Proprioceptive Training versus Progressive Adaptive Physical Activity on Balance in Subjects with Sub-Acute Stroke (original) (raw)
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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).
Effects of phase proprioceptive training on balance in patients with chronic stroke
Journal of Physical Therapy Science, 2017
This study aimed to investigate the effect of phase proprioceptive training on balance in patients with chronic stroke. [Subjects and Methods] Participants included 30 patients with stroke who were randomly assigned to the proprioceptive training group (n=15) or control group (n=15). Participants in the proprioceptive training group underwent proprioceptive training and received general physical therapy each for a total of 20 thirtyminute sessions, five times per week, during a period of four weeks; the control group received general physical therapy for a total of 20 sixty-minute sessions, five times per week, during a period of four weeks. [Results] All participants were evaluated with the Berg Balance Scale, Timed Up and Go (TUG) test, and Activities-specific Balance Confidence (ABC) Scale instrument before and after intervention. After training, the differences in BBS, TUG, and ABC scores in the proprioceptive group were significantly greater than those in the control group. [Conclusion] In conclusion, proprioceptive training was effective on balance ability. Therefore, proprioceptive training may be efficient when combining general physical therapy with phase proprioceptive training for patients with impairments of balance. Further research is needed to investigate proprioceptive training methods.
PM & R : the journal of injury, function, and rehabilitation, 2014
To compare the effect of a balance and stability-focused outpatient community-based rehabilitation and a regular physiotherapy program on balance, stability, and perceptions of improvement after acute stroke. A randomized controlled trial in a community-based therapy center. Fifty consecutive patients with a first stroke, who reported to a community-based therapy center over a 7-month period were allocated to the control group (regular physiotherapy) or the experimental group (balance and stability-focused rehabilitation). A program of physiotherapy focused on balance and stability exercises. The control group received the regular physiotherapy program. The Postural Assessment Scale for Stroke Patients (PASS) and the Berg Balance Scale (BBS) monitored stability and balance. The normalized data (PASS and BBS) were analyzed by using analysis of covariance. Qualitative data were thematically described. Internal consistency of baseline PASS and BBS scores was high (Cronbach α, .964 and ...
Pakistan biomedical journal, 2022
The mortality rate is higher in underdeveloped countries. In Pakistan, however, there is no speci c stroke estimate. The annual occurrence rate is likely to be 250 per 100,000, with 350 expected in the near future [1]. The most wellknown cause of death in the world is stroke. For the rst time, Hippocrates (the father of medicine) coined the term 'apoplexia' to describe the sudden blackout and loss of function caused by a cerebrovascular accident [2]. Stroke has a negative in uence on families due to poor dietary habits [3]. Imbalance is a signi cant aspect of stroke; this attribute demonstrates impairment in both ne and di cult activities; balance incoordination is the most accurate predictor of falls, which also causes panic in stroke patients. The risk of fall con nes the patient from daily activities. That's why balance training needs to be done in post-stroke patients [4,5]. The bene ts of training include developments in functional consequences such as activities of daily living and instrumental activities of daily living [6]. There are a lot of people who have had both acute and chronic strokes. If a person survives a stroke, he will
International Journal of Current Pharmaceutical Research
Objective: Stroke is a leading cause of mortality and disability worldwide. Balance impairment is a common issue among stroke survivors, leading to increased fall risk and decreased quality of life. Visual and verbal cues have shown the potential in improving balance in stroke patients. This study aimed to compare the effectiveness of conventional therapy alone versus conventional therapy combined with visual and verbal cues in balance training during stroke recovery. Methods: Thirty participants with post-stroke hemiplegia were randomly assigned to either a control group or an experimental group. The control group received conventional physical therapy, while the experimental group received additional visual and verbal feedback. The Berg Balance Scale was used to assess balance on the 1st, 15th, and 30th days of the study. Results: Both groups showed improvements in balance over the course of the study. On the 15th day, the experimental group had a significantly higher mean Berg Ba...
The effect of gait training and exercise programs on gait and balance in post-stroke patients
Medical Express, 2015
The aim of this review is to evaluate studies about gait training and exercise interventions applied to patients following chronic stroke on gait and balance. The studies included in this review were random clinical trials, including only chronic post-stroke individuals that evaluated gait and balance outcomes and with a PEDro scale score ≥ 7.0. Eight studies were selected. The results suggest gait and balance will only be affected in chronic post-stroke patients if training sessions last at least 30 minutes, are repeated three times a week, and maintained for at least five weeks. Gait training affects how chronic post-stroke individuals walk. They will probably walk faster and with a lower risk of falling; however, it is unclear whether the consequences of these procedures affect the quality of life.
Impact Of Balance Training and Coordination Exercises in Post Hemiplegic Stroke Patients
Pakistan BioMedical Journal
A medical condition that occurs due to interrupted blood supply to the brain leading to restricted oxygen supply to the tissues resulting in cell death is known as “stroke”. It is considered as a second leading cause of death globally and a major cause of disabilities for the patients surviving from its fatality. Monoplegia, Diplegia, Hemiplegia, Quadriplegia, hemiparesis are all the different gifts of the stroke given to multiple patients suffering from it. Objective: The aim of the study was to evaluate the difference between the hemiplegic stroke patients who have undergone physical therapy treatment in contrast to those patients who have not taken any physical therapy treatment. Methods: Cross sectional study design was selected for the performance of the research. Research setting was a Government Sector Hospital. Specific balance and coordination exercises were given to the hemiplegic stroke patients and their effect was observed in the term of their recovery speed. Out of sam...
Effect of Balance Training on Postural Control and Risk of fall in Stroke Patients
Background: Purpose of this study was to investigate of effect of visual feedbackbalance training on postural control and risk of fall in stroke patients. Methods: Forty stroke patients were included in this study. Their age ranged from40-60 years. They were evaluated using the Biodex Balance System pre and posttreatment. They were divided intotwo equal groups (control group and study groups).Subjects in both groups participated in the conventionalstroke rehabilitationprogram, one hour /day/ 5 days/week /3 successive monthsin addition, subjects in thestudy group received a 20 min of balance training once daily,five days a week for3 months using the Biodex Balance System (BBS). Results: Significantimprovements in balance training measurements were found in thetrained group at 3 months after completing the training program. Conclusion:Patients in thevisual feedback balance training group had significant improvements whencompared with the control group in term of improving of postural control anddecreasing of risk of fall. The results showed that balance training was beneficial forpatients after hemiplegic stroke.
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
Arch Phys Med Rehabil, 2004
de Haart M, Geurts AC, Huidekoper SC, Fasotti L, van Limbeek J. Recovery of standing balance in postacute stroke patients: a rehabilitation cohort study. Arch Phys Med Rehabil 2004;85:886–95.To identify and interrelate static and dynamic characteristics of the restoration of quiet standing balance in a representative sample of stroke survivors in the Netherlands during their inpatient rehabilitation.Exploratory study using an inception cohort with findings related to reference values from healthy elderly persons.Rehabilitation center.Thirty-seven inpatients (mean age, 61.6y; mean time poststroke, 10.0wk) with a first hemispheric intracerebral infarction or hematoma who were admitted to retrain standing balance and walking.Individualized therapy.Center of pressure fluctuations were registered under each foot and in the sagittal and frontal planes separately by using a dual-plate force platform. The first balance measurements took place as soon as patients were able to stand unassisted for at least 30 seconds as well as 2, 4, 8, and, 12 weeks later. Quiet standing was assessed under 4 conditions: with and without a visual midline reference, with the eyes closed, and while performing a concurrent arithmetic task.The stroke patients showed excessive postural sway and instability, particularly in the frontal plane, compared with reference values. Frontal plane balance was, however, also most responsive to the effects of balance training and recovery (P<.001). The degree of visual dependency for frontal plane balance control showed a significant reduction in time (P<.02). Weight-bearing asymmetry, which was most pronounced in patients with disturbed sensibility or ankle clonus, diminished considerably during the first 4 weeks of the follow-up period (P<.02). Yet, a substantial degree of weight-bearing asymmetry persisted during the 8 weeks thereafter, and it continued to be aggravated by attentional distraction (P<.001). During the same period, static asymmetry (ie, the degree of pes equinovarus loading at the paretic side) and dynamic asymmetry (ie, the extent to which compensatory ankle moments are applied at the nonparetic side) did not show normalization at all, although motor selectivity of the paretic leg improved by 1 stage on the 6-stage Brunnstrom scale (P<.001) and the independency level of balance and walking skills improved by 2 points on the 6-point Functional Ambulation Categories (P<.001).Balance recovery in postacute stroke inpatients is characterized by a reduction in postural sway and instability as well as by a reduction in visual dependency, particularly with regard to frontal plane balance. These restoration characteristics may be important factors underlying the relearning of independent standing and walking abilities. The clear lack of normalization for measures reflecting static and dynamic aspects of postural asymmetry suggests that the functional improvements in balance and gait must be more related to other mechanisms than to the restoration of support functions and equilibrium reactions of the paretic leg.