Published online Mar 31, 2012.
https://doi.org/10.12786/bn.2012.5.1.32
Effects of the Balance Control Training in Chronic Hemiplegic Stroke Patients
Abstract
Objective
To investigate the training effects on balance and gait ability using balance control trainer combined with partial weight-bearing system in chronic hemiplegic stroke patients.
Method
A prospective crossover clinical trial was designed. The subjects consisted of 16 chronic hemiplegic stroke patients. All patients had a stroke more than six months. In addition to conventional physical therapy (PT), 8 patients in group A were trained with the balance control trainer for 30 min/day, 5 day/week, for first 2 weeks and then received only conventional physical therapy for 2 weeks. The other 8 patients in group B received only conventional PT for first 2 weeks and then were trained with the balance control trainer for 30 min/day, 5 day/week, for next 2 weeks, with additional conventional PT. We evaluated with clinical tests including functional ambulation categories (FAC), Berg balance scale (BBS), 6 min walking distance (6mWT), timed up and go (TUG), Korean-modified barthel Index (K-MBI) and muscle strengthening of knee extensor (MMTknee) before training, 2 weeks and 4 weeks after training in those patients.
Results
After training, subjects in experimental period (2weeks period of conventional PT+Balance control trainer in group A&B) showed more improvement than those in control period (2 weeks period of only conventional PT in group A&B) in FAC, BBS, 6mWT, TUG, K-MBI (p<0.05).
Conclusion
We think the balance control trainer combined with the partial weight-bearing system can be a useful tool for improving balance and gait ability in chronic hemiplegic stroke patients.
Fig. 1
Configuration of balance control trainer of lower extremity.
Fig. 2
The balance control trainer of lower extremity consists of the Wii fit balance board which detects the degree of weight shifting to right or left side, tilting sensor which detects the degree of affected knee flexion, and the computerized system which enables to perform the apple harvesting game using these data.
Fig. 3
The wii-fit balance board system has bluetooth and contains multiple pressure sensors that are used to measure the user's COP (center of pressure)-the location of the intersection between an imaginary line drawn vertically through the center of mass and the surface of the balance boardand weight. The sensors on the board can accurately measure up to 150 kg (330 pounds).
Fig. 4
This figure shows the apple harvesting game. According to weight shift to either side, the hand moves to right or left side, and according to the degree of knee flexion, the hand moves up or down side. When the hand touch apples on screen, apples disappear. When all apples have disappeared, apples re-appear on the screen randomly, and new game started.
Table 1
Demographic Data of Subjects
Table 2
The Measurement Values of Clinical Parameters at Pretraining Period
Table 3
The Changes of Parameters in Experimental Period (n = 16)
Table 4
The Changes of Parameters in Control Period (n = 16)
Table 5
Comparison of Changes in Measurement Values of Clinical Parameters between Experimental Period and Control Period
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