Best Core Stabilization for Anticipatory Postural Adjustment and Falls in Hemiparetic Stroke

Publication date: Available online 21 February 2018
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Nam G. Lee, H. You Joshua Sung, Chung H. Yi, Hye S. Jeon, Bong S. Choi, Dong R. Lee, Jae M. Park, Tae H. Lee, In T. Ryu, Hyun S. Yoon
ObjectivesTo compare the effects of conventional core stabilization (CCS) and dynamic neuromuscular stabilization (DNS) on anticipatory postural adjustment (APA) time, balance performance, and fear of falls in chronic hemiparetic stroke.DesignTwo-group randomized controlled trial with pretest-posttest designSettingHospital's rehabilitation center.ParticipantsTwenty-eight adults with chronic hemiparetic strokeInterventionParticipants were randomly divided into either CCS (n=14) or DNS (n=14) groups. Both groups received a total of 20 sessions of CCS or DNS training for 30 minutes per session 5 times a week during the 4-week period.Main Outcome MeasuresElectromyography was used to measure the APA time for bilateral external oblique (EO), transverse abdominis/internal oblique (TrA/IO), and erector spinae (ES) activation during rapid shoulder flexion. Trunk Impairment Scale (TIS), Berg Balance Scale (BBS), and Falls Efficacy Scale (FES) were used to measure trunk movement control, balance performance, and fear of falling.ResultsBaseline APA times were delayed and fear of falling was moderately high in both the CCS and DNS groups. After the interventions, the APA times for EO, TrA/IO, and ES were shorter in the DNS group than in the CCS group (P<0.008). The BBS and TIS scores (P<0.008) as well as FES score (P<0.003) were improved compared to baseline in both groups, but FES remained stable through the two-year follow-up period only in the DNS group (P<0.003).ConclusionsThis is the first clinical evidence highlighting the importance of core stabilization exercises for improving APA control, balance, and fear of falls in individuals with hemiparetic stroke.



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