Dynamic Postural Control During Trunk Bending and Reaching in Healthy Adults and Stroke Patients

Chern, Jen Suh; Lo, Chen Yu; Wu, Ching‐yi; Chen, Chia Ling; Yang, Sai-Wei; Tang, Feng‐Yao

doi:10.1097/phm.0b013e3181c56287

Cited by 39 publications

(28 citation statements)

References 34 publications

(63 reference statements)

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“…Asymmetric gait in chronic hemiplegia is characterized by longer time spent in affected single limb stance than unaffected single limb stance [33]. Recent studies on posturographic analysis observed that stroke patients tend to avoid shifting their center of pressure towards the hemiplegic side in sitting [34] and standing [35]. A study on involving the analysis of trunk kinematics during walking found that pelvic movements were unstable and asymmetrical in patients with stroke [36].…”

Section: Discussionmentioning

confidence: 99%

Role of Trunk Rehabilitation on Trunk Control, Balance and Gait in Patients with Chronic Stroke: A Pre-Post Design

Karthikbabu¹,

Solomon²,

Natarajan³

et al. 2011

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Purpose: Although proximal stability of the trunk is a prerequisite for balance and gait, to determine the role of trunk rehabilitation on trunk control, balance and gait in patients with chronic stroke is yet unknown. Method: Fifteen sub-jects (post-stroke duration (3.53 ± 2.98) years) who had the ability to walk 10 meters independently with or without a walking aid; scoring ≤ 21 on Trunk Impairment Scale (TIS), participated in a selective trunk muscle exercise regime, consisting of 45 minutes training per day, four days a week, and for four weeks duration in an outpatient stroke reha-bilitation centre. Results: The overall effect size index for trunk rehabilitation was 1.07. This study showed large effect size index for Trunk Impairment Scale (1.75), Berg Balance Scale (1.65) than for gait variables (0.65). After trunk rehabilitation, there was a significant improvement for gait speed (p= 0.015), cadence (p= 0.001) and gait symmetry (p=0.019) in patients with chronic stroke. In addition, all the spatial gait parameters had a significant change post-intervention. There was no significant change in temporal gait parameters with the exception of affected single limb support time. The level of significance was set at p < 0.05. Conclusion: The exercises consisted of selective trunk movement of the upper and the lower part of trunk had shown larger effect size index for trunk control and balance than for gait in patients with chronic stroke. Future randomized controlled studies incorporating large sample size would provide insight into the effectiveness and clinical relevance of this intervention

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Section: Discussionmentioning

confidence: 99%

Role of Trunk Rehabilitation on Trunk Control, Balance and Gait in Patients with Chronic Stroke: A Pre-Post Design

Karthikbabu¹,

Solomon²,

Natarajan³

et al. 2011

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“…On measuring the center of pressure displacement during forward trunk bending and reaching in people after stroke, Chern et al . [3] observed less pressure distribution toward most affected side even the task demand was high. Posturography analysis revealed that balance ability after stroke as measured by Berg balance scale was strongly correlated to lateral weight shift ability than anterioposterior weight shifts.…”

Section: Discussionmentioning

confidence: 99%

“…[1] Ability to transfer weight on paralyzed lower extremity is a prerequisite for functional mobility skills such as rising from a chair,[2] reach-outs in standing[3] and walking. [1] Perceptual dysfunction, sensory loss, poor motor recovery of lower extremity, spasticity, muscular weakness, poor trunk control, and altered pelvic alignment could contribute for reduced weight acceptance on the most affected lower limb.…”

Section: Introductionmentioning

confidence: 99%

Relationship between Pelvic Alignment and Weight-bearing Asymmetry in Community-dwelling Chronic Stroke Survivors

Karthikbabu

Chakrapani

Ganesan

et al. 2016

Journal of Neurosciences in Rural Practice

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Background and Purpose:Altered pelvic alignment and asymmetrical weight bearing on lower extremities are the most common findings observed in standing and walking after stroke. The purpose of this study was to find the relationship between pelvic alignment and weight-bearing asymmetry (WBA) in community-dwelling chronic stroke survivors.Materials and Methods:This cross-sectional study was conducted in tertiary care rehabilitation centers. In standing, the lateral and anterior pelvic tilt angle of chronic stroke survivors was assessed using palpation (PALM™) meter device. The percentage of WBA was measured with two standard weighing scales. Pearson correlation coefficient (r) was used to study the correlation between pelvic tilt and WBA.Results:Of 112 study participants, the mean (standard deviation) age was 54.7 (11.7) years and the poststroke duration was 14 (11) months. The lateral pelvic tilt on the most affected side and bilateral anterior pelvic tilt were 2.47 (1.8) and 4.4 (1.8) degree, respectively. The percentage of WBA was 23.2 (18.94). There was a high correlation of lateral pelvic tilt with WBA (r = 0.631; P < 0.001) than anterior pelvic tilt (r = 0.44; P < 0.001).Conclusion:Excessive lateral pelvic tilt toward the most affected side in standing may influence the weight-bearing ability of the ipsilateral lower extremity in community-dwelling chronic stroke survivors.

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“…It is suggested that this particularly difficult movement in stroke is possibly caused by a combination of factors such as proximal hypertonia in the lower extremities or paresis of the trunk muscles and anteroposterior pelvic obliquity and rotation (Davis, 2003;Messier et al, 2004). However, the patients had some troubles when they shifted the center of gravity from sitting or standing to their paralyzed side (Van Nes et al, 2008;Chern et al, 2010). There may be a possibility exists that STE training may elevate symmetrical pelvic movement, thus better weight shifting towards hemiplegic limb during gait.…”

Section: ⅳ Discussionmentioning

confidence: 99%

The Effects of Trunk Exercise on Mobility, Balance and Trunk Control of Stroke Patients

Park

2017

KSPM

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| Abstract |1 )PURPOSE: The initiation of the trunk muscles in stroke patients is delayed because the muscles involved in reach arm are activated earlier than the trunk muscles. The objective of this study was to examine the effects of mobility, balance, and trunk control ability through selective trunk exercise (STE) in patients with chronic stroke. METHODS:A randomized pre-test and post-test control group design was initially used, with subjects randomly assigned to the STE group (n=15) and a control group (n=14).All groups underwent physical therapy based on the neuro-developmental therapy (NDT) for 30 minutes a day, five times per week for four weeks. Additionally, the STE group did the trunk exercise for 30 minutes a day, three times per week for four weeks. The timed up and go test (TUG), Berg balance scale (BBS), and trunk impairment scale (TIS) were used for assessment. RESULTS:The scores of the TUG, BBS, dynamic sitting balance subscale, and coordination subscale of TIS improved significantly in both groups but the improvement was more †Corresponding Author : daeric@konyang.ac.kr This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. pronounced in the STE group (p<.05). This study showed a large effect on the scores of the TIS coordination subscale (d=.93) (p<.05), TIS dynamic balance subscale (d=.81) (p<.05), TUG (d=.75) (p<.05), and BBS (d=.73) (p<.05). CONCLUSION:The combined STE and NDT program showed improvements in measures of mobility, balance, and trunk control in chronic stroke patients. These results suggest that STE should be considered to be included in the treatment program for patients with chronic stroke.

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Dynamic Postural Control During Trunk Bending and Reaching in Healthy Adults and Stroke Patients

Cited by 39 publications

References 34 publications

Role of Trunk Rehabilitation on Trunk Control, Balance and Gait in Patients with Chronic Stroke: A Pre-Post Design

Role of Trunk Rehabilitation on Trunk Control, Balance and Gait in Patients with Chronic Stroke: A Pre-Post Design

Relationship between Pelvic Alignment and Weight-bearing Asymmetry in Community-dwelling Chronic Stroke Survivors

The Effects of Trunk Exercise on Mobility, Balance and Trunk Control of Stroke Patients

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