Effects of "Taking the Waist as the Axis" Therapy on trunk postural control disorder after stroke: A randomized controlled trial

Rong Cui; Hongtao Liu; Meng Li; Jie Wang; Junjie Mao; Weidong Ni; Furong Wang; Jingxian Pan; Long Yu; Yan Wang; Yanmin Wang; Pufeng Huang; Gaiyan Li; Yi Zhao; Ning Zhu; Chen Chen; Ziyang Pan; Ying Zhang; Weijie Fu; Jianzhong Yang

doi:10.3389/fnagi.2023.1040277

Effects of "Taking the Waist as the Axis" Therapy on trunk postural control disorder after stroke: A randomized controlled trial

Front Aging Neurosci. 2023 Jan 27:15:1040277. doi: 10.3389/fnagi.2023.1040277. eCollection 2023.

Authors

Rong Cui^{1

2}, Hongtao Liu¹, Meng Li¹, Jie Wang¹, Junjie Mao³, Weidong Ni¹, Furong Wang¹, Jingxian Pan¹, Long Yu¹, Yan Wang¹, Yanmin Wang¹, Pufeng Huang¹, Gaiyan Li¹, Yi Zhao⁴, Ning Zhu¹, Chen Chen⁵, Ziyang Pan⁶, Ying Zhang¹, Weijie Fu², Jianzhong Yang¹

Affiliations

¹ Department of Rehabilitation, Shanghai Xuhui Central Hospital, Shanghai, China.
² School of Exercise and Health, Shanghai University of Sport, Shanghai, China.
³ Department of Respiratory and Critical Care Medicine, Shanghai Xuhui Central Hospital, Shanghai, China.
⁴ Department of Neurology, Shanghai Xuhui Central Hospital, Shanghai, China.
⁵ Shanghai Hongrun Boyuan School, Shanghai, China.
⁶ Shanghai Yichuan Middle School, Shanghai, China.

Abstract

Background: Sufficient attention to trunk rehabilitation after stroke is still lacking. Loss of trunk selective activity is considered to be the leading cause of trunk postural control disorder after stroke. "Taking the Waist as the Axis" Therapy (WAT) was developed as a combination of the concept of "Taking the Waist as the Axis" from Tai Chi and the rehabilitation of trunk dysfunction after stroke. The present clinical trial examined and assessed the effects of WAT on stroke patients.

Methods: A total of 43 stroke hemiplegic patients with trunk postural control disorder, whose Trunk Impairment Scale (TIS) scoring between 8 and 18, participated in the present study and were allocated randomly to the experimental (n = 23) or control groups (n = 20). The experimental group received WAT plus conventional therapy, and the control group received "Trunk Selective Activity" Therapy (TSAT) plus conventional therapy. Both groups received treatment once daily and 5 times per week for 3 weeks. The Trunk Impairment Scale (TIS), Fugl-Meyer Assessment (FMA), Berg Balance Scale (BBS), change of Intra-abdominal Pressure (IAP), static balance ability assessment, rapid ventilation lung function test and the Modified Barthel Index (MBI) were evaluated before and after intervention for both groups.

Results: The experimental group was superior to the control group in TIS [4 (2, 5) vs. 3 (1.25, 4), p = 0.030], change of IAP [-3 (-8, -1.33) vs. -0.02 (-3.08, 6), p = 0.011], FMA-upper extremity [10 (6, 18) vs. 1 (0, 3), p = 0.002], FMA-lower extremity [2 (1, 4) vs. 1 (0, 2), p = 0.009] and FMA [14 (7, 21) vs. 2 (0.25, 3.75), p = 0.001]. Within experimental group, forced vital capacity (FVC) [81.35 (63.30, 94.88) vs. 91.75 (79.40, 97.90), p = 0.02] was significantly improved.

Conclusion: WAT was an effective trunk treatment after stroke, which significantly improved the patients' trunk posture control ability, motor function and forced vital capacity. However, the results still need to be interpreted with caution for the intervention only lasted for 3 weeks.

Keywords: Tai Chi; selective activity; stroke; trunk postural control disorder; “Taking the Waist as the Axis” Therapy (WAT).