Shirley Handelzalts1,2, Michal Kenner-Furman1,2, Ganit Gray1,2, Nachum Soroker2,3, Guy Shani1, Itshak Melzer1. 1. 1 Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Israel. 2. 2 Loewenstein Rehabilitation Hospital, Raanana, Israel. 3. 3 Tel-Aviv University, Tel-Aviv, Israel.
Abstract
BACKGROUND:Reactive balance responses are critical for fall prevention. Perturbation-based balance training (PBBT) has shown a positive effect in reducing the risk of falls among older adults and persons with Parkinson's disease. OBJECTIVE: To explore the effect of a short-term PBBT on reactive balance responses, performance-based measures of balance and gait and balance confidence. METHODS:Thirty-four moderate-high functioning, subacute persons with stroke (PwS) (lower extremity Fugl-Meyer score 29.2 ± 4.3; Berg Balance Scale [BBS] score 43.8 ± 9.5, 42.0 ± 18.7 days after stroke onset) hospitalized in a rehabilitation setting were randomly allocated to PBBT (n = 18) and weight shifting and gait training (WS>) (n = 16). Both groups received 12 training sessions, 30 minutes each, for a period of 2.5 weeks. PBBT included unexpected balance perturbations during standing and treadmill walking, WS> included weight shifting in standing and treadmill walking without perturbations. The main outcome measures, that is, multiple step-threshold and fall-threshold were examined at baseline, immediately postintervention, and about 5 weeks postintervention. The secondary outcome measures, that is, BBS, 6-minute walk test (6MWT), 10-meter walk test (10MWT), and Activity-specific Balance Confidence (ABC) scale were examined at baseline and immediately postintervention. RESULTS: Compared with the WS> group, immediately postintervention participants in the PBBT group showed higher multiple-step thresholds in response to forward and backward surface translations (effect size [ES] = 1.07 and ES = 1.10, respectively) and moderate ES in the ABC scale (ES = 0.74). No significant differences were found in fall-threshold, BBS, 6MWT, and 10MWT between the groups. CONCLUSIONS: Inclusion of perturbation training during rehabilitation of PwS improved reactive balance and balance confidence.
RCT Entities:
BACKGROUND: Reactive balance responses are critical for fall prevention. Perturbation-based balance training (PBBT) has shown a positive effect in reducing the risk of falls among older adults and persons with Parkinson's disease. OBJECTIVE: To explore the effect of a short-term PBBT on reactive balance responses, performance-based measures of balance and gait and balance confidence. METHODS: Thirty-four moderate-high functioning, subacute persons with stroke (PwS) (lower extremity Fugl-Meyer score 29.2 ± 4.3; Berg Balance Scale [BBS] score 43.8 ± 9.5, 42.0 ± 18.7 days after stroke onset) hospitalized in a rehabilitation setting were randomly allocated to PBBT (n = 18) and weight shifting and gait training (WS&GT) (n = 16). Both groups received 12 training sessions, 30 minutes each, for a period of 2.5 weeks. PBBT included unexpected balance perturbations during standing and treadmill walking, WS&GT included weight shifting in standing and treadmill walking without perturbations. The main outcome measures, that is, multiple step-threshold and fall-threshold were examined at baseline, immediately postintervention, and about 5 weeks postintervention. The secondary outcome measures, that is, BBS, 6-minute walk test (6MWT), 10-meter walk test (10MWT), and Activity-specific Balance Confidence (ABC) scale were examined at baseline and immediately postintervention. RESULTS: Compared with the WS&GT group, immediately postintervention participants in the PBBT group showed higher multiple-step thresholds in response to forward and backward surface translations (effect size [ES] = 1.07 and ES = 1.10, respectively) and moderate ES in the ABC scale (ES = 0.74). No significant differences were found in fall-threshold, BBS, 6MWT, and 10MWT between the groups. CONCLUSIONS: Inclusion of perturbation training during rehabilitation of PwS improved reactive balance and balance confidence.
Authors: Jamie Pigman; Darcy S Reisman; Ryan T Pohlig; John J Jeka; Tamara R Wright; Benjamin C Conner; Drew A Petersen; Jeremy R Crenshaw Journal: Clin Biomech (Bristol, Avon) Date: 2019-07-26 Impact factor: 2.063
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: Avril Mansfield; Elizabeth L Inness; Cynthia J Danells; David Jagroop; Tanvi Bhatt; Andrew H Huntley Journal: BMJ Open Date: 2020-08-26 Impact factor: 2.692