We are taught from a young age that pushing is not nice. Although this is true on the playground, your doctor might tell you otherwise when it comes to stroke recovery. A new type of therapy uses pushing and other ways to throw a person off balance to reduce the risk of falling after a stroke.
If you or a loved one suffered from a stroke, you know that it can be debilitating. It can result in serious consequences like falls and fall-related injuries. Usually occurring as a result of the difficulty in recovering from a loss of balance, falls are major risk factors for complications following a stroke. Hence, researchers from the Toronto Rehabilitation Institute conducted a study to find out if perturbation-based balance training (PBT) in the sub-acute phase following a stroke can prevent falls at home.
How does PBT work?
In PBT treatment, a therapist introduces perturbations (a sudden unexpected movement or outside force) to elicit recovery response. Patients who experience a sudden loss of balance can benefit from this training. This form of therapy can help those who are at risk of falling. It improves their ability to recover from things that set them off balance. These include patients who suffered from a stroke and those with conditions like Parkinson’s disease, multiple sclerosis, and dementia. PBT uses techniques like foam balance activities and tilt board balance training.
Thirty-one participants in the study were in the PBT group. A matched number of participants, who were selected from an eligible pool of patients, were considered the control group. These patients received treatment before but only with the standard physical therapy.
Those in the PBT group underwent 30 minutes of PBT (for five days a week) instead of traditional physical therapy. They experienced tasks that upset their balance from the outside (e.g., pushing) or the inside (e.g., kicking a ball). As patients progress through the therapy, disruptions become more challenging (e.g., going from predictable to unpredictable).
The researchers counted the number of falls that patients had in the PBT group for six months after discharge. They compared this number to the number of falls of those in the control group.
Five out of 31 in the PBT group reported at least one fall, considerably low compared to the 15 out of 31 in the control group. The PBT group reported a total of 10 falls while the control group had a total of 31 falls. These results were adjusted for follow-up duration and level of motor problems. However, the number of falls from those who underwent PBT is still lower than those who just had the standard physical therapy.
These results show that incorporating PBT in your rehab routine can improve balance problems. So, the next time you show up for your rehab session, ask about PBT and the chance of having it as part of your routine. It can be the key that will help you reduce your risk of falls.
Lead author of this publication is Dr. Mansfield from the Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada.