The effectiveness of additional core stability exercises in improving dynamic sitting balance, standing balance, lower-limb spasticity, falls and gait in subacute stroke patients (CORE-trial). Study protocol for a Randomized Controlled Trial (original) (raw)
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Effects of core strengthening exercises on dynamic balance and gait speed in stroke survivors
2018
Independent ambulation is the ultimate goal of post-stroke rehabilitation, of which dynamic balance is a primary requirement. Core stability is said to be essential to balance and independent ambulation, however, core strengthening exercises have often been omitted in stroke rehabilitation. The study sought to determine the effects of core strengthening exercises on dynamic balance and gait speed in stroke survivors. A total of 48 stroke survivors participated in this study. A simple random sampling in which participants were consecutively allocated into experimental and control groups was employed. The experimental group received core strengthening exercise in addition to conventional exercise while the control group had conventional exercise only. Dynamic balance was measured by maximum reach distances and gait speed was evaluated using 10-mteres walk test. Assessment of dynamic balance and gait speed was performed before treatment and six weeks after. There was no significant dif...
Objective: To compare the effects of core the strengthening versus lower limb proprioceptive neuromuscular facilitation (PNF) techniques on trunk function and balance in chronic stroke patients. Methods: The randomized controlled trial (RCT) took place at Itiefaq hospital & Riphah Rehabilitation Centre, Lahore, Pakistan. Participants consisted of individuals of both sexes aged between 40 and 70 who were suffering from chronic stroke (6 months to 2 years). Two groups were randomly assigned; Group A received a combination of core strengthening exercises with conventional treatment, while Group B underwent PNF therapy alongside conventional treatment. Outcome measures were evaluated using the Trunk Impairment Scale (TIS) and Berg Balance Scale (BBS). Results: Out of 42 patients, there were 21 patients in each of the two groups. Between each group, scores for BBS and TIS showed statistically significant results, as evidenced by a p-value of <0.05. Within-group analysis revealed significant findings across all parameters. In contrast, the comparison between groups showed insignificant results for the TIS, as the p-value exceed 0.05. Between group results were significant in case of Berg Balance Scale (p<0.05). Conclusion: The research concluded that applying core strengthening exercises and lower limb proprioceptive neuromuscular facilitation techniques enhanced the balance and trunk function in individuals with the chronic stroke.
International Journal of Environmental Research and Public Health
Stroke is one of the main causes of disability. Telerehabilitation could face the growing demand and a good strategy for post-stroke rehabilitation. The aim of this study is to examine the possible effects of therapeutic exercises performed by an App on trunk control, balance, and gait in stroke survivors. A preliminary 12-week randomized controlled trial was developed. Thirty chronic stroke survivors were randomly allocated into two groups. Both groups performed conventional physiotherapy, in addition to, the experimental group (EG) had access to a telerehabilitation App to guide home-based core-stability exercises (CSE). Trunk performance was measured with the Spanish-Trunk Impairment Scale (S-TIS 2.0) and Spanish-Function in Sitting Test. Balance and gait were measured with Spanish-Postural Assessment Scale for Stroke patient, Berg Balance Scale and an accelerometer system. In EG was observed an improvement of 2.76 points in S-TIS 2.0 (p = 0.001). Small differences were observed ...
2013
Introduction: Balance dysfunction, particularly in standing, is a devastating sequel to stroke since the ability to balance is one of the most critical motor control factors in daily life. Physiotherapists use a variety of balance and stability techniques as a part of treatment programmes to improve functional independence in patients following a stroke. However more scientific evidence for the effectiveness of these techniques or programs is required. Purpose: The purpose of this study was to quantify the effect of a balance and stability training program on stability, balance and functional independence in stroke patients. Method: The aims of this study were achieved using a randomised controlled trial. A questionnaire allowed the collection of demographic data from fifty participants who had suffered the first stroke, regardless of gender or race. The Postural Assessment Scale for Stroke patients (PASS), Berg Balance Scale (BBS), Barthel Index (BI) and questionnaire were administered to all fifty participants on the first and last weeks of a twelve week physiotherapy program. For ten weeks twenty five randomly assigned participants in each of the control and experimental groups underwent either normal physiotherapy or stability and balance intervention exercise program respectively. Data Analysis: The raw data was normalized by calculating percent changes for each item for each participant and the pooled data subjected to Wilcoxon signed ranks testing, paired samples signed tests and Pearson's correlations. Results: PASS, BBS and BI scores increased significantly from pre-test to post-tests in both groups, with greater changes noted in the experimental group, showing improvements in stability, balance and function. In addition a strong and significant correlation between stability scores and balance scores suggested that stability is important to improve balance. Similarly a strong and significant correlation between stability and balance scores with function scores confirms the value of stability and balance in improving function. It was further noted that in addition to a certain degree of spontaneous recovery, traditional physiotherapy programs also result in improvement in stability, balance and function but not to the same extent as with the program of treatment which emphasizes stability and balance exercises. Conclusion: A significant improvement in the stability, balance and function in stroke patients was achieved with the balance and stability intervention program. Conventional physiotherapy methods also improved stability, balance and function, but to a lesser extent than the balance and stability training. Contents
2021
In stroke, there is paralysis or weakness of one side of the body including upper limb, trunk and lower limb leading to the disturbances in the trunk muscles. Trunk is often neglected part in the stroke rehabilitation, trunk training exercises and Swiss ball exercises results in better recruitment of trunk muscles thus improving sitting balance. To compare the effect of core strengthening exercises on Swiss ball and Conventional exercise, to improve trunk balance in hemiplegic patients following stroke. A total number of 70 subjects were screened as per inclusion and exclusion criteria. The subjects were divided into two groups, Group-A received core strengthening exercises on Swiss ball along with conventional treatment and Group-B received core strengthening exercises along with conventional treatment. Subjects showed improvement in trunk balance following 6 weeks of core strengthening exercises.Post-intervention the TIS, BBA and MBI score of both groups improved but the Group-A i...
Effects of Exercise Therapy on Balance Capacity in Chronic Stroke
Stroke, 2016
A fter stroke, a main goal of rehabilitation is to promote independence in activities of daily living. An important determinant of activities of daily living performance is standing balance, which is a strong predictor of functional recovery 1,2 and walking capacity 3,4 and an important risk factor for falls 5 after stroke. Although the vast majority (75%) of people after stroke regain independent standing-balance capacity, 6 weightbearing asymmetry and increased postural sway often persist, as well as a diminished capacity to voluntarily shift body weight or to withstand external perturbations. 7 Hence, a key Background and Purpose-The purpose of this systematic review and meta-analysis was to investigate the effects of exercise training on balance capacity in people in the chronic phase after stroke. Furthermore, we aimed to identify which training regimen was most effective. Methods-Electronic databases were searched for randomized controlled trials evaluating the effects of exercise therapy on balance capacity in the chronic phase after stroke. Studies were included if they were of moderate or high methodological quality (PEDro score ≥4). Data were pooled if a specific outcome measure was reported in at least 3 randomized controlled trials. A sensitivity analysis and consequent subgroup analyses were performed for the different types of experimental training (balance and/or weight-shifting training, gait training, multisensory training, high-intensity aerobic exercise training, and other training programs).
Effect of trunk control exercises on balance and gait in stroke patients-randomized control trial
International journal of physical education, sports and health, 2018
Background Sub-acute stroke patients suffer from impaired trunk control due to the affection in brain. Due to the impaired trunk control with affected shoulder girdle and lower limb strength is seen. Patient undergoes difficulty resulting into affected daily activities like sitting, standing, getting up from sit to stand, turning around. Aim: To study the effects of trunk control exercises on gait and balance of trunk in stroke patients. Objectives: 1-To study effects of trunk control exercises on gait using dynamic gait index in stroke patient 2-To study effects of trunk control exercises on balance using berg balance scale in stroke patients. Methodology: 30 samples were taken from age group 40yrs to 60yrs with mean age of (47.466±) were selected and Assessment was done on trunk impairment scale, berg balance scale for assessing trunk, balance and dynamic gait index scale for assessing the balance and gait. Group A were given conventional exercises and 15 samples with group B were given trunk control exercises with conventional exercises. Total 3 sessions per week for 4 weeks were given. The pre and post readings were compared for trunk impairment scale with berg balance scale and dynamic gait index which shows more significant improvement in experimental group (p<0.0001). Conclusion: Trunk control exercises with conventional exercises found to be more effective than conventional exercises in stroke patients.
Frontiers in Neurology, 2020
Stroke survivors show greater postural oscillations and altered muscular activation compared to healthy controls. This results in difficulties in walking and standing, and in an increased risk of falls. A proper control of the trunk is related to a stable walk and to a lower falling risk; to this extent, rehabilitative protocols are currently working on core stability. The main objective of this work was to evaluate the effectiveness of trunk and balance training performed with a new robotic device designed for evaluation and training of balance and core stability, in improving the recovery of chronic stroke patients compared with a traditional physical therapy program. Thirty chronic stroke patients, randomly divided in two groups, either underwent a traditional rehabilitative protocol, or a robot-based program. Each patient was assessed before and after the rehabilitation and at 3-months follow-up with clinical and robot-based evaluation exercises focused on static and dynamic balance and trunk control. Results from clinical scores showed an improvement in both groups in balance and trunk control. Robot-based indices analysis indicated that the experimental group showed greater improvements in proprioceptive control, reactive balance and postural control in unstable conditions, compared to the control group, showing an improved trunk control with reduced compensatory strategies at the end of the training. Moreover, the experimental group had an increased retention of the benefits obtained with training at 3 months follow up. These results support the idea that such robotic device is a promising tool for stroke rehabilitation.