F-2-17-04
EVALUATION OF DYNAMIC STANDING BALANCE IN STROKE PATIENTS
Akihisa Sugawa (Tokyo Metropolitan Rehabilitation Center For The Physically And Mentally Handicapped, Tokyo, Japan), Shigenobu Ishigami (National Defense Medical College, Saitama, Japan)
Purpose: The ability to maintain standing balance is believed to be necessary to perform functional activities such as transfer, toilet and locomotion in stroke patients. There is no widely accepted or standardized measurement of the ability to maintain one's standing balance. We tried to evaluate the dynamic standing balance in stroke patients.
Method: Twelve subjects with hemiparesis were tested with a computerized moving platform system which moves in a linear horizontal direction. Subject stood with eyes opened on the platform, putting on the instrumented shoes of which pressure sensitive switches was embedded into the heel and toes. The system was set to move 20cm during test and it reached a velocity of 40cm/s. The acceleration was varied from 5cm/s/s to 120cm/s/s. The end point was the highest acceleration at which the subject could maintain standing posture without any protective stepping responses. The evaluation was performed in 8 directions every 45 degree around the subject.
Results: Compared to controls, stroke patients showed a reduction of dynamic standing balance in all 8 directions, especially in the directions of forward and backward. Lt. hemiparesis, elderly patients and poor static balance patients also showed more reductions.
Conclusion: Reduction in dynamic standing balance were present after CVA. It is important to evaluate the dynamic standing balance for prevention from the accidental falls in stroke patients.
F-2-17-05
Clinical Assessment of Sitting Balance of Stroke in Acute Stage.
Shoji Takano MD. Mieko Kaseda MD. Akira Kogure MD. Tokyo Metropolitan Ohtsuka Hospital
Sitting Balance was not clearly evaluated in acute stage of Stroke patient. But, instead of clinical risk, gradual bed-up and sitting exercise are much important for early Rehabilitation Program Schedule. Many Rehabilitation Staff wants to start these anti-gravity exercise under permission of Doctor as soon as possible.
But there is no exact criteria to start sitting. On the other hand, at first many stroke patients can not maintain sitting, and exercise staff was requested to describe the grade of sitting balance. Trunc stability and equilibrium of body were reported in many case on many situation. We tried sitting balance in stroke patient in early period as possible, and classified the grade of sitting balance into 5 class. 1) Normal balance. 2) Good balance. 3) Fair balance. 4) Poor balance. 5) No balance. And we try to examine definition of sitting balance.
