Focus on front to back sway
Using a weighted vest equivalent to 10% of body weight while doing balance training and focusing on the front to back swaying motion when walking, rather than worrying about side to side sway, may be good strategies to improve balance and prevent falls, according to the findings of this study from Korea.
The aims of this study were to identify static and dynamic balance with the addition of weighted vests for the rehabilitation of paraplegic patients. The study was conducted using weighted vest exercises with applied optimal weight ratios.
Ten paraplegic patients who use custom orthoses were enrolled for experiments including static standing and dynamic gait with a weighted vest. We set weight ratios as 0%, 10%, and 15% of the patients’ weight. A plantar pressure device was used for static balance tests for excursion and velocity of center of pressure and we identified dynamic balance through the tool of Timed Up and Go (TUG) test.
The results of static and dynamic balance in 0%, 10%, and 15% weight ratios did not have statistically significant differences, but we found an increasing tendency of sway excursion from non-weight (0%) to weight ratios (10%, 15%) in static balance when weight is applied. Sway excursion in antero-posterior direction is greater than medio-lateral sway. In dynamic balance, the TUG results showed a more delayed time when weight ratios were applied.
In conclusion, we have to focus on balance training with antero-posterior direction to upgrade a patient’s balance and prevent falls. Exercises with weighed vests are more useful than non-weighted but there is no difference between 10% and 15% weight ratios. Weighted vest exercises may play a role in the rehabilitation of balance in those with paraplegia.
SOURCE: J Exerc Rehabil. 2017 Jun 30;13(3):348-352. doi: 10.12965/jer.1734984.492. eCollection 2017 Jun. PMID: 28702448
Study of gait using weighted vests on balance with paraplegic patients.
Choi HJ1,2, Kang HJ3.
1 Department of Physical Education, Graduate School, Soonchunhyang University, Asan, Korea.
2 Korea Workers’ Compensation & Welfare Service, Rehabilitation Engineering Research Institute, Incheon, Korea.
3 Department of Sports Medicine, College of Natural Sciences, Soonchunhyang University, Asan, Korea.
I was diagnosed in 2000 with HSP and I was a very active man and I coached and played field hockey for over thirty five years as an example, but I had to stop playing in 2004 because I did not have mobility to keep balanced. I used walking sticks and I have used a walking frame for the past four years but I am pretty slow. I have a wheelchair to use now when I want to go at a greater speed. I actually did the City To Surf run using a walking stick and the following year, I used the walking frame thinking it would be quicker but no, it took me over five and half hours to complete again. But my best running time was 64 minutes when my mobility was much better. I am now wondering about the benefits of an intensive muscle stretching and building program, to be conducted twice daily and it will probably take nearly one hour and half to complete. Is there any current research available that gives positive outcome on such programs? And I do have a list of exercises to do as well. Just wondering???
Editor’s Note: A definitive ‘Yes’ answer cannot be given to your question. The outcome is dependent on a number of factors including the individual spasticity – weakness profile of the individual and potentially biomechanical considerations, as well as the stage of disease progression for an individual. Here is what is known and can be said:
* a fit, flexible and strong HSPer with good body weight maximises their potential for mobility and quality of life
* individual assessment, program development and monitoring over time by someone appropriately qualified e.g. a neurophysiotherapist is highly recommended so that issues such as spasticity and weakness in particular muscles can be specifically targeted; complementary activities such as working on balance can be specifically prescribed and monitored; and program modifications can be thoughtfully made over time based on the outcomes and appropriately modifying or extending the level of challenge in different parts of the program. The other good reason to have a neurophysio develop a program is to avoid exercises that may well benefit the average gym goer, but will worsen spasticity, create no benefit, and quickly demotivate an HSPer who heads down the wrong path.