PURPOSE: The purpose of this study was to investigate the effect of balance training on different support surface (affected and non-affected sides) on the balance and gait function of chronic stroke patients. METHODS: The patients were randomly assigned to 1 of 4 groups. Group 1 received balance tra...
PURPOSE: The purpose of this study was to investigate the effect of balance training on different support surface (affected and non-affected sides) on the balance and gait function of chronic stroke patients. METHODS: The patients were randomly assigned to 1 of 4 groups. Group 1 received balance training on the stable surface, group 2 received balance training on the unstable surface, group 3 received balance training on different support surface (affected side: stable surface, non-affected side: unstable surface), and group 4 received balance training on different support surface (affected side: unstable, non-affected side: stable). Twelve sessions (30 min/d, 3 times/wk for 4 wk) were applied. There were assessed before and after the intervention with Balancia, functional reach test (FRT), lateral reach test (LRT), timed up-and-go (TUG), and 10-meter walking test (10MWT). RESULTS: After the training, all of the groups improved significantly than before training in Balancia, FRT, LRT, TUG, and 10MWT. There were significantly variable in sway distance, FRT, LRT, TUG, and 10MWT among the 4 groups. Post hoc analysis revealed that the group 3 had significantly higher results than other 3 groups in sway distance, and FRT, LRT, TUG, and 10MWT. CONCLUSION: Balance training on different support surface (affected side: stable surface, non-affected side: unstable surface) could facilitate a stronger beneficial effect on balance and walking ability than other balance trainings on different support surface in patients with stroke.
PURPOSE: The purpose of this study was to investigate the effect of balance training on different support surface (affected and non-affected sides) on the balance and gait function of chronic stroke patients. METHODS: The patients were randomly assigned to 1 of 4 groups. Group 1 received balance training on the stable surface, group 2 received balance training on the unstable surface, group 3 received balance training on different support surface (affected side: stable surface, non-affected side: unstable surface), and group 4 received balance training on different support surface (affected side: unstable, non-affected side: stable). Twelve sessions (30 min/d, 3 times/wk for 4 wk) were applied. There were assessed before and after the intervention with Balancia, functional reach test (FRT), lateral reach test (LRT), timed up-and-go (TUG), and 10-meter walking test (10MWT). RESULTS: After the training, all of the groups improved significantly than before training in Balancia, FRT, LRT, TUG, and 10MWT. There were significantly variable in sway distance, FRT, LRT, TUG, and 10MWT among the 4 groups. Post hoc analysis revealed that the group 3 had significantly higher results than other 3 groups in sway distance, and FRT, LRT, TUG, and 10MWT. CONCLUSION: Balance training on different support surface (affected side: stable surface, non-affected side: unstable surface) could facilitate a stronger beneficial effect on balance and walking ability than other balance trainings on different support surface in patients with stroke.
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문제 정의
This different support surface method could represent a viable new training option for the lower limb. The aim of this study was to investigate the effect of balance training on balance and walking ability on different support surface in patients with chronic stroke.
This study was conducted to examine the effects of balance training on balance and gait function by using different support surface types in chronic stroke patients. We investigated the effects of the training when applied on unstable and stable surfaces, each other on the surface to either side.
제안 방법
A 4-week training study was designed to evaluate the effect of different support surface types during balance training on balance and walking ability. All of the enrolled patents were randomly assigned to 1 of 4 groups by using a table of random numbers.
The participants were asked to reach forward as far as possible, while maintaining a standing position, with the shoulder joint at 90° flexion, the elbow and hand at full extension without base of support transfer.
The lateral reach test (LRT) can be used to measure lateral postural stability and lateral direction of COG transfer. The participants were asked to reach lateral postural stability by maintaining the standing position, with the shoulder joint at 90# abduction, the elbow and hand at extension without loss of balance. The distance change was measured at the tip of the finger when the lateral weight was heaviest during shifting from the standing position (Brauer et al, 1999).
This study was a double-blind, randomized controlled trial in which the therapist was blinded to the treatment. The assessor was experienced and qualified for using measurement tools.
대상 데이터
The subjects were 36 stroke patients admitted in the Department of Rehabilitation at B Hospital in Daejeon city. Patients who were admitted or transferred to our department because of unilateral hemiparesis caused by stroke were evaluated.
데이터처리
The chi-square test and one-way analysis of variance was used to analyze the homogeneity among the groups before the study. Because outcome measurement data showed parametric distributions, the paired t test was used to compare data obtained before and after treatment in each group. We calculated the treatment effects in each outcome measure as the change from pretreatment to post-treatment and compared this across the groups by using one-way analysis of variance.
이론/모형
0 for Windows (Chicago, IL, USA) was used for the statistical analysis. The chi-square test and one-way analysis of variance was used to analyze the homogeneity among the groups before the study. Because outcome measurement data showed parametric distributions, the paired t test was used to compare data obtained before and after treatment in each group.
The timed up-and-go test (TUG) was used as a dynamic balance test. This test records the time taken to rise from a chair (height: 50 cm), walk 3 m, turn around a marker, walk back to the chair, and sit down.
성능/효과
After treatment, there were significant differences the change in the sway distance (7.52 ± 2.78, vs. 14.99 ± 6.60 vs. 23.72 ± 11.91 vs. 8.65 ± 4.64, respectively, p < .00), FRT (1.78 ± 2.36 vs. 6.49 ± 1.83 vs. 11.08 ± 2.80 vs. 1.11 ± 0.84, respectively, p < .00), LRT (1.32 ± 0.81 vs. 3.58 ± 0.07 vs. 6.11 ± 2.07 vs. 1.26 ± 2.19, respectively, p < .00), TUG (2.34 ± 1.62 vs. 5.08 ± 3.56 vs. 16.79 ± 12.43 vs. 4.12 ± 8.38, respectively, p < .00, and 10MWT (3.23 ± 4.10 vs. 5.74 ± 3.95 vs. 11.64 ± 11.26 vs. 3.06 ± 2.93, respectively, p < .05).
17 weeks. No significant differences were observed in gender, side of stroke, type of stroke, duration since onset, age, weight, height, and MMSE among the groups at baseline (Table 1).
We investigated the effects of the training when applied on unstable and stable surfaces, each other on the surface to either side. The major finding of our study is that balance training on different support surface (affected side: stable surface, non-affected side: unstable surface) led to greater improvement in balance and walking ability than each of the other methods in the patients with chronic stroke. All 4 groups showed improvement in Balancia (sway distance & sway velocity), FRT, LRT, TUG test, and 10MWT results over time.
The results of this study seemed to indicate improved balance and gait function. Furthermore, balance training using different support surface trainings (the affected side on a stable surface and the non-affected side on an unstable surface), patients strived hard to maintain the position of the foot of the non-affected side on an unstable surface.
Smania et al (2008) conducted 2 weeks of UST in chronic stroke patients. This study showed that UST is more effective in reducing sway velocity and increasing muscle activation of the lower extremities. A significant correlation was found between the decrease of sway velocity and the increase of gastrocnemius and rectus femoris muscle activation (Seo and Kim, 2013).
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