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BACKGROUND: The balance and postural control of humans is related to the coordination of dynamic perception and movement. Multiple senses, such as vision, vestibular sense, proprioception, and/or a single sensory disorder, would lead to its integration disorder and induce imbalance and abnormal gait. OBJECTIVE: The present study aimed to determine the effects of dynamic motion instability system training (DMIST) on the balance and motor function of hemiplegic patients after stroke. METHODS: In this assessor-blinded, randomized controlled trial, the participants allocated to the intervention group (n = 20) received 30 minutes of conventional treatment and 20 minutes of DMIST training. Participants randomized to the control group (n = 20) received the same dose of conventional therapy and 20 minutes of general balance training. Rehabilitation was performed 5 times per week for 8 weeks. The primary outcome was the Fugl-Meyer assessment for the lower extremity (FMA-LE), and the secondary outcomes were the Berg balance scale (BBS) and gait function. Data were collected at baseline and immediately after the intervention. RESULTS: After 8 weeks (t1), both groups showed significant post-intervention improvements in BBS, FMA-LE, gait speed and stride length (P < 0.05); there were significant positive correlations between the increase in FMA-LE and gait speed and stride length. Compared with the control group, the DMIST group showed significant post-intervention improvements in FMA-LE, gait speed and stride length (P < 0.05). However, no significant differences between the groups were found over time with respect to BBS (P > 0.05). The experiences of patients with DMIST were positive, and no serious adverse events were related to the interventions. CONCLUSION: Supervised DMIST could be highly effective in treating lower-limb motor function in patients with stroke. Frequent (weekly) and medium-term (8 weeks) dynamic motion instability-guided interventions might be highly effective in enhancing motor function, and subsequently improving gait in stroke patients. [ABSTRACT FROM AUTHOR]

This study aims to explore the effects of aquatic strength training on the postural balance and walking function of stroke patients. A total of 56 chronic stroke patients more than 6 months post-stroke with walking and balance impairments were included in this study. After baseline evaluations, patients were randomly assigned to either the experiment group (n = 29) or control group (n = 27). Patients in the control group underwent conventional hydrotherapy, whereas patients in the experiment group received conventional hydrotherapy combined with aquatic lower extremity strength training. After six weeks of rehabilitation, all patients were evaluated by a blinded assessor, and the functional assessments including: Berg Balance Scale (BBS); Timed Up and Go Test (TUG and mTUG); 2 Minute Walk Test (2MWMT); and Gait analysis. There were no significant differences (P >.05) between the two groups in all evaluation indexes before rehabilitation. Six weeks after treatments, the results from both groups showed significant improvements compared with those in the baseline evaluations (P <.05). Notably, compared with the control group, BBS, TUG and mTUG, 2MWMT, and Gait analysis including stride length in the non-hemiplegic side, stride length, as well as walking speed and stride frequency in the hemiplegic side in experiment group were markedly improved (P <.05) Aquatic strength training can improve postural balance and lower extremity motor functions in chronic stroke patients. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study is to quantify the effects of virtual reality–based exercise on balance after stroke. Design: The PubMed, Embase, Cochrane Library, Cumulative Index of Nursing and Allied Health Literature, and Web of Science databases were searched until December 31, 2021. Independent investigators abstracted data, assessed the quality of the evidence, and rated the certainty of the evidence. The intergroup differences were determined by calculating mean difference and 95% confidence interval by RevMan 5.3 software. Results: Fourteen randomized controlled trials involving 423 stroke patients were included. Patients who received virtual reality–based exercise illustrated marked improvements in the Berg Balance Scale (mean difference, 1.35; 95% confidence interval, 0.58 to 1.86; P < 0.00001; I 2 = 44%), Timed Up and Go test (mean difference, −0.81; 95% confidence interval, −1.18 to −0.44; P < 0.0001; I 2 = 0%), Functional Reach Test (mean difference, 3.06; 95% confidence interval, 1.31–4.80; P = 0.0006; I 2 = 0%), 10-Meters Walking Test (mean difference, −1.53; 95% confidence interval, −2.92 to −0.13; P = 0.03; I 2 = 33%), and Modified Barthel Index (mean difference, 5.26; 95% confidence interval, 1.70 to 8.82; P = 0.004; I 2 = 0%) compared with the control group. Conclusions: Existing low-evidence analyses showed that virtual reality–based exercise could effectively and safely improve balance in chronic stroke. Longer-term virtual reality–based exercise was more effective on functional ability of stroke. [ABSTRACT FROM AUTHOR]