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Kwon IH, Shin WS, Choi KS, Lee MS. Effects of Real-Time Feedback Methods on Static Balance Training in Stroke Patients: A Randomized Controlled Trial. Healthcare (Basel) 2024; 12:767. [PMID: 38610189 PMCID: PMC11011765 DOI: 10.3390/healthcare12070767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 03/25/2024] [Accepted: 03/29/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND The purpose of this study was to investigate the effects of real-time feedback methods on static balance training in stroke patients. There are two types of real-time feedback methods, as follows: one is Knowledge of Result (KR), and the other is Knowledge of Performance (KP). METHOD Thirty stroke patients participated in this study and were randomly assigned to the KR group (n = 15) or the KP group (n = 15). All of the groups underwent real-time feedback training for four weeks (30 min per session, five sessions per week). The primary outcomes were sway length, sway velocity, and area 95%, which were assessed before and after the intervention. The secondary outcomes included the Berg Balance Scale, the Fugl Meyer Assessment for Lower Extremity, the Postural Assessment Scale for Stroke Trunk Impairment Scale, and the Fall Efficacy Scale. A group × time interaction was assessed using two-way ANOVA with repeated measures. RESULT There was a significant increase over time in all outcomes (p < 0.05). Significant differences were observed for a group × time interaction in sway length and area 95% (p < 0.05). CONCLUSIONS Real-time feedback training for static balance enhanced stroke patients' static balance abilities, clinical outcome assessments, and promoted self-efficacy against falls.
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Affiliation(s)
- Il-Ho Kwon
- Department of Physical Therapy, Graduate School of Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon 34520, Republic of Korea;
| | - Won-Seob Shin
- Department of Physical Therapy, College of Health Medical Science, Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon 34520, Republic of Korea
| | - Kyu-Seong Choi
- Department of Physical Therapy, Graduate School of Health and Medicine, Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon 34520, Republic of Korea;
| | - Myung-Sun Lee
- Department of Beauty Design, College of Design and Art, Daejeon University, 62, Daehak-ro, Dong-gu, Daejeon 34520, Republic of Korea;
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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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Sonobe M, Inoue Y. Center of Mass Estimation Using a Force Platform and Inertial Sensors for Balance Evaluation in Quiet Standing. SENSORS (BASEL, SWITZERLAND) 2023; 23:4933. [PMID: 37430849 DOI: 10.3390/s23104933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 05/15/2023] [Accepted: 05/19/2023] [Indexed: 07/12/2023]
Abstract
Accurate estimation of the center of mass is necessary for evaluating balance control during quiet standing. However, no practical center of mass estimation method exists because of problems with estimation accuracy and theoretical validity in previous studies that used force platforms or inertial sensors. This study aimed to develop a method for estimating the center of mass displacement and velocity based on equations of motion describing the standing human body. This method uses a force platform under the feet and an inertial sensor on the head and is applicable when the support surface moves horizontally. We compared the center of mass estimation accuracy of the proposed method with those of other methods in previous studies using estimates from the optical motion capture system as the true value. The results indicate that the present method has high accuracy in quiet standing, ankle motion, hip motion, and support surface swaying in anteroposterior and mediolateral directions. The present method could help researchers and clinicians to develop more accurate and effective balance evaluation methods.
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Affiliation(s)
- Motomichi Sonobe
- Department of Intelligent Mechanical Systems Engineering, Kochi University of Technology, Kochi 782-8502, Japan
| | - Yoshio Inoue
- Department of Intelligent Mechanical Systems Engineering, Kochi University of Technology, Kochi 782-8502, Japan
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Chen Y, Su W, Gui CF, Guo QF, Tan HX, He L, Jiang HH, Wei QC, Gao Q. Effectiveness of cerebellar vermis intermittent theta-burst stimulation in improving trunk control and balance function for patients with subacute stroke: a randomised controlled trial protocol. BMJ Open 2023; 13:e066356. [PMID: 36631236 PMCID: PMC9835952 DOI: 10.1136/bmjopen-2022-066356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION Balance impairments frequently occur after stroke. Achieving effective core trunk stability is the key to improving balance ability. However, there is still a lack of advanced well-defined rehabilitation protocols for balance improvement in patients with stroke. Intermittent theta-burst stimulation (iTBS) is a non-invasive brain activity modulation strategy that can produce long-term potentiation. The cerebellar vermis is a fundamental structure involved in balance and motor control. However, no study has demonstrated the therapeutic effect and potential mechanism of cerebellar vermis iTBS on balance after stroke. METHODS AND ANALYSIS This study will be a prospective single-centre double-blind randomised controlled clinical trial with a 3-week intervention and 3-week follow-up. Eligible participants will be randomly allocated to the experimental group or the control group in a 1:1 ratio. After routine conventional physical therapy, patients in the experimental group will receive cerebellar vermis iTBS, whereas patients in the control group will receive sham stimulation. The overall intervention period will be 5 days a week for 3 consecutive weeks. The outcomes will be measured at baseline (T0), 3 weeks postintervention (T1) and at the 3-week follow-up (T2). The primary outcomes are Berg Balance Scale and Trunk Impairment Scale scores. The secondary outcomes are balance test scores via the Balance Master system, muscle activation of the trunk and lower limbs via the surface electromyography recordings, cerebral cortex oxygen concentrations measured via the resting-state functional near-infrared spectroscopy, Fugl-Meyer Assessment of Lower Extremity and Barthel index scores. ETHICS AND DISSEMINATION This study was approved by the West China Hospital Clinical Trials and Biomedical Ethics Committee of Sichuan University. All participants will sign the informed consent form voluntarily. The results of this study will be published in peer-reviewed journals and disseminated at academic conferences. TRIAL REGISTRATION NUMBER ChiCTR2200065369.
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Affiliation(s)
- Yi Chen
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, People's Republic of China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, People's Republic of China
| | - Wei Su
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, People's Republic of China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, People's Republic of China
| | - Chen-Fan Gui
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, People's Republic of China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, People's Republic of China
| | - Qi-Fan Guo
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, People's Republic of China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, People's Republic of China
| | - Hui-Xin Tan
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, People's Republic of China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, People's Republic of China
| | - Lin He
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, People's Republic of China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, People's Republic of China
| | - Han-Hong Jiang
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, People's Republic of China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, People's Republic of China
| | - Qing-Chuan Wei
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, People's Republic of China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, People's Republic of China
| | - Qiang Gao
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, People's Republic of China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, People's Republic of China
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Daly JJ, Pundik S, McCabe JP. Underlying Mechanisms and Neurorehabilitation of Gait after Stroke. Brain Sci 2022; 12:brainsci12091251. [PMID: 36138987 PMCID: PMC9497174 DOI: 10.3390/brainsci12091251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 09/12/2022] [Indexed: 11/29/2022] Open
Affiliation(s)
- Janis J. Daly
- Brain Plasticity and NeuroRecovery Laboratory, Cleveland VA Medical Center, Cleveland, OH 44106, USA
- Department of Neurology, Case Western Reserve University, Cleveland, OH 44016, USA
- Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, FL 32608, USA
- Department of Physical Therapy, College of Public Health and Health Professions, University of Florida, Gainesville, FL 32608, USA
- Correspondence:
| | - Svetlana Pundik
- Brain Plasticity and NeuroRecovery Laboratory, Cleveland VA Medical Center, Cleveland, OH 44106, USA
- Department of Neurology, Case Western Reserve University, Cleveland, OH 44016, USA
| | - Jessica P. McCabe
- Brain Plasticity and NeuroRecovery Laboratory, Cleveland VA Medical Center, Cleveland, OH 44106, USA
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