None listed
Conditions
Brief summary
Background and purpose: Core muscles are a key part of our body and play an important role in providing stability for balance and gait. Individuals with stroke often suffer from balance and gait problems even in the chronic stage. Core muscles strengthening exercise has been reported to be beneficial for balance and trunk control. However, few studies investigated core muscles strengthening for the gait symmetry, quantitative dynamic balance performance in chronic stroke patients. Thus, the aim of this study is to investigate the effects of core muscles strengthening in chronic stroke patients for balance performance and gait symmetry. Methods: This is a single-blinded, randomized controlled trial study. Forty subjects meeting the criteria will be recruited and be randomized to the core muscle strengthening training group or conventional training group. The training for each group will be 30 minutes each time, twice a week for 6 weeks. Primary outcomes include balance performance as indicated by limit of stability, directional control and maximum excursion, measured by Balance Master and gait performance as indicated by gait speed, temporal and spatial symmetry measured by GAITRite system. Secondary outcome include trunk muscle strength measured by dynamometer. All outcomes will be assessed before (pretest) and after (post-test) the 6-week training program.
Interventions
Participants will receive 6-weeks core muscle strengthening. Core muscle strengthening contains bracing exercise that is to activate the deeper core muscles particularly which is important components in core muscles strengthening exercises. Bracing exercise are performed by pushing the abdomen out externally. Participants should hold the breath and "brace" abdominal muscles. About the trial, bracing exercise includes bracing with heel slides, bracing with leg lifts, bracing with bridging, quadruped arm lifts with bracing, and quadruped leg lifts with bracing. Participants need to learn how to contract local muscle accurately in those different bracing exercise. If deeper core muscles have been activated, core muscles strengthening can be conducted continually. Exercises have some steps, as follow: (Gymnic Physio Ball will be used in the exercises) 1. Warm-up: participants step on Swiss ball in sitting position for 1 minutes 2. Bridge exercise: hold position for 5 seconds. Perform 10 repetitions for 1 set 3. Bridge exercise with legs crossed, Hold this position for 5 seconds. Perform 10 repetitions for 1 set 4. Bridge exercise with one leg. Hold this position for 3 seconds. Perform 10 repetitions for 1 sets 5. Curl-ups with straight reaching. Hold this position for 3 seconds. Perform 10 repetitions for 1 set 6. Curl-ups with diagonal reaching. Hold this position for 3 seconds. Perform 10 repetitions for 1 set 7. Patient sit on Swiss ball and combine with pelvis anterior tilt. Hold this position for 5 seconds. Perform 15 repetitions for 1 set. 8. Patient sit on Swiss ball and combine with pelvis posterior tilt. Hold this position for 5 seconds. Perform 15 repetitions for 1 set. 9. Supine on Swiss ball with feet on the floor. Hold this position for 10 seconds. Perform 10 repetitions for 1 sets. 10.Patient prone on Swiss ball and combine with trunk extension. Hold this position for 5 seconds. Perform 10 repetitions for 1 sets 11. Cool-down: patient sit on Swiss ball and step on the ball for 1 minutes Sessions will be delivered by a certificated physiotherapist. Training frequency will be core muscles strengthening for 20 min and treadmill walking training with comfortable speed for 10 min per session, 2 sessions per week for a total of 6 weeks. It will be individual one-on-one sessions taking place in Balance training center in Yang Ming university All participants will be supervised by certified physiotherapist in the exercises program. If participants don't know how to conduct, physiotherapist will use manual contact to teach them. And, demonstrate the repeated exercise.
Sponsors
Study design
Eligibility
Inclusion criteria
Stroke >6 months Trunk impairment scale < 23 Can walk > 15 meters independently with or without assistive device Mini-mental state examination (MMSE) > 24 Brunnstrome stage > IV ( Lower extremity )
Exclusion criteria
Have any musculoskeletal problem Visual, and language problems