Browse > Article
http://dx.doi.org/10.12674/ptk.2020.27.3.178

Comparison Between Stroke Patients and Normal Persons for Trunk Position Sense and It's Relation to Balance and Gait  

Yang, Hea-Duck (Rehabilitation Center, Chungnam National University Hospital)
Kim, Chang-beom (Korea Proprioceptive Neuromuscular Facilitation Association in South Seoul Gyeonggi)
Choi, Jong-Duk (Department of Physical Therapy, College of Health & Medical Science, Daejeon University)
Moon, Young (Department of Movement Development, The ERUM Child Development Center)
Publication Information
Physical Therapy Korea / v.27, no.3, 2020 , pp. 178-184 More about this Journal
Abstract
Background: Stroke patients have reduced trunk control compared to normal people. The ability to control the trunk of a stroke patient is important for gait and balance. However, there is still a lack of research methods for the characteristics of stroke control in stroke patients. Objects: The aim of this research was to determine whether trunk position sense has any relation with balance and gait. Methods: This study assessed trunk performance by measuring position sense. Trunk position sense was assessed using the David back concept to determine trunk repositioning error in 20 stroke patients and 20 healthy subjects. Four trunk movements (flexion, extension, lateral flexion, rotation) were tested for repositioning error and the measurement was carried out 6 times per move; these parameters were used to compare the mean values obtained. Subjects with stroke were also evaluated with clinical measures of balance and gait. Results: There were significant differences in trunk repositioning error between the stroke group and the control group in flexion, lateral flexion to the affected side, lateral flexion to the unaffected side, rotation to the affected side, and rotation to the unaffected side. Mean flexion error: post-stroke: 7.95 ± 6.76 degrees, control: 3.32 ± 2.27; mean lateral flexion error to the affected side: 6.13 ± 3.79, to the unaffected side: 5.32 ± 3.15, control: 3.57 ± 1.92; mean rotation error to the affected side: 8.25 ± 3.09, to the unaffected side: 9.24 ± 3.94, control: 5.41 ± 1.82. There was an only significant negative correlation between the repositioning error of lateral flexion and the Berg balance scale score to the affected side (-0.483) and to the unaffected side (-0.497). A strong correlation between balance and gait was found. Conclusion: The results of this study indicate that stroke patients exhibit greater trunk repositioning error than age-matched controls on all planes of movement except for extension. And lateral flexion has correlation with balance and gait.
Keywords
Gait; Position sense; Postural balance; Stroke;
Citations & Related Records
Times Cited By KSCI : 1  (Citation Analysis)
연도 인용수 순위
1 Arsic S, Eminovic F, Konstantinovic L, Pavlovic D, Kljajic D, Despotovic M. Correlation between functional independence and quality of executive functions in stroke patients. Turk J Phys Med Rehabil 2015;61(4):333-8.   DOI
2 Karatas M, Cetin N, Bayramoglu M, Dilek A. Trunk muscle strength in relation to balance and functional disability in unihemispheric stroke patients. Am J Phys Med Rehabil 2004;83(2):81-7.   DOI
3 Verheyden G, Vereeck L, Truijen S, Troch M, Lafosse C, Saeys W, et al. Additional exercises improve trunk performance after stroke: a pilot randomized controlled trial. Neurorehabil Neural Repair 2009;23(3):281-6.   DOI
4 Hwang WJ, Cho MK, Chung Y. Relationship between anticipatory postural adjustment of the trunk, dual tasks and physical performance with chronic stroke survivors: a pilot test. Phys Ther Rehabil Sci 2015;4(1):44-8.   DOI
5 Jijimol G, Fayaz RK, Vijesh PV. Correlation of trunk impairment with balance in patients with chronic stroke. NeuroRehabilitation 2013;32(2):323-5.   DOI
6 Verheyden G, Vereeck L, Truijen S, Troch M, Herregodts I, Lafosse C, et al. Trunk performance after stroke and the relationship with balance, gait and functional ability. Clin Rehabil 2006;20(5):451-8.   DOI
7 Combs-Miller SA, Kalpathi Parameswaran A, Colburn D, Ertel T, Harmeyer A, Tucker L, et al. Body weight-supported treadmill training vs. overground walking training for persons with chronic stroke: a pilot randomized controlled trial. Clin Rehabil 2014;28(9):873-84.   DOI
8 Tsang WWN, Fu SN, Lui F, Hui-Chan CWY. Trunk position sense in older Tai Chi sword practitioners. Hong Kong Physiother J 2009;27(1):55-60.   DOI
9 Ryerson S, Byl NN, Brown DA, Wong RA, Hidler JM. Altered trunk position sense and its relation to balance functions in people post-stroke. J Neurol Phys Ther 2008;32(1):14-20.   DOI
10 Lanzetta D, Cattaneo D, Pellegatta D, Cardini R. Trunk control in unstable sitting posture during functional activities in healthy subjects and patients with multiple sclerosis. Arch Phys Med Rehabil 2004;85(2):279-83.   DOI
11 Gillen G, Burkhardt A. Stroke rehabilitation: a function-based approach. 2nd ed. St. Louis: Mosby; 2004.
12 Huber FE, Wells CL. Therapeutic exercise: treatment planning for progression. St. Louis: Saunders; 2006.
13 Yang YR, Tsai MP, Chuang TY, Sung WH, Wang RY. Virtual reality-based training improves community ambulation in individuals with stroke: a randomized controlled trial. Gait Posture 2008;28(2):201-6.   DOI
14 Yelnik AP, Le Breton F, Colle FM, Bonan IV, Hugeron C, Egal V, et al. Rehabilitation of balance after stroke with multisensorial training: a single-blind randomized controlled study. Neurorehabil Neural Repair 2008;22(5):468-76.   DOI
15 Folstein MF, Folstein SE, McHugh PR. "Mini-mental state": A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12(3):189-98.   DOI
16 Newcomer KL, Laskowski ER, Yu B, Johnson JC, An KN. Differences in repositioning error among patients with low back pain compared with control subjects. Spine (Phila Pa 1976) 2000;25(19):2488-93.   DOI
17 Allison GT, Fukushima S. Estimating three-dimensional spinal repositioning error: the impact of range, posture, and number of trials. Spine (Phila Pa 1976) 2003;28(22):2510-6.   DOI
18 Blum L, Korner-Bitensky N. Usefulness of the Berg balance scale in stroke rehabilitation: a systematic review. Phys Ther 2008;88(5):559-66.   DOI
19 Desmurget M, Vindras P, Grea H, Viviani P, Grafton ST. Proprioception does not quickly drift during visual occlusion. Exp Brain Res 2000;134(3):363-77.   DOI
20 Pearcy MJ, Hindle RJ. New method for the non-invasive threedimensional measurement of human back movement. Clin Biomech (Bristol, Avon) 1989;4(2):73-9.   DOI
21 Mount J, Bolton M, Cesari M, Guzzardo K, Tarsi J Jr. Group balance skills class for people with chronic stroke: a case series. J Neurol Phys Ther 2005;29(1):24-33.   DOI
22 Swinkels A, Dolan P. Spinal position sense is independent of the magnitude of movement. Spine (Phila Pa 1976) 2000;25(1):98-104; discussion 105.   DOI
23 Asell M, Sjolander P, Kerschbaumer H, Djupsjobacka M. Are lumbar repositioning errors larger among patients with chronic low back pain compared with asymptomatic subjects? Arch Phys Med Rehabil 2006;87(9):1170-6.   DOI
24 O'Sullivan PB, Burnett A, Floyd AN, Gadsdon K, Logiudice J, Miller D, et al. Lumbar repositioning deficit in a specific low back pain population. Spine (Phila Pa 1976) 2003;28(10):1074-9.   DOI
25 Petersen CM, Zimmermann CL, Cope S, Bulow ME, Ewers-Panveno E. A new measurement method for spine reposition sense. J Neuroeng Rehabil 2008;5:9.   DOI
26 Descarreaux M, Blouin JS, Teasdale N. Repositioning accuracy and movement parameters in low back pain subjects and healthy control subjects. Eur Spine J 2005;14(2):185-91.   DOI
27 Andrews AW, Bohannon RW. Distribution of muscle strength impairments following stroke. Clin Rehabil 2000;14(1):79-87.   DOI
28 Lin YH, Sun MH. The effect of lifting and lowering an external load on repositioning error of trunk flexion-extension in subjects with and without low back pain. Clin Rehabil 2006;20(7):603-8.   DOI
29 Brumagne S, Cordo P, Lysens R, Verschueren S, Swinnen S. The role of paraspinal muscle spindles in lumbosacral position sense in individuals with and without low back pain. Spine (Phila Pa 1976) 2000;25(8):989-94.   DOI
30 Ada L, Canning CG, Low SL. Stroke patients have selective muscle weakness in shortened range. Brain 2003;126(Pt 3):724-31.   DOI
31 Tanaka S, Hachisuka K, Ogata H. Muscle strength of trunk flexion-extension in post-stroke hemiplegic patients. Am J Phys Med Rehabil 1998;77(4):288-90.   DOI
32 Bohannon RW, Cassidy D, Walsh S. Trunk muscle strength is impaired multidirectionally after stroke. Clin Rehabil 1995;9(1):47-51.   DOI
33 Carr LJ, Harrison LM, Stephens JA. Evidence for bilateral innervation of certain homologous motoneurone pools in man. J Physiol 1994;475(2):217-27.   DOI