Direction-Specific Instability Poststroke Is Associated With Deficient Motor Modules for Balance Control

I was tested in one  of these called a Balance Master 4 weeks post-stroke. The force plates I was standing on could move side to side, front to back and tilt in various directions, all the while the three sides; front of you and each side were moving around. You were strapped into a harness to catch you when you fall. After it was all done my PT ran my scores thru the universe of  results and at that time my age of 50 results were better than the average 50 year old male. I just told him I would really have enjoyed that testing  challenge when I was healthy. Its like kneeling on a yoga ball  for balance practice. This was all absolutely necessary  for keeping upright in a squirrelly whitewater canoe. My favorite was a Mad River Outrage.
So after your research did you come up with ANYTHING AT ALL  that could be used to help survivors recover? Or was this an exercise for no purpose?  

Direction-Specific Instability Poststroke Is Associated With Deficient Motor Modules for Balance Control

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Digna de Kam, PhD, Alexander C. Geurts, PhD, Vivian Weerdesteyn, PhD, , , ...

First Published June 29, 2018 Research Article

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Abstract

Defective muscle coordination for balance recovery may contribute to stroke survivors’ propensity for falling. Thus, we investigated deficits in muscle coordination for postural control and their association to body sway following balance perturbations in people with stroke. Specifically, we compared the automatic postural responses of 8 leg and trunk muscles recorded bilaterally in unimpaired individuals and those with mild to moderate impairments after unilateral supratentorial lesions (>6 months). These responses were elicited by unexpected floor translations in 12 directions. We extracted motor modules (ie, muscle synergies) for each leg using nonnegative matrix factorization. We also determined the magnitude of perturbation-induced body sway using a single-link inverted pendulum model. Whereas the number of motor modules for balance was not affected by stroke, those formed by muscles with long latency responses were replaced by atypically structured paretic motor modules (atypical muscle groupings), which hints at direct cerebral involvement in long-latency feedback responses. Other paretic motor modules had intact structure but were poorly recruited, which is indicative of indirect cerebral control of balance. Importantly, these paretic deficits were strongly associated with postural instability in the preferred activation direction of the impaired motor modules. Finally, these deficiencies were heterogeneously distributed across stroke survivors with lesions in distinct locations, suggesting that different cerebral substrates may contribute to balance control. In conclusion, muscle coordination deficits in the paretic limb of stroke survivors result in direction-specific postural instability, which highlights the importance of targeted interventions to address patient-specific balance impairments.(What the fuck are those targeted interventions?)