INTRODUCTION:
A stroke occurs as a result of brain damage caused by cerebral infarction or hemorrhage. The majority, 73~88%, of cerebral infarction patients have impaired sensory motor ability on the side opposite to the brain damage appearing as hemiplegia of the arms and legs or either. Most survivors of stroke have decreased capacity to perform activities of daily living (ADL) because of a combination of sensory, motor, cognitive and emotional impairments. Of all the possible sensorimotor deficits of stroke, damaged postural control has the greatest impact on ADL independence and gait.
Hemiplegic patients have decreased balance control ability. Especially, the postural sway in static positions is more than twice that of healthy subjects of the same age group, which consequences for safety4. Balance is described as the ability to maintain equilibrium in a gravitational field by keeping or returning the center of body mass over its base of support5. Dynamic balance is a voluntary response which maintains the position in response to an external perturbation.
AIM OF THE STUDY:
To find the effectiveness of combined exercises which consists of aerobic training and functional strengthening exercise over conventional exercises which consists of balance,posture control exercise and gait training in improving balance in hemiparetic stroke patients.
OBJECTIVES:
1. To find the effectiveness of combined exercises (functional strengthening exercise and aerobic) in improving the balance in hemiparetic stroke patients.
2. To find the effectiveness of conventional exercises (balance exercise,posture exercise and gait training) in improving balance in hemiparetic stroke patients.
3. To compare the effectiveness of combined exercise versus conventional exercises training in improving balance in hemiparetic stroke patients.
MATERIALS AND METHODLOGY:
RESEARCH DESIGN:
A Pretest-Posttest experimental study consisting of 30 stroke patients were undertaken to investigate the balance of the hemiparetic stroke patients. There are two experimental groups.
SELECTION CRITERIA:
Inclusion Criteria:
1. Patients with stroke involving in lower extremity.
2. Patient within 6 months of post stroke period.
3. Both sexes.
4. Age group between 35-50 years.
5. Patient who can stand independently without any assistive devices at least for a minute.
Exclusion Criteria:
1. Haemodynamically unstable.
2. Patient could not perform functional exercise due to arthritis.
3. Low back pain, with radiating pain and numbness over legs.
4. Cardiovascular and Respiratory conditions impairing aerobic training.
5. Patient who have uncontrolled hypertension.
6. Patients who could not follow instructions due to low perceptive abilities, cognitive disorder.
7. Hearing impairment.
SAMPLE SIZE AND SAMPLING:
Purposive sampling of thirty samples was adopted in this study. A group of 30 subjects who had satisfied the inclusion criteria and exclusion criteria were selected and they were purposively divided into two groups.
Group 1 - received combined exercises with aerobics and functional strengthening exercise,
Group 2 - received conventional exercises.
Setting of Study:
Narayana Health, Multi speciality Hospital, Bangalore-99.
Duration of the Study:
It was an experimental study with the duration of 4 weeks of treatment per subject.
RESULTS:
As the calculated value is greater than the t table value. Null hypothesis 1 (Ho1) is rejected and research hypothesis 1 (H11) is accepted.
As the calculated value is greater than the t table value. Null hypothesis 2 (H02) is rejected and research hypothesis 2 (H12) is accepted.
As the calculated value is greater than the t table value. Null hypothesis 1 (H03) is rejected and research hypothesis 3 (H13) is accepted.
SUMMARY:
In this study, totally 30 subjects of the hemiparetic stroke patients are taken into two experimental groups equally into Combined exercises group (aerobic and functional strengthening exercises) group 1 and conventional exercises group (balance exercises, posture exercises and gait training) group 2 in improving the static and dynamic balance by using the Berg Balance Scale (BBS) and Timed Up and Go test (TUG) as the outcome measuring scale. Based on the results found in this study there are improvements in both the combined exercises, group 1 and conventional exercises, group 2. But, there are significant better improvement in the combined exercises, group 1 than the conventional exercises, group 2. So, the results found are published.
CONCLUSIONS:
Based on this study combined exercises given to group 1 has shown the improvement in both the static and dynamic balance scores in the hemiparetic stroke patients.
Based on this study conventional exercises given to group 2 has shown the improvement in both the static and dynamic balance scores in the hemiparetic stroke patients.
Based on this study combined exercise of group 1 had shown the marked improvement in both the static and dynamic balance than the conventional exercises of group 2 in the hemiparetic stroke patients. This suggests that combined exercise training can be prescribed for stroke patients to reduce their risk of falls and lead to independent ADL
