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Mahmud MR, Cordova A, Quarles J. Visual Cues for a Steadier You: Visual Feedback Methods Improved Standing Balance in Virtual Reality for People with Balance Impairments. IEEE TRANSACTIONS ON VISUALIZATION AND COMPUTER GRAPHICS 2023; 29:4666-4675. [PMID: 37788203 DOI: 10.1109/tvcg.2023.3320244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Users of head-mounted displays (HMDs) for virtual reality (VR) sometimes have balance issues since HMDs impede their view of the outside world. This has a greater impact on people with balance impairments since many rely more heavily on their visual cues to keep their balance. This is a significant obstacle to the universal usability and accessibility of VR. Although previous studies have verified the imbalance issue, not much work has been done to diminish it. In this study, we investigated how to increase VR balance by utilizing additional visual cues. To examine how different visual approaches (static, rhythmic, spatial, and center of pressure (CoP) based feedback) affect balance in VR, we recruited 100 people (50 with balance impairments due to multiple sclerosis and 50 without balance impairments) across two different geographic locations (United States and Bangladesh). All people completed both standing visual exploration as well as standing reach and grasp tasks. Results demonstrated that static, rhythmic, and CoP visual feedback approaches enhanced balance significantly ( ) in VR for people with balance impairments. The methods described in this study could be applied to design more accessible virtual environments for people with balance impairments.
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Effects of visual scanning exercises in addition to task specific approach on balance and activities of daily livings in post stroke patients with eye movement disorders: a randomized controlled trial. BMC Neurol 2022; 22:312. [PMID: 36002795 PMCID: PMC9400241 DOI: 10.1186/s12883-022-02843-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 08/16/2022] [Indexed: 11/11/2022] Open
Abstract
Background Impaired vision is one of the commonest and most disabling consequence following stroke. Among all visual impairments, eye movement disorders are found in 70% of stroke patients which include nystagmus, strabismus, gaze palsies, disconjugate eye movements and cranial nerve palsies. They have a wide ranging impact on balance and activities of daily livings by creating difficulties in maintaining normal alignment and appropriate movement of eyes. The purpose of this study was to examine the effects of visual scanning exercises in addition to task specific approach on balance and activities of daily livings in post stroke patients with eye movement disorders. Methods This study is a randomized controlled trial and was conducted in the University of Lahore Teaching Hospital from May 2019 to October 2020. A sample of 64 patients was recruited and randomly allocated into experimental and control group. 32 patients in experimental group were treated with visual scanning exercises along with task specific approach and 32 patients in control group were treated with task specific approach alone. Pre and post assessment of balance and activities of daily livings was assessed on BERG BALANCE SCALE and BARTHEL INDEX SCALE at baseline and at 4th week. Results Intra-group analysis of BERG BALANCE SCALE in experimental group showed statistically significant result (p < 0.05) in all items except in items 4, 13 and 14 respectively. Intra-group analysis of BERG BALANCE SCALE in control group showed statistically significant result (p < 0.05) in items 3, 5, 8 and 12 respectively, whereas remaining all items showed statistically insignificant result. Intra-group analysis of BARTHEL INDEX SCALE in experimental group showed statistically significant result in all items (p < 0.05) except in items 9 and 10 respectively. Intra-group analysis of BARTHEL INDEX in control group showed statistically significant result (p < 0.05) in items 1, 3, 4 and 8 respectively whereas remaining all items showed statistically insignificant result. Inter-group analysis showed statistically significant result in total scores of BERG BALANCE SCALE (p = 0.000) and BARTHEL INEX SCALE (p = 0.033). Conclusion Visual scanning exercises along with task specific approach were found to be more effective in comparison to task specific approach alone. Trial registration Trial registration number: [IRCT20190717044237N1], trial registration date: 10/11/2019, Supplementary Information The online version contains supplementary material available at 10.1186/s12883-022-02843-7.
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Eizad A, Lee H, Pyo S, Oh MK, Lyu SK, Yoon J. Study on the Effects of Different Seat and Leg Support Conditions of a Trunk Rehabilitation Robot. IEEE Trans Neural Syst Rehabil Eng 2022; 30:812-822. [PMID: 35294353 DOI: 10.1109/tnsre.2022.3160188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Performance of trunk rehabilitation exercises while sitting on movable surfaces with feet on the ground can increase trunk and leg muscle activations, and constraining the feet to move with the seat isolates control of the trunk. However, there are no detailed studies on the effects of these different leg supports on the trunk and leg muscle activations under unstable and forcefully perturbed seating conditions. We have recently devised a trunk rehabilitation robot that can generate unstable and forcefully perturbed sitting surfaces, and can be used with ground-mounted or seat-connected footrests. In this study, we have evaluated the differences in balance performance, trunk movement and muscle activation (trunk and legs) of fourteen healthy adults caused by the use of these different footrest configurations under the different seating scenarios. The center of pressure and trunk movement results show that the seat-connected footrest may be a more suitable choice for use in a balance recovery focused rehabilitation protocol, while the ground-mounted footrest may be a more suitable choice for a trunk movement focused rehabilitation protocol. Although it is difficult to make a clear selection between footrests due to the mixed trends observed in the muscle activation results, it appears that the seat-connected footrest may be preferable for use with the unstable seat as it causes greater muscle activations. Furthermore, the results provide limited evidence that targeting of a particular muscle group may be possible through careful selection of the seat and footrest conditions. Therefore, it may be possible to utilize the trunk rehabilitation robot to maximize the training outcomes for a wide range of patients through careful selection of training protocols.
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Jandaghi S, Tahan N, Akbarzadeh Baghban A, Zoghi M. Stroke Patients Showed Improvements in Balance in Response to Visual Restriction Exercise. Phys Ther Res 2022; 24:211-217. [PMID: 35036254 DOI: 10.1298/ptr.e10081] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 03/04/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Several strategies have been designed to improve balance after stroke. Although recent studies have suggested that the balance training in stroke should include exercises that are performed in different sensory conflict conditions, little attention has been paid to manipulation of visual input. This study aimed to compare effects of balance training on an unstable surface with balance training under visual deprivation conditions in persons with stroke. METHOD Forty-five stroke patients were randomized into three groups: the visual deprivation- stable based training (VD-SBT); unstable based training (UBT); and control (C) groups. Subjects of the VD-SBT group performed balance training on a stable surface with closed eyes. The UBT group performed balance training on an unstable surface with open eyes. Patients were assessed before and after interventions for Timed Up and Go (TUG), Four Square Step (FSS) and Five Times Sit to Stand (FTSS) tests. RESULT There was a significant difference in pre- post intervention time of TUG, FSS and FTSS tests in all three groups. In a comparison of three groups, the UBT and VD-SBT groups had a significant improvement in time of all tests but significant improvement in time of all tests was observed in the VD-SBT group in comparison with the UBT group. In the field of balance training, the manipulation of visual input was more effective than the manipulation of standing surface to reweighting the sensory information. CONCLUSION We recommended balance rehabilitation programs after stroke performed under conditions to stimulate the use of underused sensory input.
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Affiliation(s)
- Shima Jandaghi
- Faculty of Sport Injury and Corrective Exercises, Karaj Branch, Islamic Azad University, Iran
| | - Nahid Tahan
- Department of Physiotherapy, Loghman Hakim Hospital, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Iran
| | - Alireza Akbarzadeh Baghban
- Proteomics Research Center, Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Iran
| | - Maryam Zoghi
- Department of Rehabilitation, Nutrition and Sport, School of Allied Health, La Trobe University, Australia
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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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Meidian AC, Yige S, Irfan M, Rahayu UB, Amimoto K. Immediate effect of adding mirror visual feedback to lateral weight-shifting training on the standing balance control of the unilateral spatial neglect model. J Phys Ther Sci 2021; 33:809-817. [PMID: 34776614 PMCID: PMC8575481 DOI: 10.1589/jpts.33.809] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 08/02/2021] [Indexed: 11/25/2022] Open
Abstract
[Purpose] This study aimed to clarify the immediate effect of adding mirror visual feedback to lateral weight-shifting training on the standing balance control of the left unilateral spatial neglect model. [Participants and Methods] We included 64 healthy participants to create left unilateral spatial neglect models and divided them into four subgroups. Each subgroup received opposite lateral weight-shifting training with or without mirror visual feedback. We then evaluated the static and dynamic standing balance by measuring the center of pressure point alterations in the medial-lateral and anterior-posterior planes. We further evaluated the center of pressure length and bilateral load ratio. [Results] The center of pressure was significantly stable upon performing the eyes-open static standing balance test in the left weight-shifting training subgroup with mirror visual feedback. When participants performed the left dynamic standing balance test, the center of pressure moved significantly rightward and became significantly stable in the right weight-shifting training subgroup with mirror visual feedback. The left load ratio significantly decreased in the right weight-shifting training of subgroups that either did or did not receive mirror visual feedback upon performing the left dynamic standing balance test. [Conclusion] We concluded that adding mirror visual feedback to lateral weight-shifting training affected some measurements of standing balance control of the left unilateral spatial neglect model.
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Affiliation(s)
- Abdul Chalik Meidian
- Department of Physical Therapy, Graduate School of Human
Health Sciences, Tokyo Metropolitan University: 7-2-10 Higashi-Ogu, Arakawa-Ku, Tokyo
116-8551, Japan
- Faculty of Physiotherapy, Esa Unggul University,
Indonesia
| | - Song Yige
- Department of Physical Therapy, Graduate School of Human
Health Sciences, Tokyo Metropolitan University: 7-2-10 Higashi-Ogu, Arakawa-Ku, Tokyo
116-8551, Japan
| | - Muhammad Irfan
- Department of Physiotherapy, Faculty of Health Sciences,
Universitas Aisyiyah Yogyakarta, Indonesia
| | - Umi Budi Rahayu
- Department of Physiotherapy, Faculty of Health Sciences,
Universitas Muhammadiyah Surakarta, Indonesia
| | - Kazu Amimoto
- Department of Physical Therapy, Graduate School of Human
Health Sciences, Tokyo Metropolitan University: 7-2-10 Higashi-Ogu, Arakawa-Ku, Tokyo
116-8551, Japan
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Brunelli S, Gentileschi N, Iosa M, Fusco FR, Grossi V, Duri S, Foti C, Traballesi M. Early balance training with a computerized stabilometric platform in persons with mild hemiparesis in subacute stroke phase: A randomized controlled pilot study. Restor Neurol Neurosci 2020; 38:467-475. [PMID: 33337397 DOI: 10.3233/rnn-201055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Along with conventional therapy, novel tools are being developed in balance training for the rehabilitation of persons with stroke sequelae. The efficacy of Computerized Balance Training thus far been the object of studies only in persons with chronic stroke. OBJECTIVE To investigate the effects of an early Computerized Balance Training on balance, walking endurance and independence in activities of daily living, in persons with mild hemiparesis in subacute phase. METHODS Thirty-two persons with a recent hemiparesis (within 4 weeks from stroke onset), able to maintain a standing position for at least 30 seconds, were randomly assigned to an experimental or control group. The control group (CG) were administered conventional physiotherapy of 40 minutes twice a day, 5 times a week for 4 weeks, while the experimental group (EG) underwent conventional physiotherapy 40 minutes once a day and Computerized Balance Training once a day, 5 times a week for 4 weeks. Outcomes were evaluated by means of Berg Balance Scale (BBS), Tinetti Balance Scale (TBS), Two Minutes Walk Test (2MWT), Barthel Index (BI) and stabilometric tests. RESULTS Twelve participants for each group completed the training. Each group experienced 8 dropouts. The mean age (years) was 58.1±20.4 for EG and 59.7±14,7 for CG; the days from stroke were respectively 27.9±15.5 and 20±11.7. The difference between the two groups was statistically significant in experimental group for BBS (p = 0.003), for TBS (p = 0.028), for Sensory Integration and Balance tests performed with closed eyes on steady (p = 0.009) or instable surface (p = 0.023). and for 2MWT (p = 0.008). CONCLUSIONS Computerized Balance Training is an effective therapeutic tool for balance and gait endurance improvement in persons with stroke in subacute phase.
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Affiliation(s)
- Stefano Brunelli
- Fondazione Santa Lucia, Scientific Institute for Research and Healthcare, Rome, Italy
| | - Noemi Gentileschi
- Physical and Rehabilitation Medicine, Tor Vergata University of Rome, Italy
| | - Marco Iosa
- Fondazione Santa Lucia, Scientific Institute for Research and Healthcare, Rome, Italy.,Department of Psychology, Sapienza University of Rome
| | | | - Valerio Grossi
- Fondazione Santa Lucia, Scientific Institute for Research and Healthcare, Rome, Italy
| | - Silvia Duri
- Fondazione Santa Lucia, Scientific Institute for Research and Healthcare, Rome, Italy
| | - Calogero Foti
- Physical and Rehabilitation Medicine, Tor Vergata University of Rome, Italy
| | - Marco Traballesi
- Fondazione Santa Lucia, Scientific Institute for Research and Healthcare, Rome, Italy
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Choi D, Choi W, Lee S. Influence of Nintendo Wii Fit Balance Game on Visual Perception, Postural Balance, and Walking in Stroke Survivors: A Pilot Randomized Clinical Trial. Games Health J 2018. [DOI: 10.1089/g4h.2017.0126] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Donmo Choi
- Department of Physical Therapy, The Graduate School of Sahmyook University, Seoul, Korea
| | - Wonjae Choi
- Department of Physical Therapy, The Graduate School of Sahmyook University, Seoul, Korea
- Institute of Rehabilitation Science, Sahmyook University, Seoul, Korea
| | - Seungwon Lee
- Institute of Rehabilitation Science, Sahmyook University, Seoul, Korea
- Department of Physical Therapy, Sahmyook University, Seoul, Korea
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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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Llorens R, Noé E, Alcañiz M, Deutsch JE. Time since injury limits but does not prevent improvement and maintenance of gains in balance in chronic stroke. Brain Inj 2017; 32:303-309. [PMID: 29278927 DOI: 10.1080/02699052.2017.1418905] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE To determine the influence of time since injury on the efficacy and maintenance of gains of rehabilitation of balance after stroke. METHOD Forty-seven participants were assigned to a least (6-12 months), a moderate (12-24 months), or a most chronic (>24 months) group. Participants trained for 20 one-hour sessions, administered three to five times a week, combining conventional physical therapy and visual feedback-based exercises that trained the ankle and hip strategies. Participants were assessed before, after the intervention, and one month later with a posturography test (Sway Speed and Limits of Stability) and clinical scales. RESULTS In contrast to other subjects, the most chronic participants failed to improve their sway and to maintain the benefits detected in the Limits of Stability after the intervention. Although all the participants improved in those clinical tests that better matched the trained skills, time since injury limited the improvement, and over all, the maintenance of gains. CONCLUSION Time since injury limits but does not prevent improvement in chronic stages post-stroke, and this effect appears to be more pronounced with maintaining gains. These findings support that training duration and intensity as well as type of therapy may need to be adjusted based on time post-stroke.
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Affiliation(s)
- Roberto Llorens
- a Neurorehabilitation and Brain Research Group, Instituto de Investigación e Innovación en Bioingeniería , Universitat Politècnica de València , Valencia , Spain.,b Servicio de Neurorrehabilitación y Daño Cerebral de los Hospitales NISA , Fundación Hospitales NISA , Valencia , Spain
| | - Enrique Noé
- b Servicio de Neurorrehabilitación y Daño Cerebral de los Hospitales NISA , Fundación Hospitales NISA , Valencia , Spain
| | - Mariano Alcañiz
- a Neurorehabilitation and Brain Research Group, Instituto de Investigación e Innovación en Bioingeniería , Universitat Politècnica de València , Valencia , Spain
| | - Judith E Deutsch
- c Rivers Lab, Department of Movement and Rehabilitation Sciences , Rutgers University-School of Professions , Newark , USA
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Audiovisual Biofeedback-Based Trunk Stabilization Training Using a Pressure Biofeedback System in Stroke Patients: A Randomized, Single-Blinded Study. Stroke Res Treat 2017; 2017:6190593. [PMID: 29423328 PMCID: PMC5750490 DOI: 10.1155/2017/6190593] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 10/31/2017] [Indexed: 11/17/2022] Open
Abstract
The purpose of this study was to assess the effects of audiovisual biofeedback-based trunk stabilization training using a pressure biofeedback system (PBS) in stroke patients. Forty-three chronic stroke patients, who had experienced a stroke more than 6 months ago and were able to sit and walk independently, participated in this study. The subjects were randomly allocated to an experimental group (n = 21) or a control group (n = 22). The experimental group participated in audiovisual biofeedback-based trunk stabilization training for 50 minutes/day, 5 days/week, for 6 weeks. The control group underwent trunk stabilization training without any biofeedback. The primary outcome of this study was the thickness of the trunk muscles. The secondary outcomes included static sitting balance ability and dynamic sitting balance ability. The thickness of the trunk muscles, static sitting balance ability, and dynamic sitting balance ability were significantly improved in the experimental group compared to the control group (p < 0.05). The present study showed that trunk stabilization training using a PBS had a positive effect on the contracted ratio of trunk muscles and balance ability. By providing audiovisual feedback, the PBS enables accurate and effective training of the trunk muscles, and it is an effective method for trunk stabilization.
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Abstract
BACKGROUND Virtual reality and interactive video gaming have emerged as recent treatment approaches in stroke rehabilitation with commercial gaming consoles in particular, being rapidly adopted in clinical settings. This is an update of a Cochrane Review published first in 2011 and then again in 2015. OBJECTIVES Primary objective: to determine the efficacy of virtual reality compared with an alternative intervention or no intervention on upper limb function and activity.Secondary objectives: to determine the efficacy of virtual reality compared with an alternative intervention or no intervention on: gait and balance, global motor function, cognitive function, activity limitation, participation restriction, quality of life, and adverse events. SEARCH METHODS We searched the Cochrane Stroke Group Trials Register (April 2017), CENTRAL, MEDLINE, Embase, and seven additional databases. We also searched trials registries and reference lists. SELECTION CRITERIA Randomised and quasi-randomised trials of virtual reality ("an advanced form of human-computer interface that allows the user to 'interact' with and become 'immersed' in a computer-generated environment in a naturalistic fashion") in adults after stroke. The primary outcome of interest was upper limb function and activity. Secondary outcomes included gait and balance and global motor function. DATA COLLECTION AND ANALYSIS Two review authors independently selected trials based on pre-defined inclusion criteria, extracted data, and assessed risk of bias. A third review author moderated disagreements when required. The review authors contacted investigators to obtain missing information. MAIN RESULTS We included 72 trials that involved 2470 participants. This review includes 35 new studies in addition to the studies included in the previous version of this review. Study sample sizes were generally small and interventions varied in terms of both the goals of treatment and the virtual reality devices used. The risk of bias present in many studies was unclear due to poor reporting. Thus, while there are a large number of randomised controlled trials, the evidence remains mostly low quality when rated using the GRADE system. Control groups usually received no intervention or therapy based on a standard-care approach. PRIMARY OUTCOME results were not statistically significant for upper limb function (standardised mean difference (SMD) 0.07, 95% confidence intervals (CI) -0.05 to 0.20, 22 studies, 1038 participants, low-quality evidence) when comparing virtual reality to conventional therapy. However, when virtual reality was used in addition to usual care (providing a higher dose of therapy for those in the intervention group) there was a statistically significant difference between groups (SMD 0.49, 0.21 to 0.77, 10 studies, 210 participants, low-quality evidence). SECONDARY OUTCOMES when compared to conventional therapy approaches there were no statistically significant effects for gait speed or balance. Results were statistically significant for the activities of daily living (ADL) outcome (SMD 0.25, 95% CI 0.06 to 0.43, 10 studies, 466 participants, moderate-quality evidence); however, we were unable to pool results for cognitive function, participation restriction, or quality of life. Twenty-three studies reported that they monitored for adverse events; across these studies there were few adverse events and those reported were relatively mild. AUTHORS' CONCLUSIONS We found evidence that the use of virtual reality and interactive video gaming was not more beneficial than conventional therapy approaches in improving upper limb function. Virtual reality may be beneficial in improving upper limb function and activities of daily living function when used as an adjunct to usual care (to increase overall therapy time). There was insufficient evidence to reach conclusions about the effect of virtual reality and interactive video gaming on gait speed, balance, participation, or quality of life. This review found that time since onset of stroke, severity of impairment, and the type of device (commercial or customised) were not strong influencers of outcome. There was a trend suggesting that higher dose (more than 15 hours of total intervention) was preferable as were customised virtual reality programs; however, these findings were not statistically significant.
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Affiliation(s)
- Kate E Laver
- Flinders UniversityDepartment of Rehabilitation, Aged and Extended CareLevel 1, C Block, Repatriation General Hospital, Daws Road, Daw ParkAdelaideSouth AustraliaAustralia5041
| | - Belinda Lange
- Flinders UniversitySchool of Health Sciences, Discipline of PhysiotherapyAdelaideAustralia
| | - Stacey George
- Flinders UniversityDepartment of Rehabilitation, Aged and Extended CareLevel 1, C Block, Repatriation General Hospital, Daws Road, Daw ParkAdelaideSouth AustraliaAustralia5041
| | - Judith E Deutsch
- Rutgers UniversityDepartment of Rehabilitation and Movement ScienceNewarkNew JerseyUSA
| | - Gustavo Saposnik
- University of TorontoDepartment of Medicine (Neurology), St Michael's HospitalTorontoCanadaM5C 1R6
| | - Maria Crotty
- Flinders UniversityDepartment of Rehabilitation, Aged and Extended CareLevel 1, C Block, Repatriation General Hospital, Daws Road, Daw ParkAdelaideSouth AustraliaAustralia5041
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Pellegrino L, Giannoni P, Marinelli L, Casadio M. Effects of continuous visual feedback during sitting balance training in chronic stroke survivors. J Neuroeng Rehabil 2017; 14:107. [PMID: 29037206 PMCID: PMC5644142 DOI: 10.1186/s12984-017-0316-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 10/05/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Postural control deficits are common in stroke survivors and often the rehabilitation programs include balance training based on visual feedback to improve the control of body position or of the voluntary shift of body weight in space. In the present work, a group of chronic stroke survivors, while sitting on a force plate, exercised the ability to control their Center of Pressure with a training based on continuous visual feedback. The goal of this study was to test if and to what extent chronic stroke survivors were able to learn the task and transfer the learned ability to a condition without visual feedback and to directions and displacement amplitudes different from those experienced during training. METHODS Eleven chronic stroke survivors (5 Male - 6 Female, age: 59.72 ± 12.84 years) participated in this study. Subjects were seated on a stool positioned on top of a custom-built force platform. Their Center of Pressure positions were mapped to the coordinate of a cursor on a computer monitor. During training, the cursor position was always displayed and the subjects were to reach targets by shifting their Center of Pressure by moving their trunk. Pre and post-training subjects were required to reach without visual feedback of the cursor the training targets as well as other targets positioned in different directions and displacement amplitudes. RESULTS During training, most stroke survivors were able to perform the required task and to improve their performance in terms of duration, smoothness, and movement extent, although not in terms of movement direction. However, when we removed the visual feedback, most of them had no improvement with respect to their pre-training performance. CONCLUSIONS This study suggests that postural training based exclusively on continuous visual feedback can provide limited benefits for stroke survivors, if administered alone. However, the positive gains observed during training justify the integration of this technology-based protocol in a well-structured and personalized physiotherapy training, where the combination of the two approaches may lead to functional recovery.
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Affiliation(s)
- Laura Pellegrino
- Department Informatics, Bioengineering, Robotics and Systems Engineering, University of Genoa, Via Opera Pia, 16145, Genoa, Italy.
| | - Psiche Giannoni
- Department Informatics, Bioengineering, Robotics and Systems Engineering, University of Genoa, Via Opera Pia, 16145, Genoa, Italy
| | - Lucio Marinelli
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, L.go Daneo, Genoa, 16132, Italy.,Department of Neuroscience, Ospedale Policlinico San Martino, L.go R. Benzi, Genoa, 16132, Italy
| | - Maura Casadio
- Department Informatics, Bioengineering, Robotics and Systems Engineering, University of Genoa, Via Opera Pia, 16145, Genoa, Italy
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Cha HG, Kim MK, Shin YJ. The effects of visual biofeedback using ultrasonograpy on deep trunk muscle activation. J Phys Ther Sci 2016; 28:3310-3312. [PMID: 28174441 PMCID: PMC5276750 DOI: 10.1589/jpts.28.3310] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 08/02/2016] [Indexed: 11/29/2022] Open
Abstract
[Purpose] The objective of this study is to investigate the effect of visual biofeedback
using ulatrasonography on the functional improvement of deep trunk muscle. [Subjects and
Methods] This study selected ten healthy people without orthopedic history and information
on the study. The average ages, heights, and weights were 22.70 ± 2.06 years old, 171.15 ±
9.18 cm, and 66.86 ± 8.88 kg in the experimental group, respectively. The abdominal
drawing-in maneuver were executed for subjects through monitoring the status of muscle
contraction using ultrasonic waves. And motor control exercises were performed during 6
weeks, 20 minutes/day and three times/week. We collected the data using electromyography
MP150 system (BIOPAC system Inc., CA, USA) in order to measure trunk muscle activation.
[Results] The subjects showed significant improvements in Internal oblique abdominis and
lumbar multifidus muscle after intervention. [Conclusion] Visual biofeedback training
using ultrasonography might be effective in improving function of the deep trunk
muscle.
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Affiliation(s)
- Hyun-Gyu Cha
- Department of Physical Therapy, College of Kyungbuk, Republic of Korea
| | - Myoung-Kwon Kim
- Department of Physical Therapy, College of Rehabilitation Sciences, Daegu University, Republic of Korea
| | - Young-Jun Shin
- Department of Physical Therapy, College of Rehabilitation Sciences, Daegu University, Republic of Korea
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15
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Lendraitienė E, Tamošauskaitė A, Petruševičienė D, Savickas R. Balance evaluation techniques and physical therapy in post-stroke patients: A literature review. Neurol Neurochir Pol 2016; 51:92-100. [PMID: 27884459 DOI: 10.1016/j.pjnns.2016.11.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 10/04/2016] [Accepted: 11/09/2016] [Indexed: 11/19/2022]
Abstract
A stroke (cerebrovascular accident - CVA) is a significant social-economic issue. Approximately 15-30% of all patients develop life-long disability, 20% require over 3 months of specialized care in healthcare institutions, and the majority of the patients never recover the ability to maintain a proper vertical position. Such CVA sequelae as balance disturbances not only negatively affect patients' daily physical activity, but also result in social isolation. A number of standardized clinical scales, tests, and instrumental examination techniques have been proposed for evaluating not only post-CVA balance function, but also any changes in this function following various interventions. Even though scientific literature lists numerous methods and instruments for the improvement of balance after a CVA, not all of them are equally effective, and there have been rather controversial evaluations of some techniques. Nevertheless, the application of the majority of the techniques as complementary or alternative measures to traditional physical therapy (PT) frequently yields better results.
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Affiliation(s)
- Eglė Lendraitienė
- Department of Rehabilitation, Medical Academy of Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Agnė Tamošauskaitė
- Department of Rehabilitation, Medical Academy of Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Daiva Petruševičienė
- Department of Rehabilitation, Medical Academy of Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Raimondas Savickas
- Department of Rehabilitation, Medical Academy of Lithuanian University of Health Sciences, Kaunas, Lithuania.
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16
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Smartphone-Based Visual Feedback Trunk Control Training Using a Gyroscope and Mirroring Technology for Stroke Patients: Single-blinded, Randomized Clinical Trial of Efficacy and Feasibility. Am J Phys Med Rehabil 2016; 95:319-29. [PMID: 26829087 DOI: 10.1097/phm.0000000000000447] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The purpose of this study was to assess the preliminary efficacy and feasibility of smartphone-based visual feedback trunk control training (SPVFTCT) for improving balance and trunk performance in stroke patients. DESIGN Twenty-four patients who had experienced a stroke more than 6 months previously and could sit and walk independently participated in the study. The participants were allocated to a SPVFTCT (n = 12) or to a control group (n = 12). Both groups completed five 80-minute sessions per week of conventional rehabilitation for 4 weeks. The SPVFTCT group additionally received three 20-minute sessions per week of SPVFTCT for 4 weeks. The outcome was assessed using static balance assessment, the modified functional reach test, the timed up and go test, and the trunk impairment scale. Feasibility of SPVFTCT was evaluated by retention, adherence, acceptability, and safety. RESULTS The static balance assessment, modified functional reach test, timed up and go test, and trunk impairment scale scores in the SPVFTCT group improved significantly compared to those in the control group (P < 0.05). In the SPVFTCT group, retention and adherence rates were 100% and 97%, respectively. All participants reported that SPVFTCT was enjoyable, easy to use, and helpful for their recovery. CONCLUSIONS The SPVFTCT approach is a feasible method to improve balance and trunk performance in stroke patients. TO CLAIM CME CREDITS Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES:: Upon completion of this article, the reader should be able to: (1) Understand the role of trunk control in postural stability and functional improvement; (2) Describe the benefits of smartphone-based visual feedback trunk control training (SPVFTCT); and (3)Discuss the feasibility of incorporating smartphone-based visual feedback trunk control training in stroke rehabilitation. LEVEL Advanced ACCREDITATION : The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The Association of Academic Physiatrists designates this activity for a maximum of 1.5 AMA PRA Category 1 Credit(s). Physicians should only claim credit commensurate with the extent of their participation in the activity.
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17
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Park DJ. Effect of visual stimulus using central and peripheral visual field on postural control of normal subjects. J Phys Ther Sci 2016; 28:1769-71. [PMID: 27390412 PMCID: PMC4932053 DOI: 10.1589/jpts.28.1769] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 02/28/2016] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study investigated the effects of visual stimulus using central and
peripheral vision fields on postural control. [Subjects and Methods] The subjects
consisted of 40 young adult volunteers (15 males, 25 females) who had been informed of the
study purpose and procedure. The subjects were randomly divided into four groups of
differing visual stimulus. Each group was given visual intervention in a standing position
for 3 minutes. Postural control was evaluated before and after visual intervention.
[Results] The results of the functional reach test and body sway test showed significant
differences among the four groups. [Conclusion] The two-way peripheral vision-field group
showed significantly more body sway after visual intervention than the other three groups.
This finding may suggest two-way peripheral vision field is a more effective visual
stimulus for training postural control and balance.
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Affiliation(s)
- Du-Jin Park
- Department of Physical Therapy, College of Health Medicine, Kaya University: 208 Samgye-ro, Gimhae, Kyongnam 609-757, Republic of Korea
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18
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Elhinidi EIM, Ismaeel MMI, El-Saeed TM. Effect of dual-task training on postural stability in children with infantile hemiparesis. J Phys Ther Sci 2016; 28:875-80. [PMID: 27134376 PMCID: PMC4842457 DOI: 10.1589/jpts.28.875] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 12/11/2015] [Indexed: 12/03/2022] Open
Abstract
[Purpose] The aim of this study was to evaluate the influence of using a selected
dual-task training program to improve postural stability in infantile hemiparesis.
[Subjects and Methods] Thirty patients participated in this study; patients were
classified randomly into two equal groups: study and control groups. Both groups received
conventional physical therapy treatment including mobility exercises, balance exercises,
gait training exercises, and exercises to improve physical conditioning. In addition, the
study group received a selected dual-task training program including balance and cognitive
activities. The treatment program was conducted thrice per week for six successive weeks.
The patients were assessed with the Biodex Balance System. These measures were recorded
two times: before the application of the treatment program (pre) and after the end of the
treatment program (post). [Results] There was a significant improvement for both groups;
the improvement was significantly higher in the study group compared to the control group.
[Conclusion] The selected dual-task training program is effective in improving postural
stability in patients with infantile hemiparesis when added to the conventional physical
therapy program.
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Affiliation(s)
- Elbadawi Ibrahim Mohammad Elhinidi
- Department of Physical Therapy for Neuromuscular Disorders and Surgery, Faculty of Physical Therapy, Cairo University, Egypt; Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Aljouf University, Saudi Arabia
| | - Marwa Mostafa Ibrahim Ismaeel
- Department of Physical Therapy for Growth and Developmental Disorders in Children and its Surgery, Faculty of Physical Therapy, Cairo University, Egypt; Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Aljouf University, Saudi Arabia
| | - Tamer Mohamed El-Saeed
- Department of Physical Therapy for Growth and Developmental Disorders in Children and its Surgery, Faculty of Physical Therapy, Cairo University, Egypt
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Bang DH, Bong SY. Effect of combination of transcranial direct current stimulation and feedback training on visuospatial neglect in patients with subacute stroke: a pilot randomized controlled trial. J Phys Ther Sci 2015; 27:2759-61. [PMID: 26504287 PMCID: PMC4616088 DOI: 10.1589/jpts.27.2759] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 05/25/2015] [Indexed: 11/29/2022] Open
Abstract
[Purpose] To investigate the effects of a combination of transcranial direct current
stimulation (tDCS) and feedback training (FT) on subacute stroke patients with unilateral
visuospatial neglect. [Subjects] The subjects were randomly assigned to a tDCS + FT group
(n=6) and a FT group (n=6). [Methods] Patients in the tDCS + FT group received tDCS for 20
minutes and then received FT for 30 minutes a day, 5 days a week for 3 weeks. The control
group received FT for 30 minutes a day, 5 days a week for 3 weeks. [Results] After the
intervention, both groups showed significant improvements in the Motor-Free Visual
Perception Test (MVPT), line bisection test (LBT), and modified Barthel index (MBI) over
the baseline results. The comparison of the two groups after the intervention revealed
that the rDCS + FT group showed more significant improvements in MVPT, LBT, and MBI.
[Conclusion] The results of this study suggest that tDCS combined with FT has a positive
effect on unilateral visuospatial neglect in patients with subacute stroke.
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Affiliation(s)
- Dae-Hyouk Bang
- Department of Physical Therapy, Graduate School of Daejeon University, Republic of Korea
| | - Soon-Young Bong
- Department of Physical Therapy, Graduate School of Seonam University, Republic of Korea
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Jeon SN, Choi JH. The effects of ankle joint strategy exercises with and without visual feedback on the dynamic balance of stroke patients. J Phys Ther Sci 2015; 27:2515-8. [PMID: 26355721 PMCID: PMC4563303 DOI: 10.1589/jpts.27.2515] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 05/05/2015] [Indexed: 12/26/2022] Open
Abstract
[Purpose] The aim of this study was to examine the effects of visual feedback training on the balance of stroke patients performing ankle joint strategy exercises. [Subjects and Methods] In this study, 26 stroke patients were randomly and equally assigned to a visual feedback group (VFG) and a visual disuse group (VDG). They performed ankle joint strategy exercises for 30 minutes, three times per week for six weeks. The patients' balance ability was measured before and after the exercises to compare the effects of visual feedback. To assess balance ability, the limits of stability (LOS) and the distance the center of pressure (CoP) moved were measured using a BT4 portable force platform. The Berg balance scale (BBS) and the timed up and go (TUG) test were also used to assess balance before and after the exercises. [Results] Changes in LOS were significant in the anterior, posterior, left, and right directions in each group, and the interactions between the two groups were significant in the posterior, left, and right directions. The changes in TUG and BBS results between pre-test and the post-test were statistically significant in the two groups, and also between the groups. [Conclusion] Visual feedback training had a positive effect on balance when ankle joint strategy exercises were performed by stroke patients to improve balance.
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Affiliation(s)
- Si-Nae Jeon
- Department of Physical Therapy, Institute for Elderly Health and Welfare, Namseoul University, Republic of Korea
| | - Jung-Hyun Choi
- Department of Physical Therapy, Institute for Elderly Health and Welfare, Namseoul University, Republic of Korea
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21
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Bang DH, Noh HJ, Cho HS. Effects of body awareness training on mild visuospatial neglect in patients with acute stroke: a pilot randomized controlled trial. J Phys Ther Sci 2015; 27:1191-3. [PMID: 25995586 PMCID: PMC4434007 DOI: 10.1589/jpts.27.1191] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Accepted: 12/11/2014] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study aimed to investigate the effects of body awareness training (BAT) on
mild visuospatial neglect in patients following acute stroke. [Subjects] The subjects were
12 stroke patients randomly assigned to either the experimental group (n1=6) or
control group (n2=6). [Methods] The experimental group underwent BAT for 15
minutes and then task-oriented training for 30 minutes a day, five times a week for three
weeks. The control group underwent task-oriented training for 30 minutes a day, five times
a week for three weeks. Assessments were made using the Motor-free Visual Perception Test
(MVPT), Line Bisection Test (LBT), and modified Barthel index (MBI). [Results] Following
the interventions, the experimental group showed a significant change in MVPT, LBT, and
MBI scores. [Conclusion] The results of this study suggest the feasibility and suitability
of BAT with task-oriented training for mild visuospatial neglect in patients with acute
stroke.
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Affiliation(s)
- Dae-Hyouk Bang
- Department of Physical Therapy, Graduate School of Daejeon University, Republic of Korea
| | - Hyun-Jeong Noh
- Department of Physical Therapy, Graduate School of Daejeon University, Republic of Korea
| | - Hyuk-Shin Cho
- Department of Physical Therapy, Wonkwang Health Science University, Republic of Korea
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Choi JH, Kim BR, Han EY, Kim SM. The effect of dual-task training on balance and cognition in patients with subacute post-stroke. Ann Rehabil Med 2015; 39:81-90. [PMID: 25750876 PMCID: PMC4351499 DOI: 10.5535/arm.2015.39.1.81] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 09/29/2014] [Indexed: 01/08/2023] Open
Abstract
Objective To investigate the effect of dual-task training on the recovery of balance ability and cognitive function in patients with subacute stroke. Methods Twenty patients (12 males and eight females; average age, 59.70 years) with subacute stroke were enrolled in this study. All participants were randomly assigned to one of two groups, the dual-task group (n=10) or the control group (n=10). The dual task was simultaneous balance and cognitive training using the BioRescue. All patients were evaluated with posturographic parameters and the Berg Balance Scale for balance ability, a computerized neuropsychological test and the Korean version of the Mini-Mental State Examination for cognitive function, the Fugl-Meyer Assessment for motor function, and the Korean-Modified Barthel Index for activities of daily living (ADL) function before and after 4 weeks of rehabilitation. Results The dual-task group showed significant improvements in the pressure of the weight distribution index (WDI), surface area, and length of the stability index during the eyes-open condition; surface area of the limit of stability (LOS) on the hemiparetic and intact sides, and the auditory continuous performance test and backward visual span test after rehabilitation. Although no significant difference was observed for the changes in balance ability or cognitive, motor, and ADL functions between the groups, changes in the WDI pressure during the eyes-open condition and in the area ratio of LOS (hemiparetic/intact) showed a tendency to improve in the dual-task group. Conclusion Our findings suggest that dual-task training could be as effective as conventional balance training for improving balance and cognition in subacute post-stroke patients.
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Affiliation(s)
- Jun Hwan Choi
- Department of Rehabilitation Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea
| | - Bo Ryun Kim
- Department of Rehabilitation Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea
| | - Eun Young Han
- Department of Rehabilitation Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea
| | - Sun Mi Kim
- Department of Rehabilitation Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea
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23
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Wang YT, Limroongreungrat W, Chang LS, Ke X, Tsai LC, Chen YP, Lewis J. Immediate video feedback on ramp, wheelie, and curb wheelchair skill training for persons with spinal cord injury. ACTA ACUST UNITED AC 2015; 52:421-30. [DOI: 10.1682/jrrd.2014.11.0286] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Revised: 03/04/2015] [Indexed: 11/05/2022]
Affiliation(s)
- Yong Tai Wang
- College of Nursing and Health Sciences, University of Texas at Tyler, Tyler, Texas
| | | | - Li-Shan Chang
- Department of Rehabilitation, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan; Departments of
| | | | | | - Yu-Ping Chen
- Physical Therapy, Georgia State University, Atlanta, Georgia
| | - James Lewis
- Department of Physical Therapy, Brenau University, Gainesville, Georgia
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