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Does severity of motor impairment affect reactive adaptation and fall-risk in chronic stroke survivors?
BACKGROUND: A single-session of slip-perturbation training has shown to induce long-term fall risk reduction in older adults. Considering the spectrum of motor impairments and deficits in reactive balance after a cortical stroke, we aimed to determine if chronic stroke survivors could acquire and re...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6429795/ https://www.ncbi.nlm.nih.gov/pubmed/30902097 http://dx.doi.org/10.1186/s12984-019-0510-3 |
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author | Bhatt, Tanvi Dusane, Shamali Patel, Prakruti |
author_facet | Bhatt, Tanvi Dusane, Shamali Patel, Prakruti |
author_sort | Bhatt, Tanvi |
collection | PubMed |
description | BACKGROUND: A single-session of slip-perturbation training has shown to induce long-term fall risk reduction in older adults. Considering the spectrum of motor impairments and deficits in reactive balance after a cortical stroke, we aimed to determine if chronic stroke survivors could acquire and retain reactive adaptations to large slip-like perturbations and if these adaptations were dependent on severity of motor impairment. METHODS: Twenty-six chronic stroke participants were categorized into high and low-functioning groups based on their Chedoke-McMaster-Assessment scores. All participants received a pre-training, slip-like stance perturbation at level-III (highest intensity/acceleration) followed by 11 perturbations at a lower intensity (level-II). If in early phase, participants experienced > 3/5 falls, they were trained at a still lower intensity (level-I). Post-training, immediate scaling and short-term retention at 3 weeks post-training was examined. Perturbation outcome and post-slip center-of-mass (COM) stability was analyzed. RESULTS: On the pre-training trial, 60% of high and 100% of low-functioning participants fell. High-functioning group tolerated and adapted at training-intensity level-II but low-functioning group were trained at level-I (all had > 3 falls on level-II). At respective training intensities, both groups significantly lowered fall incidence from 1st through 11th trials, with improved post-slip stability and anterior shift in COM position, resulting from increased compensatory step length. Both groups demonstrated immediate scaling and short-term retention of the acquired stability control. CONCLUSION: Chronic stroke survivors are able to acquire and retain adaptive reactive balance skills to reduce fall risk. Although similar adaptation was demonstrated by both groups, the low-functioning group might require greater dosage with gradual increment in training intensity. |
format | Online Article Text |
id | pubmed-6429795 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-64297952019-04-04 Does severity of motor impairment affect reactive adaptation and fall-risk in chronic stroke survivors? Bhatt, Tanvi Dusane, Shamali Patel, Prakruti J Neuroeng Rehabil Research BACKGROUND: A single-session of slip-perturbation training has shown to induce long-term fall risk reduction in older adults. Considering the spectrum of motor impairments and deficits in reactive balance after a cortical stroke, we aimed to determine if chronic stroke survivors could acquire and retain reactive adaptations to large slip-like perturbations and if these adaptations were dependent on severity of motor impairment. METHODS: Twenty-six chronic stroke participants were categorized into high and low-functioning groups based on their Chedoke-McMaster-Assessment scores. All participants received a pre-training, slip-like stance perturbation at level-III (highest intensity/acceleration) followed by 11 perturbations at a lower intensity (level-II). If in early phase, participants experienced > 3/5 falls, they were trained at a still lower intensity (level-I). Post-training, immediate scaling and short-term retention at 3 weeks post-training was examined. Perturbation outcome and post-slip center-of-mass (COM) stability was analyzed. RESULTS: On the pre-training trial, 60% of high and 100% of low-functioning participants fell. High-functioning group tolerated and adapted at training-intensity level-II but low-functioning group were trained at level-I (all had > 3 falls on level-II). At respective training intensities, both groups significantly lowered fall incidence from 1st through 11th trials, with improved post-slip stability and anterior shift in COM position, resulting from increased compensatory step length. Both groups demonstrated immediate scaling and short-term retention of the acquired stability control. CONCLUSION: Chronic stroke survivors are able to acquire and retain adaptive reactive balance skills to reduce fall risk. Although similar adaptation was demonstrated by both groups, the low-functioning group might require greater dosage with gradual increment in training intensity. BioMed Central 2019-03-22 /pmc/articles/PMC6429795/ /pubmed/30902097 http://dx.doi.org/10.1186/s12984-019-0510-3 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Bhatt, Tanvi Dusane, Shamali Patel, Prakruti Does severity of motor impairment affect reactive adaptation and fall-risk in chronic stroke survivors? |
title | Does severity of motor impairment affect reactive adaptation and fall-risk in chronic stroke survivors? |
title_full | Does severity of motor impairment affect reactive adaptation and fall-risk in chronic stroke survivors? |
title_fullStr | Does severity of motor impairment affect reactive adaptation and fall-risk in chronic stroke survivors? |
title_full_unstemmed | Does severity of motor impairment affect reactive adaptation and fall-risk in chronic stroke survivors? |
title_short | Does severity of motor impairment affect reactive adaptation and fall-risk in chronic stroke survivors? |
title_sort | does severity of motor impairment affect reactive adaptation and fall-risk in chronic stroke survivors? |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6429795/ https://www.ncbi.nlm.nih.gov/pubmed/30902097 http://dx.doi.org/10.1186/s12984-019-0510-3 |
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