Physical Therapy Rehabilitation Science

korean Academy of Physical Therapy Rehabilitation Science (물리치료재활과학회)
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Effects of 3-dimensional balance trainer in combination with a video-game system on balance and gait ability in subacute stroke patients

  • Ha, Hyun Geun (Department of Physical & Rehabilitation Medicine, Samsung Medical Center) ;
  • Ko, Young Jun (Department of Physical & Rehabilitation Medicine, Samsung Medical Center) ;
  • Lee, Hwang Jae (Department of Physical Therapy, Myungji Choonhey Hospital) ;
  • Lee, Wan Hee (Department of Physical Therapy, College of Health and Welfare, Sahmyook University)
  • Received : 2014.03.13
  • Accepted : 2014.05.13
  • Published : 2014.06.26
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Abstract

Objective: The purpose of this study was to investigate the effects of a three dimensional balance trainer in combination with a video-game system and visual feedback on balance recovery and gait function in subacute stroke patients. Design: Randomized controlled trial. Methods: Twenty-three subacute stroke patients were assigned to either an experimental (n=12) or a control group (n=11) using a random permuted block design and sealed envelopes. The experimental group received additional 3-dimensional balance training combined with visual feedback and a game program for 30 min/day, 5 days/week for 4 weeks. Both groups received 30-min of conservative physical therapy sessions based on neurodevelopmental therapy. Before and after the 20 sessions, walking abilities were evaluated by the the GaitRite system and balances were evaluated using the Berg Balance Scale (BBS). The Trunk Impairment Scale (TIS) was used to assess trunk muscle performances. Results: After the 4-week intervention, BBS and TIS scores were significantly increased in both groups (p<0.05), and increases in these scores were significantly greater in the experimental group (p<0.05). After the 4-week intervention, gait speed and cadence were significantly increased in both groups (p<0.05), and as was observed for BBS and TIS scores, changes of gait speed and cadence were significantly greater in the experimental group (p<0.05). Conclusions: The study shows that the 3-dimensional balance trainer combined with visual biofeedback and a video-game system provides a therapeutic means for improving balance and gait ability in subacute stroke patients.

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References

  1. Hochstenbach J, Donders R, Mulder T, Van Limbeek J, Schoonderwaldt H. Long-term outcome after stroke: a disability- orientated approach. Int J Rehabil Res 1996;19:189-200. https://doi.org/10.1097/00004356-199609000-00001
  2. Bohannon RW. Importance of physical therapy grows. Phys Ther 1988;68:584.
  3. Shumway-Cook A, Anson D, Haller S. Postural sway biofeedback: its effect on reestablishing stance stability in hemiplegic patients. Arch Phys Med Rehabil 1988;69:395-400.
  4. Nashner LM, Shupert CL, Horak FB, Black FO. Organization of posture controls: an analysis of sensory and mechanical constraints. Prog Brain Res 1989;80:411-8; discussion 395-7. https://doi.org/10.1016/S0079-6123(08)62237-2
  5. Liston RA, Brouwer BJ. Reliability and validity of measures obtained from stroke patients using the Balance Master. Arch Phys Med Rehabil 1996;77:425-30. https://doi.org/10.1016/S0003-9993(96)90028-3
  6. Bohannon RW. Gait performance of hemiparetic stroke patients: selected variables. Arch Phys Med Rehabil 1987;68:777-81.
  7. Chung E, Lee BH, Hwang S. Core stabilization exercise with real- time feedback for chronic hemiparetic stroke: a pilot randomized controlled trials. Restor Neurol Neurosci 2014;32:313-21.
  8. Yavuzer G, Eser F, Karakus D, Karaoglan B, Stam HJ. The effects of balance training on gait late after stroke: a randomized controlled trial. Clin Rehabil 2006;20:960-9. https://doi.org/10.1177/0269215506070315
  9. Kim MC, Park JU, Kim WC, Lee HS, Chung HT, Kim MW, et al. Can unilateral-approach minimally invasive transforaminal lumbar interbody fusion attain indirect contralateral decompression? A preliminary report of 66 MRI analysis. Eur Spine J 2014;23:1144-9. https://doi.org/10.1007/s00586-014-3192-3
  10. Barcala L, Grecco LA, Colella F, Lucareli PR, Salgado AS, Oliveira CS. Visual biofeedback balance training using wii fit after stroke: a randomized controlled trial. J Phys Ther Sci 2013;25:1027-32. https://doi.org/10.1589/jpts.25.1027
  11. Dettmann MA, Linder MT, Sepic SB. Relationships among walking performance, postural stability, and functional assessments of the hemiplegic patient. Am J Phys Med 1987;66:77-90.
  12. Shumway-Cook A, Horak FB. Assessing the influence of sensory interaction of balance. Suggestion from the field. Phys Ther 1986;66:1548-50.
  13. Lee SH, Byun SD, Kim CH, Go JY, Nam HU, Huh JS, et al. Feasibility and effects of newly developed balance control trainer for mobility and balance in chronic stroke patients: a randomized controlled trial. Ann Rehabil Med 2012;36:521-9. https://doi.org/10.5535/arm.2012.36.4.521
  14. Van Peppen RP, Kortsmit M, Lindeman E, Kwakkel G. Effects of visual feedback therapy on postural control in bilateral standing after stroke: a systematic review. J Rehabil Med 2006;38:3-9. https://doi.org/10.1080/16501970500344902
  15. Cho KH, Lee KJ, Song CH. Virtual-reality balance training with a video-game system improves dynamic balance in chronic stroke patients. Tohoku J Exp Med 2012;228:69-74. https://doi.org/10.1620/tjem.228.69
  16. Berg KO, Wood-Dauphinee SL, Williams JI, Maki B. Measuring balance in the elderly: validation of an instrument. Can J Public Health 1992;83(Suppl 2):S7-11.
  17. Verheyden G, Willems AM, Ooms L, Nieuwboer A. Validity of the trunk impairment scale as a measure of trunk performance in people with Parkinson's disease. Arch Phys Med Rehabil 2007;88:1304-8. https://doi.org/10.1016/j.apmr.2007.06.772
  18. Webster KE, Wittwer JE, Feller JA. Validity of the GAITRite walkway system for the measurement of averaged and individual step parameters of gait. Gait Posture 2005;22:317-21. https://doi.org/10.1016/j.gaitpost.2004.10.005
  19. Nichols DS. Balance retraining after stroke using force platform biofeedback. Phys Ther 1997;77:553-8.
  20. Yang HC, Lee CL, Lin R, Hsu MJ, Chen CH, Lin JH, et al. Effect of biofeedback cycling training on functional recovery and walking ability of lower extremity in patients with stroke. Kaohsiung J Med Sci 2014;30:35-42. https://doi.org/10.1016/j.kjms.2013.07.006
  21. Blum L, Korner-Bitensky N. Usefulness of the Berg Balance Scale in stroke rehabilitation: a systematic review. Phys Ther 2008;88:559-66. https://doi.org/10.2522/ptj.20070205
  22. Karatas M, Cetin N, Bayramoglu M, Dilek A. Trunk muscle strength in relation to balance and functional disability in unihemispheric stroke patients. Am J Phys Med Rehabil 2004;83:81-7. https://doi.org/10.1097/01.PHM.0000107486.99756.C7
  23. Barclay-Goddard R, Stevenson T, Poluha W, Moffatt ME, Taback SP. Force platform feedback for standing balance training after stroke. Cochrane Database Syst Rev 2004;(4):CD004129.
  24. Sackley CM, Lincoln NB. Single blind randomized controlled trial of visual feedback after stroke: effects on stance symmetry and function. Disabil Rehabil 1997;19:536-46. https://doi.org/10.3109/09638289709166047
  25. Weiss PL, Katz N. The potential of virtual reality for rehabilitation. J Rehabil Res Dev 2004;41:vii-x.
  26. Kang HK, Chung YJ. Effects of treadmill training with real optic flow scene on balance and balance self-efficacy in individuals following stroke: a pilot randomized controlled trial. Phys Ther Rehabil Sci 2012;1:33-9.
  27. Kim CY, Min WK. The effects of virtual reality-based physical therapy in stroke patients. Phys Ther Rehabil Sci 2013;2:7-11.
  28. Chung EJ, Lee BH. The effects of treadmill training on dynamic balance and gait function in stroke patients: a pilot randomized controlled trial. Phys Ther Rehabil Sci 2013;2:39-43.
  29. Miyachi M, Yamamoto K, Ohkawara K, Tanaka S. METs in adults while playing active video games: a metabolic chamber study. Med Sci Sports Exerc 2010;42:1149-53.
  30. Saposnik G, Mamdani M, Bayley M, Thorpe KE, Hall J, Cohen LG, et al; EVREST Steering Committee; EVREST Study Group for the Stroke Outcome Research Canada Working Group. Effectiveness of Virtual Reality Exercises in STroke Rehabilitation (EVREST): rationale, design, and protocol of a pilot randomized clinical trial assessing the Wii gaming system. Int J Stroke 2010;5:47-51.
  31. Hurkmans HL, Ribbers GM, Streur-Kranenburg MF, Stam HJ, van den Berg-Emons RJ. Energy expenditure in chronic stroke patients playing Wii Sports: a pilot study. J Neuroeng Rehabil 2011;8:38. https://doi.org/10.1186/1743-0003-8-38

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