The Effects of Home Based Exercise Program on Balance Recovery in a Post-Stroke Population

뇌졸중 환자의 균형능력 회복을 위한 가정운동프로그램 효과

  • 장상훈 (김천대학교 물리치료학과) ;
  • 정병옥 (김천대학교 물리치료학과) ;
  • 방현수 (김천대학교 물리치료학과)
  • Received : 2014.05.09
  • Accepted : 2014.07.20
  • Published : 2014.07.28


The present study was designed to investigate the effect of home based exercise program on balance recovery of stroke patients. In total, 20 participants were assigned to a control group(n=10) or exercise group(n=10) between September 2013 and December 2013. In addition to existing physiotherapy, the exercise group received home based exercise program consisting of weight transfer, training endurance, mobility, sensory retraining, lower limb exercise for 30 minutes, 2 times a week, for 8 weeks, every time for 30 minutes. Balance ability was assessed by measuring foot pressure(FP), limit of stability(LOS) and velocity sway(VS) by using Biorescue and by using the functional reaching test(FRT). To compare the improvement level of each group's balance ability, examination of independent sample T was done. Significant differences between control group and exercise group in LOS, VS of affect side and FRT were observed. This study showed that home based exercise program application was effective strategy on balance recovery in a post stroke population.


  1. C. Wutzke, V. Mercer, M. Lewek, Influence of lower extremity sensory function on locomotor adaptation following stroke: a review. Topic in Stroke Rehabilitation, Vol. 20, No. 3, pp. 233-240, 2013.
  2. A. Mansfield, C. J. Danells, J. L. Zettel, S. E. Black, W. E. Mcllroy, Determinants and consequences for standing balance of spontaneous weight-bearing on the paretic side among individuals with chronic stroke. Gait & Posture, Vol. 38, No. 3, pp. 428-432, 2013.
  3. L. von Koch, J. de Pedro-Cuesta, V. Kostulas, J. Almazan, L. Widen Holmqvist, Randomized controlled trial of rehabilitation at home after stroke: one-year follow-up of patient outcome, resource use and cost. Cerebrovascular Diseases, Vol. 12, No. 2, pp. 131-138, 2001.
  4. N. S. Redzuan, J. P. Engkasan, M. Mazlan, S. J. Freddy Abdullah, Effectiveness of a video-based therapy program at home after acute stroke: a randomized controlled trial. Archives of Physical Medicine and Rehabilitation, Vol. 93, No. 12, pp. 2177-2183, 2012.
  5. I. Melzer, N. Benjuya, J. Kaplanski, N. Alexander, Association between ankle muscle strength and limit of stability in older adults. Age and Ageing, Vol. 38, No. 1, pp. 119-123, 2008.
  6. S. I. Lin, Association between sensorimotor function and functional and reactive balance control in the elderly. Age and Ageing, Vol. 34, No. 4, pp. 358-363, 2005.
  7. J. H. Lin, C. L. Hsieh, S. K. Lo, H. M. Chai, L. R. Liao, Preliminary study of the effect of low-intensity home-based physical therapy in chronic stroke patients. The Kaohsiung Journal of Medical Sciences, Vol. 20, No. 1, pp. 18-22, 2004.
  8. J. S. Chern, C. Y. Lo, C. Y. Wu, C. L. Chen, S. Yang, F. T. Tang, Dynamic postural control during trunk bending and reaching in healthy adults and stroke patients. American Journal of Physical Medicine & Rehabilitation, Vol. 89, No. 3, pp. 186-197, 2010.
  9. P. Era, E. Heikkinen, I. Gause-Nilsson, M. Schroll, Postural balance in elderly people: change over five-year follow-up and its predictive value for survival. Aging clinical and experimental research, Vol. 14, No. 3, pp. 37-46, 2002.
  10. P. Era, K. Avlund, J. Jokela, I. Gause-Nilsson, E. Heikkinen, B. Steen, M. Schroll, Postural balance and self-reported functional ability in 75-year-old men and women: a cross-national comparative study. Journal of American Geriatrics Society, Vol 45, No. 1, pp. 21-29, 1997.
  11. P. B. Thapa, P. Gideon, R. L. Fought, M. Kormicki, W. A. Ray, Comparison of clinical biomechanical measures of balance and mobility in elderly nursing home residents. Journal of the American Geriatrics Society, Vol. 42, No. 5, pp. 493-500, 1994.
  12. O. Pyoria, P. Era, U. Talvitie, Relationships between standing balance and symmetry measurements in patients following recent strokes(${\leq}3$ weeks) or older strokes(${\geq}6$ months). Physical Therapy, Vol 84, No. 2, pp. 128-136, 2004.
  13. G. R. Fernie, C. I. Gryfe, P. J. Holliday, A. Llewellyn, The relationship of postural sway in standing: the incidence of falls in geriatric subjects. Age and Ageing, Vol. 11, No. 1, pp. 11-16, 1982.
  14. P. F. Meyer, L. I. E. Oddsson, C. J. D. Luca, Reduced plantar sensitivity alters postural responses to lateral perturbations of balance. Experimental Brain Research, Vol. 157, No. 4, pp. 526-536, 2004.
  15. R. W. Simmons, C. Rchardson, R. Pozos, Postural stability of diabetic patients with and without cutaneous sensory deficit in the foot. Diabetes Research and Clinical Practice, Vol. 36, No. 3, pp. 153-160, 1997.
  16. P. Roderick, J. Low, R. Day, T. Peasgood, M. A. Mullee, J. C. Turnbull, T. Villar, J. Raftery, Stroke rehabilitation after hospital discharge: a randomized trial comparing domiciliary and day-hospital care. Age and Ageing, Vol. 30, No. 4, pp. 303-310, 2001.
  17. J. B. Young, A. Forster, The Bradford community stroke trial: results at six months. British Medical Journal, Vol. 304, No. 6834, pp. 1085-1089, 1992.
  18. A. Shurnway-Cook, D. Anson, S. Haller, Postural sway biofeedback: its effect on reestablishing stance stability in hemiplegic patients. Archives of Physical Medicine and Rehabilitation, Vol. 69, No. 6, pp. 395-400, 1988.
  19. C. M. Sackley, B. I. Baguley, S. Gent, P. Hodgson, The use of a balance performance monitor in the treatment of weight-bearing and weight transference problems after stroke. Physiotherapy, Vol. 78, No. 12, pp. 907-913, 1992.
  20. P. A. Goldie, T. M. Bach, O. M. Evans, Force platform measures for evaluating postural control: reliability and validity. Archives of Physical Medicine and Rehabilitation, Vol. 70, No. 7, pp. 510-517, 1989.
  21. D. S. Nichols, Balance retraining after stroke using force platform biofeedback. Physical Therapy, Vol. 77, No. 5, pp. 553-558, 1997.
  22. S. M. Waller, M. G. Prettyman, Arm training in standing also improves postural control in participants with chronic stroke. Gait & Posture, Vol. 36, No. 3, pp. 419-424, 2012.
  23. A. C. H. Geurts, M. de Haart, I. J. W. van Nes, J. Duysens, A review of standing balance recovery from stroke. Gait & Posture, Vol. 22, No. 3, pp. 267-281, 2005.
  24. L. A. Hale, J. Piggot, Exploring the Content of Physiotherapeutic Home-Based Stroke Rehabilitation in New Zealand. Archives of Physical Medicine and Rehabilitation, Vol. 86, No. 10, pp. 1933-1940, 2005.
  25. S. F. Tyson, L. H. DeSouza, Reliability and validity of functional balance tests post stroke. Clinical Rehabilitation, Vol. 18, No. 8, pp. 916-923, 2004.
  26. D. Wicke, R. Coppin, S. Payne, Teamworking in nursing homes. Journal of Advanced Nursing, Vol. 45, No. 2, pp. 197-204, 2004.
  27. E. Y. Kim, E. H. Cho, K. J. June, Factors influencing use of home care and nursing homes. Journal of Advanced Nursing, Vol. 54, No. 4, pp. 511-517, 2006.
  28. D. T. Wade, R. L. Hewer, Functional abilities after stroke: measurement, natural history and prognosis. Journal of Neurology, Neurosurgery & Psychiatry, Vol. 50, No. 2, pp. 177-182, 1987.
  29. K. M. Michael, J. K. Allen, R. F. Macko, Reduced ambulatory activity after stroke: the role of balance, gait, and cardiovascular fitness. Archives of Physical Medicine and Rehabilitation, Vol. 86, No. 8, pp. 1552-1556, 2005.
  30. T. Askim, S. Morkved, A. Engen, K. Roos, T. Asd, B. Indredavik, Effects of a Community-Based Intensive Motor Training Program Combined With Early Supported Discharge After Treatment in a Comprehensive Stroke Unit A Randomized, Controlled Trial. Stroke, Vol. 41, No. 8, pp. 1697-1703, 2010.
  31. J. H. Lin, C. L. Hsieh, S. K. Lo, H. M. Chai, L. R. Liao, Preliminary Study of the Effect of Low-Intensity Home-Based Physical Therapy in Chronic Stroke Patients. The Kaohsiung Journal of Medical Sciences, Vol. 20, No. 1, pp. 18-22, 2004.
  32. P. Duncan, L. Richards, D. Wallace, J. Stoker-Yates, P. Pohl, C. Luchies, A. Ogle, S. Studenski, A randomized, controlled pilot study of a home-based exercise program for individuals with mild and moderate stroke. Stroke, Vol. 29, No. 10, pp. 2055-2060, 1998.