Improving balance with wobble board exercises in stroke patients: single-blind, randomized clinical trial

ABSTRACT

Background: A primary objective in stroke rehabilitation is to restore functional balance, in order to reduce falls.

Objectives: To identify the efficacy and safety of wobble board exercises when combined with conventional physiotherapy, in improving balance in hemiplegic patients following ischemic strokes.

Methods: A block-randomized, controlled, observer blinded, superiority trial was conducted on ambulatory hemiplegic patients following ischemic strokes of middle cerebral artery territory. Subjects in the control group received a conventional physiotherapy regime. Subjects in the intervention group received training on a wobble board combined with conventional physiotherapy. Main Outcome measures were the improvement of Four-Square Step Test (FSST) and the Berg Balance Scale (BBS), both of which assess functional balance at the end of 6 weeks.

Results: Thirty patients were randomly assigned for intervention (n = 15) and control (n = 15) groups. One patient dropped out from the study, leaving 29 eligible for the analysis. Intervention and control groups were comparable in sociodemographic characteristics and pre-test scores of balance. A repeated-measures MANOVA showed a significant difference in improvement of balance between the two study groups after 6 weeks [F(1,28) = 32.6,p = .000; Wilk’s lambda = .46]. The improvement of mean score of balance in interventional group was greater than in the control group [BBS:9.5 (intervention group),5.5 (control group); FSST:3.9 (intervention group),1.7 (control group)]. There were no injuries in both groups.

Conclusions: Wobble board exercises, when combined with the conventional physiotherapy, are safe and effective in restoring functional balance in patients with hemiplegia following ischemic strokes.

KEYWORDS:

• Stroke
• Berg Balance Scale
• Four Square Step Test
• rehabilitation
• physical therapy modalities
• balance board

Acknowledgments

The authors wish to thank the patients and their family members who participated in the study. We also thank the physiotherapy staff who were involved in the trial.

Contributors

PV and DJA made substantial contribution to the conception and study design. PV was the main contributor in data collection. PV, DJA, and YM were involved in refining the study design, statistical analysis and drafting the manuscript. All authors read and approved the final manuscript.

Data sharing statement

The data are available from the corresponding author upon reasonable request.

Ethics approval

Ethics Review Committee, Faculty of Medicine, University of Colombo, Sri Lanka (UCP/LE/13/287), and the National Hospital of Sri Lanka (AAJ/ETH/COM/2018).

Supplementary material

Supplemental data for this article can be accessed here.

Additional information

Funding

This research received no specific grants from any funding agency in the public, commercial or not-for-profit sector.