%0 Journal Article
%T Effects of Perturbation
%A Ganit Gray
%A Guy Shani
%A Itshak Melzer
%A Michal Kenner-Furman
%A Nachum Soroker
%A Shirley Handelzalts
%J Neurorehabilitation and Neural Repair
%@ 1552-6844
%D 2019
%R 10.1177/1545968319829453
%X Background: Reactive balance responses are critical for fall prevention. Perturbation-based balance training (PBBT) has shown a positive effect in reducing the risk of falls among older adults and persons with Parkinson¡¯s disease. Objective: To explore the effect of a short-term PBBT on reactive balance responses, performance-based measures of balance and gait and balance confidence. Methods: Thirty-four moderate-high functioning, subacute persons with stroke (PwS) (lower extremity Fugl-Meyer score 29.2 ¡À 4.3; Berg Balance Scale [BBS] score 43.8 ¡À 9.5, 42.0 ¡À 18.7 days after stroke onset) hospitalized in a rehabilitation setting were randomly allocated to PBBT (n = 18) and weight shifting and gait training (WS&GT) (n = 16). Both groups received 12 training sessions, 30 minutes each, for a period of 2.5 weeks. PBBT included unexpected balance perturbations during standing and treadmill walking, WS&GT included weight shifting in standing and treadmill walking without perturbations. The main outcome measures, that is, multiple step-threshold and fall-threshold were examined at baseline, immediately postintervention, and about 5 weeks postintervention. The secondary outcome measures, that is, BBS, 6-minute walk test (6MWT), 10-meter walk test (10MWT), and Activity-specific Balance Confidence (ABC) scale were examined at baseline and immediately postintervention. Results: Compared with the WS&GT group, immediately postintervention participants in the PBBT group showed higher multiple-step thresholds in response to forward and backward surface translations (effect size [ES] = 1.07 and ES = 1.10, respectively) and moderate ES in the ABC scale (ES = 0.74). No significant differences were found in fall-threshold, BBS, 6MWT, and 10MWT between the groups. Conclusions: Inclusion of perturbation training during rehabilitation of PwS improved reactive balance and balance confidence
%K stroke
%K rehabilitation
%K balance reactive response
%K compensatory stepping
%K multiple-step threshold
%K fall threshold
%K falls
%U https://journals.sagepub.com/doi/full/10.1177/1545968319829453