School of Physical & Health Education, Nipissing University, 100 College Dr, Box 5002, North Bay, Ontario, Canada P1B 8L7.
Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada.
Phys Ther. 2018 Jul 1;98(7):585-594. doi: 10.1093/ptj/pzy039.
Reactive balance control is often impaired poststroke. Studies addressing responses to laterally directed perturbations in this population are currently lacking. Given that stroke-related motor impairments are unilateral, a better understanding of reactive balance responses to these types of perturbations is critical.
This study aimed to quantify differences in reactive balance control in response to laterally directed perturbations in people with chronic stroke, based on perturbation direction and ability to step with either limb.
This study used a cross-sectional design.
Participants with chronic stroke (N = 19) were divided into groups representing their ability to step with either limb, based on performance on a reactive balance task in a baseline assessment. The preferred stepping limb was also identified during this assessment. Each participant then underwent a series of laterally directed perturbations on a motion platform. Behavioral measures were compared between platform direction and group.
Trials with extra steps, step initiation with the preferred limb, and crossover steps were more common with platform motion toward the preferred limb compared to the nonpreferred limb; the latter effect was only observed for participants with an impaired ability to step with either limb. Side-step sequences were more common in those able to step with either limb when the platform moved toward the preferred limb.
The participant sample was likely higher functioning than the general population of stroke survivors due to equipment constraints. Additionally, participants may have developed strategies to use the platform's motion characteristics to aid with balance recovery.
These findings provide an indication of responses to laterally directed perturbations in people with chronic stroke and may help inform strategies for improving reactive balance control during stroke rehabilitation.
脑卒中后常出现反应性平衡控制障碍。目前缺乏针对该人群横向定向扰动反应的研究。鉴于与中风相关的运动障碍是单侧的，因此更好地了解对这些类型的扰动的反应性平衡反应至关重要。
本研究旨在根据横向定向扰动的方向和用任何一肢进行跨步的能力，量化慢性脑卒中患者对侧向定向扰动的反应性平衡控制的差异。
本研究采用了横断面设计。
根据基线评估中反应性平衡任务的表现，将慢性脑卒中患者（N=19）分为两组，分别代表他们用任何一肢进行跨步的能力。在该评估中还确定了首选跨步的肢体。然后，每位参与者在运动平台上接受一系列横向定向的扰动。在平台方向和组之间比较行为测量结果。
与平台向非优势肢体移动相比，向优势肢体移动时，额外跨步、首选肢体的起始跨步和交叉跨步更为常见；只有那些不能用任何一肢进行跨步的参与者观察到了后一种效应。当平台向优势肢体移动时，能够用任何一肢进行跨步的参与者更常见的是侧向跨步序列。
由于设备限制，参与者样本的功能可能高于一般脑卒中幸存者群体。此外，参与者可能已经开发出利用平台运动特征来帮助平衡恢复的策略。
这些发现为慢性脑卒中患者对横向定向扰动的反应提供了指示，并可能有助于为脑卒中康复期间改善反应性平衡控制提供策略。
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