The effect of body awareness on trunk control, affected upper extremity function, balance, fear of falling, functional level, and level of independence in patients with stroke

The importance of recovering body awareness in post-stroke rehabilitation: insights from clinical case reports

Introduction

Body awareness (BA) is the process of gaining sensory awareness based on the physiological states and actions of the body. It is influenced by an individual's attitudes, perceptions, beliefs, and experiences within the social and cultural contexts. Following a stroke, impairments in BA are thought to be widespread and could have a significant impact on recovery results. Regaining body awareness, however, is often neglected in the neurorehabilitation field. This study aimed to assess body image perception in two stroke patients and the potential effect of motor and cognitive rehabilitative treatments on possible improvement of BA.

Methods

Patients were evaluated through a multidimensional neuropsychological assessment before and after a 3-month motor and cognitive rehabilitative training. Sessions were scheduled 6 times per week with a total duration of 3 h per session.

Results

After the neurorehabilitative treatment, both patients showed an improvement in BA, cognition, mood, and motor skills. Differences emerged related to the progression and improvement of their respective performances.

Discussion

The causes of these differences could include the following: different brain areas affected, the ischemic or hemorrhagic nature of the stroke, age, and sex. Further research is needed to better understand the differences and similarities in the correlations between deficit and lesional sites. Structured and early multidisciplinary intervention can certainly guarantee a better functional recovery for patients after a stroke. However, in this study we show how complementary assessment methods (such as human figure drawing) may be highly informative in choosing treatment modalities and verifying rehabilitation outcomes.

Effects of body awareness therapy on balance and fear of falling in patients with chronic obstructive pulmonary disease: a randomized controlled trial

BACKGROUND

Assessment of extrapulmonary comorbidities is essential in chronic obstructive pulmonary disease (COPD). Deterioration of balance and increasing fear of falling are two of the most significant extrapulmonary manifestations. Although pulmonary rehabilitation (PR) is well-known and effective for COPD patients, there is a need for alternative treatments to enhance balance and alleviate concerns about falling. This study aimed to investigate the effect of Body Awareness Therapy (BAT), in addition to the PR program, on balance and fear of falling in patients with COPD.

METHODS

Forty-three patients were randomized into two groups: the BAT + PR group (BAT: once a week, 60 min + PR: 30 min, seven days of the week) or the PR group (PR: 30 min, seven days of the week) for eight weeks. Primary (balance, fear of falling) and secondary (dyspnea, muscle strength, functional capacity) outcomes were assessed at two different times: the baseline and end of the eight weeks.

RESULTS

Significant improvements were found in dynamic balance (reaction time η2 = 0.777, movement velocity η2 = 0.789, endpoint excursion η2 = 0.687, maximal excursion η2 = 0.887), static balance on firm ground (eyes opened η2 = 0.679, eyes closed η2 = 0.705), dyspnea (η2 = 0.546), muscle strength (η2 = 0.803), and functional capacity (η2 = 0.859) of the BAT + PR group (p < 0.05 for all). The improvement in fear of falling was significantly greater in the BAT + PR group than in the PR group (p < 0.001, η2 = 0.331).

CONCLUSION

The BAT method added to PR was more effective than PR alone in improving balance and reducing the fear of falling in COPD patients.

TRIAL REGISTRATION

This randomized controlled study was registered at clinicaltrials.gov, NCT04212676 , Registered 28 December 2019.