Effectiveness of Manual Perturbation Exercises in Improving Balance, Function and Mobility in Stroke Patients: A Randomized Controlled Trial

Background and objective of study: Following stroke hemiplegic or hemiparetic patients presented with more postural sway, asymmetric weight distribution, impaired weight-shifting ability and decreased stability capability. There are many balance exercises and strategies to improve balance in stroke population to improve trunk control. There are limited evidences of giving manual perturbation based balance training in stroke patients to improve Balance, function and Mobility. Therefore, this study has been taken up to examine whether the manual perturbation balance training is effective in improving balance, function and mobility in stroke patients. Material and Method: Thirty patients were randomly allocated into two groups, Group (Conventional PT), Group B (Manual Perturbation Exercises and Conventional PT)- with 15 patients in each group. All the patients were evaluated with Berg Balance Scale; Functional Independence Measures and Time up and Go test on pre- treatment level. At the end of 4th week, effects of intervention were assessed by Berg Balance Scale, Time up and Go Test, and Functional Independence Measures. Results: When analysis was done between Group A and Group B, no significant difference found between BBS, TUG and FIM score in both Experimental and Control Group at pre interventional level. When comparison was done between both the groups from pre to post intervention level, the values of BBS, TUG, and FIM scores were improved at post interventional level (p=0.0001) in both groups. In the inter group comparison at post intervention level, values of BBS and TUG in the experimental Group were improved (p=0.0001), but not in FIM (p=0.240). Conclusion: Manual Perturbation exercises combined with Conventional Physiotherapy and Conventional Physiotherapy alone are beneficial in improving Balance, Function and Mobility in stroke patients. However, the subjects treated with manual perturbation along with conventional physiotherapy showed an additional benefit in Balance, and Mobility.