Effect of balance training by smartphone visual feedback on standing balance in patients with stroke: pilot study

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Published: Mar 16, 2017
Keywords:
stroke balance feedback smartphone accelerometer

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Noppol Pramodhyakul
Department of Physical Therapy, Faculty of Allied Health Sciences, Thammasat University
Onnicha Yangngam
Department of Physical Therapy, Faculty of Allied Health Sciences, Thammasat University
Natthayar Satjapibantham
Department of Physical Therapy, Faculty of Allied Health Sciences, Thammasat University
Puntarik Keawtep
Department of Physical Therapy, Faculty of Allied Health Sciences, Thammasat University

Abstract

Background: Standing balance training with visual feedback improved ability to control balance in patients with stroke. Nowadays, smartphone is begun to use as a part of standing balance training with visual feedback. Therefore, this study was interesting to construct application of smartphone in order to improve balance in patients with stroke.


Objectives: To investigate the preliminary efficiency effects of balance training by smartphone visual feedback for improving standing balance in patients with stroke.


Methods: 17 patients with chronic stroke were recruited in this study. The subjects received static and dynamic standing balance training by using a developed smartphone application for 32 minutes. Prior to and after the training periods, subjects were assessed their functional balance that consisted of symmetry ratio, weight shifting through the affected leg, timed up and go test (TUGT) and multi-directional reach test (MDRT). Dependent samples t-test and Willcoxon signed rank test were used to detect change after training.


Results: After training, subjects demonstrated significantly improved their ability to shift body weight through the affected leg, timed up and go test and multi-directional reach test (p < 0.05). However, there was no significant improvement of weight distribution ratio (p > 0.05).


Conclusion: The finding demonstrated effect of balance training by using a smartphone application to improve standing balance in patients with chronic stroke. Nevertheless, one session of training may not confirm benefit of standing balance training program using the developed smartphone application, a further study with a randomized control trials and long period of training are needed.

Article Details

How to Cite
1.
Pramodhyakul N, Yangngam O, Satjapibantham N, Keawtep P. Effect of balance training by smartphone visual feedback on standing balance in patients with stroke: pilot study. Thai J Phys Ther [internet]. 2017 Mar. 16 [cited 2026 Jan. 4];39(1):20-31. available from: https://he02.tci-thaijo.org/index.php/tjpt/article/view/112249
Issue
Vol. 39 No. 1 (2017): January-April 2017
Section
Research Articles

References

1. Bohannon RW, Larkin PA. Lower extremity weight bearing under various standing conditions in independently ambulatory patients with hemiparesis. Phys Ther 1985;65:1323-5.

2. de Haart M, Geurts AC, Dault MC, Nienhuis B, Duysens J. Restoration of weight-shifting capacity in patients with postacute stroke: a rehabilitation cohort study. Arch Phys Med Rehabil 2005;86:755-62.

3. Cheng PT, Liaw MY, Wong MK, Tang FT, Lee MY, Lin PS. The sit-to-stand movement in stroke patients and its correlation with falling. Arch Phys Med Rehabil 1998;79:1043-6.

4. Geurts AC, de Haart M, van Nes IJ, Duysens J. A review of standing balance recovery from stroke. Gait Posture 2005;22:267-81.

5. Hendrickson J, Patterson KK, Inness EL, McIlroy WE, Mansfield A. Relationship between asymmetry of quiet standing balance control and walking post-stroke. Gait Posture 2014;39:177-81.

6. Marigold DS, Eng JJ. The relationship of asymmetric weight-bearing with postural sway and visual reliance in stroke. Gait Posture 2006;23:249-55.

7. Winstein CJ. Knowledge of results and motor learning--implications for physical therapy. Phys Ther 1991;71:140-9.

8. Srivastava A, Taly AB, Gupta A, Kumar S, Murali T. Post-stroke balance training: role of force platform with visual feedback technique. J Neurol Sci 2009;287:89-93.

9. Walker C, Brouwer BJ, Culham EG. Use of visual feedback in retraining balance following acute stroke. Phys Ther 2000;80: 886-95.

10. Yatar GI, Yildirim SA. Wii Fit balance training or progressive balance training in patients with chronic stroke: a randomised controlled trial. J Phys Ther Sci 2015;27:1145-51.

11. Deutsch JE, Brettler A, Smith C, Welsh J, John R, Guarrera-Bowlby P, et al. Nintendo wii sports and wii fit game analysis, validation, and application to stroke rehabilitation. Top Stroke Rehabil 2011;18:701-19.

12. Shin DC, Song CH. Smartphone-Based Visual Feedback Trunk Control Training Using a Gyroscope and Mirroring Technology for Stroke Patients: Single-blinded, Randomized Clinical Trial of Efficacy and Feasibility. Am J Phys Med Rehabil 2016;95:319-29.

13. Amick R, Chaparro A, Patterson J, Jorgensen M. Test-retest reliability of the SWAY Balance Mobile Application. JMTM 2015;4:40-7.

14. Lee BC, Kim J, Chen S, Sienko KH. Cell phone based balance trainer. J Neuroeng Rehabil 2012;9:10.

15. Afzal MR, Oh MK, Choi HY, Yoon J. A novel balance training system using multimodal biofeedback. Biomed Eng Online 2016;15:42.

16. Wai AA, Duc PD, Syin C, Zhang H. iBEST: intelligent Balance assessment and Stability Training system using smartphone. Conf Proc IEEE Eng Med Biol Soc 2014;2014:3683-6.

17. Nashner L, McCollum G. The organization of human postural movements: a formal basis and experimental synthesis. Behav Brain Sci 1985;8:135-50.

18. McIlroy WE, Maki BE. Preferred placement of the feet during quiet stance: development of a standardized foot placement for balance testing. Clin Biomech (Bristol, Avon) 1997;12:66-70.

19. Pereira L, Botelho A, Martins E. Relationships between body symmetry during weight-bearing and functional reach among chronic hemiparetic patients. Rev Bras Fisioter 2010;14:259-6.

20. Katz-Leurer M, Fisher I, Neeb M, Schwartz I, Carmeli E. Reliability and validity of the modified functional reach test at the sub-acute stage post-stroke. Disabil Rehabil 2009; 31: 243-8.

21. Podsiadlo D, Richardson S. The timed "Up & Go": a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 1991;39: 142-8.

22. Nishiguchi S, Yamada M, Nagai K, Mori S, Kajiwara Y, Sonoda T, et al. Reliability and validity of gait analysis by android-based smartphone. Telemed J E Health 2012;18: 292-6.

23. Murphy TH, Corbett D. Plasticity during stroke recovery: from synapse to behaviour. Nat Rev Neurosci 2009;10:861-72.

24. Van Wieringen P. Ecological and dynamical approaches to rehabilitation: an epilogue. Hum Mov Sci 1996;15:315-23.

25. van Vliet PM, Wulf G. Extrinsic feedback for motor learning after stroke: what is the evidence? Disabil Rehabil 2006;28:831-40.

26. Yoo EY, Chung BI. The effect of visual feedback plus mental practice on symmetrical weight-bearing training in people with hemiparesis. Clin Rehabil 2006; 20: 388-97.

27. Verheyden G, Vereeck L, Truijen S, Troch M, Herregodts I, Lafosse C, et al. Trunk performance after stroke and the relationship with balance, gait and functional ability. Clin Rehabil 2006;20: 451-8.

28. Karthikbabu S, Rao B, Manikandan N, Solomon J, Chakrapani M, Nayak A. Role of trunk rehabilitation on trunk control, balance and gait in patients with chronic stroke: a pre-post design. Neurosci Med 2011;2:61-7.

29. Winstein CJ, Gardner ER, McNeal DR, Barto PS, Nicholson DE. Standing balance training: effect on balance and locomotion in hemiparetic adults. Arch Phys Med Rehabil 1989;70:755-62.

30. Pickerill ML, Harter RA. Validity and reliability of limits-of-stability testing: a comparison of 2 postural stability evaluation devices. J Athl Train 2011;46:600-6.