Authors: (including presenting author): :
Leung NY(1), Siu CH(1), Man WK(1), Yu CH(1)
Affiliation: :
(1) Physiotherapy Department, Caritas Medical Centre
Keyword 1: :
Multi-directional Step
Keyword 5: :
Patients' satisfaction
Keyword 6: :
Physiotherapy
Introduction: :
Stroke patients commonly demonstrate deficits in balance as their center of gravity shift towards the unaffected side due to hemiplegia. They show difficulties to step their affected legs to the desired position forward, backward and laterally. At the same time, they have impaired ability to bear weight on the paretic side to move their good legs in the 3 directions of a step precisely. Multi-directional steps are essential for indoor ambulation because research showed that 35-50% of all indoor steps involve changing direction of movement, i.e. nonstraight steps. Therefore, a multi-directional step balance training with biofeedback (MSBTB) system has been introduced in Rehabilitation Medicine and Geriatrics Unit (RMG) of Caritas Medical Centre (CMC) along with conventional physiotherapy gym training for inpatient stroke survivors to encourage weight-shifting and promote their standing balance.
Objectives: :
To enhance inpatient physiotherapy stroke rehabilitation service and evaluate patients’ balance outcomes and satisfaction after introducing Multi-directional Step Balance Training with Biofeedback (MSBTB) system to conventional gym training.
Methodology: :
Data was collected since May 2025. Patients in RMG who suffered from stroke with fair standing balance, able to follow instructions and attend physiotherapy gym training were recruited. Per training session, participants received an additional MSBTB system training called “the mole” (踩地鼠) which users had to step on a virtual mole randomly popping up in multiple directions one at a time in a motion-sensing biofeedback system. To evaluate participants’ balance ability, Berg Balance Scale (BBS) was used, and pre-post outcome measures were analyzed via two-tailed Wilcoxon signed rank test. To evaluate patients’ satisfaction, a survey in 5-point Likert scale was used to collect feedback regarding the new mode of balance training.
Result & Outcome: :
Total 25 patients (19 male and 6 female) with average age 68.6±10.4 years old were recruited. They demonstrated significant improvements (p< 0.001) in balance as measured by BBS (mean from 18.0 to 33.6 out of 56). Feedback was largely positive. Some appreciated MSBTB as a new form of balance training and could motivate them to weight-shift and challenge their paretic limbs. Over 90% of participants perceived that MSBTB could improve their confidence in stepping and their standing balance. Overall, over 95% of participants were greatly satisfied with MSBTB training. These results illustrate that MSBTB is well accepted by inpatient stroke patients. To conclude, MSBTB may complement conventional physiotherapy gym training to improve balance and stepping confidence in stroke survivors, thus enhancing their indoor ambulation as a crucial preparation before discharged home.
