Effects of robot-assisted trunk control training on trunk control ability and balance in patients with stroke: A randomized controlled trial

2021 ◽  
pp. 1-10
Author(s):  
Dong-Hoon Kim ◽  
Tae-Sung In ◽  
Kyoung-Sim Jung
Keyword(s):  
Postural Control ◽  
Center Of Pressure ◽  
Training Session ◽  
Functional Independence ◽  
Control Group ◽  
Stroke Patients ◽  
Robot Assisted ◽  
Trunk Control ◽  
Functional Reach Test ◽  
Balance Ability

BACKGROUND: Trunk control ability is an important component of functional independence after the onset of stroke. Recently, it has been reported that robot-assisted functional training is effective for stroke patients. However, most studies on robot-assisted training have been conducted on upper and lower extremities. OBJECTIVE: The purpose of this study was to evaluate the effects of robot-assisted trunk control training on trunk postural control and balance ability in stroke patients. METHODS: Forty participants with hemiparetic stroke were recruited and randomly divided into two groups: the RT (robot-assisted trunk control training) group (n= 20) and the control group (n= 20). All participants underwent 40 sessions of conventional trunk stabilization training based on the Bobath concept (for 30 minutes, five-times per week for 8 weeks). After to each training session, 15 minutes of robotassisted trunk control training was given in the RT group, whereas the control group received stretching exercise for the same amount of time. Robot-assisted trunk control training was conducted in three programs: sitting balance, sit-to stand, and standing balance using a robot system specially designed to improve trunk control ability. To measure trunk postural control ability, trunk impairment scale (TIS) was used. Center of pressure (COP) distance, limits of stability (LOS), Berg Balance Scale (BBS) and functional reach test (FRT) were used to analyze balance abilities. RESULTS: In TIS, COP distance, LOS, BBS and FRT, there were significant improvements in both groups after intervention. More significant changes were shown in the RT group than the control group (p< 0.05). CONCLUSIONS: Our findings indicate that robot-assisted trunk control training is beneficial and effective to improve trunk postural control and balance ability in stroke patients. Therefore robot-assisted training may be suggested as an effective intervention to improve trunk control ability in patients with stroke.

scholarly journals Effects of Slackline Training on Acceleration, Agility, Jump Performance and Postural Control in Youth Soccer Players

2019 ◽  
Vol 67 (1) ◽  
pp. 235-245
Author(s):  
Javier Fernández-Rio ◽  
Luis Santos ◽  
Benjamín Fernández-García ◽  
Roberto Robles ◽  
Iván Casquero ◽  
...  
Keyword(s):  
Postural Control ◽  
Training Program ◽  
Perceived Exertion ◽  
Center Of Pressure ◽  
Training Session ◽  
Soccer Players ◽  
Control Group ◽  
Countermovement Jump ◽  
Jump Performance ◽  
Squat Jump

AbstractThe goal of this study was to assess the effects of a supervised slackline training program in a group of soccer players. Thirty-four male division I under-19 players (16.64 ± 0.81 years) agreed to participate in the study. They were randomly divided into an experimental group (EG) and a control group (CG). The first group (EG) followed a 6-week supervised slackline training program (3 sessions/week; 5-9 min/session), while the CG performed only regular soccer training. Several variables were assessed in all participants: acceleration (20-m sprint test), agility (90º turns test), jump performance (squat jump, countermovement jump), and postural control (Center of Pressure ( CoP) testing: length, area, speed, Xmean, Ymean, Xspeed, Yspeed, Xdeviation, Ydeviation). Ratings of perceived exertion and local muscle ratings of perceived exertions were also recorded after each slackline training session. At post-tests, there was a significant increase only in the EG in acceleration, agility, squat jump and countermovement jump performance, as well as several CoP variables: area in the bipedal support on a firm surface, and length, area and speed in the left leg on a firm surface. The program was rated as “somewhat hard” by the players, while quadriceps, gastrocnemius and tibialis anterior were the most exerted muscles while slacklining. In conclusion, slackline training can be an effective training tool for young, high-level soccer players.

scholarly journals Effect of Task-Specific Training on Trunk Control and Balance in Patients with Subacute Stroke

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Mohamed E. Khallaf
Keyword(s):  
Physical Therapy ◽  
Postural Control ◽  
Secondary Outcome ◽  
Control Group ◽  
Study Group ◽  
Walking Ability ◽  
Specific Training ◽  
Trunk Control ◽  
Subacute Stroke ◽  
Functional Reach Test

Objectives. Impairment of static and dynamic posture control is common after stroke. It is found to be a predictor and an essential component for balance, walking ability, and activities of daily living (ADL) outcomes. Studies investigating effect of physical therapy techniques with an aim to improve trunk function after stroke are limited. This study aimed at studying the effect of task-specific training on trunk control and balance in patients with subacute stroke. Methods. In this randomized controlled trail, thirty-four patients were alienated into two equal groups. The study group (n = 17) received task-specific training, and the control group (n = 17) received conventional physical therapy based on the neurodevelopmental technique. Task-specific training was applied through two phases with criteria of progression based on Chedoke–McMaster Stroke Assessment postural control stages. The interventions were applied in a dosage of 60 min per session, three times a week for ten weeks. Static and dynamic balance were measured by the trunk impairment scale (TIS), postural assessment scale (PAS), and functional reach test (FRT). Laser-guided digital goniometer was used to measure the trunk ranges of motions (ROM) as a secondary outcome. Results. Significant differences between the baseline and the follow-up measures including TIS, PAS, FRT, and trunk (ROM) were found in both groups ( P ≤ 0.05 ). In-between group comparison also showed significant differences between the results of both groups indicating more improvements among patients representing the study group. Conclusion. Task-specific training may be effective in improving the static and dynamic postural control and trunk ranges of motion among subacute stroke patients.

scholarly journals Postural Control Disturbances Induced by Virtual Reality in Stroke Patients

2021 ◽  
Vol 11 (4) ◽  
pp. 1510
Author(s):  
Charles Morizio ◽  
Maxime Billot ◽  
Jean-Christophe Daviet ◽  
Stéphane Baudry ◽  
Christophe Barbanchon ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Postural Control ◽  
Virtual Environments ◽  
Center Of Pressure ◽  
Dynamic Condition ◽  
Static Condition ◽  
Stroke Patients ◽  
Post Stroke ◽  
Subacute Stroke

People who survive a stroke are often left with long-term neurologic deficits that induce, among other impairments, balance disorders. While virtual reality (VR) is growing in popularity for postural control rehabilitation in post-stroke patients, studies on the effect of challenging virtual environments, simulating common daily situations on postural control in post-stroke patients, are scarce. This study is a first step to document the postural response of stroke patients to different challenging virtual environments. Five subacute stroke patients and fifteen age-matched healthy adults were included. All participants underwent posturographic tests in control conditions (open and closed eyes) and virtual environment without (one static condition) and with avatars (four dynamic conditions) using a head-mounted device for VR. In dynamic environments, we modulated the density of the virtual crowd (dense and light crowd) and the avoidance space with the avatars (near or far). Center of pressure velocity was collected by trial throughout randomized 30-s periods. Results showed that more challenging conditions (dynamic condition) induced greater postural disturbances in stroke patients than in healthy counterparts. Our study suggests that virtual reality environments should be adjusted in light of obtaining more or less challenging conditions.

scholarly journals Clinical Efficacy of a New Robot-assisted Gait Training System for Acute Stroke Patients

2021 ◽  
Author(s):  
Andy Chien ◽  
Fei-Chun Chang ◽  
Nai-Hsin Meng ◽  
Pei-Yu Yang ◽  
Ching Huang ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Acute Stroke ◽  
Quality Index ◽  
Pittsburgh Sleep Quality Index ◽  
Gait Training ◽  
Training System ◽  
Control Group ◽  
Stroke Patients ◽  
Robot Assisted ◽  
Significant Difference

Abstract Purpose Robot-assisted gait rehabilitation has been proposed as a plausible supplementary rehabilitation strategy in stroke rehabilitation in the last decade. However, its exact benefit over traditional rehabilitation remain sparse and unclear. It is therefore the purpose of the current study to comparatively investigate the clinical benefits of the additional robot-assisted training in acute stroke patients compared to standard hospital rehabilitation alone. Methods Ninety acute stroke patients (< 3 month) were recruited. All participants received the standard hospital neurorehabilitation comprises 45–60 min sessions daily for 3 weeks. Sixty patients also received an additional 30 min of robot-assisted gait training with the HIWIN MRG-P100 gait training system after each of the standard neurorehabilitation session. Outcome measures included: 1. Berg Balance Scale (BBS); 2. Brunnstrom Stage; 3. Pittsburgh Sleep Quality Index and 4. Taiwanese Depression Questionnaire (TDQ) which were assessed pre-treatment and then after every five training sessions. Results Both groups demonstrated significant improvement pre- and post-treatment for the BBS (robotic group p = 0.023; control group p = 0.033) but no significant difference (p > 0.1) between the groups were found. However, the robotic training group had more participants demonstrating larger BBS points of improvement as well as greater Brunnstrom stage of improvement, when compared to the control group. No significant within and between group statistical differences (p > 0.3) were found for Pittsburgh Sleep Quality Index and Taiwanese Depression Questionnaire. Conclusion The addition of robotic gait training on top of standard hospital neurorehabilitation for acute stroke patients appear to produce a slightly greater improvement in clinical functional outcomes, which is not transferred to psychological status.

scholarly journals Virtual Reality Gait Training to Promote Balance and Gait Among Older People: A Randomized Clinical Trial

Geriatrics ◽  
2020 ◽  
Vol 6 (1) ◽  
pp. 1
Author(s):  
Kyeongjin Lee
Keyword(s):  
Virtual Reality ◽  
The Elderly ◽  
Gait Training ◽  
Control Group ◽  
Timed Up And Go ◽  
Elderly Individuals ◽  
Functional Reach Test ◽  
Balance Ability ◽  
Standing Test ◽  
The One

Falls are the leading cause of injury and injury-related death in the elderly. This study evaluated the effect of virtual reality gait training (VRGT) with non-motorized treadmill on balance and gait ability of elderly individuals who had experienced a fall. Fifty-six elderly individuals living in local communities participated in this study. Subjects who met the selection criteria were randomly divided into a VRGT group (n = 28) and a control group (n = 28). The VRGT group received VRGT with non-motorized treadmill for 50 min a day for 4 weeks and 5 days a week. The control group received non-motorized treadmill gait training without virtual reality for the same amount of time as the VRGT group. Before and after the training, the one-leg-standing test, Berg Balance Scale, Functional Reach test, and Timed Up and Go test were used to assess balance ability, and the gait analyzer system was used to evaluate the improvement in gait spatiotemporal parameters. In the VRGT group, the balance ability variable showed a significant decrease in the one-leg-standing test and a significant improvement in the Timed Up and Go test. With respect to spatiotemporal gait parameters, velocity and step width decreased significantly in the VRGT group (p < 0.05), and stride length and step length were significantly improved in the VRGT group (p < 0.05). VRGT with non-motorized treadmill has been shown to improve balance and gait ability in the elderly. This study is expected to provide basic data on exercise programs for the elderly to prevent falls.

scholarly journals The Effects of Abdominal Hypopressive Training on Postural Control and Deep Trunk Muscle Activation: A Randomized Controlled Trial

2021 ◽  
Vol 18 (5) ◽  
pp. 2741
Author(s):  
María del Mar Moreno-Muñoz ◽  
Fidel Hita-Contreras ◽  
María Dolores Estudillo-Martínez ◽  
Agustín Aibar-Almazán ◽  
Yolanda Castellote-Caballero ◽  
...  
Keyword(s):  
Postural Control ◽  
Muscle Activation ◽  
Center Of Pressure ◽  
Controlled Trial ◽  
Trunk Muscle ◽  
Posture Control ◽  
Trunk Muscles ◽  
Control Group ◽  
Female Population ◽  
Imaging Results

Background: Abdominal Hypopressive Training (AHT) provides postural improvement, and enhances deep trunk muscle activation. However, until recently, there was a lack of scientific literature supporting these statements. The major purpose of this study was to investigate the effect of AHT on posture control and deep trunk muscle function. Methods: 125 female participants aged 18–60 were randomly allocated to the Experimental Group (EG), consisting of two sessions of 30 min per week for 8 weeks of AHT, or the Control Group (CG), who did not receive any treatment. Postural control was measured with a stabilometric platform to assess the static balance and the activation of deep trunk muscles (specifically the Transverse Abdominal muscle (TrA)), which was measured by real-time ultrasound imaging. Results: The groups were homogeneous at baseline. Statistical differences were identified between both groups after intervention in the Surface of the Center of Pressure (CoP) Open-Eyes (S-OE) (p = 0.001, Cohen’s d = 0.60) and the Velocity of CoP under both conditions; Open-Eyes (V-OE) (p = 0.001, Cohen´s d = 0.63) and Close-Eyes (V-CE) (p = 0.016, Cohen´s d = 0.016), with the EG achieving substantial improvements. Likewise, there were statistically significant differences between measurements over time for the EG on S-OE (p < 0.001, Cohen´s d = 0.99); V-OE (p = 0.038, Cohen´s d = 0.27); V-CE (p = 0.006, Cohen´s d = 0.39), anteroposterior movements of CoP with Open-Eyes (RMSY-OE) (p = 0.038, Cohen´s d = 0.60) and activity of TrA under contraction conditions (p < 0.001, Cohen´s d = 0.53). Conclusions: The application of eight weeks of AHT leads to positive outcomes in posture control, as well as an improvement in the deep trunk muscle contraction in the female population.

The effect of robot-assisted gait training on cortical activation in stroke patients: A functional near-infrared spectroscopy study

2021 ◽  
pp. 1-9
Author(s):  
Kyeong Joo Song ◽  
Min Ho Chun ◽  
Junekyung Lee ◽  
Changmin Lee
Keyword(s):  
Gait Speed ◽  
Functional Outcomes ◽  
Near Infrared ◽  
Gait Training ◽  
Berg Balance Scale ◽  
Cortical Activation ◽  
Control Group ◽  
Stroke Patients ◽  
Robot Assisted ◽  
Functional Near Infrared Spectroscopy

OBJECTIVE: To investigate the effects of the robot–assisted gait training on cortical activation and functional outcomes in stroke patients. METHODS: The patients were randomly assigned: training with Morning Walk® (Morning Walk group; n = 30); conventional physiotherapy (control group; n = 30). Rehabilitation was performed five times a week for 3 weeks. The primary outcome was the cortical activation in the Morning Walk group. The secondary outcomes included gait speed, 10-Meter Walk Test (10MWT), FAC, Motricity Index–Lower (MI–Lower), Modified Barthel Index (MBI), Rivermead Mobility Index (RMI), and Berg Balance Scale (BBS). RESULTS: Thirty-six subjects were analyzed, 18 in the Morning Walk group and 18 in the control group. The cortical activation was lower in affected hemisphere than unaffected hemisphere at the beginning of robot rehabilitation. After training, the affected hemisphere achieved a higher increase in cortical activation than the unaffected hemisphere. Consequently, the cortical activation in affected hemisphere was significantly higher than that in unaffected hemisphere (P = 0.036). FAC, MBI, BBS, and RMI scores significantly improved in both groups. The Morning Walk group had significantly greater improvements than the control group in 10MWT (P = 0.017), gait speed (P = 0.043), BBS (P = 0.010), and MI–Lower (P = 0.047) scores. CONCLUSION: Robot-assisted gait training not only improved functional outcomes but also increased cortical activation in stroke patients.

Abstract WP471: Significant Factors for Early Independent Toilet Activities in Acute Stroke Patients

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Yuki Sawada ◽  
Takahisa Mori ◽  
Yuna Hosaka
Keyword(s):  
Cognitive Function ◽  
Acute Stroke ◽  
Mmse Score ◽  
Multiple Logistic Regression Analysis ◽  
Early Discharge ◽  
Functional Independence ◽  
Lower Limbs ◽  
Stroke Patients ◽  
Trunk Control ◽  
Significant Factors

Introduction: Acute stroke patients have problems with toilet activities. Independent toilet activity in hospitalized patients is important for dischargee to home. Hypothesis: Lower limbs function, trunk control and cognitive function are important factors of early independent toilet activities and discharge to home within 7 days. Methods: We included acute ischemic stroke patients who 1) were admitted from June 2017 to May 2018 and 2) received early rehabilitation treatment. Patients with disturbed level of consciousness were excluded. Functional independence measure (FIM) scale of 6 or 7 was defined as independence and FIM scale of 5 or less as dependence. We evaluated Brunnstrom Recovery Stage (BRS) of arms, fingers and lower limbs, trunk control test (TCT), Mini-Mental State Examination (MMSE) and investigated significant factors of early independent toilet activities and discharge to home within 7 days. Results: One-hundred twenty-four patients met our inclusive criteria. Their average age was 75.8 years, male gender of 63.7%, median BRS of arms, fingers and lower limbs was 5, 5 and 5, median TCT score and MMSE score were 94 and 24.7, respectively. Fifty-three patients were independent in toilet activity and 73 patients were dependent. All patients with independent toilet activity discharged to home within 7 days. In independent and dependent toilet activity patients, an average age was 73.6 and 77.4 (p<0.05), median BRS of arms was 5 and 5 (p<0.01), median BRS of fingers was 6and 5 (p<0.01), median BRS of lower limbs was 5 and 5 (p<0.01), median TCT score was 100 and 61 (p<0.01), and median MMSE score was 27.8 and 22.5 (p<0.01), respectively. Multiple logistic regression analysis showed that MMSE score (p<0.01), TCT score (p<0.01), and BRS of lower limbs (p<0.05) were independent factors for independent toilet activity and discharge to home. Receiver operating characteristic (ROC) curve for early discharge to home demonstrated that cut-off values of MMSE score, TCT score and MRS of lower limbs were 27 or more, 87 or more and 5 or more, respectively. Conclusion: BRS as lower limbs function, TCT as trunk control and MMSE as cognitive function were important factors of early independent toilet activities and early discharge to home.

scholarly journals Maximal stability limits in adolescents with Tourette syndrome

2021 ◽  
Vol 4 (1) ◽  
pp. 013-022
Author(s):  
Blanchet Mariève ◽  
Prince François ◽  
Lemay Martin ◽  
Chouinard Sylvain ◽  
Messier Julie
Keyword(s):  
Postural Control ◽  
Tourette Syndrome ◽  
Center Of Pressure ◽  
Phase 1 ◽  
Sensory Information ◽  
Control Group ◽  
Eyes Closed ◽  
Highly Sensitive ◽  
Eyes Open ◽  
Stability Limits

We explored if adolescents with Gilles de la Tourette syndrome (GTS) had functional postural control impairments and how these deficits are linked to a disturbance in the processing and integration of sensory information. We evaluated the displacements of the center of pressure (COP) during maximal leaning in four directions (forward, backward, rightward, leftward) and under three sensory conditions (eyes open, eyes closed, eyes closed standing on foam). GTS adolescents showed deficits in postural stability and in lateral postural adjustments but they had similar maximal COP excursion than the control group. The postural performance of the GTS group was poorer in the eyes open condition (time to phase 1 onset, max-mean COP). Moreover, they displayed a poorer ability to maintain the maximum leaning position under the eyes open condition during mediolateral leaning tasks. By contrast, during forward leaning, they showed larger min-max ranges than control subjects while standing on the foam with the eyes closed. Together, these findings support the idea that GTS produces subclinical postural control deficits. Importantly, our results suggest that postural control disorders in GTS are highly sensitive to voluntary postural leaning tasks which have high demand for multimodal sensory integration.

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