DOI QR코드

DOI QR Code

Effects of Trunk Control Exercise Performed on an Unstable Surface on Dynamic Balance in Chronic Stroke Patients

불안정한 지지면에서의 체간조절운동이 만성 뇌졸중 환자의 동적 균형에 미치는 효과

Jang, Jun-young;Kim, Suhn-yeop
장준영;김선엽

  • Received : 2015.08.17
  • Accepted : 2015.09.21
  • Published : 2016.02.29

Abstract

PURPOSE: This study compared the effectiveness of trunk control exercise performed on an unstable surface with that of general balance exercise on dynamic balance in the patients with chronic stroke. METHODS: The persons of this study were thirty-seven chronic stroke patients were recruited and randomly divided into 2 groups; (1) those who performed trunk control exercise on a foam roll and (2) those who performed general balance exercise. The exercises were performed 5 times a week for 4 weeks. To determine the effectiveness of the 2 types of exercises, we measured dynamic balance at the beginning of the exercises and again after 4 weeks at the completion of exercises program. RESULTS: After 4 weeks of exercise, both the groups showed increased Berg's balance scale and timed-up-and-go test (p<.001) scores. However, Trunk control exercise group was more effective than general balance exercise group was in increasing the Berg's balance scale (p<.01) and timed-up-and-go test (p<.05) scores. CONCLUSION: We suggest that trunk control exercise may be effective in increasing the balance ability of patients with chronic stroke than general balance exercise. Thus, trunk control exercise is important for such patients. Further studies are needed for better understanding of the effectiveness of trunk control exercise in chronic stroke patients.

Keywords

Balance;Stroke;Trunk control;Unstable

References

  1. American Heart. Heart disease and stroke statistics - 2005 Update. Dallas. TX. American Heart Association. 2005.
  2. An SH, Chung YJ, Park SY. The effects of trunk control ability on balance, gait, and functional performance ability in patients with stroke. Phy Ther Korea. 2010;17(2):33-42.
  3. Berg K, Wood-Dauphinee S, Williams JI. The balance scale: Reliability assessment with elderly residents and patients with an acute stroke. Scand J Rehabil Med. 1995;27:27-36.
  4. Brill PW, Couzen GS. The Core Program, New York, Bantam Book. 2002.
  5. Clark MA, Cummings PD. Treinamento de estabilizacao do core. Sau Paulo, Manole. 1992.
  6. Dickstein R, Heves Y, Laufer Y, et al. Activation of selected trunk muscles during symmetric functional activities in poststrokehemiparetic and hemiplegic patients. J Neurol Neurosurg Psychiatry. 1999;66(2):218-21. https://doi.org/10.1136/jnnp.66.2.218
  7. Dickstein R, Sheffi S, Ben Haim Z, et al. Activation of flexor and extensor trunk muscles in hemiparesis. Am J Phys Med Rehabil. 2000;79(3):228-34. https://doi.org/10.1097/00002060-200005000-00003
  8. Dickstein R, Shefi S, Marcovitz E, et al. Electromyographic activity of voluntarily activated trunk flexor and extensor muscles in post-stroke hemiparetic subjects. Clin Neurophysiol. 2004;115:790-6. https://doi.org/10.1016/j.clinph.2003.11.018
  9. Duarte E, Marco E, Muniesa JM, et al. Trunk control test as a functional predictor in stroke patients. J Rehabil Med. 2002;34(6):267-72. https://doi.org/10.1080/165019702760390356
  10. Feigin L, Sharon B, Czaczkes B, et al. Sitting equilibrium 2 weeks after a stroke can predict the walking ability after 6 months. Gerontology. 1996;42(6):348-53. https://doi.org/10.1159/000213814
  11. Hall CM, Brody LT. Therapeutic Exercise: Moving toward Function. Philadelphia. Lippincott, Williams and Wilkins. 1999.
  12. Haynes W. Core stability and the unstable platform device. J Bodyw Mov Ther. 2004;8(2):88-103. https://doi.org/10.1016/S1360-8592(03)00061-5
  13. Hsieh CL, Sheu CF, Hsueh IP, et al. Trunk control as an early predictor of comprehensive activities of daily living function in stroke patients. Stroke. 2002;33(11):2212-30.
  14. Jandt SR, da Sil Caballero RM, Junior LAF, et al. Correlation between trunk control, respiratory muscle strength and spirometry in patients with stroke: An observational study. Physiother Res Int. 2011;16:218-24. https://doi.org/10.1002/pri.495
  15. Kafri M, Dickstein R. Activation of selected frontal trunk and extremities muscle during rolling from supine to side lying in healthy subjects and in post-stroke hemiparetic patients. Neuro Rehabilitation. 2005;20(2):125-31.
  16. Karatas M, Cetin N, Bayramoglu M, et al. 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
  17. Karthikbabu S, Nayak A, Vijayakumar K, et al. Comparison of physio ball and plinth trunk exercises regimens on trunk control and functional balance in patients with acute stroke: A pilot randomized controlled trial. Clin Rehabil. 2011;25:709-19. https://doi.org/10.1177/0269215510397393
  18. Kim SJ, Kwon OY, Yi CH, et al. Comparison of abdominal muscle activity during a single-legged hold in the hook-lying position on the floor and on a round foam roll. J Athl Train. 2011;46(4):403-8. https://doi.org/10.4085/1062-6050-46.4.403
  19. Lee SC, Kim TH, Cynn HS, et al. The influence of unstability of supporting surface on trunk and lower extremity muscle activities during bridging exercise combined with core-stabilization exercise. Phy Ther Korea. 2010;17(1):17-25.
  20. Lee JY, Park JS, Lee DH, et al. Effect of the trunk muscle stabilization training on balance for chronic stroke patients. Journal of the Korea Academia-Industrial Cooperation Society. 2012;13(3):1212-19. https://doi.org/10.5762/KAIS.2012.13.3.1212
  21. Liebenson C. Postural exercises on the foam roll. J Bodyw Mov Ther. 2010;14(2):203-5. https://doi.org/10.1016/j.jbmt.2010.02.003
  22. Lim JS, Song JM, Kim JS. The effect of core stabilization exercise on foot pressure in hemiplegic patients. J Korean Soc Phys Med. 2011;6(2):109-18.
  23. Masiero S, Avesani R, Armani M, et al. Predictive factors for ambulation in stroke patients in the rehabilitation setting: A multivariate analysis. Clin Neurol Neurosurg. 2007;109:763-9. https://doi.org/10.1016/j.clineuro.2007.07.009
  24. McGill SM. Low back stability: From formal description to issues for performance and rehabilitation. Exerc Sport Sci Rev. 2001;29(1):26-31. https://doi.org/10.1097/00003677-200101000-00006
  25. O'Sullivan PB, Phyty GD, Twomey LT, et al. Evaluation of specific stabilizing exercise in the treatment of chronic low back pain with radiologic diagnosis of spondylolysis or spondylolisthesis. Spine. 1997;22(24):2959-67. https://doi.org/10.1097/00007632-199712150-00020
  26. Park HJ, Oh DW, Shin WS. The study of asymmetrical contraction of the lateral abdominal muscles in stroke patients using ultrasound imaging. J Korean Soc Phys Med. 2012:7(3):319-27. https://doi.org/10.13066/kspm.2012.7.3.319
  27. Pereira LM, Marcucci FCI, de Oliveira Menacho M, et al. Electromyographic activity of selected trunk muscles in subjects with and without hemiparesis during therapeutic exercise. J Electromyogr Kinesiol. 2011;21(2):327-32. https://doi.org/10.1016/j.jelekin.2010.10.003
  28. Podsiadlo D, Richardson S. The timed up & go: A test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39:142-8. https://doi.org/10.1111/j.1532-5415.1991.tb01616.x
  29. Pollock A, Baer G, Langhorne P, et al. Physiotherapy treatment approaches for the recovery of postural control and lower limb function following stroke: A systematic review. Clin Rehabil. 2007;21(5);395-410. https://doi.org/10.1177/0269215507073438
  30. Ryerson S, Byl NN, Brown D A, et al. Altered trunk position sense and its relation to balance functions in people post-stroke. J Neurol Phys Ther. 2008;32:14-20. https://doi.org/10.1097/NPT.0b013e3181660f0c
  31. Sackley CM, Baguly BI. Visual feedback after stroke with balance performance monitor: Two single case studies. Clin Rehabil. 1993;7(3):189-95. https://doi.org/10.1177/026921559300700302
  32. Shin WS, Kim CY, Lee DY, et al. The effects of trunk stability exercise on dynamic balance in the persons with chronic stroke. Journal of Korea Academia-Industrial Cooperation Society. 2009;10(9):2509-15. https://doi.org/10.5762/KAIS.2009.10.9.2509
  33. Shumway-Cook A, Woollacott MH. Motor Control: Theory and practical applications. Baltimore. Lippincott. Williams and Wilkins. 1995.
  34. Song JM, Kim SM. The effect of trunk stability exercise on balance and gait in stroke patients. J Korean Soc Phys Med. 2010;5(3):413-20.
  35. Verheyden G, Nieuwboer A, De Wit L, et al. Time course of trunk, arm, leg, and functional recovery after ischemic stroke. Neurorehabil Neural Repair. 2007;22(2):173-9. https://doi.org/10.1177/1545968307305456
  36. Verheyden G, Nieuwboer A, Mertin J, et al. The Trunk Impairment Scale: A new tool to measure motor impairment of the trunk after stroke. Clin Rehabil. 2004;18:326-34. https://doi.org/10.1191/0269215504cr733oa
  37. Verheyden G, Nieuwboer A, Van de Winckel A, et al. Clinical tools to measure trunk performance after stroke: A systematic review of the literature. Clin Rehabil. 2007;21:387-94. https://doi.org/10.1177/0269215507074055
  38. Winzeler-Mercay U, Mudie H. The nature of the effects of stroke on trunk flexor and extensor muscles during work and rest. Disabil Rehabil. 2002;24(17):875-86. https://doi.org/10.1080/09638280210142220

Cited by

  1. The Effects of Trunk Exercise on Mobility, Balance and Trunk Control of Stroke Patients vol.12, pp.1, 2017, https://doi.org/10.13066/kspm.2017.12.1.25
  2. The Effect of Treadmill Gait Training in an Adjusted Position from Functional Training System on Chronic Stroke Patients' Walking and Balance Ability vol.12, pp.1, 2017, https://doi.org/10.13066/kspm.2017.12.1.35
  3. The Effect of Active Trunk Training in Sitting Position on Balance and Energy Consumption in Early Stroke Patients vol.12, pp.4, 2017, https://doi.org/10.13066/kspm.2017.12.4.93
  4. The Effects of Visual Feedback Self Exercise on Postural Control in Stroke Patients vol.12, pp.4, 2017, https://doi.org/10.13066/kspm.2017.12.4.105