82,5 ± 11,5; p < 0,05) increased by 7,1%, 2%, 3,9%, 5,2% and 6 % respectively. After HRS+NDT treatment, the total scores of GMFM-88 (mean baseline: 62,2 ± 23,5; mean HRS+NDT: 71,6 ± 21,4; p < 0,05), TIS (10,4 ± 3,4; 15,6 ± 2,9; p < 0,05), PBS (37,4 ± 14,6; 42,5 ± 12; p < 0,05), Pedalo® sitting (91,2 ± 6,7; 93,8 ± 3,7; p > 0,05) and standing balance points (80,2 ± 10,8; 86,2 ± 5,6; p < 0,05) increased by 15,2%, 6%, 7,3%, 6,4%, and 11,9%, respectively, compared to the initial values. Conclusion: Neurodevelopmental therapy provided significant improvements in gross motor functions, sitting postural control, sitting and standing balance of children with CP. When the hippotherapy simulator added to the treatment program, it was observed that these functions were further developed (especially with gross motor functions and dynamic balance). As a result, this pilot study showed that the hippotherapy simulator could be a useful alternative to neurodevelopmental therapy for the improvement of gross motor function, sitting postural control and dynamic balance of children with CP.

Keywords: balance, cerebral palsy, hippotherapy, rehabilitation

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Authors: Jia Wang, Wanting Zhang, Yutong Xv, Zihan Guo, Weiguang Ma

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Background: Before becoming qualified nurses, newly graduated nurses(NGNs) must experience a painful transition period, even transition shocks. Transition shocks are public health issues. To address the transition issue of NGNs, many programs or interventions have been developed and implemented. However, there are no studies to understand and assess the transition state of newly graduated nurses from work to life, from external abilities to internal emotions. Aims: Assess the transition status of newly graduated nurses in China. Identify the factors influencing the transition status of newly graduated nurses. Methods: The multi-center cross-sectional study design was adopted. From May 2022 to June 2023, 1261 newly graduated nurse in hospitals were surveyed online with the the Demographic Questionnaire and Transition Status Scale for Newly Graduated Nurses. SPSS 26.0 were used for data input and statistical analysis. Statistic description were adopted to evaluate the demographic characteristics and transition status of NGNs. Independent-samples T-test, Analysis of Variance and Multiple regression analysis was used to explore the influencing factors of transition status. Results: The total average score of Transition Status Scale for Newly Graduated Nurses was 4.00（SD = 0.61）. Among the various dimensions of Transition Status, the highest dimension was competence for nursing work, while the lowest dimension was balance between work and life. The results showed factors influencing the transition status of NGNs include taught by senior nurses, night shift status, internship department, attribute of working hospital, province of work and residence, educational background, reasons for choosing nursing, types of hospital, and monthly income. Conclusion: At present, the transition status score of new nurses in China is relatively high, and NGNs are more likely to agree with their own transition status, especially the dimension of competence for nursing work. However, they have a poor level of excess in terms of life-work balance. Nursing managers should reasonably arrange the working hours of NGNs, promote their work-life balance, increase the salary and reward mechanism of NGNs, arrange experienced nursing mentors to teach, optimize the level of hospitals, provide suitable positions for NGNs with different educational backgrounds, pay attention to the culture shock of NGNs from other provinces, etc. Optimize human resource management by intervening in these factors that affect the transition of new nurses and promote a better transition of new nurses.

Keywords: newly graduated nurse, transition, humanistic car, nursing management, nursing practice education

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Authors: Jenny Oliveros Lao Phillips, Arturo E. Osorio, José Alves

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Family business are the dominant form of business in the world, and Chinese family business (CFB) is a unique type of family business that relies on collective action to survive. This paper argues that in CFBs, entrepreneurial actions are transgenerational collective endeavors, and successors are groomed as stewards of the family legacy. Work-life relationship in CFBs is about synergy and not balance because the family identity is the business identity, and vice-versa. Using five in-depth case studies, this research introduces an alternative understanding of CFBs and proposes a model of work-life synergy in transgenerational entrepreneurship based on discussion of five theory-based propositions. This model explains that through emphasizing on the business family’s shared value and entrepreneurial legacy, elements of trust, shared identity and stewardship of family members are enhanced which leads to collective action and goal of the business family, resulting in transgenerational entrepreneurship. Limitations and future research are presented.

Keywords: Chinese family business, family legacy, stewardship, transgenerational entrepreneurship, work-life synergy

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Authors: Maike Andresen, Georg Dochtmann

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Due to political, social, and societal changes in labor organization, top-sharing, defined as job-sharing in leading positions, becomes more important in HRM. German companies are looking for practical and economically meaningful solutions that allow to enduringly increase women’s ratio in management, not only because of a recently implemented quota. Furthermore, supporting employees in achieving work-life balance is perceived as an important goal for a sustainable HRM to gain competitive advantage. Top-sharing is seen as being suitable to reach both goals. To evaluate determinants leading to effective top-sharing, a case study of a newly implemented top-sharing tandem in a large German enterprise was conducted over a period of 15 months. In this company, a full leadership position was split into two 60%-part-time positions held by an experienced female leader in her late career and a female college who took over her first leadership position (mid-career). We assumed a person-person fit in terms of a match of the top sharing partners’ personality profiles (Big Five) and their leadership motivations to be important prerequisites for an effective collaboration between them. We evaluated the person-person fit variables once before the tandem started to work. Both leaders were expected to learn from each other (mentoring, competency development). On an operational level, they were supposed to lead together the same employees in an effective manner (leader-member exchange), presupposing an effective cooperation between both (handing over information). To see developments over time, these processes were evaluated three times over the span of the project. Top-Sharing and the underlined processes are expected to positively influence the tandem’s performance which has been evaluated twice, at the beginning and the end of the project, to assess its development over time as well. The evaluation of the personality and the basic motives suggests that both executives can be a successful top-sharing tandem. The competency evaluations (supervisor as well as self-assessment) increased over the time span. Although the top sharing tandem worked on equal terms, they implemented rather classical than peer-mentoring due to different career ambitions of the tandem partners. Thus, opportunities were not used completely. Team-member exchange scores proved the good cooperation between the top-sharers. Although the employees did not evaluate the leader-member-exchange between them and the two leaders of the tandem homogeneously, the top-sharing tandem itself did not have the impression that the employees’ task performance depended on whom of the tandem was responsible for the task. Furthermore, top-sharing did not negatively influence the performance of both leaders. During qualitative interviews with the top-sharers and their team, we found that the top-sharers could focus more easily on their tasks. The results suggest positive outcomes of top-sharing (e.g. competency improvement, learning from each other through mentoring). Top-Sharing does not hamper performance. Thus, further research and practical implementations are suggested. As part-time jobs are still more often a female solution to increase their work-life- and work-family-balance, top-sharing may be a suitable solution to increase the woman’s ratio in leadership positions as well as to sustainable increase work-life-balance of executives.

Keywords: mentoring, part-time leadership, top-sharing, work-life-balance

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Authors: Ivan Struhár, Martin Sebera, Lenka Dovrtělová

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The aim of this study was to find out if the special type of exercise with elastic cord can improve the level of postural stability. The exercise programme was conducted twice a week for 3 months. The participants were randomly divided into an experimental group and a control group. The electronic balance board was used for testing of postural stability. All participants trained for 18 hours at the time of experiment without any special form of coordination programme. The experimental group performed 90 minutes plus of coordination exercise. The result showed that differences between pre-test and post-test occurred in the experimental group. It was used the nonparametric Wilcoxon t-test for paired samples (p=0.012; the significance level 95%). We calculated effect size by Cohen´s d. In the experimental group d is 1.96 which indicates a large effect. In the control group d is 0.04 which confirms no significant improvement.

Keywords: balance board, balance training, coordination, stability

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Authors: Wei-Po Wu, Wen-Yu Liu, Wei−Ting Lin, Hen-Yu Lien

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Introduction: Improving balance function for individuals after stroke is a crucial target in physiotherapy. Aquatic therapy which challenges individual’s postural control in an unstable fluid environment may be beneficial in enhancing balance functions. The purposes of the systematic review with meta-analyses were to validate the effects of aquatic therapy in improving balance functions for individuals with strokes in contrast to conventional physiotherapy. Method: Available studies were explored from three electronic databases: PubMed, Scopus, and Web of Science. During literature search, the published date of studies was not limited. The study design of the included studies should be randomized controlled trials (RCTs) and the studies should contain at least one outcome measurement of balance function. The PEDro scale was adopted to assess the quality of included studies, while the 'Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence' was used to evaluate the level of evidence. After the data extraction, studies with same outcome measures were pooled together for meta-analysis. Result: Ten studies with 282 participants were included in analyses. The research qualities of the studies were ranged from fair to good (4 to 8 points). Levels of evidence of the included studies were graded as level 2 and 3. Finally, scores of Berg Balance Scale (BBS), Eye closed force plate center of pressure velocity (anterior-posterior, medial-lateral axis) and Timed up and Go test were pooled and analyzed separately. The pooled results shown improvement in balance function (BBS mean difference (MD): 1.39 points; 95% confidence interval (CI): 0.05-2.29; p=0.002) (Eye closed force plate center of pressure velocity (anterior-posterior axis) MD: 1.39 mm/s; 95% confidence interval (CI): 0.93-1.86; p<0.001) (Eye closed force plate center of pressure velocity (medial-lateral) MD: 1.48 mm/s; 95% confidence interval (CI): 0.15-2.82; p=0.03) and mobility (MD: 0.9 seconds; 95% CI: 0.07-1.73; p=0.03) of stroke individuals after aquatic therapy compared to conventional therapy. Although there were significant differences between two treatment groups, the differences in improvement were relatively small. Conclusion: The aquatic therapy improved general balance function and mobility in the individuals with stroke better than conventional physiotherapy.

Keywords: aquatic therapy, balance function, meta-analysis, stroke, systematic review

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Authors: Doaa H. I. Mahmoud, El-Said M. Elsharkawy, Saad Z. Soliman, Soher E. Mustfa

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The opening of new promising foreign markets is one of the objectives of Egypt’s foreign trade policies, especially for agricultural exports. This study aims at the examination of the commodity structure of the Egyptian agricultural imports and exports with the COMESA countries. In addition, estimation of the surplus/deficit of the Egyptian commodities and agricultural balance with these countries is made. Time series data covering the period 2004-2016 is used. Estimation of the growth function along with the derivation of the annual growth rates of the study’s variables is made. Some of the results of the study period display the following: (1) The average total Egyptian exports to the COMESA (Common Market for Eastern and Southern Africa) countries is estimated at 1,491 million dollars, with an annual growth rate of 14.4% (214.7 million dollars). (2) The average annual Egyptian agricultural exports to these economies is estimated at 555 million dollars, with an annual growth rate of 19.4% (107.7 million dollars). (3) The average annual value of agricultural imports from the COMESA countries is set at 289 Million Dollars, with an annual growth rate of 14.4% (41.6 million dollars). (4) The study shows that there is a continuous surplus in the agricultural balance with these economies, whilst having a deficit in the raw-materials agricultural balance, as well as the balance of input requirements with these countries.

Keywords: COMESA, Egypt, growth rates, trade balance

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Authors: K. H. Oyuntungalag, Scott Kenner, O. Erdenetuya

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The life cycle phases of mining projects are described in this guidance document, and includes initial phases (exploration, feasibility and planning), mine development (construction and operations), closure and reclamation. Initial phases relate to field programs and desktop studies intended to build the data and knowledge base, including the design of water management infrastructure and development during these initial phases. Such a model is essential to demonstrate that the water management plan (WMP) will provide adequate water for the mine operations and sufficient capacity for anticipated flows and volumes, and minimize environmental impacts on the receiving environment. The water and mass balance model must cover the whole mine life cycle, from the start of mine development to a date sufficiently far in the future where the reclaimed landscape is considered self- sustaining following complete closure of the mine (i.e., post- closure). The model simulates the movement of water within the components of the water management infrastructure and project operating areas, and calculates chemical loadings to each mine component. At Erdenet Mining company an initial water balance model reflecting the tailings dam, groundwater seepage and mine process water was developed in collaboration with Dr. Scott Kenner (visiting Fulbright scholar). From this preliminary study the following recommendations were made: 1. Develop a detailed groundwater model to simulate seepage from the tailings dam, 2. Establish an evaporation pan for improving evapotranspiration estimates, and 3. Measure changes in storage of water within the tailings dam and other water storage components within the mine processing.

Keywords: evapotranspiration , monitoring program, Erdenet mining, tailings dam

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Authors: Bijad Alqahtani, Graham Arnold, Weijie Wang

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Background—Tai Chi Chuan (TCC) is a type of traditional Chinese martial art and is considered a benefiting physical fitness. Advanced techniques of motion analysis have been routinely used in the clinical assessment. However, so far, little research has been done on the biomechanical assessment of TCC players in terms of gait and balance using motion analysis. Objectives—The aim of this study was to investigate whether TCC improves the lower limb conditions and balance ability using the state of the art motion analysis technologies, i.e. motion capture system, electromyography and force platform. Methods—Twenty TCC (9 male, 11 female) with age between (42-77) years old and weight (56.2-119 Kg), and eighteen Non-TCC participants (7 male, 11 female), weight (50-110 Kg) with age (43- 78) years old at the matched age as a control group were recruited in this study. Their gait and balance were collected using Vicon Nexus® to obtain the gait parameters, and kinematic parameters of hip, knee, and ankle joints in three planes of both limbs. Participants stood on force platforms to perform a single leg balance test. Then, they were asked to walk along a 10 m walkway at their comfortable speed. Participants performed 5 trials of single-leg balance for the dominant side. Also, the participants performed 3 trials of four square step balance and 10 trials of walking. From the recorded trials, three good ones were analyzed using the Vicon Plug-in-Gait model to obtain gait parameters, e.g. walking speed, cadence, stride length, and joint parameters, e.g. joint angle, force, moments, etc. Result— The temporal-spatial variables of TCC subjects were compared with the Non-TCC subjects, it was found that there was a significant difference (p < 0.05) between the groups. Moreover, it was observed that participants of TCC have significant differences in ankle, hip, and knee joints’ kinematics in the sagittal, coronal, and transverse planes such as ankle angle (19.90±19.54 deg) for TCC while (15.34±6.50 deg) for Non-TCC, and knee angle (14.96±6.40 deg) for TCC while (17.63±5.79 deg) for Non-TCC in the transverse plane. Also, the result showed that there was a significant difference between groups in the single-leg balance test, e.g. maintaining single leg stance time in the TCC participants showed longer duration (20.85±10.53 s) in compared to Non-TCC people group (13.39±8.78 s). While the result showed that there was no significant difference between groups in the four square step balance. Conclusion—Our result showed that there are significant differences between Tai Chi Chuan and Non-Tai Chi Chuan participants in the various aspects of gait analysis and balance test, as a consequence of these findings some of biomechanical parameters such as joints kinematics, gait parameters and single leg stance balance test, the Tai Chi Chuan could improve the lower limb conditions and could reduce a risk of fall for the elderly with ageing.

Keywords: gait analysis, kinematics, single leg stance, Tai Chi Chuan

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Authors: Dina Muharib

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Specific metabolic challenges are present following spinal cord injury. The acute stage is characterized by a reduction in metabolic activity, as well as a negative nitrogen balance that cannot be corrected, even with aggressive nutritional support. Metabolic demands need to be accurately monitored to avoid overfeeding. Enteral feeding is the optimal route following SCI. When oral feeding is not possible, nasogastric, followed by nasojejunal, then by percutaneous endoscopic gastrostomy, if necessary, is suggested.

Keywords: SCI, energy, protein, nutrition assessment, eneral feeding, nitrogen balance

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Authors: Aleksandar Dedić, Duško Salemović, Matilda Lazić, Dragan Halas

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The aim of the paper was the thermal balance control of vertical kiln dryer indirect type (VSU-36) for drying sunflower seed, produced by "Cer" - Cacak, capacity 39 [t/h]. The balance control was executed because the dryer was damaged by NATO bombing in 1999, and it was planned for its reconstruction. The structural and geometric characteristics of the dryer were known, and it was necessary to determine the parameters of wet air as a drying agent and the sunflower seeds. The thermal balance control was the basis for the replacement of damaged parts of the dryer during its reconstruction. After that, it was necessary to perform the subsequent calculation of strength. The accuracy of strength had a large influence on the cost-effectiveness and safety of a single drying chamber. Also, the work provides guidelines for the regimes of drying grain crops with an explanation of the specificity of drying sunflowers.

Keywords: sunflower seeds, regimes of drying, vertical kiln dryer, thermal analysis

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Authors: Qurrat Ul Ain Farooq, Misha Arshad, Malik Abid Mehmood

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The experiment under discussion was carried out to check the effect of different concentrations of sucrose (2%, 4%, 6%), CuSO4 (200ppm, 300ppm, 400 ppm), GA3 (25ppm, 50ppm, 75 ppm), and combinations of sucrose and GA3 (2% +25 ppm), (4%+50 ppm), (6%+75 ppm) on the carnation cut flower. Visual symptoms of flower senescence, changes in weight (g) of a flower was observed and recorded by using weight balance. The experiment was laid out according to CRD (Complete Randomized Design) it was two-factor factorial, the software used for the analysis was Statistix. Maximum TSS were found in 6% sucrose + 75 ppm GA3 (8.3 %) followed by CuSO4 400 ppm, 4% sucrose + 50 ppm GA3 and 6% sucrose + 75 ppm GA3. Maximum vase life in term of days was recorded in treatment. CuSO4 400 ppm and 6% sucrose + 75 ppm GA3 (8 days) followed by CuSO4 200 ppm (7.7 days). CuSO4 300 ppm & 6% sucrose + 75 ppm GA3 were at par (7 days). Maximum water uptake was also observed in 6% sucrose + 75 ppm GA3 (56.7 ml) followed by CuSO4 400 ppm (49.7 ml) and 50 ppm GA3 (45 ml). Hence, CuSO4 400 ppm found best in all aspects.

Keywords: carnation, vaselife, GA3, CuSO4, sucrose

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Authors: Kunihisa Kakumoto

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Purpose: The global environmental problem is now raised in the global dimension. The sprawl phenomenon over the natural limitation is to be made a forecast beforehand in an algorithmic way so that the condition of our social life can hopefully be protected under the natural limitation. The sustainable condition in the globe is now to be found to keep the balance between the capacity of nature and the possibility of our social lives. The amount of water on the earth is limited. Therefore, on the reason, sustainable conditions are strongly dependent on the capacity of water. The amount of water can be considered in relation to the area of the green planting because a certain volume of the water can be obtained in the forest, where the green planting can be preserved. We can find the sustainable conditions of the water in relation to the green planting area. The reduction of CO₂ by green planting is also possible. Possible Measure and the Methods: Until now, by the opportunity of many international conferences, the concept of the solar community as one prototype has been introduced by technical papers. The algorithmic trial calculation on the basic concept of the solar community can be taken into consideration. The concept of the solar community is based on the collected data of the solar model house. According to the algorithmic results of the prototype, the simulation work in the globe can be performed as the algorithmic conversion results. This algorithmic study can be simulated by the amount of water, also in relation to the green planting area. Additionally, the submission of CO₂ in the solar community and the reduction of CO₂ by green planting can be calculated. On the base of these calculations in the solar community, the sustainable conditions on the globe can be simulated as the conversion results in an algorithmic way. The digital formation in the solar community can also be taken into consideration by this opportunity. Conclusion: For the finding of sustainable conditions around the globe, the solar community as one prototype has been taken into consideration. The role of the water is very important because the capacity of the water supply is very limited. But, at present, the cycle of the social community is not composed by the point of the natural mechanism. The simulative calculation of this study can be shown by the limitation of the total water supply. According to this process, the total capacity of the water supply and the capable residential number of the population and the areas can be taken into consideration by the algorithmic calculation. For keeping enough water, the green planting areas are very important. The planting area is also very important to keep the balance of CO₂. The simulative calculation can be performed by the relation between the submission and the reduction of CO₂ in the solar community. For the finding of this total balance and the sustainable conditions, the green planting area and the total amount of water can be recognized by the algorithmic simulative calculation. The study for the finding of sustainable conditions can be performed by the simulative calculations on the algorithmic model in the solar community as one prototype. The example of one prototype can be in balance. The activity of the social life must be in the capacity of the natural mechanism. The capable capacity of the natural environment in our world is very limited.

Keywords: the solar community, the sustainable condition, the natural limitation, the algorithmic calculation

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Authors: Anette Alén

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Intellectual property (IP) regimes have traditionally been designed to integrate various conflicting elements stemming from private entitlement and the public good. In IP laws and regulations, this design takes the form of specific uses of protected subject-matter without the right-holder’s consent, or exhaustion of exclusive rights upon market release, and the like. More recently, the pursuit of ‘balance’ has gained ground in the conceptualization of these conflicting elements both in terms of IP law and related policy. This can be seen, for example, in European Union (EU) copyright regime, where ‘balance’ has become a key element in argumentation, backed up by fundamental rights reasoning. This development also entails an ever-expanding dialogue between the IP regime and the constitutional safeguards for property, free speech, and privacy, among others. This study analyses the concept of ‘balance’ in EU copyright law: the research task is to examine the contents of the concept of ‘balance’ and the way it is operationalized and pursued, thereby producing new knowledge on the role and manifestations of ‘balance’ in recent copyright case law and regulatory instruments in the EU. The study discusses two particular pieces of legislation, the EU Digital Single Market (DSM) Copyright Directive (EU) 2019/790 and the finalized EU Artificial Intelligence (AI) Act, including some of the key preparatory materials, as well as EU Court of Justice (CJEU) case law pertaining to copyright in the digital era. The material is examined by means of document analysis, mapping the ways ‘balance’ is approached and conceptualized in the documents. Similarly, the interaction of fundamental rights as part of the balancing act is also analyzed. Doctrinal study of law is also employed in the analysis of legal sources. This study suggests that the pursuit of balance is, for its part, conducive to new battles, largely due to the advancement of digitalization and more recent developments in artificial intelligence. Indeed, the ‘balancing act’ rather presents itself as a way to bypass or even solidify some of the conflicting interests in a complex global digital economy. Indeed, such a conceptualization, especially when accompanied by non-critical or strategically driven fundamental rights argumentation, runs counter to the genuine acknowledgment of new types of conflicting interests in the copyright regime. Therefore, a more radical approach, including critical analysis of the normative basis and fundamental rights implications of the concept of ‘balance’, is required to readjust copyright law and regulations for the digital era. Notwithstanding the focus on executing the study in the context of the EU copyright regime, the results bear wider significance for the digital economy, especially due to the platform liability regime in the DSM Directive and with the AI Act including objectives of a ‘level playing field’ whereby compliance with EU copyright rules seems to be expected among system providers.

Keywords: balance, copyright, fundamental rights, platform liability, artificial intelligence

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Authors: Allan Munyao Mukuki

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The nexus between terrorism and human rights has become a big challenge in the fight against terrorism globally. This is hinged on the fact that terrorism and human rights are interrelated to the extent that, when the former starts, the latter is violated. This direct linkage was recognised in the Vienna Declaration and Programme of Action as adopted by the World Conference on Human Rights in Vienna on 25 June 1993 which agreed that acts of terrorism in all its forms and manifestations are aimed at the destruction of human rights. Hence, terrorism constitutes an assault on our most basic human rights. To this end, the first part of this paper will focus on the nexus between terrorism and human rights and endeavors to draw a co-relation between these two concepts. The second part thereafter will analyse the emerging concept of cyber-terrorism and how it takes place. Further, an analysis of cyber counter-terrorism balanced as against human rights will also be undertaken. This will be done through the analysis of the concept of ‘securitisation’ of human rights as well as the need to create a balance between counterterrorism efforts as against the protection of human rights at all costs. The paper will then concludes with recommendations on how to balance counter-terrorism and human rights in the modern age.

Keywords: balance, counter-terrorism, cyber-terrorism, human rights, security, violation

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Authors: Anna Słupik, Krzysztof Jaworski, Anna Mosiołek, Dariusz Białoszewski

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Background: Maintaining the correct body balance is essential in the prevention of falls in the elderly, which is especially important for women because of postmenopausal osteoporosis and the serious consequences of falls. One of the exercise methods which is very popular among adults, and which may affect body balance in a positive way is the pilates method. The aim of the study was to evaluate the effect of regular pilates exercises on the ability to maintain body balance in static conditions in adult healthy women. Material and methods: The study group consisted of 20 healthy women attending pilates twice a week for at least 1 year. The control group consisted of 20 healthy women physically inactive. Women in the age range from 35 to 50 years old without pain in musculoskeletal system or other pain were only qualified to the groups. Body balance was assessed using MatScan VersaTek platform with Sway Analysis Module based on Matscan Clinical 6.7 software. The balance was evaluated under the following conditions: standing on both feet with eyes open, standing on both feet with eyes closed, one-leg standing (separately on the right and left foot) with eyes open. Each test lasted 30 seconds. The following parameters were calculated: estimated size of the ellipse of 95% confidence, the distance covered by the Center of Gravity (COG), the size of the maximum shift in the sagittal and frontal planes and load distribution between the left and right foot, as well as between rear- and forefoot. Results: It was found that there is significant difference between the groups in favor of the study group in the size of the confidence ellipse and maximum shifts of COG in the sagittal plane during standing on both feet, both with the eyes open and closed (p < 0.05). While standing on one leg both on the right and left leg, with eyes opened there was a significant difference in favor of the study group, in terms of the size of confidence ellipse, the size of the maximum shifts in the sagittal and in the frontal plane (p < 0.05). There were no differences between the distribution of load between the right and left foot (standing with both feet), nor between fore- and rear foot (in standing with both feet or one-leg). Conclusions: 1. Static balance in women exercising regularly by pilates method is better than in inactive women, which may in the future prevent falls and their consequences. 2. The observed differences in maintaining balance in frontal plane in one-leg standing may indicate a positive impact of pilates exercises on the ability to maintain global balance in terms of the reduced support surface. 3. Pilates method can be used as a form preventive therapy for all people who are expected to have problems with body balance in the future, for example in chronic neurological disorders or vestibular problems. 4. The results have shown that further prospective randomized research on a larger and more representative group is needed.

Keywords: balance exercises, body balance, pilates, pressure distribution, women

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Authors: Anabel Fernandez, Leandro Rodriguez-Ortiz, Rosa RodríGuez

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Due to the negative impact of fossil fuels, renewable energies are promising sources to limit global temperature rise and damage to the environment. Also, the development of technology is focused on obtaining energetic products from renewable sources. In this study, a thermodynamic model including Exergy balance and a subsequent Life Cycle Assessment (LCA) were carried out for four subsystems of the integrated gasification-combustion of pinewood. Results of exergy analysis and LCA showed the process feasibility in terms of exergy efficiency and global energy efficiency of the life cycle (GEELC). Moreover, the energy return on investment (EROI) index was calculated. The global exergy efficiency resulted in 67 %. For pretreatment, reaction, cleaning, and electric generation subsystems, the results were 85, 59, 87, and 29 %, respectively. Results of LCA indicated that the emissions from the electric generation caused the most damage to the atmosphere, water, and soil. GEELC resulted in 31.09 % for the global process. This result suggested the environmental feasibility of an integrated gasification-combustion system. EROI resulted in 3.15, which determinates the sustainability of the process.

Keywords: exergy analysis, life cycle assessment (LCA), renewability, sustainability

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Authors: Djeffal Asma, Zemmouri Noureddine

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In order for building designer to be able to balance environmental concerns with other performance requirements, they need clear and concise information. For certain decisions during the design process, qualitative guidance, such as design checklists or guidelines information may not be sufficient for evaluating the environmental benefits between different building materials, products and designs. In this case, quantitative information, such as that generated through a life cycle assessment, provides the most value. LCA provides a systematic approach to evaluating the environmental impacts of a product or system over its entire life. In the case of buildings life cycle includes the extraction of raw materials, manufacturing, transporting and installing building components or products, operating and maintaining the building. By integrating LCA into building design process, designers can evaluate the life cycle impacts of building design, materials, components and systems and choose the combinations that reduce the building life cycle environmental impact. This article attempts to give an overview of the integration of LCA methodology in the context of building design, and focuses on the use of this methodology for environmental considerations concerning process design and optimization. A multiple case study was conducted in order to assess the benefits of the LCA as a decision making aid tool during the first stages of the building design under specific climate conditions of the North East region of Algeria. It is clear that the LCA methodology can help to assess and reduce the impact of a building design and components on the environment even if the process implementation is rather long and complicated and lacks of global approach including human factors. It is also demonstrated that using LCA as a multi objective optimization of building process will certainly facilitates the improvement in design and decision making for both new design and retrofit projects.

Keywords: life cycle assessment, buildings, sustainability, elementary schools, environmental impacts

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Authors: Chung-Yuan Wang, Kai-Chun Lee, Min-Hung Wang, Yu-Ren Chen, Hung-Sheng Lin, Sen-Shan Fan

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Taiwan National Health Insurance (NHI) was launched in 1995. It is an important social welfare policy in Taiwan. Regardless of the diversified social and economic status, universal coverage of NHI was assured. In order to regain better self-care performance, stroke people received in-patient and out-patient rehabilitation. Though NHI limited the rehabilitation frequency to one per day, the cost of rehabilitation still increased rapidly. Through the intensive rehabilitation during the post-stroke rehabilitation golden period, stroke patients might decrease their disability and shorten the rehabilitation period. Therefore, the aim of this study was to investigate the effect of intensive post-acute stroke rehabilitation in hospital under per diem payment. This study was started from 2014/03/01. The stroke patients who were admitted to our hospital or medical center were indicated to the study. The neurologists would check his modified Rankin Scale (mRS). Only patients with their mRS score between 2 and 4 were included to the study. Patients with unclear consciousness, unstable medical condition, unclear stroke onset date and no willing for 3 weeks in-patient intensive rehabilitation were excluded. After the physiatrist’s systemic evaluation, the subjects received intensive rehabilitation programs. The frequency of rehabilitation was thrice per day. Physical therapy, occupational therapy and speech/swallowing therapy were included in the programs for the needs of the stroke patients. Activity daily life performance (Barthel Index) and functional balance ability (Berg Balance Scale) were used to measure the training effect. During 3/1 to 5/31, thirteen subjects (five male and eight female) were included. Seven subjects were aged below 60. Three subjects were aged over 70. Most of the subjects (seven subjects) received intensive post-stroke rehabilitation for three weeks. Three subjects drop out from the programs and went back home respectively after receiving only 7, 10, and 13 days rehabilitation. Among these 13 subjects, nine of them got improvement in activity daily life performance (Barthel Index score). Ten of them got improvement in functional balance ability (Berg Balance Scale). The intensive post-acute stroke rehabilitation did help stroke patients promote their health in our study. Not only their functional performance improved, but also their self-confidence improved. Furthermore, their family also got better health status. Stroke rehabilitation under per diem payment was noted in long-term care institution in developed countries. Over 95% populations in Taiwan were supported under the Taiwan's National Health Insurance system, but there was no national long-term care insurance system. Most of the stroke patients in Taiwan live with his family and continue their rehabilitation programs from out-patient department. This pilot study revealed the effect of intensive post-acute stroke rehabilitation in hospital under per diem payment. The number of the subjects and the study period were limited. Thus, further study will be needed.

Keywords: rehabilitation, post-acute stroke, per diem payment, NHI

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Authors: Lianne M. Q. Lee, Mohammed Sharaf Shaiban

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The importance of bank liquidity management took center stage as policy makers promoted a more resilient global banking system after the market turmoil of 2007. The growing recognition of Islamic banks’ function of intermediating funds in the economy warrants the need to investigate its balance sheet structure which is distinct from its conventional counterparts. Given that asymmetric risk, transformation is inevitable; Islamic banks need to identify the liquidity risk within their distinctive balance sheet structure. Thus, there is a strong need to quantify and assess the liquidity position to ensure proper functioning of a financial institution. It is vital to measure bank liquidity because liquid banks face less liquidity risk. We examine this issue by using two alternative quantitative measures of liquidity creation “cat fat” and “cat nonfat” constructed by Berger and Bouwman (2009). “Cat fat” measures all on balance sheet items including off balance sheet, whilst the latter measures only on balance sheet items. Liquidity creation is measured over the period 2007-2014 in 14 countries where Islamic and conventional commercial banks coexist. Also, separately by bank size class as empirical studies have shown that liquidity creation varies by bank size. An interesting and important finding shows that all size class of Islamic banks, on average have increased creation of aggregate liquidity in real dollar terms over the years for both liquidity creation measures especially for large banks indicating that Islamic banks actually generates more liquidity to the economy compared to its conventional counterparts, including from off-balance sheet items. The liquidity creation for off-balance sheets by conventional banks may have been affected by the global financial crisis when derivatives markets were severely hit. The results also suggest that Islamic banks have the higher volume of assets and deposits and that borrowing/issues of bonds are less in Islamic banks compared to conventional banks because most products are interest-based. As Islamic banks appear to create more liquidity than conventional banks under both measures, it translates that the development of Islamic banking is significant over the decades since its inception. This finding is encouraging as, despite Islamic banking’s overall size, it represents growth opportunities for these countries.

Keywords: financial institution, liquidity creation, liquidity risk, policy and regulation

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Authors: Nurtekin Erkmen, Turgut Kaplan, Halil Taskin, Ahmet Sanioglu, Gokhan Ipekoglu

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The aim of this study was to determine the effects of an 8 week soccerspecific technical training with limited vision perception on postural control and technical parameters in 10-12 aged soccer players. Subjects in this study were 24 male young soccer players (age: 11.00 ± 0.56 years, height: 150.5 ± 4.23 cm, body weight: 41.49 ± 7.56 kg). Subjects were randomly divided as two groups: Training and control. Balance performance was measured by Biodex Balance System (BBS). Short pass, speed dribbling, 20 m speed with ball, ball control, juggling tests were used to measure soccer players’ technical performances with a ball. Subjects performed soccer training 3 times per week for 8 weeks. In each session, training group with limited vision perception and control group with normal vision perception committed soccer-specific technical drills for 20 min. Data analyzed with t-test for independent samples and Mann-Whitney U between groups and paired t-test and Wilcoxon test between pre-posttests. No significant difference was found balance scores and with eyes open and eyes closed and LOS test between training and control groups after training (p>0.05). After eight week of training there are no significant difference in balance score with eyes open for both training and control groups (p>0.05). Balance scores decreased in training and control groups after the training (p<0.05). The completion time of LOS test shortened in both training and control groups after training (p<0.05). The training developed speed dribbling performance of training group (p<0.05). On the other hand, soccer players’ performance in training and control groups increased in 20 m speed with a ball after eight week training (p<0.05). In conclusion; the results of this study indicate that soccer-specific training with limited vision perception may not improves balance performance in 10-12 aged soccer players, but it develops speed dribbling performance.

Keywords: Young soccer players, vision perception, postural control, technical

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Authors: Mina Latif Ghaly Sawiras

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The difference between Islamic terrorism and human-rights has become a big question in the fight against Islamic terrorism globally. This is was raised on the fact that terrorism and human rights are interrelated to the extent that, when the former starts, the latter is violated. This direct linkage was recognized in the Vienna Declaration and Program of Action as adopted by the World Conference on Human Rights in Vienna on 25 June 1993 which agreed that acts of terrorism in all its forms and manifestations are aimed at the destruction of human rights. Hence, Islamic-terrorism constitutes a violation on our most basic human rights. To this end, the first part of this paper will focus on the nexus between terrorism and human rights and endeavors to draw a co-relation between these two concepts. The second part thereafter will analyse the emerging concept of cyber-terrorism and how it takes place. Further, an analysis of cyber counter-terrorism balanced as against human rights will also be undertaken. This will be done through the analysis of the concept of ‘securitization’ of human rights as well as the need to create a balance between counterterrorism efforts as against the protection of human rights at all costs. The paper will then conclude with recommendations on how to balance counter-terrorism and human rights in the modern age.

Keywords: balance, counter-terrorism, cyber-terrorism, human rights, security, violation

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Authors: A. Alzahrani, G. Arnold, W. Wang

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Background: Stroke commonly occurs in middle-aged and elderly populations, and the diagnosis of early stroke is still difficult. Patients who have suffered a stroke have different balance and gait patterns from healthy people. Advanced techniques of motion analysis have been routinely used in the clinical assessment of cerebral palsy. However, so far, little research has been done on the direct diagnosis of early stroke patients using motion analysis. Objectives: The aim of this study was to investigate whether patients with stroke have different balance and gait from healthy people and which biomechanical parameters could be used to predict and diagnose potential patients who are at a potential risk to stroke. Methods: Thirteen patients with stroke were recruited as subjects whose gait and balance was analysed. Twenty normal subjects at the matched age participated in this study as a control group. All subjects’ gait and balance were collected using Vicon Nexus® to obtain the gait parameters, kinetic, and kinematic parameters of the hip, knee, and ankle joints in three planes of both limbs. Participants stood on force platforms to perform a single leg balance test. Then, they were asked to walk along a 10 m walkway at their comfortable speed. Participants performed 6 trials of single-leg balance for each side and 10 trials of walking. From the recorded trials, three good ones were analysed using the Vicon Plug-in-Gait model to obtain gait parameters, e.g., walking speed, cadence, stride length, and joint parameters, e.g., joint angle, force, moments, etc. Result: The temporal-spatial variables of Stroke subjects were compared with the healthy subjects; it was found that there was a significant difference (p < 0.05) between the groups. The step length, speed, cadence were lower in stroke subjects as compared to the healthy groups. The stroke patients group showed significantly decreased in gait speed (mean and SD: 0.85 ± 0.33 m/s), cadence ( 96.71 ± 16.14 step/min), and step length (0.509 ± 017 m) in compared to healthy people group whereas the gait speed was 1.2 ± 0.11 m/s, cadence 112 ± 8.33 step/min, and step length 0.648 ± 0.43 m. Moreover, it was observed that patients with stroke have significant differences in the ankle, hip, and knee joints’ kinematics in the sagittal and coronal planes. Also, the result showed that there was a significant difference between groups in the single-leg balance test, e.g., maintaining single-leg stance time in the stroke patients showed shorter duration (5.97 ± 6.36 s) in compared to healthy people group (14.36 ± 10.20 s). Conclusion: Our result showed that there are significantly differences between stroke patients and healthy subjects in the various aspects of gait analysis and balance test, as a consequences of these findings some of the biomechanical parameters such as joints kinematics, gait parameters, and single-leg stance balance test could be used in clinical practice to predict and diagnose potential patients who are at a high risk of further stroke.

Keywords: gait analysis, kinetics, kinematics, single-leg stance, Stroke

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Authors: Martina Perinkova, Lenka Kolarcikova, Marketa Twrda

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In Ostrava there are a lot of former post-industrial areas and areas that have gradually through conversions and their subsequent reuse. One of the largest is the national cultural monument Lower Vítkovice area where there is a large complex transformation of the former iron production. Industrial heritage today visited by tourists for entertainment, culture, history, sports and other activities. This is a unique example of reuse of technical monuments and introduction of new life into the historic area. The main task of not only find the right function and use, in terms of re integration into city life and finding a balance between history and current lifestyle, looking at the history of the area and its technical condition before reconstruction. It is not only very expensive but also time consuming. Transformations industrial monument is the result of a dialogue architect, the idea of the investor and expert opinion heritage institute.

Keywords: post-industrial area, cultural monument, conversions

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Authors: M. Torres, A. Moulay, M. Zhuldybina, M. Rozel, N. D. Trinh, C. Bois

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Printed electronics are a fast-growing market as their applications cover a large range of industrial needs, their production cost is low, and the additive printing techniques consume less materials than subtractive manufacturing methods used in traditional electronics. With the growing demand for printed electronics, there are concerns about their harmful and irreversible contribution to the environment. Indeed, it is estimated that 80% of the environmental load of a product is determined by the choices made at the conception stage. Therefore, examination through a life cycle approach at the developing stage of a novel product is the best way to identify potential environmental issues and make proactive decisions. Life cycle analysis (LCA) is a comprehensive scientific method to assess the environmental impacts of a product in its different stages of life: extraction of raw materials, manufacture and distribution, use, and end-of-life. Impacts and major hotspots are identified and evaluated through a broad range of environmental impact categories of the ReCiPe (H) middle point method. At the conception stage, the LCA is a tool that provides an environmental point of view on the choice of materials and processes and weights-in on the balance between performance materials and eco-friendly materials. Using the life cycle approach, the current work aims to provide a cradle-to-grave life cycle assessment of a roll-to-roll hybrid printed smart label designed for the food cold chain. Furthermore, this presentation will present the environmental impact of metallic conductive inks, a comparison with promising conductive polymers, evaluation of energy vs. performance of industrial printing processes, a full assessment of the impact from the smart label applied on a cellulosic-based substrate during the recycling process and the possible recovery of precious metals and rare earth elements.

Keywords: Eco-design, label, life cycle assessment, printed electronics

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Authors: Mekonen G., Sileshi M., Melkamu M.

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Recharge estimation is important for the assessment and management of groundwater resources effectively. This study applied the soil moisture balance and Baseflow separation methods to estimate groundwater recharge in the Fetam Catchment. It is one of the major catchments understudied from the different catchments in the upper Blue Nile River basin. Surface water has been subjected to high seasonal variation; due to this, groundwater is a primary option for drinking water supply to the community. This research has been conducted to estimate groundwater recharge by using fifteen years of River flow data for the Baseflow separation and ten years of daily meteorological data for the daily soil moisture balance recharge estimating method. The recharge rate by the two methods is 170.5 and 244.9mm/year daily soil moisture and baseflow separation method, respectively, and the average recharge is 207.7mm/year. The average value of annual recharge in the catchment is almost equal to the average recharge in the country, which is 200mm/year. So, each method has its own limitations, and taking the average value is preferable rather than taking a single value. Baseflow provides overestimated result compared to the average of the two, and soil moisture balance is the list estimator. The recharge estimation in the area also should be done by other recharge estimation methods.

Keywords: groundwater, recharge, baseflow separation, soil moisture balance, Fetam catchment

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Authors: Steven Wright

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This paper argues that there is an opportunity for PCH to further expand its relevance within the Canadian policy context by taking advantage of the growing international trend of using social indicators for public policy evaluation. Within the mandate and vision of PCH, there is an incomplete understanding of the value that the arts and culture provide for Canadians, specifically with regard to four social indicators: community development, civic engagement, life satisfaction, and work-life balance. As will be shown, culture and the arts have a unique role to play in such quality of life indicators, and there is an opportunity for PCH to aid in the development of a comprehensive national framework that includes these indicators. This paper lays out approach to understanding how social indicators may be included in the Canadian context by first illustrating recent trends in policy evaluation on a national and international scale. From there, a theoretical analysis of the connection between cultural policy and social indicators is provided. The second half of the paper is dedicated to explaining the shortcomings of Canadian cultural policy evaluation in terms of its tendency to justify expenditures related to arts and cultural activities in purely economic terms, and surveying how other governments worldwide are leading the charge in this regard.

Keywords: social indicators, evaluation, cultural policy, arts

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Authors: Vijaya Kumar, Vidayasagar Pagilla, Abraham Joshua, Rakshith Kedambadi, Prasanna Mithra

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Background: Post stroke rehabilitation are aimed to accelerate for optimal sensorimotor recovery, functional gain and to reduce long-term dependency. Intensive physical therapy interventions can enhance this recovery as experience-dependent neural plastic changes either directly act at cortical neural networks or at distal peripheral level (muscular components). Neuromuscular Electrical Stimulation (NMES), a traditional bottom-up approach, mirror therapy (MT), a relatively new top down approach have found to be an effective adjuvant treatment methods for lower extremity motor and functional recovery in stroke rehabilitation. However there is a scarcity of evidence to compare their therapeutic gain in stroke recovery.Aim: To compare the efficacy of neuromuscular electrical stimulation (NMES) and mirror therapy (MT) in very early phase of post stroke rehabilitation addressed to lower extremity motor recovery and balance. Design: observer blinded Randomized Clinical Trial. Setting: Neurorehabilitation Unit, Department of Physical Therapy, Tertiary Care Hospitals. Subjects: 32 acute stroke subjects with first episode of unilateral stroke with hemiparesis, referred for rehabilitation (onset < 3 weeks), Brunnstorm lower extremity recovery stages ≥3 and MMSE score more than 24 were randomized into two group [Group A-NMES and Group B-MT]. Interventions: Both the groups received eclectic approach to remediate lower extremity recovery which includes treatment components of Roods, Bobath and Motor learning approaches for 30 minutes a day for 6 days. Following which Group A (N=16) received 30 minutes of surface NMES training for six major paretic muscle groups (gluteus maximus and medius,quadriceps, hamstrings, tibialis anterior and gastrocnemius). Group B (N=16) was administered with 30 minutes of mirror therapy sessions to facilitate lower extremity motor recovery. Outcome measures: Lower extremity motor recovery, balance and activities of daily life (ADLs) were measured by Fugyl Meyer Assessment (FMA-LE), Berg Balance Scale (BBS), Barthel Index (BI) before and after intervention. Results: Pre Post analysis of either group across the time revealed statistically significant improvement (p < 0.001) for all the outcome variables for the either group. All parameters of NMES had greater change scores compared to MT group as follows: FMA-LE (25.12±3.01 vs. 23.31±2.38), BBS (35.12±4.61 vs. 34.68±5.42) and BI (40.00±10.32 vs. 37.18±7.73). Between the groups comparison of pre post values showed no significance with FMA-LE (p=0.09), BBS (p=0.80) and BI (p=0.39) respectively. Conclusion: Though either groups had significant improvement (pre to post intervention), none of them were superior to other in lower extremity motor recovery and balance among acute stroke subjects. We conclude that eclectic approach is an effective treatment irrespective of NMES or MT as an adjunct.

Keywords: balance, motor recovery, mirror therapy, neuromuscular electrical stimulation, stroke

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