DOI QR코드

DOI QR Code

The Effect of Postural Balance and Fall Efficacy on Bilateral Visual Feedback Training with Visual Targets in Stroke Patients

  • No, Seung-Min (Department of Physical Therapy, College of Health Science, Cheongju University) ;
  • Hwang, Yoon-Tae (Department of Physical Therapy, Gangneung Yeongdong University) ;
  • Son, Sung-Min (Department of Physical Therapy, College of Health Science, Cheongju University)
  • Received : 2022.03.17
  • Accepted : 2022.04.04
  • Published : 2022.04.30

Abstract

Purpose: The purpose of this study was to determine the effects of bilateral visual feedback training with visual targets on the postural balance and fall efficacy of stroke patients with hemiparesis. Methods: A total of 24 stroke patients with hemiparesis were randomly assigned to either a bilateral visual feedback training (BVFT, n=8) group, unilateral visual feedback training (UVFT, n=8) group, or a control group (n=8). The BVFT and UVFT groups performed weight-bearing training on the bilateral (less-affected and affected side) or unilateral side (affected side) with visual feedback using visual targets. The control group performed squat training without visual feedback using visual targets. The training program was conducted in the form of 3 sets a day, 3 times a week, for 4 weeks. The participants were evaluated using the Berg balance scale (BBS), lateral reaching test (LRT), timed up and go test (TUG), and the activities-specific balance confidence scale (ABC). Results: In the intra-group comparison after the intervention, the BVFT group showed a significant difference in the BBS, TUG, affected and less-affected side LRT, and ABC (p<0.05). The UVFT group showed a significant difference in the BBS and ABC (p<0.05). In the inter-group comparison after the intervention, the BVFT group showed significant improvements in their BBS, affected side LRT, and TUG, when compared to the control group (p<0.05). Conclusion: These findings show that bilateral visual feedback training with visual targets during bilateral weight-bearing exercises can improve the postural balance function in stroke patients.

Keywords

References

  1. Duncan PW, Weiner DK, Chandler J et al. Functional reach: a new clinical measure of balance. J Gerontol. 1990;45(6):192-7.
  2. Richard W Bohannon. Muscle strength and muscle training after stroke. J Rehabil Med. 2007;39(1):14-20. https://doi.org/10.2340/16501977-0018
  3. Semprini R, Sale P, Foti C, Fini M et al. Gait impairment in neurological disorders: a new technological approach. Funct Neurol. 2009;24(4):179-83.
  4. Geiger RA, Allen JB, Keefe JO et al. Balance and mobility following stroke: effects of physical therapy interventions with and without biofeedback/forceplate training. Phys Ther. 2001;81(4):995-1005. https://doi.org/10.1093/ptj/81.4.995
  5. Tyson SF, DeSouza LH. Reliability and validity of functional balance tests post stroke. Clin Rehabil. 2004;18(8):916-23. https://doi.org/10.1191/0269215504cr821oa
  6. Song CH, Lee GC, Yu JH et al. The relation between postural sway and asymmetric weight-bearing for fall prevention in patients with stroke. J Korean Soc Phys Med. 2010;5(1):81-8.
  7. Sackley CM, Baguley BI, Gent S et al. The use of a balance performance monitor in the treatment of weight-bearing and weight transferance problems after stroke. Physiotherapy. 1992;78(12):907-13. https://doi.org/10.1016/s0031-9406(10)60498-1
  8. Caldwell C, McDonald D, McNeil K et al. Symmetry of weight distribution in normal and stroke patients using digital weight scales. Physiother Theory Pract. 1986;2:109-16. https://doi.org/10.3109/09593988609022429
  9. Shumway CA, Anson D, Haller S. Postural sway biofeedback: its effect on reestablishing stance stability in hemiplegic patients. Arch Phys Med Rehabil. 1988;69(6):395-400.
  10. Cheng PT, Chen CL, Wang CM et al. Leg muscle activation patterns of sit-to-stand movement in stroke patients. Am J Phys Med Rehabil. 2004;83(1):10-6. https://doi.org/10.1097/01.PHM.0000104665.34557.56
  11. Bonan IV, Yelnik AP, Colle FM et al. Reliance on visual information after stroke. part II: effectiveness of a balance rehabilitation program with visual cue deprivation after stroke: a randomized controlled trial. Arch Phys Med Rehabil. 2004;85(2):274-8. https://doi.org/10.1016/j.apmr.2003.06.016
  12. Au Yeung SSY. Does weight-shifting exercise improve postural symmetry in sitting in people with hemiplegia? Brain Inj. 2003;17(9):789-97. https://doi.org/10.1080/0269905031000088487
  13. Kim JD, Cha YJ, Youn HJ. Effects of emphasized initial contact auditory feedback gait training on balance and gait in stroke patients. Korean Soc Phys Med. 2015;10(4):49-57. https://doi.org/10.13066/kspm.2015.10.4.49
  14. Hwang YI, Kim KS. Effects of foot pressure using the elastic band with rings during sit-to-stand in persons with stroke. Phys Ther Rehabil Sci. 2017;6(4):159-63. https://doi.org/10.14474/ptrs.2017.6.4.159
  15. Choi WJ, Lee SW, Tak SJ et al. The effect of the cognitive motor dual task using the auditory feedback on chronic stroke patients' gait and their attention. J Spec Educ. 2011;50(3):483-504.
  16. Pak NW, Lee JH. Effects of visual feedback training and visual targets on muscle activation, balancing, and walking ability in adults after hemiplegic stroke: a preliminary, randomized, controlled study. Int J Rehabil Res. 2020;43(1):76-81. https://doi.org/10.1097/mrr.0000000000000376
  17. Lee KS, Choe HS, Lee JH. Influence of visual feedback training on the balance and walking in stroke patients. J Kor Phys Ther. 2015;27(6):407-12. https://doi.org/10.18857/jkpt.2015.27.6.407
  18. Goldie PA, Matyas TA, Evans OM et al. Maximum voluntary weightbearing by the affected and unaffected legs in standing following stroke. Clin Biomech (Bristol, Avon). 1996;11(6):333-42. https://doi.org/10.1016/0268-0033(96)00014-9
  19. Lamontagne A, Paquet N, Fung J. Postural adjustments to voluntary head motions during standing are modified following stroke. Clin Biomech (Bristol, Avon). 2003;18(9):832-42. https://doi.org/10.1016/S0268-0033(03)00141-4
  20. Blum L, Korner BN. Usefulness of the berg balance scale in stroke rehabilitation: a systematic review. Phys Ther. 2008;88(5):559-66. https://doi.org/10.2522/ptj.20070205
  21. Duncan PW, Weiner DK, Chandler J et al. Functional reach: a new clinical measure of balance. J Gerontol. 1990;45(6):M192-7. https://doi.org/10.1093/geronj/45.6.M192
  22. Ng SS, Hui-Chan CW. The timed up & go test: its reliability and association with lower-limb impairments and locomotor capacities in people with chronic stroke. Arch Phys Med Rehabil. 2005;86(8):1641-7. https://doi.org/10.1016/j.apmr.2005.01.011
  23. Stasny BM, Newton RA, Viggiano LoCascio L et al. The ABC scale and fall risk: a systematic review. Phys Occup Ther Geriatr. 2011;29(3):233-42. https://doi.org/10.3109/02703181.2011.572249
  24. Arya KN, Pandian S, Kumar D et al. Task-based mirror therapy augmenting motor recovery in poststroke hemiparesis: a randomized controlled trial. J Stroke Cerebrovasc Dis. 2015;24(8):1738-48. https://doi.org/10.1016/j.jstrokecerebrovasdis.2015.03.026
  25. Sarlegna FR, Mutha PK. The influence of visual target information on the online control of movements. Vision Res. 2015;110(Pt B):144-54. https://doi.org/10.1016/j.visres.2014.07.001
  26. Yarossi M, Manuweera T, Adamovich SV et al. The effects of mirror feedback during target directed movements on ipsilateral corticospinal excitability. Front Hum Neurosci. 2017;11:242. https://doi.org/10.3389/fnhum.2017.00242
  27. Mercer VS, Chang SH, Williams CD et al. Effects of an exercise program to increase hip abductor muscle strength and improve lateral stability following stroke: a single subject design. J Geriatr Phys Ther. 2009;32(2):50-9.
  28. Stewart KC, Cauraugh JH, Summers JJ. Bilateral movement training and stroke rehabilitation: a systematic review and meta-analysis. J Neurol Sci. 2006;244(1-2):89-95. https://doi.org/10.1016/j.jns.2006.01.005
  29. Staines WR, McIlroy WE, Graham SJ et al. Bilateral movement enhances ipsilesional cortical activity in acute stroke: a pilot functional MRI study. Neurology. 2001;56(3):401-4. https://doi.org/10.1212/WNL.56.3.401
  30. Summers JJ, Kagerer FA, Garry MI et al. Bilateral and unilateral movement training on upper limb function in chronic stroke patients: a TMS study. J Neurol Sci. 2007;252(1):76-82. https://doi.org/10.1016/j.jns.2006.10.011
  31. Cauraugh JH, Lodha N, Naik SK et al. Bilateral movement training and stroke motor recovery progress: a structured review and meta-analysis. Hum Mov Sci. 2010;29(5):853-87. https://doi.org/10.1016/j.humov.2009.09.004