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Effects of noninvasive electrical stimulation combined trunk stabilization exercise on balance and fall risk in stroke patients  

Shuang-yan, Liu (Graduate School of Sehan University)
Dae-jung, Yang (Dept. of Physical Therapy, Sehan University)
Jong-hyok, Yun (Dept. of Physical Therapy, Sehan University)
Publication Information
The Journal of Korean Academy of Orthopedic Manual Physical Therapy / v.28, no.3, 2022 , pp. 61-68 More about this Journal
Abstract
Background: This study aimed to investigate the effects of noninvasive electrical stimulation combined with trunk stabilization exercise on balance and fall risk in patients with stroke. Methods: Twenty-two patients with stroke were enrolled in the study and randomly divided into experimental and control groups, each with 11 patients. noninvasive electrical stimulation combined with trunk stabilization training was applied to the experimental group, and sham noninvasive electrical stimulation combined with trunk stabilization training, to the control group. Both groups were treated for 6 weeks, five times a week for 30 min each time; the balance and fall risk of patients with stroke were measured before and after treatment, and the changes in the two groups were compared and analyzed. Results: The experimental group's left and right weight-bearing indices (affect and non-affect sides) and the front and rear weight-bearing indices, were significantly improved (p<.05, p<.001). when the changes in balance ability between groups were compared before and after treatment. The total fall efficacy score in the experimental group was substantially lower than that in the control group when the changes in fall efficacy score were compared between groups following treatment (p<.001). Conclusion: The improvement in balance and fall risk in patients with stroke can be attributed to using noninvasive electrical stimulation in combination with trunk stabilization training. This clinically helpful treatment method for patients with stroke warrants further promotion and implementation in the clinic.
Keywords
Balance; Stabilization; Stroke;
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1 Alisar DC, Ozen S, Sozay S. Effects of bihemispheric transcranial direct current stimulation on upper extremity function in stroke Patients: A randomized double-Blind sham-controlled study. J Stroke Cerebrovasc Dis. 2020;29(1):104454. https://doi:10.1016/j.jstrokecerebrovasdis.2019.104454   DOI
2 Bai X, Guo ZW, He L, et al. Different therapeutic effects of transcranial direct current stimulation on upper and lower limb recovery of stroke patients with motor dysfunction: A meta-analysis. Neural Plast. 2019;2019:1372138. https://doi:10.1155/2019/1372138   DOI
3 Broderick P, Horgan F, Blake C, et al. Mirror therapy for improving lower limb motor function and mobility after stroke: A systematic review and meta-analysis. Gait & Posture. 2018;63:208-220. https://doi:10.1016/j.gaitpost. 2018.05.017   DOI
4 Cabanas VR, Cuchi GU, Bagur CC. Trunk training exercises approaches for improving trunk performance and functional sitting balance in patients with stroke: A systematic review. NeuroRehabilitation. 2013;33(4):575-592. https://doi:10.3233/NRE-130996   DOI
5 Cayco CS, Gorgon EJR, Lazaro RT. Effects of proprioceptive neuromuscular facilitation on balance, strength, and mobility of an older adult with chronic stroke: A case report. J Bodyw Mov Ther. 2017;21(4):767-774. https://doi:10.1016/j.jbmt.2016.10.008   DOI
6 Corbetta D, Sirtori V, Castellini G, et al. Constraint-induced movement therapy for upper extremities in people with stroke. Cochrane Database Syst Rev. 2015;(10):CD004433. https://doi:10.1002/14651858.CD004433.pub3   DOI
7 Diaz-Arribas MJ, Martin-Casas P, Cano-de-la-Cuerda R, et al. Effectiveness of the Bobath concept in the treatment of stroke: A systematic review. Disabil Rehabil. 2020;42(12):1636-1649. https://doi:10.1080/09638288.2019.1590865   DOI
8 Geurts ACH, de Haart M, van Nes IJW, et al. A review of standing balance recovery from stroke. Gait & Posture. 2005;22(3):267-281. https://doi:10.1016/j.gaitpost.2004.10.002   DOI
9 Hankey GJ, Blacker DJ. Is it a stroke? BMJ. 2015;350(151):h56-h56. https://doi:10.1136/bmj.h56   DOI
10 Hee K, Jung M. Effects of one-to-one fall prevention education on decrease in falls of adults with stroke. Jour. of Ko Con a. 2015;15(5):426-435. https://doi:10.5392/JKCA.2015.15.05.426   DOI
11 Jung DI, Seo TH, Ko DS. Comparative analysis of fall-related physicopsychological according to virtual exercise and lumbar stabilization exercise in the patient with stroke. Jour. of Ko Con a. 2012;12(8):274-282. https://doi.org/10.5392/JKCA.2012.12.08.274   DOI
12 Kang TW, Ham KH. Effect of trunk stability exercises with stabilizing reversal and rhythmic stabilization of PNF for muscle strength and balance ability in stroke patients. PNF & Mov. 2014;12(2):63-69. https://doi.org/10.21598/JKPNFA.2014.12.2.63   DOI
13 Kaminski E, Steele CJ, Hoff M, et al. Transcranial direct current stimulation (tDCS) over primary motor cortex leg area promotes dynamic balance task performance. Clin Neurophysiol. 2016;127(6):2455-2462. https://doi.org/10.1016/j.clinph.2016.03.018   DOI
14 Karthikbabu S, Chakrapani M, Ganeshan S, et al. A review on assessment and treatment of the trunk in stroke: A need or luxury. Neural Regen Res. 2012;7(25):1974-1977. https://doi:10.3969/j.issn.1673-5374.2012.25.008   DOI
15 Kim JH. Effects of whole body vibration exercise on lower extremity muscle activity and gait ability in stroke patients. The Journal of Korean Academy of Orthopedic Manual Physical Therapy. 2020;26(2):29-36.
16 Lefaucheur JP, Aleman A, Baeken C, et al. Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS): An update (2014-2018). Clin Neurophysiol. 2020;131(2):474-528. https://doi:10.1016/j.clinph.2019.11.002   DOI
17 Kim SM, Kim YM. Effect of both lower extremities proprioceptive neuromuscular facilitation training with functional electrical stimulation on the balance and gait of stroke patient: A randomized controlled trial. J Korean Soc Phys Med. 2020;15(1):123-132. https://doi:10.13066/kspm.2020.15.1.123   DOI
18 Learmonth G, Benwell CSY, Marker G, et al. Non-invasive brain stimulation in stroke patients (NIBS): A prospective randomized open blinded end-point (PROBE) feasibility trial using transcranial direct current stimulation (tDCS) in post-stroke hemispatial neglect. Neuropsychol Rehabil. 2021;31(8):1163-1189. https://doi:10.1080/09602011.2020.1767161   DOI
19 Lee YH, Cho YH. The effects of trunk stability exercise using stabilizing reversal and rhythmic stabilization techniques of PNF on trunk strength and respiratory ability in the elderly after stroke. PNF and Mov. 2021; 19(1):105-113. https://doi.org/10.21598/JKPNFA.2021.19.1.105   DOI
20 Navarro-Lopez V, Molina-Rueda F, Jimenez-Jimenez S, et al. Effects of transcranial direct current stimulation combined with physiotherapy on gait pattern, balance, and functionality in stroke patients. A systematic review. Diagnostics. 2021;11(4):656. https://doi:10.3390/diagnostics11040656   DOI
21 Nguyen PT, Chou LW, Hsieh YL. Proprioceptive neuromuscular facilitation-Based physical therapy on the improvement of balance and gait in patients with chronic stroke: A systematic review and meta-analysis. Life (Basel).2022;12(6):882. https://doi:10.3390/life12060882   DOI
22 Santos FI, Teixeira CB, Lima RC, et al. Searching for the optimal tDCS target for motor rehabilitation. J Neuroeng Rehabil. 2019;16:90. https://doi:10.1186/s12984- 019-0561-5   DOI
23 Onal B, Sertel M, Karaca G. Effect of plantar vibration on static and dynamic balance in stroke patients: A randomised controlled study. Physiotherapy. 2022;116:1-8. https://doi:10.1016/j.physio.2022.02.002   DOI
24 Rungseethanakul S, Tretriluxana J, Piriyaprasarth P, et al. Task oriented training activities post stroke will produce measurable alterations in brain plasticity concurrent with skill improvement. Top Stroke Rehabil. 2022;29(4):241-254. https://doi:10.1080/10749357.2021.1926136   DOI
25 Sacco RL, Kasner SE, Broderick JP, et al. An updated definition of stroke for the 21st century: A statement for healthcare professionals from the American heart association/American stroke association. stroke. 2013;44(7):2064-2089. https://doi:10.1161/STR.0b013e318296aeca   DOI
26 Sato Y, Yoshimura Y, Abe T, et al, Matsumoto A. Relationship between trunk muscle mass and activities of daily living at discharge in acute stroke patients. Nutrition. 2022;103(104):111833. https://doi:10.1016/j.nut.2022.111833   DOI
27 Saunders DH, Sanderson M, Hayes S, et al. Physical fitness training for stroke patients. Cochrane Database Syst Rev. 2020;2020(3):CD003316.pub7
28 Shim J, Hwang S, Ki K, et al. Effects of EMG-triggered FES during trunk pattern in PNF on balance and gait performance in persons with stroke. Restor Neurol Neurosci. 2020;38(2):141-150. https://doi:10.3233/RNN-190944   DOI
29 Tanaka S, Hanakawa T, Honda M, et al. Enhancement of pinch force in the lower leg by anodal transcranial direct current stimulation. Exp Brain Res. 2009;196(3):459-465. https://doi:10.1007/s00221-009-1863-9   DOI
30 Woods AJ, Antal A, Bikson M, et al. A technical guide to tDCS, and related non-invasive brain stimulation tools. Clin Neurophysiol. 2016;127(2):1031-1048. https://doi:10.1016/j.clinph.2015.11.012   DOI
31 Yang DJ, Lee YS. Effects of robot-assisted arm training on muscle activity of arm and weight bearing in stroke patients." The Journal of Korean Academy of Orthopedic Manual Physical Therapy. 2022;28(1):71-80.
32 Zhang MK, Wei JN, Wu XP. Effects of whole-body vibration training on lower limb motor function and neural plasticity in patients with stroke: protocol for a randomised controlled clinical trial. BMJ Open. 2022;12(6):e060796. https://doi:10.1136/bmjopen-2022-060796   DOI