Effects of Balance Training on Balance and Fall Confidence After Hip Replacement Surgery
Effects of Perturbation-Based Balance Training on Balance Ability and Fall Efficacy in Patients After Total Hip Arthroplasty: A Randomized Controlled Trial
調査の概要
詳細な説明
Total hip arthroplasty (THA) is commonly performed to reduce pain and improve functional mobility in patients with hip joint disorders. However, many patients continue to experience impaired balance control, decreased proprioception, muscle weakness, and fear of falling after surgery. These impairments may negatively affect gait stability, activities of daily living, and quality of life.
Traditional balance training programs mainly focus on static posture control and predictable weight-shifting tasks. However, such approaches may not adequately improve reactive postural control required for unexpected balance disturbances encountered during daily activities. Perturbation-based balance training (PBT) has recently gained attention as an intervention designed to improve reactive balance control by exposing individuals to unexpected external disturbances and encouraging adaptive postural responses.
This study aims to investigate the effects of perturbation-based balance training using pressure biofeedback in patients following total hip arthroplasty. The pressure biofeedback system provides controlled instability and real-time sensory feedback during balance tasks, allowing participants to improve postural control strategies and weight-shifting ability.
Thirty patients who underwent THA will be recruited and randomly assigned to either an experimental group or a control group. The experimental group will receive perturbation-based balance training using pressure biofeedback in addition to conventional physical therapy, while the control group will perform conventional balance training with conventional physical therapy. Interventions will be performed 5 times per week for 6 weeks.
Outcome measures will include balance performance assessed by the Berg Balance Scale (BBS), Functional Reach Test (FRT), and center of pressure (COP) parameters measured using a Wii Balance Board. Falls efficacy will be evaluated using the Falls Efficacy Scale (FES). Hip function and lower extremity function will be assessed using the Harris Hip Score (HHS) and Lower Extremity Functional Scale (LEFS).
The findings of this study may provide evidence supporting the clinical applicability of perturbation-based balance training using pressure biofeedback as an effective rehabilitation strategy for improving postural stability and reducing fall risk after THA.
研究の種類
入学 (実際)
段階
- 適用できない
連絡先と場所
研究場所
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Gyeongsangbuk-do
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Gyeongsan-si、Gyeongsangbuk-do、韓国、38453
- Daegu University
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参加基準
適格基準
就学可能な年齢
- 大人
- 高齢者
健康ボランティアの受け入れ
説明
Inclusion Criteria:
- Patients who underwent total hip arthroplasty (THA)
- Postoperative period between 2 weeks and 6 months
- Ability to understand and follow therapist instructions
- Able to stand independently with or without an assistive device
- Berg Balance Scale (BBS) score between 21 and 45
- Receiving inpatient rehabilitation and physical therapy
Exclusion Criteria:
- Severe cognitive impairment (K-MMSE < 18)
- Severe visual impairment or vestibular dysfunction
- Any neurological or musculoskeletal disorder affecting balance other than THA
- Unstable cardiovascular or medical conditions that could interfere with participation
- Inability to safely participate in balance training
研究計画
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：処理
- 割り当て：ランダム化
- 介入モデル：並列代入
- マスキング：なし（オープンラベル）
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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実験的：Pressure Biofeedback-Based Perturbation Balance Training Group
Participants will receive perturbation-based balance training using pressure biofeedback in addition to conventional physical therapy.
The intervention will be conducted for 15 minutes per session, five times per week, for six weeks.
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Participants performed perturbation-based balance training using pressure biofeedback devices in addition to conventional physical therapy.
During standing tasks, pressure biofeedback units were placed under both feet, and temporary instability was induced by adjusting air pressure to alter support surface stability.
Participants performed progressive balance tasks including static standing, weight shifting, multidirectional reaching, and PNF-based reaching patterns.
Training intensity and task difficulty were progressively increased according to participant performance.
The intervention was conducted for 15 minutes per session, 5 sessions per week, for 6 weeks under therapist supervision.
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アクティブコンパレータ：Conventional Balance Training
Participants performed traditional balance training combined with conventional physical therapy.
Training included static and dynamic balance exercises, weight shifting, postural control tasks, and functional reaching activities without pressure biofeedback.
The intervention was conducted for 30 minutes per session, 5 sessions per week, for 6 weeks.
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Participants in the control group received traditional balance training without pressure biofeedback.
The intervention included static and dynamic balance exercises, postural control training, weight-shifting tasks, and posture transition activities.
The training tasks were performed in the same sequence and progression as the experimental group, but without perturbation induced by pressure biofeedback devices.
Participants received training for 30 minutes per session, 5 times per week, for 6 weeks in addition to conventional physical therapy.
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Berg Balance Scale (BBS)
時間枠：Baseline and after 6 weeks of intervention
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Functional balance assessed with the Berg Balance Scale, a 14-item performance-based scale scored from 0 to 56, with higher scores indicating better balance.
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Baseline and after 6 weeks of intervention
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Functional Reach Test (FRT)
時間枠：Baseline and after 6 weeks of intervention
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Maximum forward reach distance in centimetres while standing, measured with the Functional Reach Test; greater distance indicates better dynamic balance.
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Baseline and after 6 weeks of intervention
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Falls Efficacy Scale (FES)
時間枠：Baseline and after 6 weeks of intervention
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Fall-related self-efficacy assessed with the Falls Efficacy Scale; higher scores indicate greater confidence in performing activities without falling.
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Baseline and after 6 weeks of intervention
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Harris Hip Score (HHS)
時間枠：Baseline and after 6 weeks of intervention
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Hip function assessed with the Harris Hip Score, covering pain, function, deformity and range of motion, scored from 0 to 100, with higher scores indicating better hip function.
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Baseline and after 6 weeks of intervention
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Lower Extremity Functional Scale (LEFS)
時間枠：Baseline and after 6 weeks of intervention
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Lower-limb function assessed with the Lower Extremity Functional Scale, a 20-item self-report questionnaire scored from 0 to 80, with higher scores indicating better function.
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Baseline and after 6 weeks of intervention
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その他の成果指標
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Mean COP velocity, eyes open (cm/s)
時間枠：Baseline and after 6 weeks of intervention
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Mean velocity of centre-of-pressure displacement during quiet standing with eyes open, measured with a Nintendo Wii Balance Board and Balancia software; mean of three 30-second trials.
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Baseline and after 6 weeks of intervention
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COP root mean square distance, eyes closed (cm)
時間枠：Baseline and after 6 weeks of intervention
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Root-mean-square distance of the centre-of-pressure from its mean position during quiet standing with eyes closed, measured with a Nintendo Wii Balance Board and Balancia software; mean of three 30-second trials.
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Baseline and after 6 weeks of intervention
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COP 95% confidence ellipse area, eyes closed (cm^2)
時間枠：Baseline and after 6 weeks of intervention
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Area of the 95% confidence ellipse fitted to the centre-of-pressure distribution during quiet standing with eyes closed, measured with a Nintendo Wii Balance Board and Balancia software; mean of three 30-second trials.
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Baseline and after 6 weeks of intervention
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COP sway path length, eyes closed (cm)
時間枠：Baseline and after 6 weeks of intervention
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Total length of the centre-of-pressure trajectory during quiet standing with eyes closed, measured with a Nintendo Wii Balance Board and Balancia software; mean of three 30-second trials.
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Baseline and after 6 weeks of intervention
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COP mediolateral range, eyes closed (cm)
時間枠：Baseline and after 6 weeks of intervention
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Range of centre-of-pressure excursion in the mediolateral direction during quiet standing with eyes closed, measured with a Nintendo Wii Balance Board and Balancia software; mean of three 30-second trials.
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Baseline and after 6 weeks of intervention
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Mean COP velocity, eyes closed (cm/s)
時間枠：Baseline and after 6 weeks of intervention
|
Mean velocity of centre-of-pressure displacement during quiet standing with eyes closed, measured with a Nintendo Wii Balance Board and Balancia software; mean of three 30-second trials.
|
Baseline and after 6 weeks of intervention
|
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COP mediolateral range, eyes open (cm)
時間枠：Baseline and after 6 weeks of intervention
|
Range of centre-of-pressure excursion in the mediolateral direction during quiet standing with eyes open, measured with a Nintendo Wii Balance Board and Balancia software; mean of three 30-second trials.
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Baseline and after 6 weeks of intervention
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COP sway path length, eyes open (cm)
時間枠：Baseline and after 6 weeks of intervention
|
Total length of the centre-of-pressure trajectory during quiet standing with eyes open, measured with a Nintendo Wii Balance Board and Balancia software; mean of three 30-second trials.
|
Baseline and after 6 weeks of intervention
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COP 95% confidence ellipse area, eyes open (cm^2)
時間枠：Baseline and after 6 weeks of intervention
|
Area of the 95% confidence ellipse fitted to the centre-of-pressure distribution during quiet standing with eyes open, measured with a Nintendo Wii Balance Board and Balancia software; mean of three 30-second trials.
|
Baseline and after 6 weeks of intervention
|
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COP root mean square distance, eyes open (cm)
時間枠：Baseline and after 6 weeks of intervention
|
Root-mean-square distance of the centre-of-pressure from its mean position during quiet standing with eyes open, measured with a Nintendo Wii Balance Board and Balancia software; mean of three 30-second trials.
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Baseline and after 6 weeks of intervention
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協力者と研究者
スポンサー
捜査官
- 主任研究者：Deok Hoon Jun、Daegu University
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
その他の研究ID番号
- 1040621-202509-HR-074
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
IPD プランの説明
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
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