Effects Of A 8-week Pilates Exercise On Static And Dynamic Balance In Post Stroke Patients

Abstract

Stroke is the leading cause of long term adult disability in United States and impaired walking function is a common neurological deficit following stroke. Even after extensive inpatient and outpatient therapy only 60% of stroke survivors are able to walk independently. Furthermore, many continue to exhibit poor static and dynamic balance, which adversely impacts walking ability, independence and quality of life. Therefore, effective interventions aimed at improving these features are critically important. Recently, Pilates exercise that combines strength and flexibility training has been reported to improve gait performance in healthy older adults populations. However, researchers have not applied Pilates exercise for rehabilitation of post stroke patients, perhaps due to the perceived complexity of the exercise. PURPOSE: To evaluate the effectiveness of an 8 week Pilates program designed around the neuromechanical deficits observed post stroke on static and dynamic balance. METHODS: Nineteen post unilateral stroke patients (age: 63.9 ± 6.2 yr, years since stroke: 13 ± 4.65 yr) participated in this study. They were randomly divided into two groups (Pilates training group: PTG and control group: CG). PTG performed Pilates exercise 3 times a week over 8 weeks. Each session lasts 1 hour and includes 10 minutes rest in the middle of the session. Static and dynamic balance was measured in one week before training and one week after completing the training. Ground reaction forces and moments were collected using an instrumented treadmill and the center of pressure time series was computed and evaluated. Training effects were assessed using separate Group x Time repeated measures ANOVAs (critical p <0.05). RESULTS: In this study, an 8 week Pilates exercise positively affected both static and dynamic balance for post stroke patients. PTG showed 26% and 34% improved static balance in A-P and M-L directions, respectively (p<0.05). PTG also revealed that dynamic stabilities in A-P and M-L directions for both of the paretic and nonparetic foot were significantly improved 15% ~ 22% after training (p<0.05). CONCLUSION: The findings of this study provide initial evidence that a modified Pilates exercise can enhance post stroke static and dynamic stability in chronic patients.