Journal of International Academy of Physical Therapy Research (국제물리치료학회지)

International Academy of Physical Therapy Research (국제물리치료연구학회)
권호 표지
DOI QR코드

DOI QR Code

Effects of Diagonal Pattern Self-Exercise on Trunk Control, Balance, and Gait Ability in Chronic Stroke Patients

  • Received : 2020.02.02
  • Accepted : 2020.03.25
  • Published : 2020.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

Background: Weakness of the trunk muscles decreases the trunk control ability of stroke patients, which is significantly related to balance and gait. Objectives: To compare the impact of diagonal pattern self-exercise on an unstable surface and a stable surface for trunk rehabilitation on trunk control, balance, and gait ability in stroke patients. Design: Nonequivalent control group design. Methods: Twenty four participants were randomized into the experimental group (diagonal pattern self-exercise while sitting on an unstable surface, n=12) and the control group (diagonal pattern self-exercise while sitting on a stable surface, n=12). All interventions were conducted for 30 minutes, three times a week for four weeks, and the trunk impairment scale (TIS), berg balance scale (BBS), functional gait assessment (FGA), and G-walk were measured. Results: All groups indicated significant increases in all variables (TIS, BBS, FGA, cadence, speed, stride length) after four weeks. The TIS, BBS, FGA, cadence, gait speed, and stride length group-by-time were significantly different between the two groups. Conclusion: We found that, in stroke patients, diagonal pattern self-exercise on an unstable surface is a more effective method for improving trunk control, balance, and gait ability than diagonal pattern self-exercise on a stable surface.

Keywords

References

  1. Michael KM, Allen JK, Macko RF. Reduced ambulatory activity after stroke: The role of balance, gait, and cardiovascular fitness. Arch Phys Med Rehabil. 2005;86(8):1552-1556. https://doi.org/10.1016/j.apmr.2004.12.026
  2. Hsu AL, Tang PF, Jan MH. Analysis of impairments influencing gait velocity and asymmetry of hemiplegic patients after mild to moderate stroke. Arch Phys Med Rehabil. 2003;84(8):1185-1193. https://doi.org/10.1016/S0003-9993(03)00030-3
  3. Tyson SF, Hanley M, Chillala, J, Selley A, Tallis RC. Balance disability after stroke. Phys Ther. 2006;86(1):30-38. https://doi.org/10.1093/ptj/86.1.30
  4. Dickstein R, Heffes Y, Laufer Y, et al. Activation of selected trunk muscles during symmetric functional activities in poststroke hemiparetic and hemiplegic patients. J Neurol Neurosurg Psychiatry. 1999;66(2):218-221. https://doi.org/10.1136/jnnp.66.2.218
  5. Nelles G, Spiekermann G, Jueptner M, et al. Reorganization of sensory and motor systems in hemiplegic stroke patients: A positron emission tomography study. Stroke. 1999;30(8):1510-1516. https://doi.org/10.1161/01.STR.30.8.1510
  6. Fujiwara T, Sonoda S, Okajima Y, Chino N. The relationships between trunk function and the findings of transcranial magnetic stimulation among patients with stroke. J Rehabil Med. 2001;33:249-255. https://doi.org/10.1080/165019701753236428
  7. Welmer AK, Holmqvist LW, Sommerfeld DK. Hemiplegic limb synergies in stroke patients. Am J Phys Med Rehabil. 2006;85(2):112-119. https://doi.org/10.1097/01.phm.0000197587.78140.17
  8. Karthikbabu S, Chakrapani M, Ganeshan S, Rakshith KC, Nafeez S, Prem VA. A review on assessment and treatment of the trunk in stroke: A need or luxury. Neural Regen Res. 2012;7:1974. https://doi.org/10.3969/j.issn.1673-5374.2012.25.008
  9. An SH, Chung YJ, Park SY. The effects of trunk control ability on balance, gait, and functional performance ability in patients with stroke. Phys Ther Korea. 2010;17(2):33-42.
  10. Chung EJ, Lee JS, Kim SS, Lee BH. The relationships among trunk control ability, dynamic balance and gait in stroke patients. J Korean Soc Phys Med. 2012;33(1):148-159.
  11. Kim MJ, Yi CH, Chung BI, Lee YH. The relationship between balance and gait outcome in patients with stroke. Phys Ther Korea. 1998;5(1):17-29.
  12. Cabanas-Valdes R, Cuchi GU, Bagur-Calafat C. Trunk training exercises approaches for improving trunk performance and functional sitting balance in patients with stroke: A systematic review. Neuro Rehabilitation. 2013;33(4):575-592.
  13. Kim EJ, Hwang BY, Kim JH. The effect of core strength exercises on balance and walking in patients with stroke. J Kor Phys Ther. 2009;21(4):17-22.
  14. Chung EJ, Kim JH, Lee BH. The effects of core stabilization exercise on dynamic balance and gait function in stroke patients. J Phys Ther Sci. 2003;25(7):803-806. https://doi.org/10.1589/jpts.25.803
  15. Kim CB, Shin JH, Choi JD. The effect of chest expansion resistance exercise in chronic stroke patients: A randomized controlled trial. J Phys Ther Sci. 2015;27(2):451-453. https://doi.org/10.1589/jpts.27.451
  16. Song GB, Park EC. Effects of chest resistance exercise and chest expansion exercise on stroke patients' respiratory function and trunk control ability. J Phys Ther Sci. 2015;27(6):1655-1658. https://doi.org/10.1589/jpts.27.1655
  17. Park SJ, Lee JH, Min, KO. Comparison of the effects of core stabilization and chest mobilization exercises on lung function and chest wall expansion in stroke patients. J Phys Ther Sci. 2017;29(7):1144-1147. https://doi.org/10.1589/jpts.29.1144
  18. Park SJ, Oh DS. The effects of lumbar stabilization exercise on respiratory pressure in stroke patients. J Korea Converg Soc. 2017;8(9):357-364. https://doi.org/10.15207/JKCS.2017.8.9.357
  19. Park SJ. The effects of rib cage joint mobilization and threshold inspiratory muscle training applying respiratory function and respiratory activation of stroke patients [Doctoral thesis]. Yongin, Republic of Korea: Yongin University; 2018.
  20. Salter K, Jutai JW, Teasell R, Foley NC, Bitensky J, Bayley M. Issues for selection of outcome measures in stroke rehabilitation: ICF Participation. Disabil Rehabil. 2005;27(9):507-528. https://doi.org/10.1080/0963828040008552
  21. Micheo W, Esquenazi A. Orthoses in the prevention and rehabilitation of injuries. In: Frontera WR, eds. Rehabilitation of Sports Injuries: Scientific Basis. Massachusetts, USA: Blackwell Science Inc, 2003; 301.
  22. Jung KS, Cho HY, In TS. Trunk exercises performed on an unstable surface improve trunk muscle activation, postural control, and gait speed in patients with stroke. J Phys Ther Sci. 2016;28(3):940-944. https://doi.org/10.1589/jpts.28.940
  23. Van Criekinge T, Saeys W, Vereeck L, De Hertogh W, Truijen, S. Are unstable support surfaces superior to stable support surfaces during trunk rehabilitation after stroke? A systematic review. Disabil Rehabil. 1018;40(17):1981-1988.
  24. Lee SM. Effects of the type of exercise pattern on cognitive function, physical functions in elderly patients with dementia [Doctoral thesis]. Yongin, Republic of Korea: Yongin University; 2012.
  25. Moreira R, Lial L, Monteiro MGT, et al. Diagonal movement of the upper limb produces greater adaptive plasticity than sagittal plane flexion in the shoulder. Neurosci Lett. 2017;643:8-15. https://doi.org/10.1016/j.neulet.2017.02.022
  26. Verheyden G, Willems AM, Ooms L, Nieuwboer A. Validity of the trunk impairment scale as a measure of trunk performance in people with Parkinson's disease. Arch Phys Med Rehabil. 2007;88(10):1304-1308. https://doi.org/10.1016/j.apmr.2007.06.772
  27. Jung HY, Park JH, Shim JJ, Kim MJ, Hwang MR, Kim SH. Reliability Test of Korean Version of Berg Balance Scale. Journal of the Korean Academy of Rehabilitation Medicine. 2006;30(6):611-618.
  28. Wrisley DM, Marchetti GF, Kuharsky DK, Whitney SL. Reliability, internal consistency, and validity of data obtained with the functional gait assessment. Phys Ther. 2004;84(10):906-918. https://doi.org/10.1093/ptj/84.10.906
  29. Thieme H, Ritschel C, Zange C. Reliability and validity of the functional gait assessment (German version) in subacute stroke patients. Arch Phys Med Rehabil. 2009;90(9):1565-1570. https://doi.org/10.1016/j.apmr.2009.03.007
  30. Bugane F, Benedetti MG, Casadio G, et al. Estimation of spatial-temporal gait parameters in level walking based on a single accelerometer: Validation on normal subjects by standard gait analysis. Comput Methods Programs Biomed. 2002;108(1):129-137. https://doi.org/10.1016/j.cmpb.2012.02.003
  31. Pau M, Leban B, Collu G, Migliaccio GM. Effect of light and vigorous physical activity on balance and gait of older adults. Arch Gerontol Geriatr. 2014;59(3):568-573. https://doi.org/10.1016/j.archger.2014.07.008
  32. Dubey L, Karthikbabu S. Trunk proprioceptive neuromuscular facilitation influences pulmonary function and respiratory muscle strength in a patient with pontine bleed. Neurol India. 2017;65(1):183-184.
  33. Seo HD, Kim NJ, Chung YJ. Reliability of the Korean version of the trunk impairment scale in patients with stroke. Phys Ther Korea. 2008;15(4):87-96.
  34. Woo Y. Predictive analyses for balance and gait based on trunk performance using clinical scales in persons with stroke. Phys Ther Rehabil Sci. 2018;7(1):29-34. https://doi.org/10.14474/ptrs.2018.7.1.29
  35. Goo BO, Shim JM, Lee SY, Kim HS, Lee MH, Park MC. The effects of functional weight bearing exercise on balance and gait in stroke. J Korean Soc Phys Med. 2010;5(1):35-42.
  36. Shinde K, Ganvir S. Effectiveness of trunk proprioceptive neuromuscular facilitation techniques after stroke: A meta-analysis. Natl J Med Allied Sci. 2014;3(3):29-34.
  37. Yoo J, Jeong J, Lee W. The effect of trunk stabilization exercise using an unstable surface on the abdominal muscle structure and balance of stroke patients. J Phys Ther Sci. 2014;26(6):857-859. https://doi.org/10.1589/jpts.26.857
  38. Jung KS, Cho HY, In TS. Trunk exercises performed on an unstable surface improve trunk muscle activation, postural control, and gait speed in patients with stroke. J Phys Ther Sci. 2016;28(3):940-944. https://doi.org/10.1589/jpts.28.940
  39. Lee JC. A Study on the EMG Activity of Abdominal Muscles with Stable and Unstable Bridging Exercises in Individuals with Healthy Subjects. J Int Acad Phys Ther Res. 2017;8(1):1077-1083. https://doi.org/10.20540/JIAPTR.2017.8.1.1077
  40. Kim TH, Son YH, Park SJ. Effect of Paretic Side and Non-paretic Side Arm Training on Trunk Control and Upper Limb Functions in Stroke Patients. J Int Acad Phys Ther Res. 2019;10(1):1734-1738. https://doi.org/10.20540/JIAPTR.2019.10.1.1734