RELATIONSHIP OF PELVIC ALIGNMENT WITH BALANCE AND GAIT IN PATIENTS WITH STROKE: A SYSTEMATIC REVIEW
Pelvic alignment and balance
DOI:
https://doi.org/10.31878/ijcbr.2021.73.01Keywords:
Pelvic Alignment, Gait, Balance, Stroke.Abstract
Background- Pelvis is the key structure that connects the spine and the lower limbs. Altered Pelvic Alignment and asymmetrical weight bearing on affected lower limbs is a common problem leading to pelvic instability which may have an effect on balance and gait in patients with stroke. Hence, it was aimed to investigate the interdependence of these three components in patients with stroke. Methods- Four databases (PubMed, Google Scholar, Cochrane, Science Direct) were searched to identify eligible studies using the keywords Pelvic Alignment, Gait, Balance, Stroke. Only observational studies published in last 10 years (2010-2020) were included in this review. Results- Thirteen studies were included in the review conducted on sub-acute and chronic stage. All studies investigated the affection of pelvic mal-alignment, balance and gait in combination of two variables except 3 studies which investigated the combined effect of pelvic inclination on both balance and gait. The abnormal pelvic tilt results in lateral displacement of the pelvis on affected side, altered Base of Support, reduced balance control, asymmetry in weight bearing leading to altered gait. Conclusion- Pelvic tilt, anterior and lateral has a significant impact on static balance, gait variables, weight bearing symmetry.
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References
Banerjee TK, Das SK. Epidemiology of stroke in India. Neurology Asia. 2006 Jun;11:1-4
Hesse S, Reiter F, Jahnke M, Dawson M, Sarkodie-Gyan T, Mauritz KH. Asymmetry of gait initiation in hemiparetic stroke subjects. Archives of physical medicine and rehabilitation. 1997 Jul 1;78(7):719-24.
Dubey L, Karthikbabu S, Mohan D. Effects of pelvic stability training on movement control, hip muscles strength, walking speed and daily activities after stroke: a randomized controlled trial. Annals of neurosciences. 2018;25(2):80-9
Lee D, Hodges P. Principles of the integrated model of function and its application to the lumbopelvic-hip region. The Pelvic Girdle: An Approach to the Examination and Treatment of the Lumbopelvic-Hip Region. 3rd ed. Philadelphia, PA: Churchill Livingstone. 2004:41-54
Kiran LS, Balne NK, Prasad GL. Relationship between Pelvic Alignment Variables on Symmetrical Lower Limb Weight Bearing in Post Stroke Survivors-A Cross Sectional Observational Study.International Journal of Health Sciences & Research. 2019 Oct;9(10):83
Kim MK, Kim SG, Shin YJ, Choi EH, Choe YW. The relationship between anterior pelvic tilt and gait, balance in patient with chronic stroke. Journal of physical therapy science. 2017;30(1):27-30.
Karthikbabu S, Chakrapani M, Ganesan S, Ellajosyla R. Pelvic alignment in standing, and its relationship with trunk control and motor recovery of lower limb after stroke. Neurology and Clinical Neuroscience. 2017 Jan;5(1):22-8.
Patterson KK, Parafianowicz I, Danells CJ, Closson V, Verrier MC, Staines WR, et al. Gait asymmetry in community ambulating stroke survivors. Arch Phys Med Rehabil 2008;89:304 10
UMPathak S, Vijayakumar K, Nayak A, Kedambadi RC. The relationship between pelvic alignment and trunk control in stroke subjects: a cross-sectional study. Int J Res Med Sci. 2015;2(2):1483-7
Di Monaco M, Trucco M, Di Monaco R, Tappero R, Cavanna A. The relationship between initial trunk control or postural balance and inpatient rehabilitation outcome after stroke: a prospective comparative study. Clinical Rehabilitation. 2010 Jun;24(6):543-54.
Hill K, Ellis P, Bernhardt J, Maggs P, Hull S. Balance and mobility outcomes for stroke patients: a comprehensive audit. Aust J Physiother. 1997;43(3):173–180.
Sanders G, Stavrakas P: A technique for measuring pelvic tilt. PhysTher, 1981, 61: 49–50
Hsu AL, Tang PF, Jan MH. Analysis of impairments influencing gait velocity and asymmetry of hemiplegic patients after mild to moderate stroke. Arch Phys Med Rehabil. 2003;84(8):1185–1193
De Haart M, Geurts AC, Huidekoper SC, Fasotti L, van Limbeek J. Recovery of standing balance in post acute stroke patients: a rehabilitation cohort study. Arch Phys Med Rehabil 2004;85:886-95
Jørgensen L, Crabtree NJ, Reeve J, Jacobsen BK. Ambulatory level and asymmetrical weight bearing after stroke affects bone loss in the upper and lower part of the femoral neck differently: bone adaptation after decreased mechanical loading. Bone 2000;27:701-7
Nardone A, Godi M, Grasso M, Guglielmetti S, Schieppati M. Stabilometry is a predictor of gait performance in chronic hemiparetic stroke patients. Gait Posture 2009;30:5-10
Bobath B: Adult hemiplegia: evaluation and treatment, 3rd ed. Oxford: William Heinemann Medical Books, 1990, pp 20–57.
Kapandji I: The Physiology of the Joints: Lower limb, 4th ed. New York: Churchill Livingstone, 1982, pp 54–70.
Sridharan SE, Unnikrishnan JP, Sukumaran S, Sylaja PN, Nayak SD, Sarma PS, Radhakrishnan K. Incidence, types, risk factors, and outcome of stroke in a developing country: the Trivandrum Stroke Registry. Stroke. 2009 Apr 1;40(4):1212-8.
Chung EJ, Kim JH, Lee BH: The effects of core stabilization exercise on dynamic balance and gait function in stroke patients. J PhysTherSci, 2013, 25: 803–806
Lennon S. Gait re-education based on the Bobath concept in two patients with hemiplegia following stroke. Physical therapy. 2001 Mar 1;81(3):924-35.
Choe YW, Kim KR, Kim MK. Relationship between Gait, Static Balance, and Pelvic Inclination in Patients with Chronic Stroke. Journal of the Korean Society of Physical Medicine. 2021;16(1):17-22.
Gurli H, Ganvir S. Effect of pelvic tilt on parameters of gait in stroke patients. VIMS JOURNAL OF PHYSICAL THERAPY. 2019;1(1):37-42.
Karthikbabu S, Chakrapani M, Ganesan S, Ellajosyula R. Relationship between pelvic alignment and weight bearing asymmetry in community-dwelling chronic stroke survivors. J of Neurosci Rural Pract. 2016 Dec; 7: S37-S40.
Van Dijk MM, Meyer S, Sandstad S, Wiskerke E, Thuwis R, Vandekerckhove C, et al. A cross-sectional study comparing lateral and diagonal maximum weight shift in people with stroke and healthy controls and the correlation with balance, gait and fear of falling. PloS one. 2017 Aug 15;12(8)
Szopa A, Domagalska-Szopa M, Lasek-Bal A, Żak A. The link between weight shift asymmetry and gait disturbances in chronic hemiparetic stroke patients. Clinical interventions in aging. 2017; 12:2055.
Kim HS, Chung SC, Choi MH, Gim SY, Kim WR, Tack GR, et al. Primary and secondary gait deviations of stroke survivors and their association with gait performance. Journal of physical therapy science. 2016;28(9):2634-40.
Kong SW, Jeong YW, Kim JY. Correlation between balance and gait according to pelvic displacement in stroke patients. Journal of physical therapy science. 2015;27(7):2171-4.
Jijimol G, Fayaz RK, Vijesh PV. Correlation of trunk impairment with balance in patients with chronic stroke. NeuroRehabilitation. 2013 Jan 1;32(2):323-5.
Zakaria Y, Rashad U, Mohammed R. Assessment of malalignment of trunk and pelvis in stroke patients. Egypt J NeurolPsychiatNeurosurg. 2010;47(4):599-604.
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