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The Effect of Backward Walking Exercise using a Mirror on Balance and Gait in Patients with Stroke

거울을 이용한 뒤로 걷기 운동이 뇌졸중 환자의 균형과 보행능력에 미치는 영향

  • Received : 2018.03.15
  • Accepted : 2018.04.19
  • Published : 2018.05.31

Abstract

PURPOSE: This study aimed to identify the effect of a backward walking exercise using a mirror on balance and gait in patients with stroke. METHODS: Twenty subjects with post-stroke hemiparesis volunteered to participate in this study. The experimental and control groups performed backward walking exercise plus conventional therapy or conventional physical therapy, respectively, for 6 weeks. Assessment instruments included the Berg Balance Scale (BBS), timed up and go test (TUG), and 10-m walking test (10MWT). Evaluation was performed before and after the 6-week training period. We conducted a paired t-test to compare the within-group changes before and after the intervention. An independent t-test was used to compare between-group differences. The statistical significance level was set at ${\alpha}=.05$ for all variables. RESULTS: The experimental group showed a significant within-group change in the BBS, TUG, and 10MWT (p<.05). The control group also showed a significant change (p<.05). A significant difference was observed between the experimental and control groups with regard to changes in the BBS, TUG, and 10MWT results after the interventions (p<.05). CONCLUSION: This study demonstrated that backward walking exercise using a mirror may be valuable for future research. Further studies with a wider range of pathology and longer experiment duration are required to validate the results of the present study.

Keywords

References

  1. Amstrong CW, Commanger JM, Wooley SA. Comparative analysis of forward and backward walking. The sixth annual east coast gait conference. East Lansing MI: Michigan State University. 1990.
  2. Bang DH, Shin WS, Kim SY, et al. The effects of action observational training on walking ability in chronic stroke patients: a double-blind randomized controlled trial. Clin Rehabil. 2013;27(12):1118-25. https://doi.org/10.1177/0269215513501528
  3. Bayouk JF, Boucher J, PLeroux A. Balance training following stroke: effects of task-oriented exercises with and without altered sensory input. Int J Rehabil Res. 2006;29(1):51-9. https://doi.org/10.1097/01.mrr.0000192100.67425.84
  4. Berg KO, Wood-Dauphinee SL, Williams JI, et al. Measuring balance in the elderly: Validation of an instrument. Can J Public Health. 1992;83(2):7-11.
  5. Berg KO, Wood-Dauphinee SL, Williams JI. The balance scale: reliability assessment with elderly residents and patients with an acute stroke. Scand J Rehabil Med. 1995;27(1):27-36.
  6. Dobkin BH. Short-distance walking speed and timed walking distance: Redundant measures for clinical trials? Neurology. 2006;66(4):584-6. https://doi.org/10.1212/01.wnl.0000198502.88147.dd
  7. Duncan PW, Homer RD, Reker DM, et al. Adherence to post acute rehabilitation guidelines is associated with functional recovery in stroke. Stroke. 2002;33(1): 167-78. https://doi.org/10.1161/hs0102.101014
  8. Flansbjer UB, Blom J, Brogardh C. The reproducibility of Berg balance scale and the single-leg stance in chronic stroke and the relationship between the two tests. PM R. 2012;4(3):165-70. https://doi.org/10.1016/j.pmrj.2011.11.004
  9. Flansbjer UB, Holmback AM, Downham D, et al. Reliability of gait performance tests in men and women with hemiparesis after stroke. J Rehabil Med. 2005; 37(2):75-82. https://doi.org/10.1080/16501970410017215
  10. Geiger RA, Allen JB, O'Keefe J, et al. Balance and mobility following stroke: effects of physical therapy interventions with and without biofeedback/forceplate training. Phys Ther. 2001;81(4):995-1005.
  11. Grasso R, Bianchi L, Lacquaniti F. Motor patterns for human gait: backward versus forward locomotion. J Neurophysiol. 1998;80(4):1868-85. https://doi.org/10.1152/jn.1998.80.4.1868
  12. Gray GW. Successful strategies for closed chain testing and rehabilitation. In: Chain Reaction, Adrian, M1: Wynn Marketing. 1990.
  13. Ji SG, Nam GW, Kim MK, et al. The effect of visual feedback training using a mirror on the balance in hemiplegic patients. J Korean Soc Phys Med. 2011;6(2):153-63.
  14. Kim JD, Cha YJ, Youn HJ. Effects of emphasized Initial contact auditory feedback gait training on balance and gait in stroke patients. J Korean Soc Phys Med. 2015;10(4):49-57. https://doi.org/10.13066/kspm.2015.10.4.49
  15. Kim JS, Kwon OH. The effect of arm swing on gait in post-stroke hemiparesis. J Korean Soc Phys Med. 2002;7(1): 95-101. https://doi.org/10.13066/kspm.2012.7.1.095
  16. Kim SG, Ryu YU, Kim WH. The effectiveness of backward gait training on the treadmill in children with spastic diplegic cerebral palsy: a pilot study. Phys Ther Korea. 2012;19(3):81-90. https://doi.org/10.12674/ptk.2012.19.3.081
  17. Kim SJ. The effect of backward walking which influences forward walking in patients with stroke. Master's degree. Daegu University. 2009.
  18. Kim YI, Joung HB, Ahn MH, et al. Effect of the visual feedback gait training in use the mirror on stroke patient's function. J Korean Acad Ther. 2012;4(2):18-32.
  19. Kolb B, Gibb R. Brain plasticity and recovery from early cortical injury. Dev Psychobiol. 2007;49(2):107-18. https://doi.org/10.1002/dev.20199
  20. Kong HN, Bang DH, Shin WS. Effect of balance training on different support surface on balance and gait in patients with chronic stroke. J Korean Soc Phys Med. 2015;10(3):275-83.
  21. Mackie JW, Dean TE. Running backward training effects on upper leg musculature and ligamentous instability of injures knee. Med Sci Sports Exerc. 1984;16(2):151.
  22. Nadeau S, Amblard B, Mesure S, et al. Head and trunk stabilization strategies during forward and backward walking in healthy adults. Gait Posture. 2003;18(3): 134-42. https://doi.org/10.1016/S0966-6362(02)00070-X
  23. Podsiadlo D, Richardson S. The timed "Up & GO": a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39(2):142-8. https://doi.org/10.1111/j.1532-5415.1991.tb01616.x
  24. Pollock A, Baer G, Pomeroy V, et al. Physiotherapy treatment approaches for the recovery of postural control and lower limb function following stroke. Cochrane Database Syst Rev. 2007;24(1):336 .
  25. Ramachandran VS, Rogers-Ramachandran D. Synaesthesia in phantom limbs induced with mirrors. Proc Biol Sci. 1996;263(1369):377-86. https://doi.org/10.1098/rspb.1996.0058
  26. Rizzolatti G. The mirror neuron system and imitation. Perspectives on imitation: From neuroscience to social science. 2005;1:55-76.
  27. Rizzolatti G, Fadiga L, Gallese V, et al. Premotor cortex and the recognition of motor actions. Brain Res Cogn Brain Res. 1996;3(2):131-41. https://doi.org/10.1016/0926-6410(95)00038-0
  28. Rojhani-Shirazi Z, Amirian S, Meftahi N. Effects of Ankle Kinesio Taping on Postural Control in Stroke Patients. J Stroke Cerebrovasc Dis. 2015;24(11):2565-71. https://doi.org/10.1016/j.jstrokecerebrovasdis.2015.07.008
  29. Rose DK, DeMark L, Fox EJ, et al. A backward walking training program to improve balance and mobility in acute stroke: a pilot randomized controlled trial. J Neurol Phys Ther. 2018;42(1):12-21. https://doi.org/10.1097/NPT.0000000000000210
  30. Sackley CM, Baguley BI, Gent S, et al. The use of a balance performance monitor in the treatment of weight- bearing and weight-transference problems after stroke. Physiotherapy. 1992;78(12):907-13. https://doi.org/10.1016/S0031-9406(10)60498-1
  31. Seo MG, Lee JS, Woo YG. The effect of visual feedback treadmill training on balance and gait of stroke patient by using a mirror. J Korean Acad Ther. 2013; 5(2):50-61.
  32. Shin KH, Kang SH. Changes in balance and gait following backward walking exercise in hemiplegic stroke patients. J Korean Soc Phys Med. 2017;12(2):21-31. https://doi.org/10.13066/kspm.2017.12.2.21
  33. Sim GS, Jeon HS. Comparison of the effects of wii balance games and mirror self-balancing exercises on knee joint proprioception and balance in chronic stroke patients. Phys Ther Korea. 2016;24(1):30-40. https://doi.org/10.12674/ptk.2016.24.1.030
  34. Thomas MA, Fast A. One step forward and two step back: the dangers of walking backwards in therapy. Am J Phys Med Rrehabil. 2000;79(5):459-61. https://doi.org/10.1097/00002060-200009000-00011
  35. Threlkeld AJ, Horn TS, Wojtowicz G, et al. Kinematics, ground reaction force, and muscle balance produced by backward running. J Orthop Sports Phys Ther. 1989; 11(2):56-63. https://doi.org/10.2519/jospt.1989.11.2.56
  36. Visintin M, Barbeau H, Korner-Bitensky N, et al. A new approach to retrain gait in stroke patients through body weight support and treadmill stimulation. Stroke. 1998;29(6):1122-8. https://doi.org/10.1161/01.STR.29.6.1122
  37. Winstein CJ, Gardner ER, McNeal DR, et al. Standing balance training: effect on balance and locomotion in hemiparetic adults. Arch Phys Med Rehabil. 1989; 70(10):755-62.
  38. Yang YR, Yen JG, Wang RY, et al. Gait outcomes after additional backward walking training in patients with stroke: a randomized controlled trial. Clin Rehabil. 2005; 19(3):264-73. https://doi.org/10.1191/0269215505cr860oa
  39. Yavuzer G, Selles R, Sezer N, et al. Mirror therapy improves hand function in subacute stroke: a randomized controlled trial. Arch Phys Med Rehabil. 2008;89(3): 393-8. https://doi.org/10.1016/j.apmr.2007.08.162

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