Stance symmetry and sway after stroke

Sackley, Catherine Mary (1991) Stance symmetry and sway after stroke. PhD thesis, University of Nottingham.

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Abstract

The aim of the study was to investigate the assessment and treatment of stance symmetry and sway after stroke and was divided into 3 parts.

Stage 1. Sway and stance symmetry were surveyed with the Nottingham Balance Platform (NBP), a computerised limb load monitor. Over 400 volunteers of both sexes and a wide age range were recruited. There were significant differences between the sexes for both sway (p<0.05) and stance symmetry (p<O.Ol) and significant correlations between age and sway (p<O.OOl) and stance symmetry (p<O.OOl). Thus, normative data was provided.

Stage 2. Patients were surveyed to examine these variables after stroke and their relationships with age, falls and motor and ADL function. A consecutive sample of 92 patients underwent 2 assessments, 4 months apart, between 2 and 9 months post-stroke. Abnormal stance symmetry was seen, which improved with time (p<O.01) and correlated with functional measures (p<.001), length of stay and age. Abnormal sway values also present, improved with time (p<O.Ol). A significant relationship existed between sway values and falls frequency (p<O.01), but there was no significant association with functional abilities, age or sex.

Stage 3. A single-blind randomised-controlled trial was conducted with 26 stroke patients to assess the value of visual feedback training. Patients demonstrating asymmetry were randomly allocated to two groups. Group A received visual feedback and Group B a placebo program, incorporated into 12 physiotherapy sessions. Independent assessments of motor and ADL function were completed at the start (0 weeks) and end of treatment (4 weeks) and at 8 weeks. Initially, there were no significant differences between the groups. At 4 weeks, stance symmetry and measures of function were significantly better for the treatment group than controls (p<0.05), but not at the final assessment. The improvement, although maintained, did not continue after treatment. The results support the further use of feedback techniques to improve standing posture after stroke.

Item Type: Thesis (University of Nottingham only) (PhD)
Supervisors: Lincoln, N.B.
Doherty, M.
Mitchell, J.R.A.
Subjects: W Medicine and related subjects (NLM Classification) > WL Nervous system
Faculties/Schools: UK Campuses > Faculty of Medicine and Health Sciences > School of Medicine
Item ID: 14177
Depositing User: EP, Services
Date Deposited: 06 May 2014 10:37
Last Modified: 13 Sep 2016 12:30
URI: http://eprints.nottingham.ac.uk/id/eprint/14177

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