Platform training and postural stability in hemiplegia.

Abstract

Thirteen hemiplegic patients who had a cerebrovascular accident (CVA) in the anterior cerebral circulation were subjected to training on a moving platform. Each session consisted of a 5 min stance on the platform while they moved along an anteroposterior axis, and a 5min stance during transverse movement. Movement amplitude of the platform was adjusted once every three training sessions to the largest that the patients could sustain without using their hands for support. An electromyogram (EMG) was recorded from the tibialis anterior (TA) muscles of each patient during training and at stance on the floor. In addition, the distribution of body weight on the feet was measured in each case before the training program began and at its termination after three weeks (15 training sessions). A matched group of 11 hemiplegic patients served as controls. The maximal movement amplitude that each patient in the control group could sustain was determined twice, once at the beginning of the study and again after three weeks. Ten patients in the experimental group showed more than a two-fold increase in the maximal movement amplitude (MMA) that they could sustain. The patients most impaired initially showed the greatest increase in MMA--five- to seven-fold. In the control group, only one patient had an MMA increase greater than two-fold. A significant improvement in weight distribution on the feet during stance on the floor was found in the experimental patients, but not in the controls. EMG records indicated that improvement in stance did not result from increased TA activation in the hindered leg.(ABSTRACT TRUNCATED AT 250 WORDS)