The effect of functional, balance and strengthening exercises protocol in treatment of postural control and balance problems in hemi paretic patients

Background: Stroke is a major cause of death and disability in all societies and the
disability resulting from stroke most commonly presents as hemiplegia or hemiparesis. The
purpose of this study was to determine postural control and balance problems in hemiparetic
patients and the effects of functional, balance and strengthening exercises protocol (FBS) in
treatment of these impairments.
Methods and materials: This clinical trial was performed in Kahrizak charity foundation in
1382. Thirty-four hemiparetic patients secondary to stroke with a mean ± SD age of 52.41 ±
6.19 years participated in the study through simple non-probability sampling. All patients
were screened to ensure that their time since onset of stroke was at least 12 months. Patients
were assigned randomly to either an experimental group or a control group, and their
balance were assessed using balance part of functional, balance and strength scale (FBSS)
before and after 12 sessions of intervention. The experimental group received FBS protocol.
The control group received all FBS protocol except for strengthening exercises. In
parametric data independent and paired t-tests and in nonparametric data Mann-Whitney
and Wilcoxon tests allowed for comparisons between the pretreatment and post treatment
test results between and within groups, respectively.
Results: Index of total balance in the experimental group increased from 53.3 ± 8.1 to
70.5 ± 6.3 (ordinal) (P <0.0001). Index of total balance in the control group increased from
48.4 ± 8.5 to 52.9 ± 7.2 (ordinal) (P <0.0001). Significant improvement (P <0.0001) after
treatment was seen in the experimental group in measures of total balance index compared
to control group. The Mann-Whitney test also identified a significant difference (P <0.0001)
between the experimental group and the control group with respect to mean difference of
total balance variable scores.

Conclusions: The results of this study support the effectiveness of muscle strength training
to improve postural control and balance in the chronic stages of rehabilitation following
stroke.