http://www.ncbi.nlm.nih.gov/pubmed/25072700
Abstract
Weight
bearing on the paretic lower extremity and transfer of weight from one
lower extremity to the other are important goals of stroke
rehabilitation. Improvements in these limb loading and weight transfer
abilities have been shown to relate to improved performance of many
functional activities. Unfortunately, valid and practical clinical
measures of paretic lower extremity loading and weight transfer have not
been identified. The purpose of this study was to quantitatively
assess, through center of foot pressure (CoP) analysis of quiet upright
stance control, recovery of paretic limb loading as a measure of weight
transfer in early stroke subjects, testing the effectiveness of a
targeted rehabilitation intervention based on audiovisual biofeedback.
Thirty-seven adults with lower extremity motor impairment following
unilateral, non-cerebellar stroke, were Biofeedback rehabilitation of
posture and weightbearing distribution in stroke: a center of foot
pressure analysis tested twice, at an interval of at least one month
post stroke and following rehabilitation intervention aimed at
correcting their asymmetrical weight bearing. The intervention was
performed with (Study Group, SG) or without (Control Group, CG) a
postural audio-visual biofeedback approach. Indices of postural
stability and of balance control asymmetry were estimated by acquiring
the movements of the CoP during quiet upright stance condition with or
without visual input (eyes open, EO and eyes closed, EC). Clinical
scales were also administered. Both the CG and the SG subjects showed
improved control in upright stance posture as documented by significant
improvements in the scale scores and indices of stability during both
the EO and the EC condition. Only the SG showed a significantly reduced
CoP index of asymmetry. The CoP index of asymmetry, correlating with
clinical motor scales, is a valid measure of paretic limb loading during
stroke recovery. Postural audio-visual biofeedback represented the more
effective approach for reducing weight loading asymmetry of the lower
limbs in stroke.
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