ADDED EFFECT OF PILATES MAT EXERCISES ON BALANCE AND LIMITS OF STABILITY IN CHRONIC STROKE PATIENTS: A PILOT STUDY

Abstract

Background and Purpose: Stroke rehabilitation targets functional retraining of the limbs along with balance and gait. Even after extensive rehabilitation, up to 50% of stroke survivors experience motor deficits and balance problems that linger due to which the individuals are at high risk of falls. Trunk impairments though common do not manifest themselves as an individual problem and can impact balance. The purpose was to study the effect of Pilates mat exercises on balance and limits of stability in chronic stroke patients. It was hypothesized that since core training is not the point of focus in stroke rehabilitation, training the same through Pilates method could give better improvements in balance. Subjects and Methods: 9 individuals were randomly allocated to either Pilates exercise group (PG, n=5) or Control Group (CG, n=4).the CG attended a regular rehabilitation program for stroke & the balance exercises were progressed week-wise. The PG, in addition to conventional treatment, attended 18 Pilates exercise sessions over a period of 6 weeks (3 sessions / week). Tinetti Performance Oriented Mobility Assessment Scale (POMA) and Limits of Stability (LOS) including Reaction Time (RT), End Point Excursion (EPE), Maximum Excursion (MXE), Movement Velocity (MVL), and Directional Control (DC) were measured before and after the exercise program & compared to assess the training effects. [Results]: Pilates exercises positively affected both dynamic balance and LOS in Chronic Stroke patients. For LOS, the RT (0.0427) and MXE (0.0292) components showed significant improvement in the PG while the improvements in CG were not significant. Other components of LOS-EPE, MVL, DC showed improvements clinically in both PG and CG but were not statistically significant via unpaired 't' test. For dynamic balance, the improvements in POMA score were more in PG than CG (p=0.05) and were significant. Conclusion: This pilot study provides initial evidence that Pilates exercises may help improve balance and LOS in chronic stroke patients.