Effects of Eye Movement with PNF Neck Movement on Trunk Stability and Standing Position Balance Ability of Chronic Stroke Patients

Abstract

Objective We investigated the effects of eye movement with PNF neck movement on trunk stability and standing position balance ability of chronic stroke patients.

Methods A total of 30 patients were randomly divided into EMPN group and CON group. EMPN group was performed 60 min three times a week for 8 weeks in eye movement and PNF neck movement. CON group performed conservative treatment for 60min. The trunk stability was measured by the Trunk impairment scale (TIS) and the standing balance ability test was performed by Center of Pressure (COP), Limited of Stability (LOS), Berg Balance Scale (BBS) and Functional Reach Test (FRT).

Results There was a significant difference (P<0.05) between before and after training in both groups, and EMPN group showed significant improvement in both groups.

Conclusions In this study, we confirmed oculogyration and neck movement by PNF have positive effects on the trunk stability and the standing position balance ability of chronic stroke patients.

Zusammenfassung

Ziel Wir untersuchten die Wirkung von Augenbewegungen mit PNF (propriozeptiver neuromuskulärer Fazilitation) Nackenübungen auf Rumpfstabilität und Gleichgewichtsfähigkeit im Stand bei chronischen Schlaganfallpatienten.

Methoden Insgesamt 30 Patienten wurden zufällig in eine EMPN-Gruppe (Augenbewegungen und PNF-Übungen) und eine Kontrollgruppe eingeteilt. In der EMPN-Gruppe wurden 8 Wochen lang dreimal pro Woche jeweils 60 min lang Augenbewegungen und PNF Nackenübungen durchgeführt. In der Kontrollgruppe wurden entsprechend 60 min lang konservative Behandlungsmethoden durchgeführt. Die Rumpfstabilität wurde mittels Trunk impairment scale (TIS) getestet, die Bewertung der Gleichgewichtsfähigkeit im Stand wurde mit Center of Pressure (COP), Limited of Stability (LOS), Berg-Balance-Skala (BBS) and Functional Reach Test (FRT) durchgeführt.

Ergebnisse In beiden Gruppen zeigte sich ein signifikanter Unterschied (P<0,05) zwischen dem Zustand vor und nach dem Training, und die EMPN-Gruppe zeigte eine signifikante Verbeserung in beiden Gruppen.

Diskussion In dieser Studie konnten wir bestätigen, dass kreisende Augenbewegungen und PNF Nackenübungen eine positive Wirkung auf die Rumpfstabilität und die Gleichgewichtsfähigkeit im Stand bei chronischen Schlaganfallpatienten haben.

Key words

hemiplegie - physiotherapie - rehabilitation - stroke

Schlüsselwörter

Hemiplegie - Medizinische Rehabilitation - Therapie

Publikationsverlauf

Eingereicht: 04. Juni 2019

Angenommen: 17. September 2019

Artikel online veröffentlicht:
28. Oktober 2019

• References

• 1 WHO World Health Organization hompage. http://www.who.int/topics/cerebrovascular_accident/en/ 2018
• 2 National Stroke Association Understand Stroke. What is stroke 2017
• 3 Carter AR, Connor LT, Dromerick AW. Rehabilitation after stroke: Current state of the science. Current Neurology and Neuroscience Report 2010; 10: 158-166
• 4 Carr JH, Shepherd RB. Stroke Rehabilitation: Guidelines for Exercise and Training to Optimize Motor Skill. Butterworth Heinemann; Oxford: 426 2003
• 5 Park SE, Lee MJ, Yoon BC. et al. Comparison of underwater and overground treadmill walking exercise to improve gait and physical function in people after stroke. J Int Acad Phys Ther Res 2010; 1: 120-125
• 6 Brown LA, Sleik RJ, Winder TR. Attentional demands for static postural control after stroke. Arch Phys Med Rehabil 2002; 83: 1732-1735
• 7 Belgen B, Beninato M, Sullivan PE. et al. 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: 554-561
• 8 Walker C, Brouwer BJ, Culham EG. Use of visual feedback in retraining balance following acute stroke. Phys Ther 2000; 80: 886-895
• 9 Bonan IV, Yelnik AP, Colle FM. et al. 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: 274-278
• 10 Smania N, Picelli A, Gandolfi M. et al. Rehabilitation of sensorimotor integration deficits in balance impairment of patients with stroke hemiparesis: A before/ after pilot study. Neurol Sci. 2008; 29: 313-319
• 11 Kim Dong-Hoon, Kim Kyung-Hun, Lee Suk-Min. Effects of visual restriction and unstable base dual-task training on balance and concentration ability in persons with stroke. Phys Ther Rehabil Sci 2016; 5: 193-197
• 12 Son YL, Kim JW. The effects of mirror neuron system-based self-observation training on lower limb muscle activity and dynamic balance in patients with chronic stroke. J Phys Ther Sci 2018; Oct 30: 1241-1244
• 13 Shumway-cook A, Woolacott MH. Motor control: Translating Research into Clinical Practice. 3^rd edition Philadelphia, USA: Lippincott Williams & Wilkins; 2006
• 14 Grace Gaerlan M, Alpert Pt, Cross C. et al. Postural balance in young adults: The role of visual, vestibular and somatosensory systems. J Am Acad Nurse pract 2012; 24: 375-381
• 15 Malhotra P, Coulthard E, Husain M. Hemispatial neglect, balance and eye-movement control. Curr Opin Neurol 2006; 19: 14-20
• 16 Kerkhoff G, Keller I, Ritter V. et al. Reperirive optokinetic stimulation induces lasting recovery from visual neglect. Restor Neurol Neurosci 2006; 24: 357-369
• 17 Karnath HO. Optokinetic stimulation influences the disturbed perception of body orientation in spatial neglect. J Neurol Neurosurg Psychiatry 1996; 60: 217-220
• 18 Keller I, Lefin-Rank G, Losch J. et al. Combination of pursuit eye movement training with prism adaptation and arm movements in neglect therapy: A pilot study. Neurorehabilitation and Neural Repair 2009; 23: 58-66
• 19 Verheyden G, Nieuwboer A, Mertin JW. et al. The Trunk Impairment Scale: A new tool to measure motor impairment of the trunk after stroke. Clin Rehabil 2004; 18: 326-334
• 20 Latash ML, Ferreira SS, Wieczorek SA. et al. Movement sway: Changes in postural sway during voluntary shifts of the center of pressure. Exp Brain Res 2003; 150: 314-324
• 21 Berg K, Wood-Dauphinee S, Williams JI. et al. “Measuring balance in the elderly: Preliminary development of an instrument.”. Physiother Can 1989; 41: 304-311
• 22 Bogle Thorbahn LD, Newton RA. Use of the Berg Balance test to predict falls in elderly persons. Phys Ther 1996; 76: 576-585
• 23 Duncan PW, Weiner DK, Chandler J. et al. Functional reach: A new clinical measure of balance. J Gerontol 1990; 45: M192-M197
• 24 Park GH, Kim YJ, Cho HM. et al. A study on the change of visual activity and refractive angle through eye exercise. Korean J Phy Edu 1991; 30: 1117-1127
• 25 Adler SS, Beckers D, Buck M. et al. PNF in Practice. Springer; 2000
• 26 Roh H. Effect of visual perceptual disturbance on gait and balance. J Phys Ther Sci 2015; 27: 3109-3111
• 27 Bente E, Bassoe G. The Bobath concept in Adult Neurology. Thieme edical Publishers; 2008
• 28 Anabella G, Silva. Mark I. et al. Does forward head posture affect postural control in human healthy volunteers?. Gait & Posture 2013; 38: 352-353
• 29 Anders C, Brose G. Activation characteristics of trunk muscles during whole body tilt with unsupported trunk. European Journal of Applied Physiology 2005; 11: 195-20
• 30 Karberg M. Theneck and human balance Dissertation, Lund. University Hospital 1995
• 31 Koo BO. The effect of eye movement on balance restoration of adult hemiplegic patient. Daegu University Rehabilitaion Science Graduate School 2002
• 32 Lee BH, Lee HR, Kim KM. et al. Effects of spiral taping applied to the neck and ankle on the body balance index. J Phys Ther Sci 2015; 27: 79-82
• 33 Nolte J. The human brain: an introduction to its functional anatomy. Mosby: Elsevier; 2009
• 34 Kim DH, Kim KH, Lee SM. The effects of virtual reality training with upper limb sensory exercise stimulation on the AROM of upper limb joints, function, and concentration in chronic stroke patients. Phys Med Rehab Kuror 2019; 29: 1-9