Effects Of Dynamic Instability Training On Postural Control In Stroke Patients

Objective Decreased posture control,impaired balance function and high incidence of falls are common complications of stroke.This affects the quality of life,and patients often reduce activity in order to avoid falls,leading to further dysfunction.This study aimed to observe the effect of dynamic motor instability training on postural control and balance function in stroke.Methods In this study,we selected stroke patients with balance dysfunction who received rehabilitation treatment in rehabilitation medical center of Jiaxing Second Hospital from May 2021 to August 2022,40 inpatients were randomly divided into observation group and control group by random number table method,20 people in each group.All patients were given conventional drug therapy and conventional rehabilitation.The observation group was given 20min of dynamic motor instability training on this basis,and the control group was added to 20min conventional rehabilitation,5 times a week for 8 consecutive weeks.Before the intervention and 8 weeks after the intervention,surface electromyography(sEMG)was used to detect the anticipatory postural adjustments(APAs)’ early activation time and activation intensity(iEMGAPAs)of bilateral rectus femoris(RF),biceps femoris(BF),and erector spinae(ES),and the compensatory postural adjustment(CPAs)’s activation intensity(iEMGCPAs)of above muscles to evaluate the postural control ability of patients;Berg balance scale(BBS),lower extremity Fugl-Meyer assessment(FMA),and GAIT-watch gait analysis system were used to evaluate the balance function,motor function and walking ability,and the results of the two groups were analyzed to compare whether there were differences.Results There was no significant difference in the above indexes between the two groups before intervention.Afterward the early activation time of RF and BF on the hemiplegic side,the iEMGAPAs of BF and ES on the non-hemiplegic side,the iEMGAPAs of RF and ES on the hemiplegic side were significantly better in the observation group than in the pre-intervention and control group.And the results of BBS,lower extremity FMA,stride length and pace showed significant improvement in both groups,and the observation group showed significantly greater improvement than the control group.Conclusion(1)Compared with conventional rehabilitation training alone,it combined with dynamic motor instability training can further improve the balance function and the ability of anticipatory postural adjustments of stroke patients,and improve the anti-disturbance ability.(2)Stroke patients with dynamic motor instability training had better motor function,stride length,pace and disturbance response of hemiplegic lower extremity than patients with conventional rehabilitation training,which has important significance to reduce the risk of falling.(3)Compared with BBS,lower extremity FMA and gait analysis,sEMG can directly better reflect the actual balance function and anti-disturbance ability of stroke patients with hemiplegia.