The Additive Effects of Core Muscle Strengthening and Trunk NMES on Trunk Balance in Stroke Patients
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Objective To investigate an additive effect of core muscle strengthening (CMS) and trunk neuromuscular electrical stimulation (tNEMS) on trunk balance in stroke patientsMethods Thirty patients with acute or subacute stroke who were unable to maintain static sitting balance for >5 minutes were enrolled and randomly assigned to 3 groups, i.e., patients in the CMS (n=10) group received additional CMS program; the tNMES group (n=10) received additional tNMES over the posterior back muscles; and the combination (CMS and tNMES) group (n=10) received both treatments. Each additional treatment was performed 3 times per week for 20 minutes per day over 3 weeks. Korean version of Berg Balance Scale (K-BBS), total score of postural assessment scale for stroke patients (PASS), Trunk Impairment Scale (TIS), and Korean version of Modified Barthel Index (K-MBI) were evaluated before and after 3 weeks of therapeutic intervention.Results All 3 groups showed improvements in K-BBS, PASS, TIS, and K-MBI after therapeutic interventions, with some differences. The combination group showed more improvements in K-BBS and the dynamic sitting balance of TIS, as compared to the CMS group; and more improvement in K-BBS, as compared to the tNMES group.Conclusion The results indicated an additive effect of CMS and tNMES on the recovery of trunk balance in patients with acute or subacute stroke who have poor sitting balance. Simultaneous application of CMS and tNMES should be considered when designing a rehabilitation program to improve trunk balance in stroke patients.
Abstract
Objective To investigate an additive effect of core muscle strengthening (CMS) and trunk neuromuscular electrical stimulation (tNEMS) on trunk balance in stroke patientsMethods Thirty patients with acute or subacute stroke who were unable to maintain static sitting balance for >5 minutes were enrolled and randomly assigned to 3 groups, i.e., patients in the CMS (n=10) group received additional CMS program; the tNMES group (n=10) received additional tNMES over the posterior back muscles; and the combination (CMS and tNMES) group (n=10) received both treatments. Each additional treatment was performed 3 times per week for 20 minutes per day over 3 weeks. Korean version of Berg Balance Scale (K-BBS), total score of postural assessment scale for stroke patients (PASS), Trunk Impairment Scale (TIS), and Korean version of Modified Barthel Index (K-MBI) were evaluated before and after 3 weeks of therapeutic intervention.Results All 3 groups showed improvements in K-BBS, PASS, TIS, and K-MBI after therapeutic interventions, with some differences. The combination group showed more improvements in K-BBS and the dynamic sitting balance of TIS, as compared to the CMS group; and more improvement in K-BBS, as compared to the tNMES group.Conclusion The results indicated an additive effect of CMS and tNMES on the recovery of trunk balance in patients with acute or subacute stroke who have poor sitting balance. Simultaneous application of CMS and tNMES should be considered when designing a rehabilitation program to improve trunk balance in stroke patients.
참고문헌 (28)
- Warlow CP, "Stroke: practical management" (2008), Blackwell Publishing
- Merkert J, "Combined whole body vibration and balance training using Vibrosphere: improvement of trunk stability, muscle tone, and postural control in stroke patients during early geriatric rehabilitation", Z Gerontol Geriatr, 44, pp.256~261 (2011)
- Perlmutter S, "Quantitative analysis of static sitting posture in chronic stroke", Gait Posture, 32, pp.53~56 (2010)
- Carr LJ, "Evidence for bilateral innervation of certain homologous motoneurone pools in man", J Physiol, 475, pp.217~227 (1994)
- 유승돈, "The Efficacy of Core Strengthening on the Trunk Balance in Patients with Subacute Stroke", Annals of Rehabilitation Medicine, 34(6), pp.677~682 (2010), 대한재활의학회
- Karatas M, "Trunk muscle strength in relation to balance and functional disability in unihemispheric stroke patients", Am J Phys Med Rehabil, 83, pp.81~87 (2004)
- Slijper H, "Task-specific modulation of anticipatory postural adjustments in individuals with hemiparesis", Clin Neurophysiol, 113, pp.642~655 (2002)
- Dickstein R, "Anticipatory postural adjustment in selected trunk muscles in post stroke hemiparetic patients", Arch Phys Med Rehabil, 85, pp.261~267 (2004)
- Hsieh CL, "Trunk control as an early predictor of comprehensive activities of daily living function in stroke patients", Stroke, 33, pp.2626~2630 (2002)
- Moreland J, "Efficacy of electromyographic biofeedback compared with conventional physical therapy for upper-extremity function in patients following stroke: a research overview and metaanalysis", Phys Ther, 74, pp.534~547 (1994)
- van der Lee JH, "Exercise therapy for arm function in stroke patients: a systematic review of randomized controlled trials", Clin Rehabil, 15, pp.20~31 (2001)
- 유성훈, "The effects of core stability strength exercise on muscle activity and trunk impairment scale in stroke patients", Journal of exercise rehabilitation, 9(3), pp.362~367 (2013), 한국운동재활학회[DOI]
- 김용미, "편마비 뇌졸중 환자에서 체간근 전기 자극이 체간 균형 향상에 미치는 영향", Annals of Rehabilitation Medicine, 33(3), pp.265~270 (2009), 대한재활의학회
- Blum L, "Usefulness of the Berg Balance Scale in stroke rehabilitation: a systematic review", Phys Ther, 88, pp.559~566 (2008)
- Benaim C, "Validation of a standardized assessment of postural control in stroke patients: the Postural Assessment Scale for Stroke Patients (PASS)", Stroke, 30, pp.1862~1868 (1999)
- Verheyden G, "The Trunk Impairment Scale: a new tool to measure motor impairment of the trunk after stroke", Clin Rehabil, 18, pp.326~334 (2004)
- 정한영, "한글화된 Berg 균형검사법의 신뢰도 분석", Annals of Rehabilitation Medicine, 30(6), pp.611~618 (2006), 대한재활의학회
- Verheyden G, "Discriminant ability of the Trunk Impairment Scale: a comparison between stroke patients and healthy individuals", Disabil Rehabil, 27, pp.1023~1028 (2005)
- Verheyden G, "Additional exercises improve trunk performance after stroke: a pilot randomized controlled trial", Neurorehabil Neural Repair, 23, pp.281~286 (2009)
- Van Nes IJ, "Posturographic assessment of sitting balance recovery in the subacute phase of stroke", Gait Posture, 28, pp.507~512 (2008)
- Verheyden G, "Trunk performance after stroke and the relationship with balance, gait and functional ability", Clin Rehabil, 20, pp.451~458 (2006)
- Hodges PW, "Core stability exercise in chronic low back pain", Orthop Clin North Am, 34, pp.245~254 (2003)
- Richardson CA, "Therapeutic exercise for spinal segmental stabilization in low back pain: scientific basis and clinical approach" (1999), Churchill Livingstone
- Porterfield JA, "Mechanical low back pain:perspectives in functional anatomy" (1998), W. B. Saunders
- Tanaka S, "Muscle strength of trunk flexion-extension in post-stroke hemiplegic patients", Am J Phys Med Rehabil, 77, pp.288~290 (1998)
- Kimberley TJ, "Electrical stimulation driving functional improvements and cortical changes in subjects with stroke", Exp Brain Res, 154, pp.450~460 (2004)
- Wu CW, "Enduring representational plasticity after somatosensory stimulation", Neuroimage, 27, pp.872~884 (2005)
- Sheffler LR, "Neuromuscular electrical stimulation in neurorehabilitation", Muscle Nerve, 35, pp.562~590 (2007)