Foot Pressure and Trunk Muscle Activity during Reaching Tasks Performed by Seated Hemiplegia Patients

The Relations between Sitting Balance and Functional Recovery according to Characteristics of the Stroke Patients

We measured the difference of sitting pressure between the affected and unaffected sides (DSPAU) using sitting pressure measured with a force platform to identify sitting imbalance. The aim of this study is to investigate the relations between sitting balance and functional status or parameters according to characteristics stroke patients. We examine changes in DSPAU and functional assessment before and after a 3 week of rehabilitation in hemiplegic stroke patients (n = 73). These pre- and post-treatment data according to stroke characteristics, and correlations between the DSPAU and functional scales were analyzed. The DSPAU was greater in the non-ambulatory group compared to the ambulatory group, in patients who scored lower in the Medical Research Council (MRC) scores, and in patients whose the MRC scores for the lower limbs were lower than of the upper limbs. We observed that a decrease in the DSPAU was associated with an improvement in functional assessment parameters following rehabilitation. Further, changes in DSPAU were significantly correlated to the Modified Barthel Index. We observed that a decrease in DSPAU was associated with an improvement in functional parameters following rehabilitation. In conclusion, repeated measurements of sitting balance using DSPAU may be helpful to predict motor and functional recovery in stroke patient with hemiplegia.

Therapeutic effects of reaching with forward bending of trunk on postural stability, dynamic balance, and gait in individuals with chronic hemiparetic stroke

[Purpose] The objective of this study was to perform forward bending of the trunk and reaching training in chronic stroke patients and to investigate subsequent changes in trunk control, dynamic balance, and gait. [Subject] Twenty-three chronic stroke patients were randomly divided into two groups, with 10 patients in the forward bending of the trunk and reaching group and 13 patients in the control group. [Methods] Both groups underwent 30 minutes of rehabilitation therapy, five days a week, for four weeks. The forward bending of the trunk and reaching group additionally performed forward bending of the trunk and reaching training five times a week for four weeks, which involved four sets of pressing buttons 35 times, for a total of 140 button presses per session. The subjects were tested before and after training using the Trunk Impairment Scale, Berg Balance Scale, Timed Up and Go Test, Six-Minute Walking Test, and 10-Meter Walking Test. Trunk control, dynamic balance, and walking ability were compared between the two groups. [Result] The results of the study showed that the results of the Trunk Impairment Scale, Berg Balance Scale, Timed Up and Go Test, Six-Minute Walking Test improved significantly in the FBR group, while there were no significant differences in the control group. [Conclusion] This study results suggest that forward bending of the trunk and reaching training can be an effective exercise method for chronic stroke patients.

Repetitive sit-to-stand training with the step-foot position on the non-paretic side, and its effects on the balance and foot pressure of chronic stroke subjects

[Purpose] This study aimed to improve the asymmetrical weight-bearing ratio by applying repetitive sit-to-stand training methods that feature a step-foot position to the paretic-side foot of hemiplegic patients; it sought also to provide the information needed to apply weight-bearing and balance training to hemiplegic patients. [Subjects and Methods] The subjects were divided into two groups: a spontaneous group and a step group. They all performed repetitive sit-to-stand training five times per week for a total of six weeks. The Biodex Balance System, TUG, and 5XSST were used to measure the static and dynamic standing balance of each patient. A foot mat system was used to measure foot pressure. [Results] In the balance measurements, differences in the Overall index, Ant-post index, Med-lat index, Fall risk index, TUG, and 5XSST after training was significantly different between the two study groups. In evaluating foot pressure measurements, we found that the COP (Ant-post), Peak pressure: hind foot, and Contact area: hind foot measurements significantly differed between the groups after the training. [Conclusion] Repetitive sit-to-stand training that involves positioning the non-paretic leg upward can be considered a significant form of training that improves the symmetric posture adjustment and balance of hemiplegic patients following a stroke.

Effects of activation of the foot on trunk mobility of patients with hemiplegia

[Purpose] The purpose of this study was to determine the effects of activation of the foot on the trunk mobility of patients with hemiplegia. [Subjects] Sixteen subjects with hemiplegia took part in the immediate group (IG), and 14 subjects with hemiplegia participated in the 2-month group (2MG). [Methods] The subjects in IG were given one leg stance training through activation of the foot only once, and 2MG received the same intervention for 30 minutes 3 times a week for, 8 weeks. The Spinal Mouse was used to collect spinal alignment data. Also, the trunk Impairment Scale (TIS) and Sensory test were used as functional tests. [Results] Sacral hip (SH), lumbar spine (LS) and thoracic spine (TS) angles in IG improved significantly, but not inclination (I), and 2MG showed increased angles of SH, LS and I, but not TS. Also, TIS Dynamic, TIS Coordination and Sensory test results of 2MG increased significantly. [Conclusion] One leg stance training through activation of the foot was effective at improving sensory input and alignment of the spine, therefore trunk mobility was improved.