Open Access Open Access  Restricted Access Subscription Access
Open Access Open Access Open Access  Restricted Access Restricted Access Subscription Access

A Comparative Study of effectiveness of Balance Training with and without Visual Cues on Activities of Daily Living in Stroke Patients


Affiliations
1 Government Physiotherapy College, Jamangar, India
2 Ahmedabad Institute of Medical Sciences, Ahmedabad, India
3 Shree Devi College of Physiotherapy, Mangalore, India
4 Prayas Multispeciality Physiotherapy Center, Rajkot, India
5 KIDS Paediatric Physiotherapy Clinic, Bhavnagar, India
     

   Subscribe/Renew Journal


Background: In stroke balance can be affected by deficits of strength, range of motion, proprioception, vision, vestibular function. Patients are trained to rely more on visual input to maintain balance but rarely are trained for the vestibular and other sensory system. Balance is also a predictor of functional rehabilitation. Hence aim of this study is to find out the difference between training somatosensory, vestibular and tactile system with and without visual cues, with emphasis on balance and its effect on ADL and mobility in stroke patients.

Materials and Method: Thirty post stroke subjects with balance problem were assigned into two groups: GroupA (Control) and GroupB (Experimental). Both the groups received similar balance training program for six weeks. Subjects of group A were allowed to use free vision and group B were deprived of visual cues during balance training. After six weeks both groups were re-evaluated for balance, ADL and mobility.

Results: There was significant improvement in balance(p0.05)and mobility(p>0.05).

Discussion and Conclusion: Balance is the basic need for doing all ADL activities but training for balance will not necessarily improve quality of ADL. This study suggests that patients improved their integration of somatosensory and vestibular input and enables them to use the pertinent input to become less reliant on visual input. From this result it was concluded that balance training without vision is more effective in balance recovery in stroke patients.


Keywords

Balance, Activities of Daily Living, Vision, Stroke
Subscription Login to verify subscription
User
Notifications
Font Size


  • LiSC, SchoenbergBS, Cerebrovascular disease in the people‚Äôs Republic of China: epidemiologic and clinical features. Neurology 1985 Dec; 35(12): 1708-13.
  • WinsteinCJ, RoseDK, A Randomised controlled comparison of upper extremity rehabilitation strategies in acute stroke: A pilot study of immediate and long term outcomes; ArchPhysMed Rehab.2004 Apr:85(4):620-8.
  • WHO (1980).Bull WHO,58:113-130.
  • Tapas Kumar Banerjee, Shyamal Kumar, Epidemiology of stroke in India; NeurologyAsia 2006;11:1-4
  • Nashner LM.Sensory, neuromuscular and biochemical contribution to human balance. In: Duncan PW(ed) Balance: Proceedings of APTA forum.Alexandria,VA: APTA 1990:5-12.
  • Newton R.Review of tests of standing balance abilities, Brain Injury.1989 Oct-Dec; 3(4):335-343.
  • Schenkman M, Butler RB. A model for multisystem evaluation,interpretation and treatment of individuals with neurologic dysfunction. PhysTher1989;69:538-547.
  • HorakFB, EarhartGM, Postural responses to combinations of head and body displacements: Vestibular-somatosensory interactions. ExpBrain Res.2001Dec;141(3):410-414.
  • HobeikaCP. Equilibrium and balance in the elderly. Ear Nose Throat J.1999Aug;78(8):558-566.
  • MergnerT, HuberW,Vestibular-neck interaction and transformation of sensory coordinates.J vestib Res.1997Jul-Aug;7(4):347-367.
  • NashmerLM; Evaluation of postural stability, movement and control. In S.H., editor:Clin Exer Physiol,Philadelphia,Mosby,1994.
  • Shumway-cookA, McCollumG. Assessment and treatment of balance disorders. In: PC Montgomery, BH Connolly,editor:Motor control and physical therapy. Hixson. TN: Chattanooga GroupInc; 1993: 123-138.
  • DiFabioRP, BadkeMB. Relationship of sensory organization to balance function in patients with hemiplegia. PhysTher1990 Sep;70(9):542-548.
  • BonanIV, ColleFF, Reliance on visual information after stroke part- 1 Balance on dynamic posturography. ArchPhysMedRehab 2004; 85(2): 268-273.
  • BonanIV, Yelnik AP et.al. Reliance on visual information after stroke. Part-2effectiveness of balance rehabilitation program with visual cue deprivation after stroke: A randomised controlled trial. ArchPhysMedRehab2004 Feb; 85(2):274-278
  • Ann Ashburn; Physical recovery following stroke. Physiotherapy,1997Sep;83(9)PP:480-490
  • MJaneRiddoch, GlynW Humphreys. Stroke:issues in recovery and rehabilitation. Physiotherapy 1995Nov;81(11):689-694
  • DiFabio RP, BadkeMB. Stance duration under sensory conflict conditions in patients with hemiplegia. ArchPhysMedRehab1991 Apr; 72(5): 292-295.
  • Daniel S.Marigold and Janice J. The relationship of asymmetric weight bearing with postural sway and visual reliance in stroke. Gait and Posture2006Feb;23(2):249-255.
  • ChenIC, ChengPT,Effects of balance training on hemiplegic stroke patients. ChangGungMed J 2002Sep; 25(9):583-90.
  • Bonan I. Derighetti F.,Visual dependence after recent stroke. Ann.ReadaptMedPhys2006May; 49(9): 166-71.
  • Mount J. Bolton M, Cesari M,.Group balance skills class for people with chronic stroke: a case series. J. NeuralPhysTher.2005 Mar;29(1): 24-33.
  • Cheng PT Wang CM,. Effects of visual feedback rhythmic weight-shift training on hemiplegic stroke patients.ClinRehab.2004Nov;18(7):747-53
  • Walker C. Brouwer BJ.Use of visual feedback in retraining balance following acute stroke.Phys. Ther.2000Sep.80(9)886-95.
  • Ruth Ann Geiger, Jeffery B.Balance and mobility following stroke: Effects of physical therapy interventions with and without biofeedback/ forceplate training. Physical Therapy2001 Apr; 81(4) pp 995-1005.
  • Hammam RG, Training effects during repeated therapy sessions of balance training using visual feedback.ArchPhysMedRehab1992 Aug;73 (8):738-64.
  • de Haart M,. Recovery of standing balance in postacute stroke patients: a rehabilitation cohort study. ArchPhyMedRehab.2004Jun;85(6):886-95.
  • Van Peppen RP,Effects of visual feedback therapy on postural control in bilateral standing after stroke: a systemic review. J RehabilMed.2006 Jan;38(1):3-9.
  • Bonan IV, Leman MC, Evolution of subjective visual vertical pertubation after stroke. Neurorehabil NeuralRepair2006 Dec;20(4): 484-491.
  • Chen IC, Cheng PT, Balance evaluation in hemiplegic stroke patients. Cheng Gung Med J.2000 Jun; 23(6):339-47.
  • SarahF. Tyson, Balance disability after stroke. PhysicalTherapy2006;86:30-38.
  • Nancy M. Salbach, Balance self-efficacy and its relevance to physical function and perceived health status after stroke. ArchPhys MedRehabil. 2006Mar;87(3):364-70.
  • Vearrier LA, An intensive massed practice approach to retraining balance post-stroke. Gait Posture. 2005Oct22(2):154-63.
  • Shigeru Usuda, Construct validity of functional balance scale in stroke patients.J.Phys.Ther.Sci. 1998;10:53-56.
  • BergK, The balance scale: Reliability assessment with elderly residents and patients with an acute stroke. ScandJRehabilMed.1995 Mar;27(1):27-36.
  • Hsieh CL,Validity and responsiveness of the rivermead mobility index in stroke patients. Scand J RehabilMed.2000Aug;32(3):140-142.
  • John Green, A test-retest reliability study of the Barthel Index, the Rivermead Mobility Index, the Nottingham extended Activities of Daily Living Scale and the Frenchay Activities Index in stroke patients.Disability & Rehabilitation. 2001Oct; 23(15):670-676.
  • Williams LS, Development of a stroke-specific quality of life scale. Stroke 1999 Jul;30(7): 1362-1369.
  • V. Dietz. Human neuronal control of automatic functional movement: interaction between central programs and afferent input. PhysRev 1992; 70:33-69.

Abstract Views: 223

PDF Views: 0




  • A Comparative Study of effectiveness of Balance Training with and without Visual Cues on Activities of Daily Living in Stroke Patients

Abstract Views: 223  |  PDF Views: 0

Authors

B. Dhoriyani Narendra
Government Physiotherapy College, Jamangar, India
B. Patel Fagun
Ahmedabad Institute of Medical Sciences, Ahmedabad, India
D. Smitha
Shree Devi College of Physiotherapy, Mangalore, India
Kagathra Shailesh
Prayas Multispeciality Physiotherapy Center, Rajkot, India
Bhatt Kaushal
KIDS Paediatric Physiotherapy Clinic, Bhavnagar, India

Abstract


Background: In stroke balance can be affected by deficits of strength, range of motion, proprioception, vision, vestibular function. Patients are trained to rely more on visual input to maintain balance but rarely are trained for the vestibular and other sensory system. Balance is also a predictor of functional rehabilitation. Hence aim of this study is to find out the difference between training somatosensory, vestibular and tactile system with and without visual cues, with emphasis on balance and its effect on ADL and mobility in stroke patients.

Materials and Method: Thirty post stroke subjects with balance problem were assigned into two groups: GroupA (Control) and GroupB (Experimental). Both the groups received similar balance training program for six weeks. Subjects of group A were allowed to use free vision and group B were deprived of visual cues during balance training. After six weeks both groups were re-evaluated for balance, ADL and mobility.

Results: There was significant improvement in balance(p0.05)and mobility(p>0.05).

Discussion and Conclusion: Balance is the basic need for doing all ADL activities but training for balance will not necessarily improve quality of ADL. This study suggests that patients improved their integration of somatosensory and vestibular input and enables them to use the pertinent input to become less reliant on visual input. From this result it was concluded that balance training without vision is more effective in balance recovery in stroke patients.


Keywords


Balance, Activities of Daily Living, Vision, Stroke

References