İnmeli Hastalarda Bobath Eğitimine Ek Olarak Uygulanan Gövde Propriosepsiyon Eğitiminin Denge, Yürüyüş ve Gövde Pozisyon Hissi Üzerine Olan Etkilerinin Araştırılması

Abstract

Karaca O. Investigation of the effects of trunk proprioception training applied in addition to Bobath training on balance, gait and trunk position sense in stroke patients. Hacettepe University, Graduate School of Health Sciences, Neurology Physiotherapy Programme Philosophy of Doctorate Thesis, Ankara, 2023. The aim of this study is to investigate the effects of proprioception training applied in addition to trunk-centered Bobath exercises on trunk functions, trunk position sense, balance, walking function, activities of daily living, and quality of life in stroke patients. 27 stroke individuals were included in the study. Individuals were randomly divided into two groups. In addition to routine physiotherapy, the individuals in the first group received proprioception training with trunk-centered Bobath exercises (Group 1), and the individuals in the second group received trunk-centered Bobath exercises in addition to routine physiotherapy (Group 2). As proprioceptive training, TENS and foam stick applications were applied to the posterior-lateral region of the trunk and trunk reposition exercises were used. In addition to routine treatment, exercises were applied for 8 weeks, 3 days a week and 40 minutes a day. Individuals were evaluated twice, before and after treatment. Trunk functions and trunk position sense were assessed using the Trunk Impairment Scale and trunk reposition error (TRE). Balance and walking performance were assessed using the Berg Balance Scale, Functional Reach Test, and 2-minute walking test. Motor functions and mobility were assessed using the Stroke Rehabilitation Assessment of Movement and Fugl Meyer Assessment. Activities of daily living and quality of life were assessed using the Barthel Index and Stroke-Specific Quality of Life Scale respectively. The mean age of 11 patients in Group 1 was 63.1±13.6 years, while the mean age of 12 patients in Group 2 was 62.3±10.2 years. As a result of intra-group analyses performed before and after treatment, trunk functions, trunk position sense, balance and walking performance, motor functions and mobility, activities of daily living and quality of life were found to be statistically significant improvements in both groups (p<0.05). According to the analysis results between the groups, no significant difference was found in all evaluated parameters except for the TRE parameter (p>0.05). The mean difference of the GRH values of the participants in Group 1 before and after the treatment was found to be significantly lower than Group 2 (p<0.05). According to the results obtained from this study shows that Bobath exercises are effective in developing trunk position sense as well as trunk functions. In addition, proprioception training applied in addition to Bobath exercises provided further development of trunk position sense. We think that new studies should be planned to investigate the effectiveness of sensory training with different content to be applied to the trunk and/or different body parts.