Effect of a virtual reality exercise program accompanied by cognitive tasks on the balance and gait of stroke patients

[Purpose] This study aimed to assess the effect of a virtual reality exercise program accompanied by cognitive tasks on the balance and gait of stroke patients. [Subjects] Twenty stroke patients were randomly assigned to two groups 10 to an experimental group that performed a virtual reality exercise program accompanied by cognitive tasks and 10 to a control group. The control group performed a proprioceptive neuromuscular facilitation exercise program. Balance was measured with the Berg Balance Scale. Gait was assessed using the Timed Up and Go Test. The paired t-test was used to compare groups before and after the experiment. The independent t-test was conducted to assess differences in the degree of change between the two groups before and after the experiment. [Results] Within-group comparison in the experimental group showed significant differences in the Berg Balance Scale and Timed Up and Go Test. In a comparison between groups, the differences in the Berg Balance Scale and Timed Up and Go Test in the experimental group appeared significant compared with the control group. [Conclusion] The results of the experiment indicate that a virtual reality exercise program accompanied by cognitive tasks has a positive effect on the balance and gait of stroke patients.Key words: Virtual reality exercise program accompanied by cognitive tasks, Balance, Gait     

Effects of mechanical horseback riding on the balance ability of the elderly

[Purpose] This study was conducted to evaluate the effect of mechanical horseback riding exercise on the balance ability of the elderly. [Subjects and Methods] Ten elderly patients were assigned to an experimental group, and they performed 15 min of horseback riding. Another 10 elderly patients were assigned to a control group, and they performed 15 min of one-leg standing exercise. Both exercises were repeated five times a week for a total of six weeks. The participants’ balance ability was evaluated. [Results] The horseback-riding group showed significant differences between the pre-and post-test balance abilities as assessed by the Berg Balance Scale (BBS) and the Timed Up and Go (TUG) test. [Conclusion] Horseback riding effectively improves the balance ability of the elderly. Horseback riding should be considered as a therapeutic method for the physical therapy of the elderly.Key words: Balance ability, Elderly, Mechanical horseback riding     

Effects of the Horse Riding Simulator and Ball Exercises on Balance of the Elderly

[Purpose] The aim of this study was to examine the effects of horse riding exercise using a horse riding simulator (HRS) and a ball on static and dynamic balance of elderly people. [Methods] Thirty-two elderly people hospitalized in geriatric hospitals were randomly assigned to the HRS exercise group or the ball exercise groups, and they performed exercise for eight weeks. [Results] The length of postural sway during quite standing with and without eyes closed significantly decreased in both groups after the exercises and there was no significant difference between both groups in the Romberg test. In the functional reach test (FRT), there were significant increases in distance in both groups after the exercises, and the distance of the HRS exercise group was significantly greater than that of the ball exercise group. In the Timed Up & Go test (TUG) and Timed 10-meter walk test (10MWT), the time significantly decreased in both groups, and there was a more significant decrease in the HRS exercise group than in the ball exercise group. [Conclusion] The results of this study indicate that HRS and ball exercises may improve the balance and gait ability of elderly people hospitalized in nursing homes or geriatric hospitals.Key words: Elderly, Balance, Hippotherapy     

Effects of Sling Exercise Therapy on Trunk Muscle Activation and Balance in Chronic Hemiplegic Patients

Weakening of trunk muscles in stroke patients hinders functional ability, safety and balance. To confirm whether strengthening trunk muscles could facilitate rehabilitation of stroke patients, we investigated the effectiveness of sling exercise therapy (SET) using closed kinetic chain exercises to activate trunk muscles and improve balance in stroke patients. [Subjects and Methods] Twenty stroke patients with chronic hemiplegia were equally divided into 2 groups, a SET group and a control group that performed regular exercises on a mat with the assistance of a table. Patients in both groups exercised for 30 min, three times per week for 4 weeks. Trunk muscle activity was measured using surface electromyography, whereas balance was measured using the Berg Balance Scale, Frailty and Injuries Cooperative Studies of Intervention Technique, Timed Up & Go test, and BioRescue before and after the 4-week experimental period. [Results] Trunk muscle activity and balance before and after intervention in both groups were significantly different. However, no significant differences were observed between the 2 groups. [Conclusion] Although SET was not more effective than regular exercise, significant improvement was observed before and after SET. Therefore, SET can be considered effective in strengthening trunk muscles in stroke patients with chronic hemiplegia.Key words: Chronic stroke patients, Sling exercise therapy, Trunk muscles     

Effect of coordination movement using the PNF pattern underwater on the balance and gait of stroke patients

[Purpose] To investigate the effect of coordination movement using the Proprioceptive Neuromuscular Facilitation pattern underwater on the balance and gait of stroke patients. [Subjects and Methods] Twenty stroke patients were randomly assigned to an experimental group that performed coordination movement using the Proprioceptive Neuromuscular Facilitation pattern underwater and a control group (n =10 each). Both the groups underwent neurodevelopmental treatment, and the experimental group performed coordination movement using the Proprioceptive neuromuscular facilitation pattern underwater. Balance was measured using the Berg Balance Scale and Functional Reach Test, and gait was measured using the 10-Meter Walk Test and Timed Up and Go Test. To compare in-group data before and after the intervention, paired t-test was used. Independent t-test was used to compare differences in the results of the Berg Balance Scale, Functional Reach Test, 10-Meter Walk Test, and Timed Up and Go Test before and after the intervention between the groups. [Results] Comparison within the groups showed significant differences in the results of the Berg Balance Scale, Functional Reach Test, 10-Meter Walk Test, and Timed Up and Go Test before and after the experimental intervention. On comparison between the groups, there were greater improvements in the scores of the Berg Balance Scale, Functional Reach Test, 10-Meter Walk Test, and Timed Up and Go Test in the experimental group. [Conclusion] The findings demonstrate that coordination movement using the Proprioceptive Neuromuscular Facilitation pattern under water has a significant effect on the balance and gait of stroke patients.Key words: Coordination movement using the PNF pattern, Balance, Gait     

Effect of Whole Body Vibration Exercise in the Horizontal Direction on Balance and Fear of Falling in Elderly People: A Pilot Study

[Purpose] The purpose of the present study was to investigate the effects of whole body vibration exercise in the horizontal direction on balance and fear of falling in the elderly. [Methods] This study was a case series of 17 elderly individuals. Participants performed whole body vibration exercise in the horizontal direction using a whole body vibration device for 15 minutes a day, 3 times a week, for 6 weeks. At baseline and after the 6-week intervention, balance was measured using the Berg Balance Scale and Timed Up and Go test, and fear of falling was assessed using the Falls Efficacy Scale. [Results] After the intervention, significant improvements from baseline values in the Berg Balance Scale, Timed Up and Go test, and Falls Efficacy Scale were observed in the study participants. [Conclusion] Elderly individuals who performed whole body vibration exercise in the horizontal direction showed significant improvements in balance and fear of falling. However, the observed benefits of whole body vibration exercise in the horizontal direction need to be confirmed by additional studies.Key words: Whole body vibration, Elderly, Balance     

平衡仪反馈训练法和Bobath平衡训练法对偏瘫患者平衡和功能性行走能力的影响

目的：探讨平衡仪反馈训练法和Bobath平衡训练法对偏瘫患者平衡和功能性行走能力的影响。方法：将符合试验条件的住院卒中患者分层随机分为试验组（20例）和对照组（20例）,两组对象在试验开始前Berg平衡得分（BBS）、“起立-走”计时试验（Up＆Go）比较差异无显著性意义。试验组的平衡训练使用平衡仪视觉反馈法,对照组平衡训练使用Bobath平衡训练法,测试指标采用BBS和Up＆Go,在试验开始前和训练6周后各评定1次。结果：训练6周后试验组的BBS、Up＆Go均优于对照组比较差异具有显著性意义。结论：使用平衡仪训练对改善脑卒中患者的平衡和行走功能比单纯的Bobath平衡训练法更有效。     

Berg平衡量表在脑卒中患者中的内在信度和同时效度

目的：探讨Berg平衡量表在脑卒中患者中的内在信度和同时效度。方法：40例符合入选标准的脑卒中偏瘫患者参与本研究。对患者进行Berg平衡量表、计时起立-步行测验和Barthel指数的评价。结果：Berg平衡量表的Cronbach α系数为0.864,14项目的Cronbach α系数范围为0.844—0.869,Berg平衡量表折半信度系数为0.915。Berg平衡量表与效标工具计时起立-步行测验和Barthel指数之间显著相关。结论：Berg平衡量表在脑卒中患者中具有良好的内在信度和同时效度。     

An efficacy study on improving balance and gait in subacute stroke patients by balance training with additional motor imagery: a pilot study

[Purpose] The few studies conducted on subacute stroke patients have focused only on gait function improvement. This study therefore aimed to confirm the effect of balance training with additional motor imagery on balance and gait improvement in subacute stroke patients. [Subjects and Methods] Participants were divided into an experimental or control group. The experimental group received balance training for 20 minutes/day with mental imagery for 10 minutes/day, three days/week, for four weeks. The control group received only balance training for 30 minutes. Before and after the 12 sessions, balance and gait ability were assessed by the researcher and a physical therapist. [Results] After completion of the 4-week intervention, Berg Balance Scale, Timed Up and Go test, Functional Reach Test, and Four Square Step test scores significantly increased in the experimental group. In the control group, Berg Balance Scale and Functional Reach Test scores significantly improved. Changes in the Timed Up and Go test, Functional Reach Test, and Four Square Step Test scores after intervention were significantly higher in the experimental than in the control group. [Conclusion] Specific balance training with additional motor imagery may result in better rehabilitation outcomes of gait and balance ability than balance training alone.Key words: Balance, Gait, Motor imagery     

Effects of Pilates on muscle strength,postural balance and quality of life of older adults: a randomized,controlled, clinical trial

[Purpose] The aim of the present study was to determine the effects of Pilates on lower leg strength, postural balance and the health-related quality of life (HRQoL) of older adults. [Subjects and Methods] Thirty-two older adults were randomly allocated either to the experimental group (EG, n = 16; mean age, 63.62 ± 1.02 years), which performed two sessions of Pilates per week for 12 weeks, or to the control group (CG, n = 16; mean age, 64.21 ± 0.80), which performed two sessions of static stretching per week for 12 weeks. The following evaluations were performed before and after the interventions: isokinetic torque of knee extensors and flexors at 300°/s, the Timed Up and Go (TUG) test, the Berg Balance Scale, and the Health Survey assessment (SF-36). [Results] In the intra-group analysis, the EG demonstrated significant improvement in all variables. In the inter-group analysis, the EG demonstrated significant improvement in most variables. [Conclusion] Pilates exercises led to significant improvement in isokinetic torque of the knee extensors and flexors, postural balance and aspects of the health-related quality of life of older adults.Key words: Exercise, Age, Muscle strength dynamometer     

Therapeutic effects of reaching with forward bending of trunk on postural stability,dynamic balance,and gait in individuals with chronic hemiparetic stroke

[Purpose] The objective of this study was to perform forward bending of the trunk and reaching training in chronic stroke patients and to investigate subsequent changes in trunk control, dynamic balance, and gait. [Subject] Twenty-three chronic stroke patients were randomly divided into two groups, with 10 patients in the forward bending of the trunk and reaching group and 13 patients in the control group. [Methods] Both groups underwent 30 minutes of rehabilitation therapy, five days a week, for four weeks. The forward bending of the trunk and reaching group additionally performed forward bending of the trunk and reaching training five times a week for four weeks, which involved four sets of pressing buttons 35 times, for a total of 140 button presses per session. The subjects were tested before and after training using the Trunk Impairment Scale, Berg Balance Scale, Timed Up and Go Test, Six-Minute Walking Test, and 10-Meter Walking Test. Trunk control, dynamic balance, and walking ability were compared between the two groups. [Result] The results of the study showed that the results of the Trunk Impairment Scale, Berg Balance Scale, Timed Up and Go Test, Six-Minute Walking Test improved significantly in the FBR group, while there were no significant differences in the control group. [Conclusion] This study results suggest that forward bending of the trunk and reaching training can be an effective exercise method for chronic stroke patients.Key words: Postural control, Stroke, Trunk     

The effects of ankle joint muscle strengthening and proprioceptive exercise programs accompanied by functional electrical stimulation on stroke patients’ balance

[Purpose] The purpose of the present study was to examine the effects of ankle joint muscle strengthening and proprioceptive exercises accompanied by functional electrical stimulation on stroke patients’ balance ability. [Methods] For six weeks beginning in April 2015, 22 stroke patients receiving physical therapy at K Hospital located in Gyeonggi-do were divided into a functional electrical stimulation (FES), ankle proprioceptive exercise and ankle joint muscle strengthening exercise group (FPS group) of 11 patients and an FES and stretching exercise group (FS group) of 11 patients. The stimulation and exercises were conducted for 30 min per day, five days per week for six weeks. Balance ability was measured using a BioRescue and the Berg balance scale, functional reach test, and the timed up-and-go test were also used as clinical evaluation indices. Repeated measures ANOVA was conducted to examine differences between before the exercises and at three and six weeks after beginning the exercises within each group, and the amounts of change between the two groups were compared. [Results] In the comparison within each group, both groups showed significant differences between before and after the experiment in all the tests and comparison between the groups showed that greater improvement was seen in all values in the FPS group. [Conclusion] In the present study, implementing FES and stretching exercises plus ankle joint muscle strengthening and proprioceptive exercises was more effective at improving stroke patients balance ability than implementing only FES and stretching exercises.Key words: Proprioceptive, Strengthening, Stroke     

Neck Proprioceptive Training for Balance Function in Patients with Chronic Poststroke Hemiparesis: A Case Series

[Purpose] This study investigated the effects of neck proprioceptive training on the balance of patients with chronic poststroke hemiparesis. [Subjects] Three patients with chronic stroke were recruited for this study. [Methods] The subjects underwent neck proprioceptive training using the red light of a laser pointer (30 min daily, five times per week for 4 weeks). Outcome measures included the stability and weight distribution indices measured with a Tetrax system and Timed Up and Go (TUG) and proprioception tests. [Results] For all subjects, the stability and weight distribution indices increased by 1.87–9.66% in the eyes-open and eyes-closed conditions, and the TUG and proprioception test scores improved by 2.49–15.27%. [Conclusion] Neck proprioceptive training may be a good option for improving the balance function of patients with chronic poststroke hemiparesis.Key words: Neck proprioceptive training, Balance, Stroke     

The effects of virtual reality game exercise on balance and gait of the elderly

[Purpose] The aim of this study was to examine the effects of ball exercise as a general exercise on the balance abilities of elderly individuals by comparing ball exercise with virtual reality exercise. [Subjects and Methods] Thirty elderly individuals residing in communities were randomly divided into a virtual reality game group and a ball exercise group and conducted exercise for 30 min 3 times a week for 8 weeks. [Results] Step length increased significantly, and the average sway speed and Timed Up and Go time significantly decreased in both groups. A comparison of sway length after the intervention between the two groups revealed that the virtual reality game exercise resulted in a reduction than the ball exercise. [Conclusion] The results of this study indicated that the virtual reality game exercise may improve balance and gait of elderly individuals in communities.Key words: Elderly, Balance, Virtual reality exercise     

Factors affecting early knee-flexion range of motion after total knee arthroplasty

[Purpose] To investigate the factors affecting the knee-flexion range of motion in the early period after total knee arthroplasty. [Participants and Methods] Ninety-nine patients who had undergone total knee arthroplasty at our hospital between 2016 and 2019 were allocated into two groups based on the presence of a 110° knee-flexion range of motion at 14 days post-surgery. From medical records, we extracted data for the participants’ basic attributes and preoperative/postoperative physical function (knee-flexion range of motion, Timed Up & Go Test results, resting/walking pain according to a numerical rating scale, and knee-extension muscle strength). Postoperative physical function was measured 14 days post-surgery. [Results] Preoperative knee-flexion range of motion, preoperative femorotibial angle, postoperative knee-extensor strength, and postoperative Timed Up & Go Test value differed significantly as factors related to achieving a 110° knee-flexion range of motion. Through further statistical analyses, we selected the preoperative knee-flexion range of motion, preoperative femorotibial angle, preoperative Timed Up & Go Test result, and postoperative knee-extension strength as factors affecting the knee-flexion range of motion at 14 days post-surgery. [Conclusion] Preoperative knee-flexion range of motion, preoperative femorotibial angle, preoperative Timed Up & Go Test result, and postoperative knee-extension strength influence knee-flexion range of motion at 14 days after total knee arthroplasty, and our findings indicate the effectiveness of active physiotherapy interventions.     

正常人动态平衡能力测试的信度及效度分析

目的　对正常人平衡功能进行动态姿势图重复检测 ,分析各参数间的内在一致性、重测信度及不同测试者间的信度 ;并与Berg平衡量表、功能性前伸测量、起立行走计时测定结果比较 ,检验其效标效度。方法　 2名测试者应用BiodexBalanceSystem (BBS)分别对 40名正常受试者 ( 18～ 67岁 )进行 2次 8级平台稳定性动态姿势图测试及稳定性测试 ;同时还应用Berg平衡量表、功能性前伸距离及起立行走计时等方法进行检测。结果　研究结果发现年龄因素对所有检测参数均有影响 ,体重指数对稳定指数及平均方向控制能力有影响。各参数间内部存在一致性 (r =0 .2 2～ 0 .93 ,均P <0 .0 1) ,其重测信度 (r =0 .70～ 0 .99)及不同测试者间信度 (r =0 .71～ 0 .98)较佳 (ICC =0 .88～ 0 .99)。在测试过程中 ,发现不同跌下次数的受试者其年龄差异和测试结果间差异显著相关 (P <0 .0 0 1)。BBS测试数据与Berg平衡量表、功能性前伸测量、起立行走计时测评结果有较高的相关性 (r =0 .72～ 0 .86)。结论　BBS能反映受试者平衡能力的年龄变化趋势 ,具有较高的内在一致性、重测信度及不同测试者间的信度 ,与Berg平衡量表、起立行走计时及功能性前伸测量结果具有一致性 ,可用于平衡功能的定量评定。     

The Effect of Ankle Taping and Balance Exercises on Postural Stability Indices in Healthy Women

[Purpose] The purpose of this study was to compare the effect of ankle taping and balance exercises on postural stability indices in healthy women. [Subjects and Methods] Thirty healthy female students were randomly assigned into two equal groups: ankle taping and balance exercise. The balance exercise group performed balance exercises for 6 weeks, with 3 sessions per week and each session lasting 40 minutes. Ankle joint taping was performed for 6 weeks and was renewed three times a week. Before and after the interventions, overall, anteroposterior, and mediolateral stability indices were measured with a Biodex Balance System in bilateral and unilateral stance positions with the eyes open and closed. [Results] In the taping group during bilateral standing with the eyes closed, the overall stability index changed from 6±1.4 to 4.8±1.3, anteroposterior stability index changed from 4.2±1.27 to 3.4±0.97, and mediolateral stability index changed from 3.2±0.75 to 2.7± 0.7. In the balance exercise group during bilateral standing with the eyes closed, the overall stability index changed from 5.7±1.69 to 4.5±1.94, anteroposterior stability index changed from 4.1±1.61 to 3±1.21, and mediolateral stability index changed from 3.5±1.4 to 2.2± 1.3. No significant difference was seen between the two groups regarding any study variables. [Conclusion] The results showed that compared with the taping technique, balance training increases postural stability in the majority of the studied balance situations.Key words: Balance exercise, Taping, Biodex     

Efficacy of supervised vestibular rehabilitation on functional mobility in patients with chronic vestibular hypofunction

[Purpose] This study aimed to compare the effects of different intervention frequencies on walking ability and balance in patients with chronic unilateral vestibular hypofunction. [Participants and Methods] Participants included in this case-control study were assigned to one of two groups: the multiple-intervention (once a week) and single-intervention groups. Results for the Timed Up and Go test, Dynamic Gait Index, Functional Gait Assessment, and Activities-specific Balance Confidence scale were determined at baseline and four weeks after initiating the vestibular rehabilitation program. Thereafter, intra- and inter-group differences in the rates of change of these parameters were determined. [Results] The Timed Up and Go test values, Dynamic Gait Index, and Functional Gait Assessment scores improved significantly after four weeks in the multiple-intervention group. The improvement rate in the Timed Up and Go test differed significantly between the two groups. The Activities-specific Balance Confidence scale scores did not significantly change in either group after four weeks. [Conclusion] Compared to a single intervention, multiple interventions by a physical therapist produced significantly greater benefits in a relatively shorter period of time in patients with chronic unilateral vestibular hypofunction.     

Effects of aquatic PNF lower extremity patterns on balance and ADL of stroke patients

[Purpose] This study investigated the effect of aquatic proprioceptive neuromuscular facilitation (PNF) patterns in the lower extremity on balance and activities of daily living (ADL) in stroke patients. [Subjects] Twenty poststroke participants were randomly assigned to an experimental group (n = 10) or a control group (n = 10). The experimental group performed lower extremity patterns in an aquatic environment, and the control group performed lower extremity patterns on the ground. Both exercises were conducted for 30 minutes/day, 5 days/week for 6 weeks. Balance was measured with the Berg Balance Scale (BBS), Timed Up and Go Test (TUGT), Functional Reach Test (FRT), and One Leg Stand Test (OLST). Activities of daily living were measured with the Functional Independence Measure (FIM). A paired t-test was used to measure pre- and post-experiment differences, and an independent t-test was used to measure between-group differences. [Results] The experimental and control groups showed significant differences for all pre- and post-experiment variables. In the between-group comparison, the experimental group was significantly difference from the control group. [Conclusion] These results indicate that performing aquatic proprioceptive neuromuscular facilitation patterns in the lower extremity enhances balance and ADL in stroke patients.Key words: Proprioceptive neuromuscular facilitation, Balance, Activities of daily living     

Specific balance training included in an endurance-resistance exercise program improves postural balance in elderly patients undergoing haemodialysis

Purpose: The purpose of this study was to evaluate the effects of 6 months of specific balance training included in endurance-resistance program on postural balance in haemodialysis (HD) patients.

Methods: Forty-nine male patients undergoing HD were randomly assigned to an intervention group (balance training included in an endurance-resistance training, n?=?26) or a control group (resistance-endurance training only, n?=?23). Postural control was assessed using six clinical tests; Timed Up and Go test, Tinetti Mobility Test, Berg Balance Scale, Unipodal Stance test, Mini-Balance Evaluation Systems Test and Activities Balance Confidence scale.

Results: All balance measures increased significantly after the period of rehabilitation training in the intervention group. Only the Timed Up and Go, Berg Balance Scale, Mini-Balance Evaluation Systems Test and Activities Balance Confidence scores were improved in the control group. The ranges of change in these tests were greater in the balance training group.

Conclusions: In HD patients, specific balance training included in a usual endurance-resistance training program improves static and dynamic balance better than endurance-resistance training only.

• Implications for rehabilitation

• Rehabilitation using exercise in haemodialysis patients improved global mobility and functional abilities.

• Specific balance training included in usual endurance resistance training program could lead to improved static and dynamic balance.