Effects of dynamic core-postural chain stabilization on diaphragm movement, abdominal muscle thickness, and postural control in patients with subacute stroke: A randomized control trial

Article type: Research Article

Authors: Yoon, Hyun Sik^{a; b} | Cha, Young Joo^b | You, Joshua (Sung) Hyun^{b; *}

Affiliations: [a] Department of Rehabilitation Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea | [b] Department of Physical Therapy, Movement Healing Laboratory, The Graduate School, Yonsei University, Wonju, Republic of Korea

Correspondence: [*] Address for correspondence: Professor Joshua (Sung) Hyun You, PT, PhD, Department of Physical Therapy, Movement Healing Lab, Yonsei University, 1 Yonseidae-gil, Wonju, Gangwon-do 220-710, Republic of Korea. Tel.: +82 33 760 2476; Fax: +82 33 760 2496; E-mail: [email protected].

Abstract: BACKGROUND:Neurodevelopmental treatment (NDT) and Dynamic neuromuscular stabilization (DNS)-based exercise is effective for improving core stability and postural control in stroke patients. OBJECTIVE:To compare the effects of DNS and conventional NDT exercises on diaphragm movement, abdominal muscle thickness, and postural control in stroke patients. METHODS:The participants were randomly allocated into DNS (n = 16) and NDT (n = 15) for 30 minutes each per day, 3 days a week for 4 weeks. Diaphragm movement and abdominal muscle thickness were determined using ultrasonography. The trunk impairment scale (TIS) and Berg Balance Scale (BBS) were used to measure postural control. The functional ambulation category (FAC) was used to evaluate gait ability. Analysis of covariance (ANCOVA) was used to evaluate post-test differences in the DNS and NDT exercise groups. RESULTS:ANCOVA revealed the superior effects of DNS in diaphragm movement and abdominal muscle thickness (transversus abdominis, internal oblique), as well as clinical BBS and FAC tests, compared with those of NDT (p < 0.05). CONCLUSIONS:This novel clinical trial suggests that DNS training was more effective than NDT training in improving postural movement control and gait ability via a balanced co-activation of the diaphragm and TrA/IO in stroke patients.

Keywords: Diaphragm movement, dynamic neuromuscular stabilization, subacute stroke, core stabilization

DOI: 10.3233/NRE-192983

Journal: NeuroRehabilitation, vol. 46, no. 3, pp. 381-389, 2020