Objective : The purpose of this study is to compare the effects of postural vertical training with and without visual feedback to improve functional recovery and activities of daily living in stroke hemiparesis with pusher syndrome.
Method : This study used a single subject experimental design alternating with multiple baselines across individuals. Participant 1, 2, and 3 performed 4, 7, and 10 sessions each during the baseline phase, and 14, 11, and 8 sessions at the intervention, respectively. Assessments were made by using the Scale for Contraversive Pushing (SCP) and the Barthel Index (BI), which were separately implemented. Additionally, EMG was separately applied for the evaluation of activation of both gluteus medius muscles in pre-/post intervention.
Results : The SCP scores of participant 1, 2, and 3 were respectively improved by 52.4%, 36.4%, and 23.6% in postural vertical training without visual feedback; however, less improvement occurred on postural vertical training with visual feedback, as the scores were 42.9%, 26.1%, and 13.2% each. Likewise, the BI scores of participants 1, 2, and 3 were improved by 22.4%, 15.5%, and 15.8% in postural vertical training without visual feedback, while the scores were improved by 17.0%, 11.4%, and 14.8%, relatively with postural vertical training with visual feedback. Additionally, the result of electromyography on the gluteal muscle was improved in post-intervention, as compared to preintervention.
Conclusion : The findings suggest that postural vertical training without visual feedback is more adaptable in clinical applications than postural vertical training without visual feedback on functional recovery and activities of daily living in stroke hemiparesis with pusher syndrome. Future studies, using more participants and longterm training, are required to generalize the results of this study.