Effects of Weight-Shift Training on Balance Control and Weight Distribution in Chronic Stroke: A Pilot Study

Abstract

Purpose: The objective was to evaluate the effect of weight-shift training on functional balance, weight distribution, and postural control measures during standing and forward reach tasks in subjects with chronic stroke. Methods: Nine male subjects (mean age, 66 years; range, 60–75 years) who experienced a stroke 3 to 13 years previously participated in a 4-week training program consisting of static and dynamic balance exercises with visual feedback and gait training with wall support. Balance control was assessed before and after the intervention with clinical measures (Berg Balance Scale) and with a pressure platform for registering the center of pressure (CoP) during quiet stance (weight distribution, CoP sway area, and velocity), and during a forward reach task at shoulder and knee levels. Intervention effects were evaluated with the Wilcoxon matched-pairs test. Results: After training, the group improved their Berg Balance Scale median score from 42 (range, 14–54) to 46 (20–55) (P = .01), CoP sway area [10.6 (5.0–31.4) to 3.0 (1.8–10.8) cm²; P = .01], and mean velocity [3.5 (2.4–8.0) to 1.7 (0.9–3.7) mm/s; P = .01] during quiet standing but not weight distribution (P = .59). During the forward reach tasks, most of the postural control measures such as movement time, CoP displacement, and CoP velocity were significantly (P < .05) improved after the training period for both the affected and nonaffected sides as compared to before the training period. Conclusion: A weight-shift training program improved balance control but not weight distribution in a group of chronic stroke subjects. Larger, randomized, and controlled studies are necessary.

Keywords:

• center of pressure
• exercise
• gait
• postural control
• postural stability
• reach
• visual feedback