Study Of Visual Intervention's Effects On Balance Function And Walking Ability Of Patients With Hemiplegia After Stroke

ObjectiveThe purpose of this study was to explore the effect of eye-shielding during the procession of rehabilitation training on static balance ability, proprioception, vestibular sensation and functional walking ability. And it will provide a new way to develop individualized rehabilitation research and training programs.Methods45 patients with hemiplegia after stroke were selected as the research subjects from the First Affiliated Hospital of Soochow University who were hospitalized in department of rehabilitation, and divided into three groups randomly: control group (group A, 15 people), visual reinforcement group (group B, 15 people) and visual deprivation group (group C, 15 people). The routine methods and time of rehabilitation training for each group were same. During the training process, eyes of patients in group C had been token cover with bandages and affected lower extremity was binding with elastic bandage locally, then they completed actions following the instructions of therapist. In addition, group C was increased rotated training for 15 minutes to improve vestibular function and group B was increased visual biofeedback training for 15 minutes. Routine methods included training of range of motion, reducing muscle tension and enhancing muscle strength, (6 times/week, 30 minutes/time, 6 days/week, 6 weeks for training). Bridge movement training, sitting training or standing balance training and walking training were all included. (6 times/week, 40 minutes/time, 6 days/week, 6 weeks for training). All patients were evaluated for Berg Balance Scale (BBS), timed up and go test (TUGT), and Weight Distribution Index (WDI) and Stability Coefficient (ST) under following three postures of Tetrax balancer before and after treatment cycle.The data was statistically analyzed by software of SPSS13.0, and the statistical results was showed as the format of "mean±standard deviation"( x±s). All data were normal distribution and homogeneity which were tested by the statistical software. Patients' "timed up and go" and BBS scores which were compared by paired t test before and after treatment. The three groups were analyzed by means of one way ANOVA after treatment and pair comparison of two groups was analyzed by SNK. Balance function of different positions was compared by independent samples t test. The data was compared by statistical method of paired t test before and after treatment. P<0.05 was considered statistical significance and P<0.01 was considered highly statistical significance.ResultThere was no significant difference among three groups of subjects before treatment in TUGT. After training, there was statistical significance (P<0.05) in group A and B, and difference in group C was highly statistical significance (P<0.01). Compared between two groups after training, TUGT of group B was completed less than group A and the difference was statistical significance (P<0.05).Group C completed less than B and the difference was statistical significance (P<0.05).There was no significant difference in BBS among three groups of subjects before treatment. After treatment, there was statistical significance (P<0.05) in group A and B, and difference in group C was highly statistical significance (P<0.01). Compared between the two groups after treatment, there was statistical significance (P<0.05) between group A and B, and the same compared result to pair of group B and C. There was highly statistical significance (P<0.01) between group C and A.To group A before and after treatment, there were no statistical difference in WDI and ST of NO. The WDI and ST of NO was statistical significance (P<0.05) to group B. There was statistical significance (P<0.05) in WDI and was no differences in ST of NC to group B. There was no difference in WDI and ST of PC to group B. The WDI and ST of NO, NC, PC, were highly statistical significance to group C before and after treatment (P<0.01). Compared two groups after treatment with three postures, the WDI and ST of NO were statistical significance (P<0.05) between group A and B, and the same compared result to pairs of group A and C, group C and B. The WDI of NC was statistical significance (P<0.05) between group A and B. The ST of NC was no differences between group A and B. The WDI and ST of NC were highly statistical significance (P<0.01) between group A and C. The WDI and ST of NC were statistical significance (P<0.05) between group Band C. The WDI and ST of PC were no differences between group A and B. There was highly significant differences (P<0.01) between group A and B, group B and C.ConclusionOur study suggested that visual biofeedback training would improve transformation of the center and weight-bearing affected lower limb for patients with hemiplegia after stroke and reduce the difference between lower limbs. At the same time, it would improve the balance function and walking ability to some extent.The training of visual deprivation could be conductive to proprioception and vestibular sensation. Thereby it would improve controlling capacity of proprioception and vestibular sensation to balance and walking ability.Visual deprivation training would enhance balance function of patients with hemiplegia after stroke by improving proprioception and vestibular sensation and it could be more effective than conventional training and visual biofeedback training.