Abstract
Background: Exercise-based conventional training has predominantly benefited fall-associated volitional balance control domain; however, the effect on reactive balance control is under-examined. Therefore, the purpose of this study was to examine the effect of exercise-based conventional training on reactive balance control. Methods: Eleven people with chronic stroke (PwCS) underwent multi-component training for six weeks (20 sessions) in a tapering manner. Training focused on four constructs-stretching, functional strengthening, balance, and endurance. Volitional balance was measured via movement velocity on the Limits of Stability (LOS) test and reactive balance via center of mass (COM) state stability on the Stance Perturbation Test (SPT). Additionally, behavioral outcomes (fall incidence and/or number of steps taken) were recorded. Results: Movement velocity significantly increased on the LOS test (p < 0.05) post-intervention with a significant decrease in fall incidence (p < 0.05). However, no significant changes were observed in the COM state stability, fall incidence and number of recovery steps on the SPT post-intervention. Conclusion: Although volitional and reactive balance control may share some neurophysiological and biomechanical components, training based on volitional movements might not significantly improve reactive balance control for recovery from large-magnitude perturbations due to its task-specificity.
Highlights
Stroke is the leading cause of long-term disability, and more than half of the communitydwelling people with stroke live with residual sensorimotor and balance impairments [1]
This study examined the effect of a six-week, multi-component, exercise-based conventional training intervention for improving both reactive and volitional balance control in people with chronic stroke (PwCS)
The results of this study showed that exercise-based balance training based on volitional movements improves performance on clinical balance and Limits of Stability (LOS) tests, and limited benefits in the Stance Perturbation Test (SPT) test, lack of control group could limit the interpretation of these results
Summary
Stroke is the leading cause of long-term disability, and more than half of the communitydwelling people with stroke live with residual sensorimotor and balance impairments [1] Due to such impairments, approximately 40–70% of them experience a detrimental fall each year in the United States, creating significant healthcare costs [2,3,4,5,6,7,8,9]. Reactive balance control is assessed by measuring postural stability and the compensatory in-place or stepping responses in response to externally induced perturbations via platform or treadmill translations [18,19,20,21,22]. No significant changes were observed in the COM state stability, fall incidence and number of recovery steps on the SPT post-intervention. Conclusion: volitional and reactive balance control may share some neurophysiological and biomechanical components, training based on volitional movements might not significantly improve reactive balance control for recovery from large-magnitude perturbations due to its task-specificity
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