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OBJECTIVE: To investigate the effects of combination functional electrical stimulation (FES) and standing frame training on standing balance in stroke patients. METHODS: Patients who had hemiparesis and postural instability after stroke were randomly assigned to one of the two groups; study group underwent FES on the quadriceps and tibialis anterior muscle simultaneously with standing balance training. The control group received standing frame training and FES separately. Both the groups received their respective therapies for 3 weeks. Stability index in Biodex Balance master system, Berg Balance Scale (BBS), manual muscle test, the Korean version of Modified Barthel Index, and Korean version of Mini-Mental State Examination were used to evaluate the effects of the treatment. RESULTS: In total, 30 patients were recruited to the study group and 30 to the control group. Three weeks after treatment, both the groups showed improvement in postural stability scores and physical and cognitive functions. When changes in postural stability were compared between the groups, the study group showed more significant improvement than the control group with regards to the scores of BBS and the stability indices. CONCLUSION: In this study, we found the therapeutic effectiveness of combined therapy of FES and standing frame in subacute stroke patients. The presented protocol is proposed as time-saving and can be applied easily in the clinical setting. Thus, the proposed combined therapy could be a useful method for improving standing balance in subacute stroke patients.
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Humans , Cognition , Electric Stimulation , Methods , Paresis , Rehabilitation , StrokeABSTRACT
This study aimed to evaluate dynamic balance capability, bathyesthesia, and the composite compensation of bathyesthesia and visual sense for dynamic balance assessed by use of force plates and to examine their correlation to age in a cross-sectorial manner. Participants of this study were 147 healthy people (55 men, 92 women). To evaluate dynamic balance capability, we evaluated the index of postural stability (IPS), which is the logarithmic value of the ratio of the area of stability limits to the area of postural sway, with participants standing on a hard surface with eyes opened. To measure bathyesthesia, we evaluated the modified index of postural stability (MIPS), i.e., the IPS with participants standing on a soft surface with eyes closed. As for the composite compensation index of bathyesthesia and visual sense for dynamic balance, we calculated the rubber IPS Romberg ratio (MIPS/IPS). The correlation coefficients (Spearman’s rho) of IPS, MIPS and MIPS/IPS to age were −0.666 (p < 0.001), −0.697 (p < 0.001) and −0.600 (p < 0.001), respectively. These results suggest that dynamic balance capability and bathyesthesia decline with advancing age, and the composite compensation of bathyesthesia and visual sense for dynamic balance strengthens with advancing age.
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Objective To investigate the influence of proprioceptive training of hemiplegic stroke patients on their visually compensatory dependence.Methods Twenty stroke patients without vestibular abnormalities were recruited.They were able to walk for 10 meters.All the patients underwent 4 weeks of rehabilitation training including proprioceptive training,treadmill exercises and isometric muscle strengthening.Static standing balance test was performed before and after 4 weeks of treatment.The parameters such as the anteroposterior and mediolateral sway of the center of gravity,center of gravity distribution were analyzed before and after the treatment,taking into consideration of visual feedback (eyes open or closed) by using t-test and multiple linear regression analysis.Results Visual feedback had significant no influence on the anteroposterior sway of center of gravity before and after training (P ＞ 0.05) ; Visual feedback had significant influence on mediolateral sway of center of gravity.Rehabilitation training significantly improved the mediolateral sway in opened-eye standing (P ＜ 0.05) but not closedeye standing (P ＞ 0.05).Visual feedback played significant role in center of gravity distribution after training (P ＜ 0.05).Conclusions Visual compensation is of significant influence on the mediolateral sway.Proprioceptive training can help decrease the patient's dependence on visual feedback and enhance the patient's balance ability.
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It has been pointed out that a biased perception of the subjective visual vertical (SVV) in stroke patients might be related to balance deficits and impaired activities of daily living (ADL). The relationship between SVV and static balance in stroke patients, however, still remains unclear. Thus we examined the relationship between SVV and standing balance in 29 hemiparetic patients with a first-ever supratentorial stroke. We measured the rotation angle formed by a subjective vertical and the gravitational vertical (rotation to the non-paretic side was set as positive) 8 times, and employed the mean value as the SVV value. We also calculated the absolute rotation angle for each time and employed the mean value as the absolute SVV value. Then we evaluated postural balance using four stabilometer parameters : length of center of pressure per time (LNG/T), envelopment area (ENV), root mean square (RMS) and weight-bearing asymmetry (WBA) during standing. The relationship between the SVV values or the absolute SVV values and the four stabilometer parameters were analyzed using the Spearman's rank correlation coefficient. The mean values for SVV and absolute SVV of all participants were -0.3±2.3° and 2.0±1.5°, respectively. The absolute SVV value and each of the four parameters were positively correlated with statistical significance (LNG/T ; <i>r</i>=0.44, ENV ; <i>r</i>=0.41, RMS ; <i>r</i>=0.46, WBA ; <i>r</i>=0.40), while there was no statistically significant correlation between the SVV value and each of them. These results suggest that the SVV bias size is possibly related to standing balance in stroke patients.
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Objective To explore the effects of sole desensitization physical therapy on standing balance and walking function among recovering stroke patients.MethodsStroke patients who met the inclusion criteria were randomly assigned to the observation group (40 cases) or the control group (40 cases). All patients received traditional rehabilitation. In addition, the observation group received sole densensitization physical therapy. The total course of treatment lasted for 1 month. The Berg balance scale (BBS) and Holden's functional ambulation classification (FAC) were used to evaluate balance and walking ability before and after treatment. The Fugl-Meyer assessment (FMA) was used to assess the motor function of the affected ankle, and footprint analysis was used to measure and record any changes in time and distance walked and to analyze improvements in gait.ResultsAfter the sole desensitization training, the BBS (37.41 ± 8.14), FAC ( 3.91 ±0.92) and FMA motor function (6.42 ± 1.12) results of the observation group were all significantly better than before training. Walking time and distance also improved.ConclusionsSole desensitization can affect foot proprioception. As a result, stroke patients' soles adapt to the surroundings, recover their ability to provide physiological support and promote improved motor function of the ankle.Sole desensitization can thus improve the standing balance and walking of stroke patients.
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OBJECTIVE: To evaluate the effects of transcutaneous electrical nerve stimulation (TENS) applied at lower extremity for standing balance in patients with hemiplegia. METHOD: Twenty-two hemiplegic patients were tested while standing on balance trainer under eight stimulation modes (No TENS, bilateral TENS, hemiplegic TENS, and unaffected TENS. These four conditions were applied both with and without vision). All patients were able to stand independently more than five minutes. TENS was applied with pulse width 200micron s, frequency of 100 Hz, amplitude set at the sensory detection threshold of each patients. TENS was applied thirty seconds for each stimulation modes, and resting period was 10 minutes. Postural sway was determined during the testing period by the sum of anterior-posterior (AP) center of pressure (COP) sway, medio-lateral (ML) COP sway, and total sum of COP sway. Also postural sway was determined by proportion of time of COP in three circles, which semidiameters are 10 mm, 20 mm, 30 mm each. RESULTS: When patients were applied with TENS eyes closed at the unaffected lower extremity, AP, ML, and total sum of COP sway decreased significantly. CONCLUSION: In hemiplegic patients with independent standing, TENS application at the unaffected leg over five minutes can be helpful standing balance enhancement.
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Humans , Eye , Hemiplegia , Leg , Lower Extremity , Proprioception , Transcutaneous Electric Nerve StimulationABSTRACT
Objective To study the effect of modified sensorimotor training (SMT) method on standing ba- lance of the stroke patients during their recovery stage. Methods Sixty stroke patients at recovery stage were ran- domly divided into an intervention group and a control group. The intervention group was trained by modified SMT method which combined Thera-band with partial body weight support (PBWS) system, while the control group was trained only with their standing balance in the parallel bars based on the neurodevelopment therapy (NDT) method. Both groups were given the same medications as well as physical therapy, acupuncture and OT. The patients in the two groups practiced standing balance in front of a mirror daily, 40 minutes every day and 6 days every week for 4 weeks. The balance abilities of patients were evaluated by Berg balance scale (BBS) , and their lower extremity func- tions were assessed by simplification Fugl-Meyer assessment (FMA). Results After training, both groups showed significant improvement in BBS and FMA ( P
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OBJECTIVE: To examine the validity of the fuctional reach test (FRT) for evaluation of standing balance in hemiplegic patients. METHOD: Twenty three hemiplegic patients who were capable of standing without assistive devices were assessed on the FRT only with intact upper limb, the one-legged stance, the timed up and go test (TUG), the 10 meter walking time (10 mWT), the 'Hauser' ambulation index (AI), and the standing balance of Bohannon. RESULTS: The forward reach of FRT demonstrated significant correlation with the TUG and the 10 mWT (p<0.01), but no significant relationship with the one-legged stance, standing balance of Bohannon and AI. CONCLUSION: The forward reach of FRT may be simple and useful tool for assessing the clinical balance function and reflecting gait ability and fall-down risk in hemiplegic patients.
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Humans , Gait , Gait Disorders, Neurologic , Self-Help Devices , Upper Extremity , WalkingABSTRACT
@#73 patients with cervical vertebra syndrome have been examined by body balance function with Japanese centre of gravity vacillate instrument. In six basis indexes. 58 patients with two or more abnormal, (80%). 11 Patients, one abnormal, (15%) only 4 had normal indexes (5%), but the centre of gravity chart showed two of them at middle pattern, one at disperse,another at polycentric pattern. The rate of difference remarkble cheek was significant (p>2.58, P<0.01)The examination of body balance function and the index has quantitative analysis significance. It can be effective method for assistant diagnosis and healing effective observation on certebra syndrome