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Chen K, Zhu S, Tang Y, Lan F, Liu Z. Advances in balance training to prevent falls in stroke patients: a scoping review. Front Neurol 2024; 15:1167954. [PMID: 38375467 PMCID: PMC10875131 DOI: 10.3389/fneur.2024.1167954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 01/18/2024] [Indexed: 02/21/2024] Open
Abstract
Objective To summarize the status and characteristics of the available evidence, research gaps, and future research priorities for preventing falls in stroke patients through balance training. Methods We used a scoping review framework. A systematic search of PUBMED, Embase, and Cochrane databases for main articles was conducted. Our study only included articles that on balance training and fall-related indicators in stroke patients. Two researchers independently screened the literature according to the inclusion and exclusion criteria. The data of demographic, clinical characteristics, intervention, sample, and outcome indicators were extracted. The characteristics and limitations of the included literature were comprehensively analyzed. Results Of the 1,058 studies, 31 were included. The methods of balance training include regular balance training, Tai Chi, Yoga, task balance training, visual balance training, multisensory training, aquatic balance training, perturbation-based balance training, cognitive balance training, system-based balance training, and robot-assisted balance training. The commonly used outcome measures include clinical balance test, such as Berg balance scale (BBS), Timed Up-and-Go Test (TUG), Fall Risk Index assessment (FRI), Fall Efficacy Scale score (FES), and instrumented balance tests. Conclusion This scoping review summarizes the existing primary research on preventing falls in stroke patients by balance training. Based on the summary of the existing evidence, the characteristics of balance training and their relation to falls in stroke patients were found. The future researches should explore how to develop personalized training program, the sound combination of various balance training, to more effectively prevent falls.
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Affiliation(s)
- Kehan Chen
- Department of Rehabilitation Medicine, Rehabilitation Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- West China School of Nursing, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Siyi Zhu
- Department of Rehabilitation Medicine, Rehabilitation Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yidan Tang
- Department of Rehabilitation Medicine, Rehabilitation Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Fuxia Lan
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zuoyan Liu
- Department of Rehabilitation Medicine, Rehabilitation Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- West China School of Nursing, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Verrienti G, Raccagni C, Lombardozzi G, De Bartolo D, Iosa M. Motivation as a Measurable Outcome in Stroke Rehabilitation: A Systematic Review of the Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4187. [PMID: 36901206 PMCID: PMC10001639 DOI: 10.3390/ijerph20054187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 02/22/2023] [Accepted: 02/24/2023] [Indexed: 06/18/2023]
Abstract
Motivated behaviours are thought to lead to enhanced performances. In the neurorehabilitation field, motivation has been demonstrated to be a link between cognition and motor performance, therefore playing an important role upon rehabilitation outcome determining factors. While motivation-enhancing interventions have been frequently investigated, a common and reliable motivation assessment strategy has not been established yet. This review aims to systematically explore and provide a comparison among the existing motivation assessment tools concerning stroke rehabilitation. For this purpose, a literature search (PubMed and Google Scholar) was performed, using the following Medical Subject Headings terms: "assessment" OR "scale" AND "motivation" AND "stroke" AND "rehabilitation". In all, 31 randomized clinical trials and 15 clinical trials were examined. The existing assessment tools can be grouped into two categories: the first mirroring the trade-off between patients and rehabilitation, the latter reflecting the link between patients and interventions. Furthermore, we presented assessment tools which reflect participation level or apathy, as an indirect index of motivation. In conclusion, we are left to put forth a possible common motivation assessment strategy, which might provide valuable incentive to investigate in future research.
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Affiliation(s)
- Giulio Verrienti
- Department of Neurorehabilitation, Casa di Cura Villa Verde, 73100 Lecce, Italy
| | - Cecilia Raccagni
- Department of Neurology, Provincial Hospital of Bolzano (SABES-ASDAA), Lehrkrankenhaus der Paracelsus Medizinischen Privatuniversität, 39100 Bolzano, Italy
- Department of Neurology, Innsbruck Medical University, 6030 Innsbruck, Austria
| | | | | | - Marco Iosa
- Smart Lab, IRCCS Santa Lucia Foundation, 00179 Rome, Italy
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
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Yakşi E, Yaşar MF, Türel CA, Balcı M. Are static posturography-assisted biofeedback exercises effective in Parkinson's disease? ARQUIVOS DE NEURO-PSIQUIATRIA 2022; 80:935-943. [PMID: 36351419 PMCID: PMC9770088 DOI: 10.1055/s-0042-1755325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Parkinson disease (PD) is a progressive condition that causes disorders in movement and balance. OBJECTIVE To evaluate the effectiveness of static posturography-assisted biofeedback exercises in PD-related balance disorder. METHODS We screened 83 patients, 48 of whom were enrolled, and 41 completed the study. The sample was randomized into two groups, one submitted to static posturography-assisted biofeedback exercises and the other, to a conventional exercise program. The patients in the biofeedback group (n = 20) performed biofeedback exercises in addition to conventional balance exercises. Those in the conventional exercise group (n = 21) performed classic balance exercises. Both groups were treated for 20 minutes per session 3 times a week for 6 weeks. The patients were evaluated using the Hoehn and Yahr Scale, the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS), the Berg Balance Scale (BBS), the Tinetti Gait and Balance Assessment (TGBA), the Timed Up and Go Test (TUG), the Tandem Stance Test (TST), a Turkish version of the Stanford Health Assessment Questionnaire (HAQ), and the Beck Depression Inventory (BDI) before and at the end of the treatment. RESULTS No statistically significant differences were observed between the two groups in terms of the MDS-UPDRS, BBS, TGBA, TST, TUG, HAQ, or BDI measurements before and after the treatment (p > 0.05). CONCLUSIONS Improved balance parameters were observed following balance training in the patients with PD, although static posturography-assisted biofeedback exercises appeared to provide no additional benefit. However, larger, randomized controlled trials are needed to investigate their effectiveness.
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Affiliation(s)
- Elif Yakşi
- Abant Izzet Baysal University, Medical Faculty, Department of Physical Medicina and Rehabilitation, Bolu, Turkey.,Address for correspondence Elif Yakşi
| | - Mustafa Fatih Yaşar
- Abant Izzet Baysal University, Medical Faculty, Department of Physical Medicina and Rehabilitation, Bolu, Turkey.
| | - Canan Akünal Türel
- Abant Izzet Baysal University, Medical Faculty, Department of Neurology, Bolu, Turkey.
| | - Muhammed Balcı
- Abant Izzet Baysal University, Medical Faculty, Department of Physical Medicina and Rehabilitation, Bolu, Turkey.
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Rosero-Herrera J, Acuña-Bravo W. A lower limb rehabilitation platform with mirror therapy, electrical stimulation and virtual reality for people with limited dorsiflexion movement. HARDWAREX 2022; 11:e00285. [PMID: 35509932 PMCID: PMC9058726 DOI: 10.1016/j.ohx.2022.e00285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This paper presents a low-cost portable system for applying a rehabilitation therapy, based on virtual reality, functional electrical stimulation and a training device. This open-hardware system, intended to support a home-made therapy process in people with reduced dorsiflexion ability, contains three main building blocks: an electromechanical platform, an immersive virtual reality interface and the firmware. The electromechanical training platform is the core of the system, which acts as a gateway interface of sensors-actuators for a closed loop system, through an immersive virtual reality application, the patient closes the loop by acting as the controller by means of a "virtual dummy" preforming in mirror configuration. The platform measures and process the dorsiflexion angle described by both ankles, real-time transmitting the information to the mobile phone virtual application to be presented as a mirror. The onboard microprocessor drives the operation of the electric stimulation interface, which is sent through two channels to both, healthy and affected lower limbs. The platform communicates continuously through a USB bidirectional interface with a personal computer, in which the physician enters the rehabilitation protocol and follows the patient performance. A first case study by using this device has been reported in [1].
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Affiliation(s)
| | - W. Acuña-Bravo
- Departamento de Electrónica, Instrumentación y Control, Facultad de Ingeniería Electrónica y Telecomunicaciones, Universidad del Cauca, Campus Tulcán, Popayán, Colombia
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Mańdziuk M, Krawczyk-Suszek M, Maciejewski R, Bednarski J, Kotyra A, Cyganik W. The Application of Biological Feedback in the Rehabilitation of Patients after Ischemic Stroke. SENSORS 2022; 22:s22051769. [PMID: 35270916 PMCID: PMC8914769 DOI: 10.3390/s22051769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 02/14/2022] [Accepted: 02/18/2022] [Indexed: 11/17/2022]
Abstract
Balance disorders are the main concern for patients after an ischemic stroke. They are caused by an abnormal force on the affected side or paresis, which causes uneven loading and visuospatial disorders. Minimizing the effects of stroke is possible through properly conducted rehabilitation. One of the known ways to achieve this objective is biological feedback. The lack of proper muscle tone on one side of the body is manifested by the uneven pressure of the lower extremities on the ground. The study and control groups were composed of two equal groups of 92 people each, in which the same set of kinesiotherapeutic exercises were applied. Patients in the study group, in addition to standard medical procedures, exercised five days a week on a Balance Trainer for four weeks. The examination and training with the device were recorded on the first day of rehabilitation, as well as after two and four weeks of training. The assessment was performed using the following functional tests and scales: Brunnström, Rankin, Barthel, Ashworth, and VAS. Patients in the control group started exercising on the Balance Trainer two weeks after the first day of rehabilitation using traditional methods. The study results reveal statistically significant reductions in the time the body’s center of gravity (COG) spent in the tacks, outside the tracks and in the COG distance, lower COG excursions in all directions. Post-stroke patients that received biofeedback training presented significantly better results than patients that did not receive such training.
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Affiliation(s)
- Marzena Mańdziuk
- Medical College, University of Information Technology and Management in Rzeszow, 2 Sucharskiego Str., 35-225 Rzeszow, Poland; (M.K.-S.); (W.C.)
- Correspondence:
| | - Marlena Krawczyk-Suszek
- Medical College, University of Information Technology and Management in Rzeszow, 2 Sucharskiego Str., 35-225 Rzeszow, Poland; (M.K.-S.); (W.C.)
| | - Ryszard Maciejewski
- Department of Human Anatomy, Medical University of Lublin, 19 Chodzki Str., 20-093 Lublin, Poland; (R.M.); (J.B.)
| | - Jerzy Bednarski
- Department of Human Anatomy, Medical University of Lublin, 19 Chodzki Str., 20-093 Lublin, Poland; (R.M.); (J.B.)
| | - Andrzej Kotyra
- Department of Electronics and Information Technology, Faculty of Electrical Engineering and Computer Science, Lublin University of Technology, 38a Nadbystrzycka Str., 20-618 Lublin, Poland;
| | - Weronika Cyganik
- Medical College, University of Information Technology and Management in Rzeszow, 2 Sucharskiego Str., 35-225 Rzeszow, Poland; (M.K.-S.); (W.C.)
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Chan KGF, Jiang Y, Choo WT, Ramachandran HJ, Lin Y, Wang W. Effects of exergaming on functional outcomes in people with chronic stroke: A systematic review and meta-analysis. J Adv Nurs 2021; 78:929-946. [PMID: 34877698 DOI: 10.1111/jan.15125] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 10/12/2021] [Accepted: 11/25/2021] [Indexed: 11/28/2022]
Abstract
AIMS The aim of this review is to synthesize and evaluate effectiveness of exergaming on balance, lower limb functional mobility and functional independence in individuals with chronic stroke. DESIGN The present review is a systematic review and meta-analysis. The review is written in accordance with the guidelines from the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) DATA SOURCE: Searches were conducted across seven databases (PubMed, EMBASE, Web of Science, CINAHL, CENTRAL, Scopus and PEDro) and in grey literature from inception until January 2021. REVIEW METHODS Only randomized controlled trials (RCTs) written in English were included. All eligible studies were assessed for risk of bias by two reviewers independently. Meta-analyses were performed using RevMan 5.4.1 software. Narrative syntheses were adopted whenever meta-analysis was inappropriate. The overall quality of evidence from included studies was assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework. RESULTS 4511 records were retrieved, with 32 RCTs eligible for inclusion and 27 RCTs included in meta-analysis. Meta-analyses reported statistically significant small effect sizes favouring exergaming on balance (pooled standardized mean difference [SMD] = 0.25, 95% confidence interval [CI, 0.08-0.41], p = .004), lower limb functional mobility (pooled SMD = 0.29, 95% CI [0.08-0.50], p = .007) and functional independence (pooled SMD = 0.41, 95% CI [0.09-0.73], p = .01). Most of the included studies failed to provide adequate description of the measures taken to prevent bias. CONCLUSION Exergaming has favourable effects on improving balance, lower limb functional mobility and functional independence among individuals with chronic stroke, making it a suitable adjunct to conventional physiotherapy. IMPACT People with chronic stroke have difficulty achieving the required rehab intensity. Exergaming can help individuals with chronic stroke to undertake further rehabilitation exercises at home. It can be a suitable adjunct to conventional physiotherapy.
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Affiliation(s)
- Kendy Gui Fang Chan
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ying Jiang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Wen Ting Choo
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Hadassah Joann Ramachandran
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yanjuan Lin
- Department of Nursing, Fujian Medical University Union Hospital, Fuzhou, China
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Alneyadi M, Drissi N, Almeqbaali M, Ouhbi S. Biofeedback-Based Connected Mental Health Interventions for Anxiety: Systematic Literature Review. JMIR Mhealth Uhealth 2021; 9:e26038. [PMID: 33792548 PMCID: PMC8103295 DOI: 10.2196/26038] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 02/16/2021] [Accepted: 03/31/2021] [Indexed: 12/18/2022] Open
Abstract
Background Connected mental health, which refers to the use of technology for mental health care and technology-based therapeutic solutions, has become an established field of research. Biofeedback is one of the approaches used in connected mental health solutions, which is mainly based on the analysis of physiological indicators for the assessment and management of the psychological state. Biofeedback is recommended by many therapists and has been used for conditions including depression, insomnia, and anxiety. Anxiety is associated with several physiological symptoms, including muscle tension and breathing issues, which makes the inclusion of biofeedback useful for anxiety detection and management. Objective The aim of this study was to identify interventions using biofeedback as a part of their process for anxiety management and investigate their perceived effectiveness. Methods A systematic literature review of publications presenting empirically evaluated biofeedback-based interventions for anxiety was conducted. The systematic literature review was based on publications retrieved from IEEE Digital Library, PubMed, ScienceDirect, and Scopus. A preliminary selection of papers was identified, examined, and filtered to include only relevant publications. Studies in the final selection were classified and analyzed to extract the modalities of use of biofeedback in the identified interventions, the types of physiological data that were collected and analyzed and the sensors used to collect them. Processes and outcomes of the empirical evaluations were also extracted. Results After final selection, 13 publications presenting different interventions were investigated. The interventions addressed either primarily anxiety disorders or anxiety associated with health issues such as migraine, Parkinson disease, and rheumatology. Solutions combined biofeedback with other techniques including virtual reality, music therapy, games, and relaxation practices and used different sensors including cardiovascular belts, wrist sensors, or stretch sensors to collect physiological data such as heart rate, respiration indicators, and movement information. The interventions targeted different cohorts including children, students, and patients. Overall, outcomes from the empirical evaluations yielded positive results and emphasized the effectiveness of connected mental health solutions using biofeedback for anxiety; however, certain unfavorable outcomes, such as interventions not having an effect on anxiety and patients’ preferring traditional therapy, were reported in studies addressing patients with specific physical health issues. Conclusions The use of biofeedback in connected mental health interventions for the treatment and management of anxiety allows better screening and understanding of both psychological and physiological patient information, as well as of the association between the two. The inclusion of biofeedback could improve the outcome of interventions and boost their effectiveness; however, when used with patients suffering from certain physical health issues, suitability investigations are needed.
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Affiliation(s)
- Mahra Alneyadi
- Department of Computer Science & Software Engineering, College of Information Technology, Al Ain, Abu Dhabi, United Arab Emirates
| | - Nidal Drissi
- Department of Computer Science & Software Engineering, College of Information Technology, Al Ain, Abu Dhabi, United Arab Emirates
| | - Mariam Almeqbaali
- Department of Computer Science & Software Engineering, College of Information Technology, Al Ain, Abu Dhabi, United Arab Emirates
| | - Sofia Ouhbi
- Department of Computer Science & Software Engineering, College of Information Technology, Al Ain, Abu Dhabi, United Arab Emirates
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Kurul R, Cankaya T, Yildirim NU. Kinesio taping techniques for ankle stabilisation in patients with stroke: a single-blinded randomised controlled study. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2021. [DOI: 10.12968/ijtr.2019.0082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/AimsAnkle proprioception and neuromuscular feedback from this region provides the sensory input needed for balance. The aim of this study was to investigate the effects of repeated correction taping applied on the ankle and peroneus longus and peroneus brevis muscles on balance and gait in patients with stroke.MethodsA total of 61 patients with stroke with a mean age of 62.25 ± 7.04 years were included in this study. The patients were randomly divided into two groups. The control group (n=30) received 1 hour of rehabilitation, which took place during weekdays over the course of 2 weeks. The intervention group (n=31) received 1 hour of daily rehabilitation as well as having kinesio tape applied to their ankle. Both groups were assessed with the Balance Evaluating Systems Test, Timed Up and Go Test, Functional Reach Test, Tetrax Balance System and Barthel Index. Clinical assessments were performed at baseline, immediately after the first application, 1 week and 2 weeks later, following the first taping.ResultsThere was a significant improvement in the Balance Evaluating Systems and Functional Reach Tests scores between the first and last measurements in favour of the intervention group (P<0.05). There were no significant changes between baseline and immediately after assessment for all measurements (P>0.05). There was no significant difference in Tetrax scores, Timed Up and Go Test and Barthel Index scores (P>0.05).ConclusionsIn this study, it was found that dynamic balance was improved by taping the peroneus longus and peroneus brevis muscles, but the static balance did not change. One week of kinesio taping would be beneficial; however, prolonged use would not provide further improvement.
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Affiliation(s)
- Ramazan Kurul
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Tamer Cankaya
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Necmiye Un Yildirim
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Saglık Bilimleri University, Ankara, Turkey
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Chang MC, Chun MH. The effect of balance training with Tetra-ataxiometric posturography on balance function in patients with parkinsonism. NeuroRehabilitation 2019; 45:379-384. [PMID: 31796700 DOI: 10.3233/nre-192850] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Balance impairment is a major clinical concern in patients with parkinsonism. Balance training with tetra-ataxiometric posturography (Tetrax) is known to improve balance function through visual biofeedback effects. OBJECTIVE In this study, we evaluated the effects of balance training with Tetrax in patients with parkinsonism. METHODS Patients with parkinsonism (idiopathic Parkinson's disease, multiple systemic atrophy, and multiple systemic atrophy) who were able to stand with or without an assistive device were recruited for the study. Twenty patients with parkinsonism were randomly assigned to one of the following two groups: (1) the Tetrax group, in which patients received Tetrax biofeedback balance training for 30 min/day for 2 weeks (10 sessions); and (2) the control group, in which patients received conventional balance training for 30 min/day for 2 weeks (10 sessions). One day before and after training, we measured patients' balance parameters using the Berg balance scale (BBS) and fall index (FI). RESULTS The BBS and FI scores of the Tetrax group showed significant improvements after compared to before training. However, the scores in the control group were not significantly changed after vs. before conventional balance training. CONCLUSIONS For patients with parkinsonism, Tetrax biofeedback balance training had a positive effect on balance function.
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Affiliation(s)
- Min Cheol Chang
- Department of Rehabilitation Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea
| | - Min Ho Chun
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Use of a Gaming Platform for Balance Training After a Stroke: A Randomized Trial. Arch Phys Med Rehabil 2018; 100:591-597. [PMID: 30468730 DOI: 10.1016/j.apmr.2018.11.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 10/30/2018] [Accepted: 11/01/2018] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To evaluate a personal computer (PC) gaming platform as a means of improving postural balance in stroke patients. PARTICIPANTS Stroke patients (N=54) were enrolled and randomly divided into experimental and control groups. DESIGN The experimental group underwent 12 weeks of rehabilitation involving playing PC games with the proposed gaming platform, whereas the control group played PC games with a computer mouse in the standing position. INTERVENTIONS The experimental PC gaming platform allowed trunk movements in 3 directions, including lateral, downward, or upward reaching. MAIN OUTCOME MEASURES Balance control was assessed before and after the intervention with the Midot Posture Scale Analyzer (a pressure platform) by measuring the center of pressure during quiet stance. The Berg Balance Scale, Fullerton Advanced Balance Scale, and timed Up and Go tests were used to evaluate functional balance. RESULTS Analysis of covariance was used to assess how the PC games improve balance abilities. There were significant differences between the experimental and control groups in the results of sway kinematics and functional balance tests. The experimental group showed greater improvement than the control group. CONCLUSION This new gaming platform with adaptive PC games could be a useful therapy to stroke rehabilitation in patients with postural imbalance.
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Kim HY, Moon HI, Chae YH, Yi TI. Investigating the Dose-Related Effects of Video Game Trunk Control Training in Chronic Stroke Patients With Poor Sitting Balance. Ann Rehabil Med 2018; 42:514-520. [PMID: 30180519 PMCID: PMC6129702 DOI: 10.5535/arm.2018.42.4.514] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 10/18/2017] [Indexed: 11/21/2022] Open
Abstract
Objective To investigate the dose-related effect of trunk control training (TCT) using Trunk Stability Rehabilitation Robot Balance Trainer (TSRRBT) in chronic stroke patients with poor sitting balance. Methods This was a retrospective study of 38 chronic stroke patients with poor sitting balance that underwent TCT with TSRRBT. The participants were assigned either to the low-dose training (LDT) group (n=18) or to the highdose training (HDT) group (n=20). In addition to the conventional rehabilitation therapy, the LDT group received 5 sessions of TSRRBT intervention per week, whereas the HDT group received 10 sessions of TSRRBT intervention per week. The outcome measures were the scores on the Trunk Impairment Scale (TIS) and its subscales, Berg Balance Scale (BBS), Functional Ambulation Classification (FAC), and the Korean version of Modified Barthel Index (K-MBI). All outcome measures were assessed before the training and at the end of the 4-week training. Results After the 4-week intervention, TIS, BBS, FAC, and K-MBI scores showed improvement in both LDT and HDT groups. Furthermore, the improvements in TIS scores and its subscales were significantly greater in the HDT group than in the LDT group (p<0.05). Conclusion TCT using TSRRBT could be an additional treatment for the conventional rehabilitation therapy of chronic stroke patients with poor sitting balance. HDT may provide more beneficial effects on improving patients’ sitting balance than LDT.
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Zhao C, Könönen M, Vanninen R, Pitkänen K, Hiekkala S, Jolkkonen J. Translating experimental evidence to finding novel ways to promote motor recovery in stroke patients – a review. Restor Neurol Neurosci 2018; 36:519-533. [PMID: 29889087 DOI: 10.3233/rnn-180814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
| | | | | | - Kauko Pitkänen
- Brain Research and Rehabilitation Center Neuron, Kuopio, Finland
| | - Sinikka Hiekkala
- Finnish Association of People with Physical Disabilities, Helsinki, Finland
| | - Jukka Jolkkonen
- Institute of Clinical Medicine – Neurology, University of Eastern Finland, Kuopio, Finland
- NeuroCenter, Kuopio University Hospital, Kuopio, Finland
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Posturographic examination of body balance in patients with Chiari type I malformation and correlation with the presence of syringomyelia and degree of cerebellar ectopia. Turk J Phys Med Rehabil 2018; 65:74-79. [PMID: 31453546 DOI: 10.5606/tftrd.2019.2003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 11/10/2017] [Indexed: 11/21/2022] Open
Abstract
Objectives We aimed to evaluate balance using the Tetrax Interactive Balance System (TIBS) in patients with Chiari type I malformation (CM-I) and to assess their fall risk with other clinical parameters. Patients and methods This cross-sectional, prospective study was conducted at physical medicine and rehabilitation outpatient clinics and neurosurgery department of a university hospital between December 2013 and December 2014. The study included a total of 36 patients (31 females, 5 males; mean age 40.6±10.0 years; range, 18 to 60 years) with CM-I. Dynamic balance was assessed using the Berg Balance Scale (BBS), and posturographic examinations were performed using the TIBS. Results The mean Fall Risk Index (FI) value was 42.4±29.8 and the mean BBS score was 55.5±1.5. The most common complaints were neck pain (94.4%), headache (88.9%), paresthesia (86.1%), fatigue (83.3%), and vertigo (80.6%). The mean tonsillar herniation below the foramen magnum was 8.7±3.8 (mm). Of the patients, 15 (42.85%) had syringomyelia. The degree of tonsillar ectopia was statistically significantly lower in patients with syringomyelia (p<0.05). The BBS scores were near identical among the patients with or without syringomyelia, although the FI values were lower in the patients with syringomyelia. Comparing cerebellar ectopia ≤9 mm versus >10 mm, the FI values were slightly higher in the patients with ectopia >10 mm, although there was no statistically significant difference in the FI or BBS values. Conclusion Our study results suggest that CM-I can decrease the body balance stability and, thus, increase the fall risk. Evaluation of balance in patients with CM using TIBS static posturography is a simple and effective technique.
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