Effects Of Proprioception Training On Balance And The Sensory Integration Mode Of Hemiplegic Patients

Objective: To explore the effect of two different trainings on balance and sensory integration with hemiplegic patients, the balance stability and three elements in equilibrium sense with hemiplegic patients were measured after two different rehabilitation trainings.Method: Thirty patients with hemiplegia who met the inclusion criteria were enrolled,then hemiplegia randomly divided into the traditional training group(A, n=15) and the proprioception training group(B, n=15). Groups A and B were carried out on the basis of conventional treatments, group B includes two parts: primary training and moderate training.Balance test utilized equipment(Pro-Kine Line 254p) to record the nine indexes such as center of pressure(XCOP), whole path length(WPL) in four states which are standing on the plat(T1) with eyes open, standing on the plat(T2) with eyes closed, standing on the sponge(T3) with eyes open, standing on the sponge(T4) with eyes closed. To record changes of balance, vision, proprioceptive sense, vestibular sensation, and analyzed the effect of two different trainings.Results:1) After the traditional training, the whole path length(WPL=202.88±52.32mm)decreased 64.26 mm, and the sway velocity(SV=8.93±1.97 mm/s) decreased 2.02mm/s in state of T1, it was statistically significant after a set of rehabilitation training(P < 0.01), it showed that the patient improved ability to control and the stability of balance increased. In state of T2,T3 and T4, the indicators showed similar results.2) After the proprioception training of T1, the center of pressure(YCOP =-2.70 ± 9.38)closed to the center of gravity of the body. The standard deviation of Y(YSD) was statistically significant(P < 0.05), the moving more stable than before. The sway velocity had dropped(XSV = 5.46 ± 1.43 mm / s, YSV = 6.29 ± 2.12 mm / s) than before, and it was significantdifference(P < 0.05), the whole path length(WPL = 229.22 ± 37.58 mm) and other 3 index decreased compared with beginning, it was significant difference(P < 0.01). The other indicators showed similar results inT2, T3, and T4. It showed that stability of balance improved after the proprioceptive training.3) After 4 weeks, the effect of two different training on balance: ① on the plat with eyes open(T1), it showed that the center of pressure(YCOP=-2.70±9.38),the whole path length(WPL=229.22±37.58mm), and sway area(SA=140.70±47.13 mm2) were significant difference(P < 0.05) ②on the plat with eyes closed(T2) and on the sponge with eyes open(T3), there is no significant difference for two different trainings. it showed that two states of two different trainings have the same effect. ③on the sponge with eyes closed(T4),the standard deviation of X(XSD) and the standard deviation of X(XSD) were significantly different(P < 0.01). On three indicators of the sway velocity of Y(YSV=-2.82±3.88mm) and sway velocity(SV= 2.23±5.96mm/s),there were significantly different(P < 0.05), it showed that the proprioceptive training is better than the traditional training on balance.4) The participation proportion of vestibular sensation, proprioceptive sense, and vision and before training is 63.03%, 26.87%, 25.97% respectively. Meanwhile, after tradition training participation proportion is respectively 65.19%, 24.33%, 19.23%, and after proprioceptive training participation proportion is respectively is 59.25%, 31.46%, 23.38%.The participation proportion of proprioceptive sense significantly increased after the proprioceptive training, and the participation proportion of vision has declined in both training.Conclusion:The study showed that two trainings can effectively improve balance for the hemiplegic patient in four weeks. In addition, studies suggest that: 1) To adjust the sensorimotor integration model will have an impact for balance, loss of visual effects help to improve the balance at some stage, the experiment may be prompted to change sensory integration mode as a monitoring indicators to guide rehabilitation; 2) Compared with the traditional group and proprioception group which have different integration mode, increase the proportion ofproprioception, after a set of proprioceptive training, which activate a large number of proprioception, so that more units involved in the movement to improve the balance; 3)Proprioceptive training better than traditional training for balance in the flat open the eye(T1)and sponge eyes closed(T4), the following research may try to combine the advantages of two trainings, so that patients get the best rehabilitation results.