1
|
Nagai K, Amimoto K, Teshima M, Ito T, Nariya H, Ueno R, Ikeda Y. Immediate effects of standing unstable board intervention on the non-paralyzed leg on sitting balance in severe hemiplegia: a randomized controlled trial. Top Stroke Rehabil 2024; 31:446-456. [PMID: 38224997 DOI: 10.1080/10749357.2024.2302730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 12/29/2023] [Indexed: 01/17/2024]
Abstract
BACKGROUND Unstable board intervention for patients with stroke improves sitting balance and trunk function. However, because patients with severe stroke are at high risk of falling, it is mostly adapted in mild cases. OBJECTIVE We aimed to examine the effect of standing unstable board intervention for the non-paralyzed lower limbs on sitting balance in patients with hemiplegia. METHODS The participants were 42 patients with stroke who were randomly assigned to a control or intervention group. In the intervention group, the non-paralyzed leg was placed on an unstable board, and the patient wore a knee-ankle-foot orthosis on the paralyzed side and practiced standing and weight-bearing exercises on the unstable board for 3 days. The outcomes were the angle of righting reaction of the neck, trunk, and both lower legs and the movement distance of the center of pressure of the righting reaction from lateral tilted sitting. RESULTS In the intervention group, the righting reaction angle of the trunk to the paralyzed and non-paralyzed sides and the movement distance of the center of pressure were increased significantly after the unstable board intervention. CONCLUSION The standing unstable board intervention for the non-paralyzed lower limb increased sensory input to the non-paralyzed side of the trunk weight-bearing on the lower limb of the paralyzed side. The increase in the righting reaction angle and the movement distance of the center of pressure contributed to improved sitting balance.
Collapse
Affiliation(s)
- Koki Nagai
- Department of Rehabilitation, Medical Corporation Sonodenkai, Hanahata Rehabilitation Hospital, Hanahata, Adachi-ku, Tokyo, Japan
- Department of Physical Therapy, Tokyo Metropolitan University Graduate School of Health Sciences, Arakawa-ku, Tokyo, Japan
| | - Kazu Amimoto
- Department of Rehabilitation, Sendai Seiyo Gakuin College, Nagamachi Taihaku-ku, Sendai-shi, Miyagi, Japan
| | - Masato Teshima
- Department of Rehabilitation, Medical Corporation Sonodenkai, Hanahata Rehabilitation Hospital, Hanahata, Adachi-ku, Tokyo, Japan
| | - Takeshi Ito
- Department of Rehabilitation, Medical Corporation Sonodenkai, Hanahata Rehabilitation Hospital, Hanahata, Adachi-ku, Tokyo, Japan
| | - Honoka Nariya
- Department of Rehabilitation, Medical Corporation Sonodenkai, Hanahata Rehabilitation Hospital, Hanahata, Adachi-ku, Tokyo, Japan
| | - Ryuji Ueno
- Department of Rehabilitation, Medical Corporation Sonodenkai, Hanahata Rehabilitation Hospital, Hanahata, Adachi-ku, Tokyo, Japan
| | - Yumi Ikeda
- Department of Physical Therapy, Tokyo Metropolitan University Graduate School of Health Sciences, Arakawa-ku, Tokyo, Japan
| |
Collapse
|
2
|
Garay-Sánchez A, Marcén-Román Y, Ferrando-Margelí M, Franco-Sierra MÁ, Suarez-Serrano C. Effect of Physiotherapy Treatment with Immersive Virtual Reality in Subjects with Stroke: A Protocol for a Randomized Controlled Trial. Healthcare (Basel) 2023; 11:healthcare11091335. [PMID: 37174877 PMCID: PMC10177902 DOI: 10.3390/healthcare11091335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/30/2023] [Accepted: 05/02/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Many stroke survivors suffer from sensorimotor deficits, especially balance impairments. The purpose of this trial is to investigate whether the designed Immersive Virtual Reality training program is better in the short term (15 sessions) and in the medium term (30 sessions) than physiotherapy training with Bayouk, Boucher and Leroux exercises, with respect to static balance in sitting and standing, dynamic balance and quality of life in patients with balance impairment in stroke survivors. METHODS This study is a randomized controlled trial with two treatment arms and evaluators blinded, and a functionality treatment group in combination with specific balance exercise training according to Bayouk, Boucher and Leroux (control group) or a balanced treatment using Immersive VR. The primary outcome will be static, Dynamic balance and gait measured by Bestest Assessment Score (BESTest), Berg Scale (BBS), Pass Scale (PASS) and Time Up and Go test (TUG). The secondary outcome will be the stroke-associated quality of life using the Stroke Quality of Life Scale (ECVI-38). CONCLUSIONS The results of this study may add new insights into how to address balance using Immersive Virtual Reality after a stroke. If the new training approach proves effective, the results may provide insight into how to design more comprehensive protocols in the future for people with balance impairments after stroke.
Collapse
Affiliation(s)
- Aitor Garay-Sánchez
- Institute for Health Research Aragón, 50009 Zaragoza, Spain
- Miguel Servet University Hospital, 50009 Zaragoza, Spain
| | - Yolanda Marcén-Román
- Institute for Health Research Aragón, 50009 Zaragoza, Spain
- Department of Human Anatomy and Histology, Faculty of Medicine, University of Zaragoza, 50009 Zaragoza, Spain
| | - Mercedes Ferrando-Margelí
- Institute for Health Research Aragón, 50009 Zaragoza, Spain
- Miguel Servet University Hospital, 50009 Zaragoza, Spain
- Department of Human Anatomy and Histology, Faculty of Medicine, University of Zaragoza, 50009 Zaragoza, Spain
| | - M Ángeles Franco-Sierra
- Institute for Health Research Aragón, 50009 Zaragoza, Spain
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain
| | - Carmen Suarez-Serrano
- Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain
| |
Collapse
|
3
|
Aphiphaksakul P, Siriphorn A. Home-based exercise using balance disc and smartphone inclinometer application improves balance and activity of daily living in individuals with stroke: A randomized controlled trial. PLoS One 2022; 17:e0277870. [PMID: 36409753 PMCID: PMC9678269 DOI: 10.1371/journal.pone.0277870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 11/02/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Sitting ability is critical for daily activities in individuals who have experienced a stroke. A combination of seated balance training on an unstable surface and real-time visual feedback via a simple mobile inclinometer application may improve trunk control in stroke survivors. OBJECTIVE This randomized controlled trial aimed to determine the effects of home-based exercise utilizing a balance disc with input from a smartphone inclinometer application on sitting balance and activities of daily living in stroke survivors. METHODS This trial enrolled 32 stroke survivors aged 30 to 75 years. Participants were randomly assigned to one of two groups: intervention or control. Both groups underwent four weeks of traditional therapy. Additionally, the intervention group received four weeks of multidirectional lean training utilizing a balance disc and a smartphone application with an inclinometer. The Postural Assessment Scale for Stroke (PASS), the Function in Sitting Test (FIST), and the Barthel Index (BI) were used to assess the results. To compare between group effects, an ANCOVA analysis was performed using a baseline as a covariate. RESULTS The PASS changing posture and BI were considerably greater in the intervention group compared to the control group. Other metrics revealed no statistically significant differences between the groups. CONCLUSION Home-based training with balance discs and input from a smartphone inclinometer application may improve postural control and daily activity in stroke patients. TRIAL REGISTRATION Clinical trials registry number: TCTR20210617004.
Collapse
Affiliation(s)
- Pantawit Aphiphaksakul
- Department of Physical Therapy, Human Movement Performance Enhancement Research Unit, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Akkradate Siriphorn
- Department of Physical Therapy, Human Movement Performance Enhancement Research Unit, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
- * E-mail:
| |
Collapse
|
4
|
Effects of Immersive and Non-Immersive Virtual Reality on the Static and Dynamic Balance of Stroke Patients: A Systematic Review and Meta-Analysis. J Clin Med 2021; 10:jcm10194473. [PMID: 34640491 PMCID: PMC8509616 DOI: 10.3390/jcm10194473] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 09/25/2021] [Accepted: 09/26/2021] [Indexed: 11/17/2022] Open
Abstract
(1) Background: The development of new technologies means that the use of virtual reality is increasingly being implemented in rehabilitative approaches for adult stroke patients. OBJECTIVE To analyze the existing scientific evidence regarding the application of immersive and non-immersive virtual reality in patients following cerebrovascular incidents and their efficacy in achieving dynamic and static balance. (2) Data sources: An electronic search of the databases Medline, Cochrane Library, PEDro, Scopus, and Scielo from January 2010 to December 2020 was carried out using the terms physiotherapy, physical therapy, virtual reality, immersive virtual reality, non-immersive virtual reality, stroke, balance, static balance, and dynamic balance. SELECTION OF STUDIES Randomized controlled trials in patients older than 18 developed with an adult population (>18 years old) with balance disorders as a consequence of suffering a stroke in the previous six months before therapeutic intervention, including exercises harnessing virtual reality in their interventions and evaluations of balance and published in English or Spanish, were included. A total of two hundred twenty-seven articles were found, ten of which were included for review and of these, nine were included in the subsequent meta-analysis. (3) Data extraction: Two authors selected the studies and extracted their characteristics (participants, interventions, and validation instruments) and results. The methodological quality of the studies was evaluated using the PEDro scale, and the risk of bias was determined using the Cochrane risk-of-bias tool. DATA SYNTHESIS Of the selected studies, three did not show significant improvements and seven showed significant improvements in the intervention groups in relation to the variables. (4) Conclusions: Non-immersive virtual reality combined with conventional rehabilitation could be considered as a therapeutic option.
Collapse
|
5
|
Zouita S, Zouhal H, Ferchichi H, Paillard T, Dziri C, Hackney AC, Laher I, Granacher U, Ben Moussa Zouita A. Effects of Combined Balance and Strength Training on Measures of Balance and Muscle Strength in Older Women With a History of Falls. Front Physiol 2020; 11:619016. [PMID: 33424642 PMCID: PMC7786296 DOI: 10.3389/fphys.2020.619016] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 12/07/2020] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE We investigated the effects of combined balance and strength training on measures of balance and muscle strength in older women with a history of falls. METHODS Twenty-seven older women aged 70.4 ± 4.1 years (age range: 65 to 75 years) were randomly allocated to either an intervention (IG, n = 12) or an active control (CG, n = 15) group. The IG completed 8 weeks combined balance and strength training program with three sessions per week including visual biofeedback using force plates. The CG received physical therapy and gait training at a rehabilitation center. Training volumes were similar between the groups. Pre and post training, tests were applied for the assessment of muscle strength (weight-bearing squat [WBS] by measuring the percentage of body mass borne by each leg at different knee flexions [0°, 30°, 60°, and 90°], sit-to-stand test [STS]), and balance. Balance tests used the modified clinical test of sensory interaction (mCTSIB) with eyes closed (EC) and opened (EO), on stable (firm) and unstable (foam) surfaces as well as spatial parameters of gait such as step width and length (cm) and walking speed (cm/s). RESULTS Significant group × time interactions were found for different degrees of knee flexion during WBS (0.0001 < p < 0.013, 0.441 < d < 0.762). Post hoc tests revealed significant pre-to-post improvements for both legs and for all degrees of flexion (0.0001 < p < 0.002, 0.697 < d < 1.875) for IG compared to CG. Significant group × time interactions were found for firm EO, foam EO, firm EC, and foam EC (0.006 < p < 0.029; 0.302 < d < 0.518). Post hoc tests showed significant pre-to-post improvements for both legs and for all degrees of oscillations (0.0001 < p < 0.004, 0.753 < d < 2.097) for IG compared to CG. This study indicates that combined balance and strength training improved percentage distribution of body weight between legs at different conditions of knee flexion (0°, 30°, 60°, and 90°) and also decreased the sway oscillation on a firm surface with eyes closed, and on foam surface (with eyes opened or closed) in the IG. CONCLUSION The higher positive effects of training seen in standing balance tests, compared with dynamic tests, suggests that balance training exercises including lateral, forward, and backward exercises improved static balance to a greater extent in older women.
Collapse
Affiliation(s)
- Sghaier Zouita
- Higher Institute of Sport and Physical Education, Ksar-said, University of Manouba, Manouba, Tunisia
| | - Hassane Zouhal
- M2S (Laboratoire Mouvement, Sport, Santé), University of Rennes, Rennes, France
| | - Habiba Ferchichi
- Department of Medicine Physical and Functional Rehabilitation of the National Institute of Orthopedics “M.T. Kassab”, Tunis, Tunisia
| | - Thierry Paillard
- Movement, Balance, Performance and Health Laboratory, Tarbes, E2S/University of Pau and Pays de l’Adour, Pau, France
| | - Catherine Dziri
- Department of Medicine Physical and Functional Rehabilitation of the National Institute of Orthopedics “M.T. Kassab”, Tunis, Tunisia
| | - Anthony C. Hackney
- Department of Exercise and Sport Science, Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Ismail Laher
- Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, BC, Canada
| | - Urs Granacher
- Division of Training and Movement Science, University of Potsdam, Potsdam, Germany
| | - Amira Ben Moussa Zouita
- Higher Institute of Sport and Physical Education, Ksar-said, University of Manouba, Manouba, Tunisia
| |
Collapse
|