20Jan 2017

Effect of Balance Training on Postural Control and Risk of fall in Stroke Patients.

  • Department of Physical Therapy, Faculty of Applied Medical Sciences, Umm Al-Qura University, Saudi Arabia. Department of Physical Therapy, Faculty of Applied Medical Sciences, Taif University, Saudi Arabia. Department of Physical Therapy for Neuromuscular Disorders and Its Surgeries, Faculty of Physical Therapy, Cairo University, Egypt.
Crossref Cited-by Linking logo
  • Abstract
  • Keywords
  • References
  • Cite This Article as
  • Corresponding Author

Background: Purpose of this study was to investigate of effect of visual feedbackbalance training on postural control and risk of fall in stroke patients. Methods: Forty stroke patients were included in this study. Their age ranged from40-60 years. They were evaluated using the Biodex Balance System pre and posttreatment. They were divided intotwo equal groups (control group and study groups).Subjects in both groups participated in the conventionalstroke rehabilitationprogram, one hour /day/ 5 days/week /3 successive monthsin addition, subjects in thestudy group received a 20 min of balance training once daily,five days a week for3 months using the Biodex Balance System (BBS). Results: Significantimprovements in balance training measurements were found in thetrained group at 3 months after completing the training program. Conclusion:Patients in thevisual feedback balance training group had significant improvements whencompared with the control group in term of improving of postural control anddecreasing of risk of fall. The results showed that balance training was beneficial forpatients after hemiplegic stroke.


  1. Yang, S., Hwang, W.H., Tsai, Y.C., Liu, F.K., Hsieh, L.F. &Chern, J.S. Improving balance skills in patients who had stroke through virtual reality treadmill training. Am. J. Phys. Med. Rehabil. 2011; 90, 969-978.
  2. Kelley, R.E. &Borazanci, A.P. Stroke rehabilitation. Neurol. Res.2009; 31, 832-840.
  3. Belgen B, Beninato M, Sullivan PE, Narielwalla K. The association of balance capacity and falls self-efficacy with history of falling in community-dwelling people with chronic stroke. Arch Phys Med Rehabil 2006; 87:554-61.
  4. Graham, J.V., Eustace, C., Brock, K., Swain, E. & Irwin-Carruthers, S. The Bobath concept in contemporary clinical practice.TopStroke.Rehabil. 2009; 16, 57-68.
  5. Geiger RA, Allen JB, O’Keefe J, Hicks RR. Balance and Mobility Following Stroke: Effects of Physical Therapy Interventions with and Without Biofeedback/Forceplate Training. PhyTher 2001; 81: 414-18.
  6. Gil-Gomez, J.A., Llorens, R., Alcaniz, M. &Colomer, C. Effectiveness of a Wii balance board-based system (eBaViR)for balance rehabilitation: a pilot randomized clinical trial inpatients with acquired brain injury. J. Neuroeng. Rehabil.2011; 8, 30.
  7. Flansbjer, U.B., Miller, M., Downham, D. &Lexell, J. Progressive resistance training after stroke: effects on muscle strength, muscle tone, gait performance and perceived participation. J. Rehabil. Med.2008; 40, 42-48.
  8. De Oliveira C, De Medeiros I, Frota N, Greters M, Conforto A,. Balance control in hemiparetic stroke patients: Main tools for evaluation. Journal of Rehabilitation Research & Development. 2008; 45 (8): 1215–1226.
  9. Adegoke B, Olaniyi O, Akosile C. Weight Bearing Asymmetry and Functional Ambulation PerformanceIn Stroke Survivors. Global Journal of Health Science, March 2012; DOI: 10.5539/gjhs.v4n2p87.
  10. Leroux, A., Pinet, H. & Nadeau, S. Task-oriented intervention in chronic stroke: changes in clinical and laboratory measures of balance and mobility. Am. J. Phys. Med. Rehabil.2006; 85, 820-830.
  11. Karimi N, Ebrahimi I, Kharizi S, Torkaman G. Reliability of postural balance evaluation using the biodex balance system in subjects with and without low back pain. J of Postgraduate Medical Institute.2008;20:2:1013-16.
  12. Aydog E, Bal A, Aydog ST, Cakei A. Evaluation of dynamic postural balance using the Biodex Stability System in rheumatoid arthritis patients. Clin.Rheumatol.2005; 10:1-6.
  13. Wikstrom E, Tillman M,  Smith A, and BorsaA New Force-Plate Technology Measure of Dynamic Postural Stability: The Dynamic Postural Stability Index.JAthl Train. 2005; 40(4): 305–309.
  14. Chun C , Pao-Tsai C, Chia-Ling C, Shih-Ching C, Chia-Ying C, Tu-Hsueh Y. Effects of Balance Training on Hemiplegic Stroke Patients,Chang Gung Med J 2002; 25(9):583-589.
  15. Glanz M, Klawansky S, Chalmers T. Biofeedback therapy in stroke rehabilitation: a review. J R Soc Med 1 997;90(1):33-9.
  16. Goldie PA, Matyas TA, Evans OM, Galea M, Bach TM. Maximum voluntary weight-bearing by the affected and unaffected legs in standing following stroke.ClinBiomech. 1996; 11(6):333-42.
  17. Badke MB, Duncan PW. Patterns of Rapid Motor Responses During Postural Adjustments When Standing in Healthy Subjects and Hemiplegic Patients. Phys Ther1983;47:1020-8.
  18. Horak FB, Esselman P, Anderson ME, Lynch MK. The effects of movement velocity, mass displaced, and task certainty on associated postural adjustments made by normal and hemiplegic individuals. J NeurolNeurosurg Psychiatry 1984;47:1020-8.
  19. Dickstein R, Abuluflo N. Postural Sway of the Affected and Nonaffected Pelvis and Leg in Stance of Hemiparetic Patients. Arch Phys Med Rehabil 2000;81(3):364-7.
  20. Lamb SE, Ferrucci L, Volapto S, Fried LP, Guralnik JM. Women’s Health and Aging Study. Risk factors for falling in home dwelling older women with stroke: The Women’s Health and Aging Study. Stroke 2003;34(2):494–501.
  21. Harris JE, Eng JJ, Marigold DS, Tokuno CD, Louis CL. Relationship of balance and mobility to fall incidence in people with chronic stroke. PhysTher. 2005;85(2):150–8.
  22. Belgen B, Beninato M, Sullivan PE, Narielwalla K. The association of balance capacity and falls self-efficacy with history of falling in community-dwelling people with chronic stroke. Arch Phys Med Rehabil 2006;87(4):554–61.
  23. McCollum G, Leen TK. Form and exploration of mechanical stability limits in erect stance. J Motor Behav 1989;21:225-44.
  24. Geurts AC, de Haart M, van Nes IJ, DuysensJ. A review of standing balance recovery from stroke. Gait Posture 2005;22:267-81.
  25. Bonan IV, Yelnik AP, Colle FM, Michaud C, Normand E, Panigot B, Roth P,Guichard JP, Vicaut E. Reliance on visual information after stroke. Part II: Effectiveness of a balance rehabilitation program with visual cue deprivation after stroke: a randomized controlled trial. Arch Phys Med Rehabil 2004;85:274-8.
  26. Eser F, Yavuzer G, Karakus D, Karaoglan B. The effect of balance training on motor recovery and ambulation after stroke: a randomized controlled trial. Eur J PhysRehabil Med 2008;44:19-25.
  27. Oliveira CB, Medeiros IT, Frota NF, Greters ME, Conforto AB. Balance control in hemiparetic stroke patients: Main tools for evaluation. J Rehabilit Res Dev2008;45(8):1215–26.
  28. Walker C, Brouwer BJ, Culham EG. Use of Visual Feedback in Retraining Balance Following Acute Stroke.PhysTher 2000;80:886-95.
  29. Hocherman S, Dickstein R. Platform training and postural stability in hemiplegia.ArchPhys Med Rehabil 1984;65:588-92.
  30. Shumway-Cook A, Anson D, Haller S. Postural sway biofeedback: its effect on reestablishing stance stability in hemiplegic patients. Arc Phys Med Reahabil 1988;69:395-400.
  31. Barclay-Goddard R, Stevenson T, Poluha W, Moffatt ME; Taback, SP. Force platform feedback for standing balance training after stroke. Cochrane Database Syst Rev 2004;18(4):CD004129.
  32. Geiger RA, Allen JB, O´keefe J, Hicks RR. Balance and mobility following stroke: effects of physical therapy interventions with and without biofeedback/force plate training. PhysTher 2004;81:995-1005.
  33. Dault M, de Haart M, Geurts AC, Arts IM, Nienhuis, B. Effects of visual center of pressure feedback on postural control in young and elderly healthy adults and in stroke patients. Hum MovSci 2003;22(3):221–36.
  34. Yavuzer G, Ergin S. Effect of an arm sling on gait pattern in patientswithhemiplegia. Arch Phys Med Rehabil 2002;83:960-3.
  35. Wong A, Lee MY, KuoJK , Tang, FT. The Development and Clinical Evaluation of a Standing Biofeedback Trainer. J Rehabil Res Dev 1997;34( 3):322-327.
  36. Sacley C. The relationships between weight-bearing asymmetry after stroke, motor function and activities of daily living. Physiotherapy Theory Pract 1990;6:179-85.
  37. deHaart M, Geurts AC, Huidekoper SC, Fasotti L, van Limbeek J. Recovery of standing balance in postacute stroke patients: a rehabilitation cohort study. Arch Phys Med Rehabil 2004;85:886-95.
  38. Bonan IV, Colle FM, Guichard JP, Vicaut E, Eisenfisz M, Tran Ba Huy P, YelnikAP. Reliance on visual information after stroke. Part I: Balance on dynamic posturography. Arch Phys Med Rehabil 2004;85:268-73.
  39. Sacley CM, Lincoln NB. Single blind randomized controlled trial of visual feedback after stroke: effects on stance symmetry and function. DisabilRehabil 1997;19(12):536-46.
  40. Chen IC, Cheng PT, Chen CL, Chen SC, Chung CY, Yeh TH. Effects of Balance Training on Hemiplegic Stroke Patients. Chang Chung Med J 2002;25(9):583-90.
  41. Yavuzer G, Eser F, Karakus D, Karaoglan B, Stam HJ. The effects of balance training on gait late after stroke: a randomized controlled trial ClinRehabil. 2006;20(11):960-9.

[HeshamGalal Mahran, EmadTawfik Ahmed, Shamekh Mohammed El-Shamy and Amir Abdel-Raouf El-Fiky. (2017); Effect of Balance Training on Postural Control and Risk of fall in Stroke Patients. Int. J. of Adv. Res. 5 (Jan). 316-325] (ISSN 2320-5407). www.journalijar.com


Hesham Galal Mahran
Department of Physical Therapy, Faculty of Applied Medical Sciences, Umm Al-Qura University, Saudi Arabia.

DOI:


Article DOI: 10.21474/IJAR01/2749      
DOI URL: http://dx.doi.org/10.21474/IJAR01/2749