Single blind randomized controlled trial of visual feedback after stroke: Effects on stance symmetry and function

Abstract

A number of before and after and single case design studies of visual feedback have shown improvements in stance symmetry after stroke, an associated improvement in function has been demonstrated. This study examines this promising technique further using a single-blind controlled trial. Twenty-six patients were recruited from a register of consecutive admissions and randomized into treatment and control groups. Both groups received additional therapy, only the treatment group received visual feedback. Assessments were carried out independently. Significant improvements were seen in the treatment group in measures of stance symmetry and sway and motor and ADL function. Between group differences had disappeared at three months. The results indicate that feedback training incorporated into functional physiotherapy treatment can improve stance symmetry and sway. Transfer of training was indicated by improvements in ADL and gross motor function. Three months later the improvement was maintained, but did not automatically continue without treatment.

Can augmented feedback facilitate learning a reactive balance task among older adults?

“…Concurrent augmented visual feedback has also been applied to re-learning balancing tasks among individuals with impaired balance due to neurologic injury (Shumway-Cook et al 1988;Winstein et al 1989;Sackley and Lincoln 1997;Walker et al 2000;Ioffe et al 2010;Sayenko et al 2010;Tsaklis et al 2012) or aging (Wolf et al 1997;Rose and Clark 2000;Lajoie 2004;Sihvonen et al 2004b;Hatzitaki et al 2009). Typically, this is done by asking the participant to stand on one or two force platforms and providing visual feedback regarding weight distribution between the two limbs (Winstein et al 1989;Sackley and Lincoln 1997;Hatzitaki et al 2009), or the location of the centre of gravity (COG; Rose and Clark 2000;Walker et al 2000) or centre of pressure (COP; Shumway-Cook et al 1988;Lajoie 2004;Sihvonen et al 2004b;Ioffe et al 2010;Sayenko et al 2010;Tsaklis et al 2012). With the goal of improving quiet standing balance control when provided with feedback of the COG or COP, participants are asked to minimize movement of the COG or COP (Shumway-Cook et al 1988;Lajoie 2004;Sayenko et al 2010;Tsaklis et al 2012).…”

Mirror versus stationary cross feedback in controlling the center of foot pressure displacement in quiet standing in elderly subjects

“…In such a protocol, the subject stands on a force platform, the COP position is depicted in real time on a computer screen and he/she is required to confine it to the narrowest possible area. This so-called "visual feedback technique" allowed individuals to decrease their postural sway, in both the anteroposterior (AP) and ML directions and is considered an efficient tool in the rehabilitation of patients with impaired balance (17)(18)(19)(20)(21). However, such a technique requires high-cost equipment not often available in rehabilitation or community-living environments.…”

Effect of Balance Training on Postural Control and Risk of fall in Stroke Patients.

“…They assessed sway and stance symmetry, motor and ADL function at 0, 4 and 12 weeks. They concluded that significant improvements were seen in the treatment group in measures of sway, stance symmetry, motor and ADL function, but differences between groups had disappeared at 3 months [39].…”