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OBJECTIVE: To investigate the dose-related effect of trunk control training (TCT) using Trunk Stability Rehabilitation Robot Balance Trainer (TSRRBT) in chronic stroke patients with poor sitting balance. METHODS: This was a retrospective study of 38 chronic stroke patients with poor sitting balance that underwent TCT with TSRRBT. The participants were assigned either to the low-dose training (LDT) group (n=18) or to the highdose training (HDT) group (n=20). In addition to the conventional rehabilitation therapy, the LDT group received 5 sessions of TSRRBT intervention per week, whereas the HDT group received 10 sessions of TSRRBT intervention per week. The outcome measures were the scores on the Trunk Impairment Scale (TIS) and its subscales, Berg Balance Scale (BBS), Functional Ambulation Classification (FAC), and the Korean version of Modified Barthel Index (K-MBI). All outcome measures were assessed before the training and at the end of the 4-week training. RESULTS: After the 4-week intervention, TIS, BBS, FAC, and K-MBI scores showed improvement in both LDT and HDT groups. Furthermore, the improvements in TIS scores and its subscales were significantly greater in the HDT group than in the LDT group (p < 0.05). CONCLUSION: TCT using TSRRBT could be an additional treatment for the conventional rehabilitation therapy of chronic stroke patients with poor sitting balance. HDT may provide more beneficial effects on improving patients’ sitting balance than LDT.
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Humans , Biofeedback, Psychology , Classification , Outcome Assessment, Health Care , Rehabilitation , Retrospective Studies , Stroke , Video Games , WalkingABSTRACT
Background: Following stroke static as well as dynamic components of postural control were affected. Ability to maintain postural alignment is also a vital component of the postural control system. Pelvic asymmetry is commonly observed in stroke subjects which can influence trunk control. However, there is a paucity of literature that determines the relationship between pelvic alignment and trunk control in subjects with stroke. Aim: To analyze the relationship between pelvic alignments using PALM and trunk control as measured by the Trunk Impairment Scale (TIS). Setting: Inpatient rehabilitation unit, Tertiary Care Hospitals, Mangalore. Design: A cross-sectional study. Subjects: 38 supra-tentorial stroke subjects with more than 3 weeks duration and who can be able to sit independently were recruited. Methods: The medio-lateral pelvic alignment of the stroke subjects was measured in sitting using the PALM™. The deviation in the pelvic tilt on the paretic side in comparison to the non-paretic side was measured in degrees. Following which the trunk control was evaluated using the Trunk Impairment Scale. Results: The correlation between the pelvic tilt and the trunk control in the stroke subjects showed a negative correlation which indicates that a change in the pelvic alignment which affects the trunk control. Pelvic tilt values negatively correlated with all the sub-items of trunk impairment scores (p < 0.00). The pelvic tilt and the items of TIS scores. Brunnstrom’s stage of lower extremity Motor Recovery demonstrated a significant association (p < 0.05), except for the coordination sub score of the TIS. Conclusion: Pelvic alignment influences the trunk control and is also available to be associated significantly with the acute phase of stroke (3 weeks to 3 months). Brunnstrom’s Stage of lower extremity motor recovery is also associated significantly with the static and dynamic sub scores of the TIS, hence trunk control may influence extremity motor recovery.
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@#Objective To investigate the effect of different head flexion/extension angles on static sitting balance in normal youth. Methods34 selected healthy college students were measured with the track length of the centre of gravity under eyes closed, head in a neutral position,flexed in 15°, 30°, 45°, and extended in 15°, 30° (30 s each position). Results the average length from small to big were: head flexedin 30°, neutral position, flexed in 15°, flexed in 45°, extended in 15°, extended in 30°. There was no significant difference among the averagelength when head flexed in 30°, in neutral position and flexed in 15° (P>0.05). Conclusion The static sitting balance is the most whenhead put in neutral position to flexed in 30°, and worst in extended in 30° in healthy youth.
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@#ObjectiveTo investigate the effects of strengthening internal and external abdominal oblique muscles on sitting balance in stroke patients with hemiplegia. Methods60 cases of patients with hemiplegia were randomly divided into treatment group and control group, 30 cases in each group. Control group patients were treated with conventional treatment. Internal and external abdominal oblique muscles training were accepted in treatment group in addition. Before and 1 month after treatment, all the patients were assessed with Fugl-Meyer Assessment of balance function and muscle strength. ResultsAfter treatment, the Fugl-Meyer assessment scores of balance, muscle strength were significantly higher in the treatment group than in the control group（P＜0.01）. ConclusionMuscle strengthen training in internal and external abdominal oblique muscles will promote sitting balance in hemiplegic patients.
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OBJETIVOS: Descrever uma nova metodologia de análise da oscilação postural estática sentada e comparar os resultados de jovens e idosos saudáveis. MÉTODOS: Participaram do estudo 38 indivíduos saudáveis, 17 jovens (idade média 23±2,38 anos) e 21 idosos (idade média 67±2,42 anos). A oscilação postural foi mensurada por meio do sistema eletromagnético Polhemus® 3Space Isotrack II. As avaliações foram feitas nas condições olhos abertos (OA) e fechados (OF), com os voluntários sentados sem apoio plantar e sem encosto em suportes de madeira (superfície estável-SE) e de espuma (superfície instável-SI). Cada condição sensorial foi avaliada durante 90 segundos. Os parâmetros analisados foram: deslocamento máximo (Dmáx), trajetória total (Traj) e velocidade média (Vel) nos planos sagital (X) e frontal (Y). RESULTADOS: Nas condições OA e OF em SE, foram encontradas oscilações nos planos X e Y dos parâmetros Traj e Vel maiores em jovens que em idosos. Em SI, foram observadas maiores Traj Y e Vel Y nos jovens, sem diferença significativa entre os grupos quanto a Traj X e Vel X com olhos fechados. Em relação ao Dmáx, tanto no plano X quanto no Y, em todas as condições sensoriais, só houve diferença significativa na condição OASE no plano sagital, sendo maior nos jovens. CONCLUSÕES: Jovens saudáveis oscilam mais que os idosos saudáveis na posição sentada. Além disso, a ferramenta utilizada mostrou ser útil para análise da oscilação postural estática na posição sentada, possibilitando o surgimento de estudos que a associem com o efeito de diversas tarefas motoras.
OBJECTIVES: To describe a new method to analyze the static sitting postural sway and to compare the results of healthy young and older adult subjects. METHODS: Thirty-eight healthy subjects took part in the study, including 17 young adults (mean age 23±2.38 years old) and 21 older adults (mean age 67±2.42 years old). The device used to quantify trunk sway was the magnetic field sensor Polhemus® 3Space Isotrack II. The measurements were taken in the eyes-opened (EO) and eyes-closed (EC) condition with the subjects seated first on a wooden stable surface (SS) then on a foam unstable surface (US) without back or foot support. Each sensory condition was assessed for 90 seconds. The analyzed parameters were: maximum amplitude (Amp), total trajectory (Traj) and mean velocity (Vel) in the sagittal (X) and frontal (Y) planes. RESULTS: In the EO and EC conditions on SS, young adults presented greater postural sway in the X and Y planes on the Traj and Vel parameters. In the US, young adults showed greater Y Traj and Y Vel in the EO and EC conditions, and there was no significant difference between the groups with regard to X Traj and X Vel in the EC condition. The young adults presented greater Amp only in the EOSS condition in the X plane. CONCLUSIONS: The young adult subjects presented greater sway in the sitting position than the older adult subjects. In addition, the Polhemus® device was a useful tool to analyze static sitting postural sway and can be used in future studies that associate static sitting postural sway with the effect of various motor tasks.
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The aim of this study is to investigate the relationship between wheelchair type and impairments among patients with Duchenne muscular dystrophy (DMD). Participants were 52 patients with DMD who used wheelchairs for daily locomotion. We assessed muscle strength, spinal deformity, sitting balance, respiratory function and ADL among 4 groups using different types of wheelchairs (manual wheelchair, manual wheelchair attached with powered component, powered wheelchair, and assist type wheelchair). Spinal deformity was related with wheelchair type. Muscle strength, peak flow and FIM motor score were significantly different among the four groups. The duration of daily use of ventilators was significantly different between the powered wheelchair users and the completely dependent group.
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OBJECTIVE: This study was aimed to compare the effect of visuo-perceptual biofeedback sitting balance training using Balance Master in stroke patients with that of conventional sitting balance training. METHOD: The subjects were twenty-four stroke patients receiving rehabilitation therapy who could maintain sitting posture independently. These patients were randomly divided into a control and an experimental group. The ability of static postural balance control with the modified Clinical Test Sensory Interaction Balance (mCTSIB) and the weight bearing test was measured before and after the balance training. The ability of dynamic postural balance control was measured with the limit of stability (LOS) test and the rhythmic weight shift test. Motor assessment scale (MAS) and modified Barthel index (MBI) were also checked for measuring the effects. RESULT: There was significant improvement in both abilities of static and dynamic postural balance control in the experimental group that had visuo-perceptual biofeedback training using the Balance Master (p<0.05). MAS and MBI scores after the training showed a bigger increase in the experimental group than in the control group. CONCLUSION: The visuo-perceptual biofeedback sitting balance training using the Balance Master was considered to be more effective than the conventional training in the stroke patients.