Effect of Home-based Trunk Training on Reactive Stepping in Individuals with Chronic Stroke: A Single-subject Experimental Study with Two Cases.

Progress in rehabilitation medicine Pub Date : 2025-06-03 eCollection Date: 2025-01-01 DOI:10.2490/prm.20250015

Hideyuki Tashiro, Sota Hirosaki, Yui Sato, Megumi Toki, Naoki Kozuka

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Abstract

Objectives: Reactive stepping is necessary to prevent falls when a person slips or trips while walking, particularly in outdoor activities. Individuals with stroke usually exhibit reactive balance impairment. Trunk training is effective for improving balance and mobility after stroke; however, its effect on reactive stepping remains unknown. This study aimed to examine the effects of trunk training on reactive stepping in community-dwelling individuals after stroke.

Methods: This study was conducted using an A-B-A single-subject design. Two community-dwelling women with chronic stroke (79 years old, 9 years post-stroke and 83 years old, 17 years post-stroke) participated in this study. The baseline (A) and intervention (B) phases lasted for 6 weeks. Specifically, the participants did not receive any intervention in phase A, whereas they performed home-based trunk training in phase B. Outcome measures included the foot-off time, maximum trunk rotation angular velocity, number of steps during forward reactive stepping following perturbation, and Trunk Impairment Scale (TIS) score.

Results: Decreased trunk rotation and step count corresponding to improved TIS score were observed in one case after the intervention. However, trunk control did not improve in the other case after the intervention, and reactive stepping kinematics remained unchanged.

Conclusions: Enhancing trunk control may improve reactive stepping in individuals with chronic stroke; nevertheless, further evidence is required.

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家庭躯干训练对慢性脑卒中患者反应性步进的影响：两例单受试者实验研究

目的：当一个人在走路时滑倒或绊倒时，特别是在户外活动中，反应性台阶是必要的，以防止跌倒。中风患者通常表现为反应性平衡障碍。躯干训练对提高中风后的平衡和活动能力是有效的；然而，其对反应步进的影响尚不清楚。本研究旨在探讨躯干训练对社区居民脑卒中后反应性迈步的影响。方法：本研究采用A-B-A单受试者设计。两名慢性脑卒中社区居住女性（79岁，脑卒中后9年和83岁，脑卒中后17年）参与了本研究。基线(A)期和干预(B)期持续6周。具体来说，参与者在A阶段没有接受任何干预，而他们在b阶段进行了基于家庭的躯干训练。结果测量包括脚离开时间，最大躯干旋转角速度，扰动后向前反应步数，以及躯干损伤量表（TIS）评分。结果：干预后1例患者躯干旋转和步数减少，TIS评分提高。然而，在另一种情况下，干预后躯干控制没有改善，反应性步进运动学保持不变。结论：加强躯干控制可改善慢性脑卒中患者的反应性步进；然而，还需要进一步的证据。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Progress in rehabilitation medicine

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