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http://dx.doi.org/10.15268/ksim.2019.7.2.019

Effect of Multi-Sensorimotor Training on Gait Ability and Fall Risk in Subacute Stroke Patients: A Randomized Controlled Pilot Trial  

Lim, Chaegil (Dept. of Physical Therapy, Gachon University)
Publication Information
Journal of The Korean Society of Integrative Medicine / v.7, no.2, 2019 , pp. 19-29 More about this Journal
Abstract
Purpose : To determine whether an advanced rehabilitation therapy combined with conventional rehabilitation therapy consisting of sensorimotor exercises that would be superior to a usual treadmill training in gait ability and fall risk in subacute stroke patients. Methods : Thirty subjects randomly assigned to either multi-sensorimotor training group (n=19) or treadmill training group (n=18). Both groups first performed conventional physical therapy for 30 min, after which the multi-sensorimotor training group performed multi-sensorimotor training for 30 min, and the treadmill training group performed treadmill gait training for 30 min. Both groups performed the therapeutic interventions 5 days per week for 8 weeks. Gait ability was evaluated using the GAITRite system and Fall risk was measured using the Biodex Balance system before intervention and after 8 weeks. Results : There were no intergroup differences between demographic and clinical characteristics at baseline (p>.05). Both groups showed a significant improvement in gait ability (p<.05) and Fall risk (p<.05). In particular, the multi-sensorimotor training group showed more significant differences in gait velocity (p=.05), step length (p=.01) and stride length (p=.014) than the treadmill training group. Conclusion : The multi-sensorimotor training program performed on multiple types of sensory input had beneficial effect on gait ability. A large-scale randomized controlled study is needed to prove the effect of this training.
Keywords
fall risk; gait ability; hemiplegia; sensorimotor training; stroke;
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1 Hwang JH, Jung HM, Lee MH, et al(2010). Effects of fall prevention program on gait, balance and falls efficacy in stroke patients. J Korean Clin Nurs Res, 16, 27-37.
2 Jeong HY, Choi JD(2014). The effects of vestibular sensory stimulation training on balance and gait in the patients with stroke. J Korean Phys Ther, 26(5), 365-371.
3 Jung SM(2017). The effects of vibratory stimulation employed to forearm and arm flexor muscles on upper limb function in patients with chronic stroke. J Phys Ther Sci, 29(9), 1620-1622.   DOI
4 Kim DY, Lim CG(2017). Effects of $Pedalo^{(R)}$ training on balance and fall risk in stroke patients. J Phys Ther Sci, 29(7), 1159-1162.   DOI
5 Lee GC(2015). Balance training using Pedalo equipment for improving balance and fear of falling in elderly people: A preliminary study. Isokinetics Exerc Sci, 23(3), 199-203.   DOI
6 Lee SW, Lee WH(2010). Comparison of the effects on balance abilities in the women elderly with application TENS versus balance training. J Korea Gerontol Soc, 30(3), 993-1003.
7 Lee YB, Kim JB, Lee GC(2013). The effects of training using Pedalo equipment on balance of post-stroke patients: pilot study. J Korean Soc Phys Med, 8(3), 387-395.   DOI
8 Macko RF, Ivey FM, Forrester LW, et al(2005). Treadmill exercise rehabilitation improves ambulatory function and cardiovascular fitness in patients with chronic stroke: a randomized, controlled trial. Stroke, 36(10), 2206-2211.   DOI
9 Ng SS, Hui-Chan CW(2009). Does the use of TENS increase the effectiveness of exercise for improving walking after stroke?. a randomized controlled clinical trial. Clin Rehabil, 23(12), 1093-1103.   DOI
10 Pang MY, Eng JJ, Dawson AS, et al(2005). A community-based fitness and mobility exercise program for older adults with chronic stroke: A randomized, controlled trial. J Am Geriatr Soc, 53(10), 1667-1674.   DOI
11 Saleh S, Fluet G, Qiu Q, et al(2017). Neural patterns of reorganization after intensive robot-assisted virtual reality therapy and repetitive task practice in patients with chronic stroke. Front Neurol, 8, 452.   DOI
12 Patterson SL, Rodgers MM, Macko RF, et al(2008). Effect of treadmill exercise training on spatial and temporal gait parameters in subjects with chronic stroke: a preliminary report. J Rehabil Res Dev, 45(2), 221-228.   DOI
13 Peterka RJ, Loughlin PJ(2004). Dynamic regulation of sensorimotor integration in human postural control. J Neurophysiol, 91(1), 410-423.   DOI
14 Roerdink M, Lamoth CJ, Kwakkel G, et al(2007). Gait coordination after stroke: benefits of acoustically paced treadmill walking. Phys Ther, 87(8), 1009-1022.   DOI
15 Sherafat S, Salavati M, Ebrahimi Takamjani I, et al(2013). Intrasession and intersession reliability of postural control in participants with and without nonspecific low back pain using the Biodex Balance System. J Manipulative Physiol Ther, 36(2), 111-118.   DOI
16 Smania N, Picelli A, Gandolfi M, et al(2008). Rehabilitation of sensorimotor integration deficits in balance impairment of patients with stroke hemiparesis: a before/after pilot study. Neurol Sci, 29(5), 313-319.   DOI
17 Stephenson JL, Lamontagne A, De Serres SJ(2009). The coordination of upper and lower limb movements during gait in healthy and stroke individuals. Gait Posture, 29(1), 11-16.   DOI
18 Sullivan JL, Bhagat NA, Yozbatiran N, et al(2017). Improving robotic stroke rehabilitation by incorporating neural intent detection: Preliminary results from a clinical trial. IEEE Int Conf Rehabil Robot 2017, 122-127.
19 Van Uden CJ, Besser MP(2004). Test-retest reliability of temporal and spatial gait characteristics measured with an instrumented walkway system ($GAITRite^{(R)}$). J BMC Musculoskelet Disord, 5(1), 13.   DOI
20 Unger M, Jelsma J, Stark C(2013). Effect of a trunk-targeted intervention using vibration on posture and gait in children with spastic type cerebral palsy: A randomized control trial. Dev Neurorehabil, 16(2), 79-88.   DOI
21 Watanabe Y(2005). Fear of falling among stroke survivors after discharge from inpatient rehabilitation. Int J Rehabil Res, 28(2), 149-152.   DOI
22 Woldag H, Hummelsheim H(2002). Evidence-based physiotherapeutic concepts for improving arm and hand function in stroke patients: a review. J Neurol, 249(5), 518-528.   DOI
23 Bolton DA, Cauraugh JH, Hausenblas HA(2004). Electromyogram-triggered neuromuscular stimulation and stroke motor recovery of arm/hand functions: a meta-analysis. J Neurol Sci, 223(2), 121-127.   DOI
24 Alexander LD, Black SE, Patterson KK, et al(2009). Association between gait asymmetry and brain lesion location in stroke patients. Stroke, 40(2), 537-544.   DOI
25 Aman JE, Elangovan N, Yeh IL, et al(2015). The effectiveness of proprioceptive training for improving motor function: a systematic review. Front Hum Neurosci, 8, 1075.   DOI
26 Ayres AJ, Robbins J(2005). Sensory integration and the child: understanding hidden sensory challenges. Los Angeles, CA: Western Psychological Services, pp.27-43.
27 Gandolfi M, Munari D, Geroin C, et al(2015). Sensory integration balance training in patients with multiple sclerosis: A randomized, controlled trial. Mult Scler, 21(11), 1453-1462.   DOI
28 Cadore EL, Rodriguez-Manas L, Sinclair A, et al(2013). Effects of different exercise interventions on risk of falls, gait ability, and balance in physically frail older adults: a systematic review. Rejuvenation Res, 16(2), 105-114.   DOI
29 Chen JC, Shaw FZ(2014). Progress in sensorimotor rehabilitative physical therapy programs for stroke patients. World J Clin Cases, 2(8), 316-326.   DOI
30 Dickstein R, Laufer Y, Katz M(2006). TENS to the posterior aspect of the legs decreases postural sway during stance. Neurosci Lett, 393(1), 51-55.   DOI
31 Geurts AC, de Haart M, van Nes IJ, et al(2005). A review of standing balance recovery from stroke. Gait Posture, 22(3), 267-281.   DOI
32 Hatzitaki V, Pavlou M, Bronstein AM(2004). The integration of multiple proprioceptive information: effect of ankle tendon vibration on postural responses to platform tilt. Exp Brain Res, 154(3), 345-354.   DOI