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Effects of Static and Dynamic Balance Training on Posture and Selected Gait Parameters in Survivors of Hemiparetic CVA

Preye Precious Oshoniyi, Cozens Bankole Aiyejusunle and Olajide Ayinla Olawale

Background: Survivors from hemiparetic cerebrovascular accidents (CVAs) frequently experience significant impairments of posture and walking, which are the basic requirements for any upright functional activity. This loss is characterized by musculoskeletal imbalance, loss of symmetry and reduction in the individual’s ability to control the center of gravity. Rehabilitation of postural and walking balance has been a subject of deep interest among clinicians and clinical researchers. Hence the investigators evaluated the effects of static and dynamic balance training on posture and selected gait parameters in individuals with hemiparesis due to CVA.

Objective: The aim of this study was to determine the effect of static and dynamic balance training on posture and selected gait parameters in survivors from CVA.

Materials and methods: Twenty-eight individuals with hemiparesis due to CVA, attending the physiotherapy clinics in Lagos University Teaching Hospital (LUTH), Idi-Araba, Lagos, Nigeria and the General Hospital, Gbagada, Lagos, Nigeria participated in this study. They were assigned randomly into two groups (Dynamic Balance and Static Balance training). Before and after intervention both groups had posture and gait assessed. The Postural Assessment Scale for Stroke (PASS), Bergs Balance Scale (BSS) and Timed Up and Go (TUG) were used to assess posture. Selected gait parameters (velocity, cadence and endurance) were assessed using 10-Meter walk test and 6-Minute Walk Test. Descriptive statistics of mean and standard deviation was used to analyze individual’s socio-demographic variables with nineteen males (67.90%) and nine females (32.10%), with mean age of the participants for static and dynamic balance groups as 58.29 ± 12.07 and 57.29 ± 14.85 years respectively. Independent t-test was used to determine whether the changes differed significantly between static balance and dynamic balance treatment groups. Paired t-test was used to determine whether the changes differed significantly within each groups. The Mann-Whitney U test and Wilcoxon signed rank test were used to compare test results between groups for ordinal data such as Berg Balance Scale scores and Postural Assessment Scale for Stroke. The level of significance was set at p<0.05.

Result: The results of this study showed the mean age of the participants, for static balance group was 58.29 ± 12.07 years while dynamic balance group was 57.29 ± 14.85 years respectively. Distribution of laterality was 53.60% for left hemispheric CVA and 46.40% for right hemispheric CVA respectively. There was no statistically significant difference in the variables between the static and dynamic balance training groups post-intervention with p-value (p>0.05). However, there was statistically significant difference within the groups pre- and post-intervention (p<0.05).

Conclusion: Both static balance and dynamic balance training were effective in improving posture and selected gait parameters (velocity, cadence and endurance) and neither of the two was superior to the other.

Limitations: The relatively small sample size and short duration of intervention might have affected the quality of data used in the analysis and compromised the generalizability of the findings.

Implication for further studies: Further studies using a balance training programme with more diverse training components would help to identify a broader rehabilitation strategy for clinical use. Longer periods of intervention will be needed to determine the effects of static and dynamic balance training on posture and selected gait parameters in individuals with hemiparetic cerebrovascular accidents. Further study should be conducted to determine the difference between early and late post- CVA survivors in balance training.