Effects of the Balance Control of the Affected Lower Extremity on Balance and Gait in Hemiparetic Patients
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Objective: To investigate the effects of balance control of affected lower extremity on berg balance scale and gait in hemiparetic patients, using the newly developed balance control trainer of lower extremity. Method: Thirty five hemiparetic patients who could stand and ambulate more than 10 meters without assist on even surface were included in this study. The balance control trainer of lower extremity was designed to measure weight shift and knee flexion angle of hemiparetic side and to play a game named Board which use these data, so considering the vertical movement of the center of gravity. We measured above three parameters, and also evaluated with clinical tests including berg balance scale (BBS). We evaluated correlations between parameters on the balance control trainer of lower extremity and clinical parameters. Results: Weight shifting to affected side statistically significantly correlated only with BBS. Affected knee flexion had statistically significant correlations with all clinical tests examined, especially 10 meters walking time (10mWT), timed up and go test (TUG), and BBS. Scores earned from board cleaner game also had statistically significant correlations with all clinical tests examined, especially 10mWT, TUG, and BBS. Conclusion: Correlation exists between the ability to control the affected knee measured by balance control trainer of lower extremity and clinical parameters including 10mWT, TUG, and BBS, so we think the balance control trainer can be a useful tool for the evaluation in hemiparetic patients. (J Korean Acad Rehab Med 2008; 32: 394-399)Keywords:
Berg Balance Scale
Trainer
Knee flexion
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Objective To explore the effect of ankle strategy stability limit training on balance and gait in recovering stroke patients with hemiplegia. Methods Forty recovering stroke patients were randomized into an intervention group and a control group.The patients in the intervention group were given ankle strategy stability limit training using visual feedback on the static long sets of a Smart Equitest Balance Master (SEBM) machine.Those in the control group practiced routine postural balance training using mirror visual feedback in parallel bars.Both groups of patients practiced balance and posture control for 30 minutes,once daily,6 days a week for two weeks. Both groups were also given routine therapy and other rehabilitation.The patients' balance function was evaluated using the Berg Balance Scale (BBS),and their gait was assessed using the walk across technique (WA). Results There was no significant difference between the two groups with regard to general information,BBS scores or WA results before treatment.After 2 weeks of treatment,BBS scores as well as the step length and pace in the WA improved significantly in both groups,but all improved significantly more in the intervention group.There was no significant difference in width of gait. Conclusion Ankle strategy stability limit training can enhance weight-bearing on stroke patients' affected foot as well as their balance and the symmetry of their steps.
Key words:
Ankle joint; Stroke; Musculoskeletal equilibrium; Gait; Ankle strategy; Stability limits
Berg Balance Scale
Stroke
Balance training
Gait training
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Objective To investigate the effects of strengthened control training of knee joint(0-15°) on the balance and walking ability in stroke patients with hemiparalysis.Methods 60 patients with stroke and hemiparalysis were randomly divided into 2 groups:control group(n = 30) and treatment group(n = 30).The control group received conventional rehabilitative treatment,and the treatment group received conventional rehabilitative treatment combined with strengthened control training of knee joint(0-15°).Before and 6 weeks after the treatment,the Berg balance scale(BBS) was used to evaluate the balance function,timed up and go test(TUGT) and maximum walking speed(MWS) were used to test the up and go ability and 10-meter maximum walking speed,respectively.Results After 6 weeks of treatment,the BBS,TUGT and MWS scores were significantly different in both groups from those before the treatment(P 0.01),these scores in treatment group were significantly different from those in control group after the treatment(P 0.05).Conclusion Strengthened control training of knee joint(0-15°) can correct the over-extended knee joint,strengthen its stability,and effectively improve the balance and walking ability of patients with stroke and hemiparalysis.
Berg Balance Scale
Balance training
Stroke
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ObjectiveTo discusse the relationship between static balance in laboratory approaches and dynamic balance in clinical assessment and identify the value of static and dynamic balance at functional outcome in hemiparetic stroke patients. MethodsNineteen stroke subjects were assessed in this study. The static balance was measured by postural sway test, the dynamic balance was measured by Berg balance scale(BBS)and Time up to go test(TUGT),the outcome was measured by FIM and 10m maximum walking speed(MWS). The level of association between the parameters of postural sway test and clinical variables were examined with Pearson's correlation coefficients. ResultsThe parameters of postural sway test was significantly negative related to BBS( r =-0.705--0.475, P 0.05);The parameters of postural sway close-eye test was significantly positive related to TUGT( r =0.508-0.583, P 0.05);The parameters of postural sway test was no related to FIM and MWS ( r =-0.048--0.296; r =-0.404--0.01, P 0.05);BBS was significantly positive related to FIM and MWS( r =0.752; r =0.700, P 0.001). TUGT was significantly negative related to FIM and MWS( r =-0.600, P 0.01; r =-0.817, P 0.001). ConclusionClinical and laboratory balance assessments are related and that dynamic rather than static balance measures are valid indicators of functional outcome performance in hemiparetic stroke patients.
Berg Balance Scale
Stroke
Balance Test
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Background/Objectives: Forced weight support and whole-body vibration exercise are being widely used in patients with stroke to improve balance and gait. Thirty patients with stroke participated in the experiment. Methods/Statistical analysis: A 10-mm insole underneath the non-affected lower foot and Galileo equipment were used in the experimental group. Only a 10-mm insole was provided underneath the shoe in the control group, and all activities of daily living were performed without the whole-body vibration exercise. The Berg balance scale (BBS), Timed up & go (TUG), and bio rescue balance tests before and after intervention were conducted in all subjects. Statistical analysis was performed using the SPSS version 22.0. Findings: There were statistically significant differences in the BBS test result, limit of stability (LOS), and 10 compared to comparator controls. However, there was no statistically significant difference in the TUG test result and foot print (FP). The experimental group displayed statistically significant differences between the BBS, TUG, FP, LOS, and 10mWT items in the before- and after-intervention comparisons. On the contrary, the control group displayed statistically significant differences in the BBS, TUG, FP, and 10mWT items; however, there was no statistically significant difference in the LOS. Improvements/Applications: In balance and gait, the forced weight support and whole-body vibration exercise yielded symmetrical body weight support and improved the walking speed of the patients with stroke.
Whole body vibration
Stroke
Weight-bearing
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Background: Impaired postural balance is a common symptom after stroke and a common cause of falling. Most common daily tasks use arm and hand movements. Impairment in an upper extremity is a common stroke symptom, affecting 50-80% in the acute phase after stroke, and 40-50% in the sub-acute phase. The impact of leg function on postural balance has been investigated in several studies, but few have stressed the importance of arm function on postural balance. Objective: To explore whether there is any association between arm function and postural balance after stroke. Method: A cross sectional study where 121 adults (mean age: 70 ± 12.3 years, 72 men) from two different data sources, Gothenburg Very Early Supported Discharge (GOTVED), and a study by Carvalho et al. were merged. Time for assessments ranged from 1 to 13 years when the patients were in the chronic phase. The dependent variables were Berg Balance scale (BBS) and Time Up and Go (TUG) both dichotomized to "impaired postural balance" and "not impaired postural balance." As independent variables, the Fugl-Meyer Assessment-Upper Extremity (FMA-UE) scale was used. The FMA-UE was presented with the total score. Results: The motor function in the arm affected after stroke onset correlated with postural balance both measured with the BBS (0.321, p < 0.001) and the TUG (-0.315, p = 0.001). Having impaired motor function in the arm was significantly associated with impaired postural balance assessed with the BBS with OR = 0.879 (CI 0.826-0.934, p < 0.001). Regression analysis with the TUG showed the same result, OR = 0.868 (CI 0.813-0.927, p < 0.001) for FM-UE. Conclusion: The motor function of the affected arm was significantly associated with impaired postural balance post stroke, as assessed by BBS or TUG. It could be of clinical importance to be aware of the fact that not only lower extremity impairment, but also arm function can have an impact on postural balance in a late stage after stroke. Trial Registration: VGFOUGSB-669501.
Berg Balance Scale
Stroke
Cross-sectional study
Fear of falling
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Aging is associated with numerous deleterious muscular, skeletal, and neurologic adaptations that may result in functional performance decrements. These decrements are accelerated during periods of unplanned physical inactivity (e.g. hospitalization). Reductions in gait velocity are well documented in the elderly and may result from fear of falling, poor balance, or inability to accelerate because of reduced ground reaction force capabilities. Purpose: To determine if timed up-and-go scores were related to balance or lower extremity force production in skilled nursing facility patients. Methods: Data were collected on 40 patients (77.1±1.4y; 164.2±1.7cm; 75.3±3.3 kg) in an inpatient skilled nursing facility. The 15 males and 25 female patients had a mini mental exam score of >20, and provided informed consent. Each patient completed a timed up-and-go (TUG) test where they stood from a 40cm chair and walked 3 meters before circling a cone and returning to the chair. Total time from the initiation of movement until patients regained the seated position was recorded and used for analysis. The Berg Balance Test was also completed by each patient; only composite scores were used for comparison. Manual muscle tests were completed on the hip, knee, and ankle using a hand-held dynamometer that provided isometric peak force. Isometric force tests were completed for hip flexion (HF), hip abduction (HA), knee extension (KE), knee flexion (KF), plantar flexion (PF), and dorsi-flexion (DF). Pearson’s correlation coefficients were calculated between TUG and Berg composite score and isometric force production at each joint. A multiple regression model was determined using backward elimination. For each comparison, an alpha of p<0.05 was used to determine statistical significance. Results: Independently, TUG times were significantly associated with Berg (r=-0.61; p <0.001), but not age (r=0.24), height (r=0.22), weight (r=0.00), or force production in HF (r=-0.04), HA (r=0.06), KE (r=0.07), KF (r=0.07), DF (r=0.07), or PF (r=-0.11). The final multiple regression model derived via backward elimination explained 53% of the variance in TUG (r=-0.74) and included Berg (p<0.001), HA (p=0.001) and KF (p=0.02) scores. Conclusions: These data suggest that decrements in gait performance with an agility component (TUG) are associated with balance, but poorly associated with single-joint measurements of lower extremity force production. Experimental studies are needed to determine if therapeutic interventions improving balance result in improved gait performance or if multi-joint force production tests better predict gait velocity.
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The purpose of this study was to investigate the effect of balance training with upper extremity exercise on the improvement of balance performance in people who have had a stroke. Eighteen candidates who have all experienced a stroke, were living in Dong-Gu, Ulsan and were participating in a community based rehabilitation program, have been included in this study. The program was conducted three times weekly, 1 hour per session, for 7 consecutive weeks. Subjects were tested with 7 m and 100 m Timed Gait Test (sec), Timed Get Up and Go Test (sec), Functional Reach Test (cm) and 5 items of Berg's Balance Test at pre-training and post-training. Total balance index and balance ratios were measured by K.A.T. 3000. The balance training program performed by sitting on a chair and gymnastic ball and standing on stable and unstable surfaces during upper extremity exercises such as Proprioceptive Neuromuscular Facilitation (PNF) upper extremity pattern, picking a ball up from floor, throwing and catching it. After seven weekends of balance training, subjects showed a significant difference in balance test results. The exceptions were three items of Berg's Balance Test (p
Berg Balance Scale
Balance training
Stroke
Proprioception
Balance Test
Hemiparesis
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The purpose of this study was to investigate the effectiveness of two exercise programs with three different measurements (Falls Efficacy Scale–FES, Berg Balance Scale–BBS, and bilateral ankle dorsiflexor strength–ADFS) and to determine if these measurements correlate to each other. Thirteen pairs of subjects residing in a senior living community were recruited and matched for age, gender, and assistive device. The matched subjects were randomly divided into one of two exercise groups–resistance group (RG) provided with the exercise combination of resistance strengthening, balance and gait or seated group (SG) provided with seated range of motion exercise. Eleven pairs completed the 12-week exercise program. The results revealed that subjects in the RG made more improvement in fear of falling, balance, and ankle dorsiflexor strength than those in the SG. The decrease of FES score (fear of falling) is moderately correlated with the increase of BBS (balance) and ADFS scores. The improved BBS is also moderately correlated with the increased ADFS.
Berg Balance Scale
Fear of falling
Ankle dorsiflexion
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Proprioception
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[Purpose] This study aimed to compare the effects of horizontal-vibration with those of vertical-vibration training on the balance and gait of patients with stroke. [Subjects and Methods] A sample population of 20 subjects was randomly divided into 2 groups: the horizontal-vibration group and the vertical-vibration group. We evaluated the Berg Balance Scale (BBS) score, Timed Up-and-Go (TUG) test results, and 10-meter Walk Test (10MWT) results at 3 times points: before the training, 3 weeks after the training, and 6 weeks after the training. [Results] The BBS score, TUG test result, and 10MWT result differed significantly among the subjects in the vertical-vibration group. However, only the BBS score differed significantly among the subjects in the horizontal-vibration group. [Conclusion] The vibration training used in this study heightened the activity of the trunk muscles and improved balance ability of the patients. In particular, we recommend the vertical-vibration training because dynamic movements such as gait improved the balance ability through activation of the trunk stabilizer muscles.
Whole body vibration
Berg Balance Scale
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