Abstract
Objectives
To compare the effects of conventional core stabilization and dynamic neuromuscular
stabilization (DNS) on anticipatory postural adjustment (APA) time, balance performance,
and fear of falls in chronic hemiparetic stroke.
Design
Two-group randomized controlled trial with pretest-posttest design.
Setting
Hospital rehabilitation center.
Participants
Adults with chronic hemiparetic stroke (N=28).
Interventions
Participants were randomly divided into either conventional core stabilization (n=14)
or DNS (n=14) groups. Both groups received a total of 20 sessions of conventional
core stabilization or DNS training for 30 minutes per session 5 times a week during
the 4-week period.
Main Outcome Measures
Electromyography was used to measure the APA time for bilateral external oblique (EO),
transverse abdominis (TrA)/internal oblique (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.
Results
Baseline APA times were delayed and fear of falling was moderately high in both the
conventional core stabilization and DNS groups. After the interventions, the APA times
for EO, TrA/IO, and ES were shorter in the DNS group than in the conventional core
stabilization group (P<.008). The BBS and TIS scores (P<.008) and the FES score (P<.003) were improved compared with baseline in both groups, but FES remained stable
through the 2-year follow-up period only in the DNS group (P<.003).
Conclusions
This 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.
Keywords
List of abbreviations:
AD (anterior deltoid), APA (anticipatory postural adjustment), BBS (Berg Balance Scale), DNS (dynamic neuromuscular stabilization), EO (external oblique), ES (erector spinae), FES (Falls Efficacy Scale), IAP (intra-abdominal pressure), IO (internal oblique), MANOVA (multivariate analysis of variance), RA (rectus abdominis), TIS (Trunk Impairment Scale), TrA (transverse abdominis)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: February 21, 2018
Footnotes
Supported by a Brain Korea 21 PLUS Project Grant (grant no. 2016-51-0009) from the Korean Research Foundation.
Clinical Trial Registration No.: KCT0002126 (Clinical Research Information Service, Republic of Korea).
Disclosures: none.
Identification
Copyright
© 2018 by the American Congress of Rehabilitation Medicine
