Alison Schinkel-Ivy1, Andrew H Huntley2, Anthony Aqui2, Avril Mansfield3. 1. Robert J. Surtees Athletic Centre, School of Physical & Health Education, Nipissing University, North Bay, Ontario, Canada. Electronic address: alisons@nipissingu.ca. 2. Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada. 3. Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada; Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada; Evaluative Clinical Sciences, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada.
Abstract
BACKGROUND: Although perturbation-based balance training (PBT) may be effective in improving reactive balance control and/or reducing fall risk in individuals with stroke, the characteristics of reactive balance responses that improve following PBT have not yet been identified. This study aimed to determine if reactive stepping characteristics and timing in response to support-surface perturbations improved to a greater extent following PBT, compared to traditional balance training. MATERIALS AND METHODS: This study represents a substudy of a multisite randomized controlled trial. Sixteen individuals with chronic stroke were randomly assigned to either perturbation-based or traditional balance training, and underwent 6-weeks of training as a part of the randomized controlled trial. Responses to support-surface perturbation were evaluated pre- and post-training, and 6-months post-training. Reactive stepping characteristics and timing were compared between sessions within each group, and between groups at post-training and 6-months post-training while controlling for each measure at the pre-training session. RESULTS: The frequency of extra steps in response to perturbations decreased from pre-training to post-training for the PBT group, but not for the control group. CONCLUSIONS: Improvements in reactive balance control were identified after PBT in individuals with chronic stroke. Findings provide insight into the mechanism by which PBT improves reactive balance control poststroke, and support the use of PBT in balance rehabilitation programs poststroke.
RCT Entities:
BACKGROUND: Although perturbation-based balance training (PBT) may be effective in improving reactive balance control and/or reducing fall risk in individuals with stroke, the characteristics of reactive balance responses that improve following PBT have not yet been identified. This study aimed to determine if reactive stepping characteristics and timing in response to support-surface perturbations improved to a greater extent following PBT, compared to traditional balance training. MATERIALS AND METHODS: This study represents a substudy of a multisite randomized controlled trial. Sixteen individuals with chronic stroke were randomly assigned to either perturbation-based or traditional balance training, and underwent 6-weeks of training as a part of the randomized controlled trial. Responses to support-surface perturbation were evaluated pre- and post-training, and 6-months post-training. Reactive stepping characteristics and timing were compared between sessions within each group, and between groups at post-training and 6-months post-training while controlling for each measure at the pre-training session. RESULTS: The frequency of extra steps in response to perturbations decreased from pre-training to post-training for the PBT group, but not for the control group. CONCLUSIONS: Improvements in reactive balance control were identified after PBT in individuals with chronic stroke. Findings provide insight into the mechanism by which PBT improves reactive balance control poststroke, and support the use of PBT in balance rehabilitation programs poststroke.
Authors: Jamie Pigman; Darcy S Reisman; Ryan T Pohlig; John J Jeka; Tamara R Wright; Benjamin C Conner; Drew A Petersen; Michael S Christensen; Jeremy R Crenshaw Journal: Clin Biomech (Bristol, Avon) Date: 2020-12-23 Impact factor: 2.063
Authors: Daniel Lemus; Andrew Berry; Saher Jabeen; Chandrasekaran Jayaraman; Kristen Hohl; Frans C T van der Helm; Arun Jayaraman; Heike Vallery Journal: Sci Rep Date: 2020-06-26 Impact factor: 4.379