The Journal of Korean Physical Therapy

The Korean Society of Physical Therapy (대한물리치료학회)
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Effect of Various Lower Extremity Exercises Using the Swiss Ball While Standing on Balance, Muscle Strength, Gait and Fall Efficacy in Stroke Patients: A Pilot Study

  • Lim, Yun-Jeong (Department of Physical Therapy, Korea National University of Transportation) ;
  • Kang, Soon-Hee (Department of Physical Therapy, Korea National University of Transportation)
  • Received : 2021.07.21
  • Accepted : 2021.08.29
  • Published : 2021.08.31
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Abstract

Purpose: This study examined whether various lower extremity exercises using a Swiss ball in the standing position could improve balance, muscle strength, gait, and fall efficacy in stroke patients. Methods: Twenty-one stroke patients were randomly divided into three groups, each with seven participants. For four weeks, experimental group 1 performed various lower extremity exercises using a Swiss ball, while experimental group 2 executed the same exercises without a Swiss ball, and the control group underwent general physical therapy. The subjects' knee extensor muscle strength, balance, gait, and fall efficacy were evaluated before and after the intervention using portable muscle strength measurement, the Berg Balance Scale (BBS), G-walk, and the Korean Falls Efficacy Scale (K-FES). Results: Knee extensor strength increased significantly in all three groups after the intervention; in particular, a significant increase was seen in experimental groups 1 and 2 compared to the control group. Moreover, all three groups had significantly better BBS scores and higher cadence after the intervention; notably, experimental group 1 had better scores and increased cadence than the control group. Additionally, gait speed was significantly increased in the experimental group 1 than in the control group. The step length of the non-affected leg was also significantly higher in the same group. The K-FES score improved significantly in all three groups, but there was no significant difference between the groups. Conclusion: This study suggests that lower extremity exercises with or without a Swiss ball could be effective interventions to improve muscle strength, balance, gait, and fall efficacy in stroke patients.

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References

  1. M Nabavi S, Daglia M, H Moghaddam A et al. Tea consumption and risk of ischemic stroke: a brief review of the literature. Curr Pharm Biotechno. 2014;15(4):298-303. https://doi.org/10.2174/1389201015666140617100945
  2. Hwang BY, Han SD, Lee EJ. Effect of home visiting physical therapy on motor function and ADL in the person with chronic stroke. J Kor Phys Ther. 2003;15(4):319-30.
  3. Kim EJ, Hwang BY, Kim JH. The effect of core strength exercises on balance and walking in patients with stroke. J Kor Phys Ther. 2009;21(4): 17-22.
  4. Bleyenheuft C, Bleyenheuft Y, Hanson P et al. Treatment of genu recurvatum in hemiparetic adult patients: a systematic literature review. Ann Phys Rehabil Med. 2010;53(3):189-99. https://doi.org/10.1016/j.rehab.2010.01.001
  5. Jorgensen L, Crabtree N, Reeve J et al. Ambulatory level and asymmetrical weight bearing after stroke affects bone loss in the upper and lower part of the femoral neck differently: Bone adaptation after decreased mechanical loading. Bone. 2000;27(5):701-7. https://doi.org/10.1016/S8756-3282(00)00374-4
  6. Patterson KK, Parafianowicz I, Danells CJ et al. Gait asymmetry in community-ambulating stroke survivors. Arch Phys Med Rehabil. 2008; 89(2):304-10. https://doi.org/10.1016/j.apmr.2007.08.142
  7. Chen CL, Chen HC, Tang SFT et al. Gait performance with compensatory adaptations in stroke patients with different degrees of motor recovery. Am J Phys Med Rehabil. 2003;82(12):925-35. https://doi.org/10.1097/01.PHM.0000098040.13355.B5
  8. Nashner L. Evaluation of postural stability, movement, and control. J Clin Exerc Physiol. 1994:199-234.
  9. Dodd KJ, Morris ME. Lateral pelvic displacement during gait: abnormalities after stroke and changes during the first month of rehabilitation. Arch Phys Med Rehabil. 2003;84(8):1200-5. https://doi.org/10.1016/S0003-9993(03)00142-4
  10. Cikajlo I, Rudolf M, Goljar N et al. Telerehabilitation using virtual reality task can improve balance in patients with stroke. Disabil Rehabil. 2012; 34(1):13-8. https://doi.org/10.3109/09638288.2011.583308
  11. Goldie P, Matyas T, Evans O et al. Maximum voluntary weight-bearing by the affected and unaffected legs in standing following stroke. Clin Biomech. 1996;11(6):333-42. https://doi.org/10.1016/0268-0033(96)00014-9
  12. Kang YH, No JY. Motor recovery after stroke. J of Korean Acad of Rehab Med. 1995;19(1):55-61.
  13. Kim JH, Kim CS. Effects of virtual reality program on standing balance in chronic stroke patients. J Kor Phys Ther. 2005;17(3):351-67.
  14. An SH, Park CS. The relationship between postural control, ADL function, muscle tone, and functional improvement in chronic stroke patients. Phys Ther Korea. 2007;14(1):64-73.
  15. Karthikbabu S, Nayak A, Vijayakumar K et al. Comparison of physio ball and plinth trunk exercises regimens on trunk control and functional balance in patients with acute stroke: a pilot randomized controlled trial. Clin Rehabil 2011;25(8):709-19. https://doi.org/10.1177/0269215510397393
  16. Seo NS, Han MS, Lee JS. Effects of a tilting training program on lower extremities function, depression, and self-efficacy among stroke inpatients. J Korean Acad Nurs. 2006;36(3):514-22. https://doi.org/10.4040/jkan.2006.36.3.514
  17. Bagley P, Hudson M, Forster A et al. A randomized trial evaluation of the oswestry standing frame for patients after stroke. Clin Rehabil. 2005;19(4):354-64. https://doi.org/10.1191/0269215505cr874oa
  18. Logan A, Freeman J, Kent B et al. Standing practice in rehabilitation early after stroke (spires): a functional standing frame programme (prolonged standing and repeated sit to stand) to improve function and quality of life and reduce neuromuscular impairment in people with severe subacute stroke-a protocol for a feasibility randomised controlled trial. Pilot Feasibility Stud. 2018;4(1):1-18. https://doi.org/10.1186/s40814-017-0145-8
  19. Bang JH. The effects of theratainment task-oriented swiss ball exercise program on the upper extremity function, balance, and functional selfefficacy in stroke patients. Journal of Korea Entertainment Industry Association. 2016;10(4):93-104. https://doi.org/10.21184/jkeia.2016.08.10.4.93
  20. Seo YJ, Oh YS. Effect of swiss ball exercise on trunk ability and postural sway in stroke patients. The Official Journal of the Korean Academy of Kinesiology. 2016;18(2):71-80. https://doi.org/10.15758/jkak.2016.18.2.71
  21. Shinde SG, Ganvir SS. Effect of swiss ball training on trunk performance in patients with stroke. Rom J Physical Ther Revista Romana de Kinetoterapie. 2014;20(34):97-101.
  22. Han SW, Lee DJ, Lee ES. Effects of trunk muscle strength, coordination and pain after sling and swiss ball exercise for low back pain patients. Journal of Coaching Development. 2014;16(3):123-32.
  23. Kim GD, Heo M. Effects of swiss ball exercise program for improvement of life care on balance and gait in local community elderly. Journal of KOEN. 2018;12(7):353-9.
  24. Han SW, Cho SY, Kim YS et al. The effect of isometric exercise using swiss ball on the flexibility, the strength and the waist and hip circumferences. J Kor Phys Ther. 2001;13(1):73-82.
  25. Mori A. Electromyographic activity of selected trunk muscles during stabilization exercises using a gym ball. Electromyogr Clin Neurophysiol. 2004;44(1):57-64.
  26. Muniyar KD, Darade SB. Effect of swiss ball training and conventional physio-therapy to improve balance and mobility in post-stroke patients. Int J Physiother Res. 2018;6(4):2813-22. https://doi.org/10.16965/ijpr.2018.156
  27. Bohannon RW. Test-retest reliability of hand-held dynamometry during a single session of strength assessment. Phys Ther. 1986;66(2):206-9. https://doi.org/10.1093/ptj/66.2.206
  28. Kim YE, Bang DH, Shin WS. Effects of ankle joint position during closed kinetic chain exercise on strength and balance in chronic stroke. J Kor Phys Ther. 2015;27(5):345-50. https://doi.org/10.18857/jkpt.2015.27.5.345
  29. Berg K, Wood-Dauphinee S, Williams J. The balance scale: Reliability assessment with elderly residents and patients with an acute stroke. Scand J Rehab Med. 1995;27(1):27-36.
  30. Blum L, Korner-Bitensky N. Usefulness of the berg balance scale in stroke rehabilitation: a systematic review. Phys Ther. 2008;88(5):559-66. https://doi.org/10.2522/ptj.20070205
  31. De Ridder R, Lebleu J, Willems T et al. Concurrent validity of a commercial wireless trunk triaxial accelerometer system for gait analysis. J Sport Rehabil. 2019;28(6):1-13. https://doi.org/10.1123/jsr.2017-0079
  32. Ahn SH, Shin HH, Cho HY et al. The reliability and validity of the falls efficacy scale (korean version) in stroke patients. J Spec Educ Rehabil Sci. 1990;45(6):239-43.
  33. Kim H, Jung MY. Effects of one-to-one fall prevention education on decrease in falls of adults with stroke. Jour of KoCona. 2015;15(5):426-35.
  34. Laufer Y, Dickstein R, Resnik S et al. Weight-bearing shifts of hemiparetic and healthy adults upon stepping on stairs of various heights. Clin Rehabil. 2000;14(2):125-9. https://doi.org/10.1191/026921500674231381
  35. Gong WT, Lee JN, Park JM. The influence of unstable modified wall squat exercises on the gait variables of healthy adults. J Korean Acad Orthop Man Physi Ther. 2016;22(1):9-15.
  36. Oh TY. The effects of squatting exercise with gym ball and wall on lower extremity muscles activation. J Korean Soc Phys Med. 2013;8(4):647-53. https://doi.org/10.13066/kspm.2013.8.4.647
  37. Ko DS, Kim CK, Jung DI. Analysis of spasticity and balance of lower extremity on swiss ball lumbar stabilization exercise (lse) in patients with stroke. Jour of KoCona. 2011;11(3):262-70.
  38. Viswaja K, Pappala KP, Tulasi PR et al. Effectiveness of trunk training exercises versus swiss ball exercises for improving sitting balance and gait parameters in acute stroke subjects. Int J Physiother. 2015;2(6):925-32.
  39. Lee HJ, Seong RM, Kim BS. The effects of elastic band and swiss ball exercise on the Stroke Patient's muscle strength and walking biomechanical variables. Korean J Sport Sci. 2008;17(4):1387-96.
  40. Jin YS, Jeong TG. Effects of neuromuscular electrical stimulation of the vastus medialis on pain and muscle function in patients with knee osteoarthritis. Jour of KoCona. 2012;12(1):329-37.
  41. Kim JM, Yi CH, Current ME. A study on the effects of weight-transfer training upon the gait patterns of hemiplegic patients through visual and auditory feedback. Phys Ther Korea. 1995;2(2):9-23.
  42. Cho HT, Park YJ, Moo HH. Effect of applied exercise swiss ball and a balance pad maximum strength in the elderly woman lumbar muscle endurance, fear of falling, and physical functions. Journal of Sport and Leisure Studies. 2013;51(2):747-58. https://doi.org/10.51979/KSSLS.2013.02.51.747