An ankle proprioceptive control program improves balance, gait ability of chronic stroke patients

Yu-Hyung Park, Yu-Mi Kim, Byoung-Hee Lee, Yu-Hyung Park, Yu-Mi Kim, Byoung-Hee Lee

Abstract

[Purpose] Balance and gait ability determine to a large degree the level of independence of daily living which is an important goal of rehabilitation. This study was conducted in order to examine the effectiveness of an ankle proprioceptive control program on ankle muscle strength, balance, and gait of chronic stroke patients. [Methods] Thirteen chronic stroke patients more than six months post-stroke were recruited. All subjects received ankle proprioceptive control training for 30 minutes per session, two days per week, over a period of six weeks. Outcome measures were ankle strength (BTE-Primus), the Timed Up and Go test (TUG), and spatiotemporal parameters measured by a GAITRite instrument. [Results] Significant improvements in ankle dorsiflexor strength, TUG, gait speed and cadence, step length, and stride length were observed on the paretic side. [Conclusion] The results of this study provide evidence in support of incorporation of an ankle proprioceptive control program for effective improvement of both balance and gait ability of chronic stroke patients. The findings of this study suggest the feasibility and suitability of an ankle proprioceptive control program for chronic stroke patients.

Keywords: Ankle; Proprioception; Stroke.

References

    1. Edwards S: Neurological Physiotherapy: A Problem-Solving Approach. Edingburgh: Churchill Livingstone, 2001, pp 26–37.
    1. Andrews AW, Bohannon RW: Short-term recovery of limb strength after acute stroke. Arch Phys Med Rehabil, 2003, 84: 125–130
    1. Donald AN: Kinesiology of the Musculoskeletal System: Foundations for Physical Rehabilitation. Mosby Publication, 2002, pp 528–529.
    1. Burridge JH, Taylar PN, Hagan SA: The effects of common peroneal stimulation on the effort and speed of walking: a randomized. Clin Rehabil, 1997, 11: 201–210
    1. McCollum G, Shupert CL, Nashner LM: Organizing sensory information for postural control in altered sensory environments. J Theor Biol, 1996, 180: 257–270
    1. Shumway-Cook A, Wollacott M: Attentional demands and postural control: the effect of sensory context. J Gerontol A Biol Sci Med Sci, 2000, 55: 10–16
    1. Niam S, Wayne C, Patricia E, et al. : Balance and physical impairments after stroke. Arch Phys Med Rehabil, 1999, 80: 1227–1233
    1. Lin PY, Yang YR, Cheng SJ, et al. : The relation between ankle impairments and gait velocity and symmetry in people with stroke. Arch Phys Med Rehabil, 2006, 87: 562–568
    1. Lynch M, Grisogono V: Stroke and head injuries. London: John Murray, 1991, pp 113–136.
    1. Podsiadlo D, Richardson S: The timed “Up and Go”: a test of basic functional mobility for frail elderly person. J Am Geriatr Soc, 1991, 39: 142–148
    1. McDonough AL, Batavia M, Chen FC, et al. : The validity and reliability of the GAITRite system's measurements: a preliminary evaluation. Arch Phys Med Rehabil, 2001, 82: 419–425
    1. Whitney SL, Poole JL, Cass SP: A review of balance instruments for older adults. Am J Occup Ther, 1998, 52: 666–671
    1. Almeida GL, Carvalho RL, Talis VL: Postural strategy to keep balance on the seesaw. Gait Posture, 2006, 23: 17–21
    1. Kim CM, Eng JJ: The relationship of lower-extremity muscle torque to locomotor performance in people with stroke. Phys Ther, 2003, 83: 49–57
    1. Docherty CL, Arnold BL, Zinder SM, et al. : Relationship between two proprioceptive measure and stiffness at the ankle. J Electromyogr Kinesiol, 2004, 14: 317–324
    1. Horak FB, Nashner L, Diener H: Postural strategies associated with somatosensory and vestibular loss. Exp Brain Res, 1990, 82: 167–177
    1. Horak FB, Henry SH, Shumway-Cook A: Postural pertubations: new insight for treatment of balance disorders. Phys Ther, 1997, 77: 517–533
    1. Ng SS, Hui-Chan CW: The timed Up & Go test: its reliability and association with lower-limb impairment and locomotor capacities in people with chronic stroke. Arch Phys Med Rehabil, 2005, 86: 1641–1647
    1. Walker C, Brouwer BJ, Culham EG: Use of visual feedback in retraining balance following acute stroke. Phys Ther, 2000, 80: 886–895
    1. Turnbull GI, Charteris J, Wall JC: A comparison of the range of walking speeds between normal and hemiplegia subjects. Scand J Rehabil Med, 1995, 27: 175–182
    1. Titianova EB, Pitkanen K, Paakkonen A, et al. : Gait characteristics and functional ambulation profile in patients with chronic unilateral stroke. Am J Phys Med Rehabil, 2003, 82: 778–786

Source: PubMed

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