Balance In Chronic Stroke Patients Research Articles

Examining the effects of non-immersive virtual reality game-based training on knee hyperextension control and balance in chronic stroke patients: a single-blind randomized controlled study.

Post-stroke hemiparesis can lead to decreased mobility, gait disturbances, impaired balance, postural instability, limitations in activities of daily living (ADL), and long-term disability. The aim of this study was to examine the effect of non-immersive virtual reality game-based training (nIVRGT) in addition to conventional rehabilitation in stroke patients on dynamic balance, knee hyperextension control, and ADL. Twenty-five chronic stroke patients aged between 51 and 70 were included in the study. Stroke patients were randomized to a control group (n = 12) and a study group (n = 13). Individuals in control group participated conventional physiotherapy and rehabilitation program for 60min, 3 days a week for 6 weeks. individuals in the study group received 40min of conventional physiotherapy and rehabilitation program plus 20min nIVRGT. Functional Reach Test, Timed Up and Go Test, Computerized Gait Evaluation System and Barthel Index were used in the evaluation. The study group improved significantly in dynamic balance, knee control, and ADL (p < 0.05). In the control group, significant improvements were observed in dynamic balance and knee control (p < 0.05), except ADL (p > 0.05). The study group improved in dynamic balance compared with the control group (p < 0.05). Knee control and ADL improved similarly in both groups (p > 0.05). Our results showed that conventional and additional nIVRGT rehabilitation improved dynamic balance and knee hyperextension control in chronic stroke. However, it was observed that the non-immersive virtual reality (nIVR) approach was more effective in improving dynamic balance in stroke patients than conventional rehabilitation alone. NCT05907473.

Effects of core muscles strengthening exercises with routine physical therapy on trunk balance in stroke patients: A randomized controlled trial.

To compare the effects of core muscle strengthening exercises with and without routine physical therapy on trunk balance in chronic stroke patients. The randomised controlled trial was conducted at Mubarak Medical Complex, Sargodha, Pakistan, from October 28, 2021, to April 28, 2022, and comprised patients of either gender with chronic stroke aged 40-60 years. The subjects were randomised using the lottery method into group A that was managed with routine physical therapy, and group B which was further managed with core strengthening exercises. The intervention comprised 4 sessions per week for 8 weeks. Outcome was measured using Trunk Impairment Scale and Time Up and Go test. Data was collected at baseline, week 4 and post-intervention. Data was analysed using SPSS 23. Of the 80 individuals screened, 74(92.5%) were included. There were 37(50%) patients in group A; 30(81%) males and 7(19%) females with mean age 56.73±2.37 years. The remaining 37(50%) patients were in group B; 27(73%) males and 10(27%) females with mean age 55.65±2.88 years. Trunk balance and functional mobility improved significantly post-intervention in both groups (p<0.05), but group B values were significantly better compared to group A values (p<0.05). Core muscle strengthening exercises combined with routine physical therapy were found to be more effective compared to routine physical therapy alone in chronic stroke patients for improving trunk balance and functional mobility. IRCT20211116053070N1.

Effects of ErigoPro Training on the Trunk Alignment and Balance in Chronic Stroke Patients

Effects of ErigoPro Training on the Trunk Alignment and Balance in Chronic Stroke Patients

Effects of virtual balance training and conservative rehabilitation on balance in chronic stroke patients

Objective: This study aimed to test the comparative efficacy of virtual balance training (VBT) and conservative rehabilitation (CR) relative to CR alone on balance in chronic stroke patients. Methods: Thirty patients with chronic stroke (&gt;6-months post-stroke) were allocated into 2 groups (n=15) as Group CR and Group VBT. CR was performed for 60 min, 4 times a week, for 8 weeks in both groups. VBT was applied for 20 min, 4 times a week, for 8 weeks along with the CR, in Group VBT. Brunnstrom motor recovery (BMR) stage, spasticity degrees, Functional Ambulation Scale (FAS), Short Form-36 (SF-36) scale, Berg Balance Scale (BBS) in both groups were assessed before and after treatment. Mann-Whitney U, Wilcoxon signed rank tests were used to evaluate BBS data (p&lt;0.05). Results: Although, no significant difference was observed between groups in terms of BBS scores, BMR stages, FAS scores, SF-36 scale scores, and spasticity degrees before and after treatment; significant improvements were observed in BBS scores, BMR stages, and FAS scores after treatment in both groups (p&lt;0.05). Comparing the SF-36 subscale scores before and after treatment, significant differences were noted in emotional role limitation scores for Group VBT (p=0.03) and in pain scores for Group CR (p=0.01). Conclusion: VBT along with the CR in chronic stroke patients was not superior to the CR alone, in terms of improving balance, motor recovery, ambulation level, and quality of life.

The Effects of a Group Exercise Program with Competitive Games on Balance in Chronic Stroke Patients

The Effects of a Group Exercise Program with Competitive Games on Balance in Chronic Stroke Patients

Effects of Mastication during the Bridging Exercise on Balance of Chronic Stroke Patients

Effects of Mastication during the Bridging Exercise on Balance of Chronic Stroke Patients

Pendulum test in chronic hemiplegic stroke population: additional ambulatory information beyond spasticity

Spasticity measured by manual tests, such as modified Ashworth scale (MAS), may not sufficiently reflect mobility function in stroke survivors. This study aims to identify additional ambulatory information provided by the pendulum test. Clinical assessments including Brünnstrom recovery stage, manual muscle test, MAS, Tinetti test (TT), Timed up and go test, 10-m walk test (10-MWT), and Barthel index were applied to 40 ambulant chronic stroke patients. The pendular parameters, first swing excursion (FSE) and relaxation index (RI), were extracted by an electrogoniometer. The correlations among these variables were analyzed by the Spearman and Pearson partial correlation tests. After controlling the factor of motor recovery (Brünnstrom recovery stage), the MAS of paretic knee extensor was negatively correlated with the gait score of TT (r = − 0.355, p = 0.027), while the FSE revealed positive correlations to the balance score of TT (r = 0.378, p = 0.018). RI were associated with the comfortable speed of 10-MWT (r = 0.367, p = 0.022). These results suggest a decrease of knee extensor spasticity links to a better gait and balance in chronic stroke patients. The pendular parameters can provide additional ambulatory information, as complementary to the MAS. The pendulum test can be a potential tool for patient selection and outcome assessment after spasticity treatments in chronic stroke population.

Short-Term Effect of Kinesio Taping of Lower-Leg Proprioceptive Neuromuscular Facilitation Pattern on Gait Parameter and Dynamic Balance in Chronic Stroke with Foot Drop.

The aim of this study is to identify the effectiveness of proprioceptive neuromuscular facilitation (PNF) leg Kinesio taping on gait parameters and dynamic balance in chronic stroke patients with foot drop. A total 22 chronic stroke patients were randomly assigned to experimental (n = 11) and control groups (n = 11). All subjects underwent conventional therapy and gait training for 50 min. The experimental group additionally received KT of tibialis anterior muscle (TA) and hamstring muscles according to the PNF pattern. The control group received KT of only TA. The primary outcome measures that the gait parameter are gait velocity, cadence, step length, and stride length. Dynamic balance was measured by the timed up-and-go test (TUG) time and activity-specific balance confidence scale (ABC) as the secondary outcomes. All of the measurements were performed baseline and 24 h after intervention. Our results showed that the experimental group showed significant improvements in gait velocity, cadence, step length, stride length and TUG, and ABC score compared with the control group. We conclude that the short term effect of application of lower-leg KT according to the PNF pattern increased the gait ability and dynamic balance of chronic stroke patients with foot drop.

Effects of Cerebellar Transcranial Direct Current Stimulation (tDCS) on Timed Up and Go Test with Foot Placement in Chronic Stroke Patients

Objectives: The purpose of this study was to assess the effect of a single session of cerebellar anodal cerebellar transcranial direct current stimulation (tDCS) on timed up and go test (TUG) with foot placement in patients with chronic stroke. Methods: Twenty patients with chronic stroke participated in this clinical trial. TUG test was carried out with four different foot positions, 1- spontaneous foot positions (SP), 2- symmetrical foot positions (SYP), 3- asymmetrical foot positions (PBNP), paretic foot behind the non-paretic foot, and 4- asymmetrical foot positions (NPBP), nonparetic foot behind the paretic foot, before and after using tDCS. Anodal tDCS (1.5 mA) was applied over the cerebellum for 20 minutes. Results: The time of the TUG test was significantly different after using tDCS at all foot positions: SP (P = 0.012), SYP (P = 0.010), PBNP (P = 0.047), and NPBP (P = 0.037). Conclusions: It seems that cerebellar tDCS can be a useful method in improving functional balance in chronic stroke patients.

Effect of Body Weight Support Treadmill Training on Gait Recovery, Lower Limb Function and Dynamic Balance in Patients with Chronic Stroke: A Randomised Controlled Trial

Introduction: Stroke is an omnipresent health problem that causes impairments in multiple domains and often leads to serious long-lasting consequences like pathological gait patterns. Gait rehabilitation is an important criterion for improvement in functionality. Body Weight Supported Treadmill Training (BWSTT) is being used as a method of gait rehabilitation, but efficiency of this method beyond traditional training is lacking evidence. Aim: To evaluate the effect of body weight supported treadmill training on gait recovery, lower limb function and dynamic balance in chronic stroke patients. Materials and Methods: A randomised controlled trial conducted in the Department of Neurorehabilitation of a specialty hospital, on 30 ambulatory chronic stroke patients having post stroke duration of six months or more. Study subjects were randomised into two groups. Group A received BWSTT with conventional rehabilitation for four weeks. Group B received only conventional rehabilitation for four weeks. Duration of conventional rehabilitation was 40 minutes in each group. Along with that group A received 20 minutes BWSTT and group B received 20 minutes of conventional gait training. Therapy was given three days a week. Assessment tools were Timed Up and Go test (TUG), Cadence, 10 metre Walk Test and Berg Balance Scale (BBS). The paired t-test was used for intragroup analysis and the unpaired t-test was used for intergroup analysis. Results: Total of 30 patients were registered in the study with mean age (years) 52.07±3.6736 and 52.40±3.906 for group A and group B, respectively. There was significant improvement in all outcome measures, e.g., BBS, TUG, 10 metre walk test and Cadence, in both the groups, pre and post intervention, but group A showed statistically significant improvement in parameters like dynamic balance, walking speed, and postural control and walking function (p&lt;0.05). Conclusion: The BWSTT offers improvement in gait, in terms of walking speed, dynamic balance, posture control, that is significantly more than that of conventional gait training, as found in this study. The BWSTT might be included as a part of stroke rehabilitation program. Further multicentre studies with larger samples can throw more light on the intensity, dosage and methods of using BWSTT.

Effects of white noise auditory stimulus on stability and balance in sit-to-stand and standing motion of chronic stroke patients

Purpose The purpose of this study was to investigate the effect of auditory stimulus using white noise on stability and balance during sit-to-stand and standing tasks of chronic stroke patients. Methods Eighteen chronic stroke patients participated in this study. They asked to perform the tasks of sit-to-stand, standing with eyes open and standing with eyes closed before and after listening to white noise. Eight infrared cameras and one force plate were used to evaluate the stability and balance before and after the white noise stimulus during each task. Results There was no significant difference between before and after white noise stimulus in all tasks. On the other hand, the anteroposterior range of CoP was significantly decreased after white noise stimulus in standing with eyes-closed (p&lt;.05), and the sagittal angle of CoP-CoM was significantly decreased after white noise stimulus in standing with eyes-open and eyes-closed (p&lt;.05). Conclusion Auditory stimulus using white noise improves the balance of chronic stroke patients. Therefore it is thought to be helpful for the independent daily life of chronic stroke patients.

Comparison of Aquatic Therapy vs. Dry Land Therapy to Improve Mobility of Chronic Stroke Patients.

One of the most serious and disabling problems of stroke is pain and a decrease in balance, with the consequent increased risk of falls. The aim of the randomized controlled trial study was to compare the efficacy of three different treatment proposals to improve pain, gait, and balance in chronic stroke patients. Forty patients diagnosed with stroke were divided into three groups: the dry-land therapy group (control group) received sessions that included walking exercises and trunk mobility. The experimental group received Ai Chi aquatic therapy, and the combined group received alternating dry-land therapy sessions and Ai Chi aquatic therapy. The measurement instruments used were: the Tinetti balance and gait scale, the visual analog scale (VAS), 360° turn, single leg stance, and the 30-s stand test (CS-30). After twelve weeks of treatment, the results were significantly better for the combined therapy group and the experimental group compared to the dry-land therapy group (p < 0.01) in the VAS scale, CS-30, and 360° turn, although improvements were also found in the evaluations carried out in the aquatic therapy group. In total, for the Tinetti scale and single-leg stance, the differences between the groups were evident, although not statistically significant (p = 0.001). Aquatic therapy with Ai Chi and the combination of aquatic therapy with dry-land therapy was effective in improving pain, balance, and gait in patients with chronic stroke, thus improving their functional capacity and quality of life.

Effects of Action Observation Training with Auditory Stimulation on Static and Dynamic Balance in Chronic Stroke Patients

Purpose: The purpose of this study was to investigate the effects of action observation physical training accompanied by rhythmic auditory stimulation on the balance abilities of patients with stroke. Method: In total, 30 patients with stroke at more than 6 months after the onset of the disease were included in the present investigation. Experimental programs were employed for 30 minutes a day, 3 times a week for 8 weeks. The audiovisual action observation training (AAO) group received action observation training with rhythmic auditory stimulation at a comfortable speed and physical training, and the visual action observation training (VAO) group received action observation training and physical training. The balance was assessed using a Biodex balance system. Results: In overall balance index, anteroposterior balance index, mediolateral balance index, and fall risk, there were significant improvements in both groups after intervention. A greater degree of changes were observed in the AAO group than those in the VAO group (P< .05). Conclusions: The simultaneous application of action observation physical training and rhythmic auditory training seems to be an effective treatment method for patients with stroke. Furthermore, it is presented as a more effective therapeutic intervention method for those with motor disorders, such as patients with stroke.

The Effects of Combined Balance Exercise on Balance in Chronic Stroke Patients

The Effects of Combined Balance Exercise on Balance in Chronic Stroke Patients

Robot-Assisted Stair Climbing Training on Postural Control and Sensory Integration Processes in Chronic Post-stroke Patients: A Randomized Controlled Clinical Trial.

BackgroundPostural control disturbances are one of the important causes of disability in stroke patients affecting balance and mobility. The impairment of sensory input integration from visual, somatosensory and vestibular systems contributes to postural control disorders in post-stroke patients. Robot-assisted gait training may be considered a valuable tool in improving gait and postural control abnormalities.ObjectiveThe primary aim of the study was to compare the effects of robot-assisted stair climbing training against sensory integration balance training on static and dynamic balance in chronic stroke patients. The secondary aims were to compare the training effects on sensory integration processes and mobility.MethodsThis single-blind, randomized, controlled trial involved 32 chronic stroke outpatients with postural instability. The experimental group (EG, n = 16) received robot-assisted stair climbing training. The control group (n = 16) received sensory integration balance training. Training protocols lasted for 5 weeks (50 min/session, two sessions/week). Before, after, and at 1-month follow-up, a blinded rater evaluated patients using a comprehensive test battery. Primary outcome: Berg Balance Scale (BBS). Secondary outcomes:10-meter walking test, 6-min walking test, Dynamic gait index (DGI), stair climbing test (SCT) up and down, the Time Up and Go, and length of sway and sway area of the Center of Pressure (CoP) assessed using the stabilometric assessment.ResultsThere was a non-significant main effect of group on primary and secondary outcomes. A significant Time × Group interaction was measured on 6-min walking test (p = 0.013) and on posturographic outcomes (p = 0.005). Post hoc within-group analysis showed only in the EG a significant reduction of sway area and the CoP length on compliant surface in the eyes-closed and dome conditions.ConclusionPostural control disorders in patients with chronic stroke may be ameliorated by robot-assisted stair climbing training and sensory integration balance training. The robot-assisted stair climbing training contributed to improving sensorimotor integration processes on compliant surfaces. Clinical trial registration (NCT03566901).

Effects of Using Scapular and Pelvic Patterns Simultaneously exercise on Balance Ability for patients with Chronic Stroke Patients

Objective: The purpose of this study was to determine the effects of simultaneous scapular and pelvic patterns exercise on the balance of chronic stroke patients. Method: The participants, which included a total of 26 chronic stroke patients, were randomly divided into 2 groups: the scapular and pelvic patterns group (n=12) and the control group (n=12). Discharged patients were excluded (n=2). The scapular and pelvic patterns group engaged in a combination of scapular and pelvic patterns exercises for 30 minutes a day, 5 days per week for 6 weeks, while the control group received conventional treatment. The data were analyzed using a paired t-test and independent t-test to determine the statistical significance. Results: The scapular and pelvic patterns group showed significantly increased foot pressure ratio and total pressure compared to the control group (p<.05), and body sway also decreased (p<.05). In addition, the scapular and pelvic patterns group had significant improvement on the Berg Balance Scale (BBS) and a decrease on the Timed Up and Go test (TUG) compared to the control group(p<.05). Conclusion: This study demonstrated that simultaneous scapular and pelvic patterns exercise may be used to improve balance, meaning this is an effective treatment for chronic stroke patients.

The Immediate Effects of Posterior Pelvic Tilt with Taping on Pelvic Inclination, Gait Function and Balance in Chronic Stroke Patients*

PURPOSE: The purpose of this study is to identify the immediate effect of posterior pelvic tilt taping on anterior pelvic inclination, gait function, and balance in chronic stroke patients. METHODS: Fourteen chronic stroke subjects were enrolled in this study. Subjects who consented to participate in this cross-over experiment were assigned three interventions: posterior pelvic tilt taping, placebo taping, and no taping, in random order. After tape application, subjects were asked to complete: 1) Anterior pelvic tilt measurement, 2) 10-Meter Walk test, and 3) Limits of stability (LOS) test. To eliminate the learning effect of the tape after tearing off the tape, a 10 minute break was given between posterior pelvic tilt taping intervention and placebo taping intervention. RESULTS: Significant decreases were observed for the anterior pelvic inclination on both sides after posterior pelvic tilt taping application compared with placebo taping and no taping application (p .05). CONCLUSION: Posterior pelvic tilt taping in chronic stroke patients decreases the inappropriate anterior pelvic inclination immediately and improves gait function, but it has little effect on balance.

Sagittal lumbar motion during sit-to-stand task and its relation to balance in chronic stroke patients

Background and purpose Sit-to-stand (STS) task requires the ability to maintain balance while pivoting the body mass over the feet. Following stroke, the rising ability from the seated position is reduced because of difficulty in generating timing and sufficient force in muscles of the trunk and lower limbs to propel the body mass vertically. The aims of this study were to analyze the sagittal lumbar range of motion (ROM) during STS task, calculate the total time of the task, and investigate their relations to balance in patients with chronic stroke. Patients and methods Thirty male patients with chronic stroke (mean age: 51.2±3.75 years) were included in this study. They were divided into two equal groups (group I and group II). Group I had a mild degree of spasticity, whereas group II had a moderate degree in the affected lower limb. Lumbar ROM before and after buttock lift-off (LO) and the total time of STS were recorded using three-dimensional motion analysis system. Balance was assessed using Berg Balance Scale (BBS). Results The patients in group I showed a significant increase of lumbar ROM before (P=0.02) and after (P=0.03) buttock LO and also in BBS scores (P=0.0001) as compared with the patients in group II. However, there was a significant reduction in STS duration in favor to group I compared with group II (P=0.01). In addition, there was a statistically significant moderate negative correlation between BBS scores and lumbar ROM before buttock LO in both groups (P Conclusion Patients suffering from stroke with moderate degree of spasticity show less lumbar ROM at pre-LO and post-LO phases than those with mild spasticity, and took longer time to execute STS task aiming to improve balance and postural stability.

Comparison of the Effects of Wii Balance Games and Mirror Self-Balancing Exercises on Knee Joint Proprioception and Balance in Chronic Stroke Patients

Comparison of the Effects of Wii Balance Games and Mirror Self-Balancing Exercises on Knee Joint Proprioception and Balance in Chronic Stroke Patients

Immediate effects of ankle eversion taping on dynamic and static balance of chronic stroke patients with foot drop.

[Purpose] This study evaluates the immediate effect of ankle eversion taping on dynamic and static balance of chronic stroke patients with foot drop. [Subjects and Methods] This study was conducted with nine subjects who were diagnosed with stroke. A cross-over randomized design was used. Each subject performed three interventions in a random order. Subjects were randomly assigned to an ankle everion taping, placebo taping, and no taping. For dynamic and static balance, ability was measured using BIO Rescue. Limit of stability, sway length and sway speed for one minute were measured. [Results] The Limit of Stability, Sway length and Sway speed differed significantly among the three different taping methods. [Conclusion] We conclude that ankle eversion taping that uses kinesiology tape instantly increases the dynamic and static balance ability of chronic stroke patients with foot drop.