Feasibility and Effects of Newly Developed Balance Control Trainer for Mobility and Balance in Chronic Stroke Patients: A Randomized Controlled Trial
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Objective To investigate the feasibility and effects of balance training with a newly developed Balance Control Trainer (BCT) that applied the concept of vertical movement for the improvements of mobility and balance in chronic stroke patients.Method Forty chronic stroke patients were randomly assigned to an experimental or a control group. The experimental group (n=20) underwent training with a BCT for 20 minutes a day, 5 days a week for 4 weeks, in addition to concurrent conventional physical therapy. The control group (n=20) underwent only conventional therapy for 4 weeks. All participants were assessed by: the Functional Ambulation Categories (FAC), 10-meter Walking Test (10mWT), Timed Up and Go test (TUG), Berg Balance Scale (BBS), Korean Modified Barthel Index (MBI), and Manual Muscle Test (MMT) before training, and at 2 and 4 weeks of training.Results There were statistically significant improvements in all parameters except knee extensor power at 2 weeks of treatment, and in all parameters except MBI which showed further statistically significant progress in the experimental group over the next two weeks (p<0.05). Statistically significant improvements on all measurements were observed in the experimental group after 4 weeks total. Comparing the two groups at 2 and 4 weeks of training respectively, 10mWT, TUG, and BBS showed statistically more significant improvements in the experimental group (p<0.05).Conclusion Balance training with a newly developed BCT is feasible and may be an effective tool to improve balance and gait in ambulatory chronic stroke patients. Furthermore, it may provide additional benefits when used in conjunction with conventional therapies.
Abstract
Objective To investigate the feasibility and effects of balance training with a newly developed Balance Control Trainer (BCT) that applied the concept of vertical movement for the improvements of mobility and balance in chronic stroke patients.Method Forty chronic stroke patients were randomly assigned to an experimental or a control group. The experimental group (n=20) underwent training with a BCT for 20 minutes a day, 5 days a week for 4 weeks, in addition to concurrent conventional physical therapy. The control group (n=20) underwent only conventional therapy for 4 weeks. All participants were assessed by: the Functional Ambulation Categories (FAC), 10-meter Walking Test (10mWT), Timed Up and Go test (TUG), Berg Balance Scale (BBS), Korean Modified Barthel Index (MBI), and Manual Muscle Test (MMT) before training, and at 2 and 4 weeks of training.Results There were statistically significant improvements in all parameters except knee extensor power at 2 weeks of treatment, and in all parameters except MBI which showed further statistically significant progress in the experimental group over the next two weeks (p<0.05). Statistically significant improvements on all measurements were observed in the experimental group after 4 weeks total. Comparing the two groups at 2 and 4 weeks of training respectively, 10mWT, TUG, and BBS showed statistically more significant improvements in the experimental group (p<0.05).Conclusion Balance training with a newly developed BCT is feasible and may be an effective tool to improve balance and gait in ambulatory chronic stroke patients. Furthermore, it may provide additional benefits when used in conjunction with conventional therapies.
참고문헌 (34)
- Brandstater ME, "Hemiplegic gait: analysis of temporal variables", Arch Phys Med Rehabil, 64, pp.583~587 (1983)
- Skilbeck CE, "Recovery after stroke", J Neurol Neurosurg Psychiatry, 46, pp.5~8 (1983)
- Wade DT, "Recovery after stroke--the first 3 months", J Neurol Neurosurg Psychiatry, 48, pp.7~13 (1985)
- Bobath B, "Adult hemiplegia: evaluation and treatment,3rd ed", pp.70~160 (1990), Butterworth-Heinemann
- Lorish TR, "Stroke rehabilitation.3. Rehabilitation evaluation and management", Arch Phys Med Rehabil, 75, pp.47~51 (1994)
- Hesse S, "Treadmill training with partial body weight support compared with physiotherapy in nonambulatory hemiparetic patients", Stroke, 26, pp.976~981 (1995)
- Hesse S, "Restoration of gait in nonambulatory hemiparetic patients by treadmill training with partial body-weight support", Arch Phys Med Rehabil, 75, pp.1087~1093 (1994)
- Patton J, "KineAssist: design and development of a robotic overground gait and balance therapy device", Top Stroke Rehabil, 15, pp.131~139 (2008)
- Mayr A, "Prospective, blinded, randomized crossover study of gait rehabilitation in stroke patients using the Lokomat gait orthosis", Neurorehabil Neural Repair, 21, pp.307~314 (2007)
- Husemann B, "Effects of locomotion training with assistance of a robot-driven gait orthosis in hemiparetic patients after stroke: a randomized controlled pilot study", Stroke, 38, pp.349~354 (2007)
- Chen IC, "Effects of balance training on hemiplegic stroke patients", Chang Gung Med J, 25, pp.583~590 (2002)
- Nichols DS, "Balance retraining after stroke using force platform biofeedback", Phys Ther, 77, pp.553~558 (1997)
- Liston RA, "Reliability and validity of measures obtained from stroke patients using the Balance Master", Arch Phys Med Rehabil, 77, pp.425~430 (1996)
- Matjacic Z, "BalanceReTrainer: a new standing-balance training apparatus and methods applied to a chronic hemiparetic subject with a neglect syndrome", NeuroRehabilitation, 18, pp.251~259 (2003)
- 김철현, "편마비 환자에서 하지 균형조절 능력이 균형 및 보행에 미치는 영향", Annals of Rehabilitation Medicine, 32(4), pp.394~399 (2008), 대한재활의학회
- Yelnik A, "Clinical tools for assessing balance disorders", Neurophysiol Clin, 38, pp.439~445 (2008)
- 정한영, "한글화된 Berg 균형검사법의 신뢰도 분석", Annals of Rehabilitation Medicine, 30(6), pp.611~618 (2006), 대한재활의학회
- Mehrholz J, "Predictive validity and responsiveness of the functional ambulation category in hemiparetic patients after stroke", Arch Phys Med Rehabil, 88, pp.1314~1319 (2007)
- Pohl PS, "Influence of stroke-related impairments on performance in 6-minute walk test", J Rehabil Res Dev, 39, pp.439~444 (2002)
- Podsiadlo D, "The timed “Up & Go”: a test of basic functional mobility for frail elderly persons", J Am Geriatr Soc, 39, pp.142~148 (1991)
- 정한영, "한글판 수정바델지수(K-MBI)의 개발: 뇌졸중 환자 대상의 다기관 연구", Annals of Rehabilitation Medicine, 31(3), pp.283~297 (2007), 대한재활의학회
- Winstein CJ, "Knowledge of results and motor learning- implications for physical therapy", Phys Ther, 71, pp.140~149 (1991)
- Dickstein R, "Foot-ground pressure pattern of standing hemiplegic patients. Major characteristics and patterns of improvement", Phys Ther, 64, pp.19~23 (1984)
- de Haart M, "Restoration of weight-shifting capacity in patients with postacute stroke: a rehabilitation cohort study", Arch Phys Med Rehabil, 86, pp.755~762 (2005)
- Winstein CJ, "Standing balance training: effect on balance and locomotion in hemiparetic adults", Arch Phys Med Rehabil, 70, pp.755~762 (1989)
- Moseley AM, "Treadmill training and body weight support for walking after stroke", Cochrane Database Syst Rev (2005)
- Mehrholz J, "Electromechanical- assisted training for walking after stroke", Cochrane Database Syst Rev (2007)
- Yavuzer G, "The effects of balance training on gait late after stroke: a randomized controlled trial", Clin Rehabil, 20, pp.960~969 (2006)
- Eser F, "The effect of balance training on motor recovery and ambulation after stroke: a randomized controlled trial", Eur J Phys Rehabil Med, 44, pp.19~25 (2008)
- Barclay-Goddard R, "Taback SP. Force platform feedback for standing balance training after stroke", Cochrane Database Syst Rev (2004)
- Richards CL, "Task-specific physical therapy for optimization of gait recovery in acute stroke patients", Arch Phys Med Rehabil, 74, pp.612~620 (1993)
- Lee MY, "Comparison of balance responses and motor patterns during sit-to-stand task with functional mobility in stroke patients", Am J Phys Med Rehabil, 76, pp.401~410 (1997)
- Cheng PT, "The sit-to-stand movement in stroke patients and its correlation with falling", Arch Phys Med Rehabil, 79, pp.1043~1046 (1998)
- Vander Linden DW, "Variant and invariant characteristics of the sit-to-stand task in healthy elderly adults", Arch Phys Med Rehabil, 75, pp.653~660 (1994)
