Effects of continuous visual feedback during sitting balance training in chronic stroke survivors

Abstract

BackgroundPostural control deficits are common in stroke survivors and often the rehabilitation programs include balance training based on visual feedback to improve the control of body position or of the voluntary shift of body weight in space. In the present work, a group of chronic stroke survivors, while sitting on a force plate, exercised the ability to control their Center of Pressure with a training based on continuous visual feedback. The goal of this study was to test if and to what extent chronic stroke survivors were able to learn the task and transfer the learned ability to a condition without visual feedback and to directions and displacement amplitudes different from those experienced during training.MethodsEleven chronic stroke survivors (5 Male - 6 Female, age: 59.72 ± 12.84 years) participated in this study. Subjects were seated on a stool positioned on top of a custom-built force platform. Their Center of Pressure positions were mapped to the coordinate of a cursor on a computer monitor. During training, the cursor position was always displayed and the subjects were to reach targets by shifting their Center of Pressure by moving their trunk. Pre and post-training subjects were required to reach without visual feedback of the cursor the training targets as well as other targets positioned in different directions and displacement amplitudes.ResultsDuring training, most stroke survivors were able to perform the required task and to improve their performance in terms of duration, smoothness, and movement extent, although not in terms of movement direction. However, when we removed the visual feedback, most of them had no improvement with respect to their pre-training performance.ConclusionsThis study suggests that postural training based exclusively on continuous visual feedback can provide limited benefits for stroke survivors, if administered alone. However, the positive gains observed during training justify the integration of this technology-based protocol in a well-structured and personalized physiotherapy training, where the combination of the two approaches may lead to functional recovery.

A Novel Trunk Rehabilitation Robot Based Evaluation of Seated Balance Under Varying Seat Surface and Visual Conditions

“…Overall, it is observed that majority of the parameters showed statistically significant variations between different trial conditions. This indicates that, similar previous works [21][22][23][24], the seat mode and visual status both have a strong relationship with the quality of seated postural control. This is in line with our first hypothesis that difficulty of the task of seated postural control is affected by the variation in seat and visual modes.…”

“…The system is also capable of generating visual biofeedback based on the position of the user's COP. A review of previous studies on the use of COP based visual biofeedback during trunk rehabilitation on stable and unstable surfaces revealed that the inclusion of visual biofeedback improves balance related outcomes [14,[21][22][23][24][25][26]. However, these studies have mostly used stable or uncontrolled unstable platforms.…”

“…Static seat with visual feedback of COP [21] To test if and to what extent chronic stroke survivors were able to learn the center of pressure control task and transfer the learned ability to a condition without visual feedback and with varied goals…”

Development of a Smartphone-Based Balance Assessment System for Subjects with Stroke

“…Gyroscopes collect angular velocity data, and can be used to compute changes in COG angular velocity and angular position. Larger values of COG angular velocity and position indicate reduced balance performance [12][13][14][15][16][17][18][19].…”

Effect of Taping of Thoracic and Abdominal Muscles on Pelvic Alignment and Forward Reach Distance Among Stroke Subjects: A Randomized Controlled Trial

“… 1 , 2 Stroke survivors often adapt compensatory strategies to maintain balance which leads to poor sitting ability. 3 , 4 Sitting, being a skill that is critical to independent living, is one of the useful prognostic indicators of functional outcome for stroke population. Re-establishment of control in sitting for function is an important early goal in stroke rehabilitation.…”