Immediate effects of standing unstable board intervention on the non-paralyzed leg on sitting balance in severe hemiplegia: a randomized controlled trial

ABSTRACT

Background

Unstable board intervention for patients with stroke improves sitting balance and trunk function. However, because patients with severe stroke are at high risk of falling, it is mostly adapted in mild cases.

Objective

We aimed to examine the effect of standing unstable board intervention for the non-paralyzed lower limbs on sitting balance in patients with hemiplegia.

Methods

The participants were 42 patients with stroke who were randomly assigned to a control or intervention group. In the intervention group, the non-paralyzed leg was placed on an unstable board, and the patient wore a knee-ankle-foot orthosis on the paralyzed side and practiced standing and weight-bearing exercises on the unstable board for 3 days. The outcomes were the angle of righting reaction of the neck, trunk, and both lower legs and the movement distance of the center of pressure of the righting reaction from lateral tilted sitting.

Results

In the intervention group, the righting reaction angle of the trunk to the paralyzed and non-paralyzed sides and the movement distance of the center of pressure were increased significantly after the unstable board intervention.

Conclusion

The standing unstable board intervention for the non-paralyzed lower limb increased sensory input to the non-paralyzed side of the trunk weight-bearing on the lower limb of the paralyzed side. The increase in the righting reaction angle and the movement distance of the center of pressure contributed to improved sitting balance.

KEYWORDS:

• Unstable board
• trunk function
• balance
• righting reaction
• non-paralyzed leg
• stroke

Acknowledgments

The authors would like to thank the patients and therapists who cooperated in this study.

Disclosure statement

The authors report there are no competing interests to declare.

Author contributions

K. Nagai, K. Amimoto, and Y. Ikeada contributed to the research concept, idea, and design of this study, interpretation of results, and drafted/revised the manuscript. T. Ito, H. Nariya, and R. Ueno collected the date. K. Nagai, T. Ito, and R. Ueno provided the participants. K. Amimoto provided equipment. All authors have read and approved the final manuscript.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/10749357.2024.2302730

Additional information

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.