Department of Rehabilitation Center, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan.
Department of Physical Therapy, Faculty of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan.
Physiother Theory Pract. 2023 Jul 3;39(7):1536-1544. doi: 10.1080/09593985.2022.2037031. Epub 2022 Feb 12.
Effects of therapeutic interventions backward disequilibrium following stroke are scarcely reported.
To clarify the effects of standing and sit-to-stand/stand-to-sit training aimed at postural deviation in the anterior direction for backward disequilibrium and posterior deviation of subjective postural vertical.
The participant presented with backward disequilibrium and pontine hemorrhage-associated sensory impairment of the extremities. Physical therapy included standing and sit-to-stand/stand-to-sit training, expected to bias the center of gravity in the anterior direction. We measured subjective postural vertical on the sagittal plane to assess vertical perception. Backward disequilibrium was evaluated using the Backward Disequilibrium Scale. Walking ability was assessed using the functional ambulation category. These outcomes were assessed before and at 3 days post-intervention.
Neurological findings were unchanged between pre- and post-intervention. Post-intervention, in subjective postural vertical, tilt direction modulated from -6.1° to 1.3°, variability changed from 5.9° to 3.3°, and Backward Disequilibrium Scale score improved from 7 to 1 point. Functional ambulation category changed from 2 to 3.
Standing and sit-to-stand/stand-to-sit training aimed at shifting center of gravity and subjective postural vertical in the anterior direction appeared to improve backward disequilibrium and correct tilt to the anterior direction for this participant. Long-term effects of the training for this participant were not determined.
治疗干预对脑卒中后平衡反向障碍的影响鲜有报道。
阐明旨在使身体重心向前倾斜的站立和坐站/站坐训练对平衡反向障碍和主观垂直姿势后倾的影响。
患者表现为平衡反向障碍和与桥脑出血相关的四肢感觉障碍。物理治疗包括站立和坐站/站坐训练,旨在使身体重心向前倾斜。我们测量矢状面上的主观垂直姿势,以评估垂直感知。使用平衡反向障碍量表评估平衡反向障碍。使用功能性步行分类评估步行能力。这些结果在干预前和干预后 3 天进行评估。
干预前后神经学发现无变化。干预后,主观垂直姿势的倾斜方向从-6.1°变为 1.3°,变异性从 5.9°变为 3.3°,平衡反向障碍量表评分从 7 分变为 1 分。功能性步行分类从 2 级变为 3 级。
旨在使身体重心和主观垂直姿势向前倾斜的站立和坐站/站坐训练似乎改善了该患者的平衡反向障碍,并纠正了向前倾斜。该患者训练的长期效果尚未确定。