Abstract
Background:
Reactive balance responses are critical for fall prevention.
Perturbation-based balance training (PBBT) has shown a positive effect
in reducing the risk of falls among older adults and persons with
Parkinson’s disease.
Objective: To explore the effect of a
short-term PBBT on reactive balance responses, performance-based
measures of balance and gait and balance confidence.
Methods:
Thirty-four moderate-high functioning(cherry picking better candidates again), subacute persons with stroke
(PwS) (lower extremity Fugl-Meyer score 29.2 ± 4.3; Berg Balance Scale
[BBS] score 43.8 ± 9.5, 42.0 ± 18.7 days after stroke onset)
hospitalized in a rehabilitation setting were randomly allocated to PBBT
(n = 18) and weight shifting and gait training (WS>) (n = 16).
Both groups received 12 training sessions, 30 minutes each, for a period
of 2.5 weeks. PBBT included unexpected balance perturbations during
standing and treadmill walking, WS> included weight shifting in
standing and treadmill walking without perturbations. The main outcome
measures, that is, multiple step-threshold and fall-threshold were
examined at baseline, immediately postintervention, and about 5 weeks
postintervention. The secondary outcome measures, that is, BBS, 6-minute
walk test (6MWT), 10-meter walk test (10MWT), and Activity-specific
Balance Confidence (ABC) scale were examined at baseline and immediately
postintervention.
Results: Compared with the WS> group,
immediately postintervention participants in the PBBT group showed
higher multiple-step thresholds in response to forward and backward
surface translations (effect size [ES] = 1.07 and ES = 1.10,
respectively) and moderate ES in the ABC scale (ES = 0.74). No
significant differences were found in fall-threshold, BBS, 6MWT, and
10MWT between the groups.
Conclusions: Inclusion of perturbation training during rehabilitation of PwS improved reactive balance and balance confidence.
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