The influence of deep sensory foot stimulation on balance and gait function in patients with hemiparesis

• Main Authors: Agnieszka Śliwka, Rafał Dębowski
• Format: Article
• Language: English
• Published: Univeristy of Physical Education in Krakow 2018-01-01
• Series: Rehabilitacja Medyczna
• Subjects: stroke; hemiparesis; Bobath concept; balance; gait; sensory stimulation
• Online Access: http://rehmed.pl/gicid/01.3001.0010.8159
• ISSN: 1427-9622; 1896-3250

Background: Current research emphasizes the importance of sensory afference for movement control. Multisensory information may be processed in the brain even when its damage is located in multimodal association areas and specific sensory cortex. Aim: The aim of the study was to assess the influence of sensory stimulation of the hemiparetic foot on balance and gait improvement in stroke patients with respect to the their age, time from onset and location of stroke. Material and methods: The study was carried out from March to July 2016 and involved 40 consecutive inpatients (age 39-86 years; mean=68,3; SD=10.2) staying at the “Pasternik” rehabilitation centre in Modlniczka for 6 weeks. On the day of the physician’s examination, medical history was recorded and patients were interviewed about their health condition. After that, three functional tests were carried out: the Two-scale test, the Tinetti test and the Timed Up and Go test (TUG). The measurements were taken: before sensory stimulation, after the first treatment, after 4 weeks of treatment and at 2 weeks of follow- up. Every day, treatment consisted of individual sensory stimulation of the hemiparetic foot performed by a physiotherapist according to the specific principles of the Bobath concept. Additionally, aimed at foot sensory stimulation, patients performed their own supervised exercises using designated equipment at a gym. Results: 4 weeks of treatment aimed at the sensory stimulation of the hemiparetic foot influenced balance and gait improvement in stroke survivors. Significant improvement in weight distribution on the Two-scale test was detected immediately after the first stimulation. The results of both gait tests measured after 4 weeks of physiotherapy allowed to classify subjects into the group of average fall risks in comparison to the initial high-risk group. The study indicated more efficacy of sensory stimulation in younger patients with left side paresis and a shorter period after stroke onset. Conclusion: Foot sensory stimulation is a non-invasive, efficient therapeutic tool for regaining balance and gait improvement in hemiparetic subjects after stroke.