Best Core Stabilization for Anticipatory Postural Adjustment and Falls in Hemiparetic Stroke

Nam G. Lee, Joshua (Sung) H. You, Chung H. Yi, Hye S. Jeon, Bong S. Choi, Dong R. Lee, Jae M. Park, Tae H. Lee, In T. Ryu, Hyun S. Yoon

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)2168-2174
Number of pages7
JournalArchives of Physical Medicine and Rehabilitation
Volume99
Issue number11
DOIs
Publication statusPublished - 2018 Nov

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Social Adjustment
Stroke
Fear
Rehabilitation Centers
Electromyography
Randomized Controlled Trials
Outcome Assessment (Health Care)

All Science Journal Classification (ASJC) codes

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

Cite this

Lee, Nam G. ; You, Joshua (Sung) H. ; Yi, Chung H. ; Jeon, Hye S. ; Choi, Bong S. ; Lee, Dong R. ; Park, Jae M. ; Lee, Tae H. ; Ryu, In T. ; Yoon, Hyun S. / Best Core Stabilization for Anticipatory Postural Adjustment and Falls in Hemiparetic Stroke. In: Archives of Physical Medicine and Rehabilitation. 2018 ; Vol. 99, No. 11. pp. 2168-2174.
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title = "Best Core Stabilization for Anticipatory Postural Adjustment and Falls in Hemiparetic Stroke",
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.",
author = "Lee, {Nam G.} and You, {Joshua (Sung) H.} and Yi, {Chung H.} and Jeon, {Hye S.} and Choi, {Bong S.} and Lee, {Dong R.} and Park, {Jae M.} and Lee, {Tae H.} and Ryu, {In T.} and Yoon, {Hyun S.}",
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Lee, NG, You, JSH, Yi, CH, Jeon, HS, Choi, BS, Lee, DR, Park, JM, Lee, TH, Ryu, IT & Yoon, HS 2018, 'Best Core Stabilization for Anticipatory Postural Adjustment and Falls in Hemiparetic Stroke', Archives of Physical Medicine and Rehabilitation, vol. 99, no. 11, pp. 2168-2174. https://doi.org/10.1016/j.apmr.2018.01.027

Best Core Stabilization for Anticipatory Postural Adjustment and Falls in Hemiparetic Stroke. / Lee, Nam G.; You, Joshua (Sung) H.; Yi, Chung H.; Jeon, Hye S.; Choi, Bong S.; Lee, Dong R.; Park, Jae M.; Lee, Tae H.; Ryu, In T.; Yoon, Hyun S.

In: Archives of Physical Medicine and Rehabilitation, Vol. 99, No. 11, 11.2018, p. 2168-2174.

Research output: Contribution to journalArticle

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T1 - Best Core Stabilization for Anticipatory Postural Adjustment and Falls in Hemiparetic Stroke

AU - Lee, Nam G.

AU - You, Joshua (Sung) H.

AU - Yi, Chung H.

AU - Jeon, Hye S.

AU - Choi, Bong S.

AU - Lee, Dong R.

AU - Park, Jae M.

AU - Lee, Tae H.

AU - Ryu, In T.

AU - Yoon, Hyun S.

PY - 2018/11

Y1 - 2018/11

N2 - 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.

AB - 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.

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