Effect of Dynamic Balance Training Using Visual Biofeedback of Center of Pressure in Patients with Stroke

OBJECTIVE: To investigate the effect of dynamic balance training with center of pressure (COP) games using visual biofeedback of COP movement in stroke patients. METHOD: Thirty-eight stroke patients were randomly as signed to the static or dynamic balance training group, or control group. Static group received weight-shift training with visual biofeedback of weight distribution bar. Dynamic group received dynamic balance training using COP games. Each training session lasted 30 minutes, 3 times in a week during 3 weeks. Control group received traditional rehabilitation only. The ability of balance control was assessed using posturography by total path distance, frequency of sway, and COP weight-spectrums during standing, and during presentation of virtual moving surround. Total patherror was also assessed during sine curve and dynamic circle trace test. RESULTS: In static group, there were significant improvement in the total path distance during comfortable standing and path error during sine curve tracing. In dynamic group, significant improvements were found in the path error during sine curve and dynamic circle tracing. CONCLUSION: Dynamic training group showed more improvement in dynamic balance ability, whereas static group showed more changes in the static balance ability. The visual biofeedback training is more specified for balance rehabilitation in stroke patients.

Predicting the Effect of Complex Physical Therapy: Utility of Manual Lymph Drainage Performed on Lymphoscintigraphy

OBJECTIVE: To evaluate the utility of manual lymph drainage (MLD) during lymphoscintigraphy (LS) in predicting the effect of complex physical therapy (CPT). METHOD: Forty seven patients were included in this study. MLD was done for 30 minutes after one hour LS image was obtained. 24 patients were followed up for 3~6 months. According to one hour LS image, patients were assigned to visible lymph node or lymphatic vessel group (Either group) and invisible lymph node and lymphatic vessel group (Neither group), and also according to LS changes after MLD, good and poor response group. The limb volume was checked before, and immediately after CPT, and at 1 month and 3~6 months after CPT. The treatment response was evaluated by percent volume reduction (PVR). RESULTS: There were no significant differences in volume reduction between Either group and Neither group. Otherwise, good response group showed significantly greater volume reduction after CPT than poor response group. Mean PVR in the good response group was 37.02% immediately after CPT, 41.2% at 1 month after CPT, and 47.4% at 3~6 months after CPT. Mean PVR in the poor response group was 19.22% immediately after CPT, 13.0% at 1 month after CPT, and 5.21% at 3~6 months after CPT. CONCLUSION: LS changes after MLD reflected the effects of CPT more accurately than one hour LS image.