The Effectiveness Of Trunk And Pelvic Stability On Postural Control In Post-stroke Hemiparetic Subjects

ObjectivesThe purpose of this study is to investigate the characteristics of postural control,trunk control and pelvic stability in post-stroke patients,and to examine the relationship between postural control and trunk control and hip muscular strength in people post-stroke.MethodsTwenty-one post-stroke patients were sequentially enrolled into observation group and 16 age-matched healthy subjects formed the control group.A computerized posturography system was used for the centre of pressure path(CoP path),medio-lateral CoP path(ML path),anterior-posterior CoP path(AP path),sway area and the maximum excursion values in the anterior,posterior,and medio-lateral directions.Trunk Impairment Scale 2.0(TIS 2.0)were administered to the subjects.In addition,a hand-held dynamometer was used to assess hip muscular strength during flexion,extension,abduction and adduction.The posturographic parameters,TIS 2.0 and hip muscular strength of the two groups were compared.Pearson correlation analysis was used to investigate the relationship between the posturographic parameters and TIS 2.0 and hip muscular strength in the observation group.ResultsA significant difference was observed between the two groups in the posturographic parameters(p=0.001-0.022),TIS 2.0(p<0.001),hip muscular strength(the differences between the right hip muscles of control group and the affected side hip muscles of observation group:hip flexors p<0.001,hip extensors p<0.001,hip abductors p<0.001,hip adductors p<0.001;the differences between the right hip muscles of control group and the unaffected side hip muscles of observation group:hip extensors p=0.011,hip abductors p=0.017,hip adductors p=0.048).Posturographic parameters were not significantly associated with TIS 2.0.TIS 2.0 was significantly associated with bilateral hip flexors,bilateral hip extensors,hip abductors on the affected side(p=0.005-0.040).In the eyes open condition,CoP Path,AP Path,sway area were significantly associated with hip muscular strength(p=0.003-0.039).In the eyes closed condition,only AP path was significantly associated with hip flexors on the affected side(p=0.009).The maximum excursion value in the affect side was significantly associated with hip flexors on the affected side,bilateral hip extensors,hip abductors on the affected side(p=0.003-0.039).The maximum excursion value in the unaffected side was significantly associated with hip flexors and hip abductors on the affected side(p=0.045).The maximum excursion value in the anterior direction was significantly associated with hip flexors,extensors,abductors and adductors on the affected side(p=0.004-0.017).The maximum excursion value in the posterior direction was not significantly associated with hip muscular strength.ConclusionsPost-stroke patients show greater postural control disorder,poorer trunk control,and decrease more muscle strength than matched-healthy subjects.Hip muscles strength have relationship with trunk control and static postural stability.And the ability to shift the body forward and medio-lateral directions have relationship with part of hip muscular strength.