Effect of the goal-oriented physical therapy and ergotherapy tasks and dual task activities on the Berg balance scale and balance indicators in patients with the unilateral neglect

Abstract

Purpose: to assess the effect of the goal-oriented physical therapy and ergotherapy tasks and dual task activities on balance indicators of the Berg Balance Scale (BBS) in patients with the unilateral neglect. Materials and methods: The study involved 58 patients. Stroke patients were randomly divided into main group (MG) (29 individuals) and control group (CG) (29 individuals). The exclusion criteria were scores above 3 on the Scale for Contraversive Pushing and above 14 on the NIH Stroke Scale. Physical therapy of CG patients included proprioceptive neuromuscular facilitation (PNF) (shoulder blade and upper limb patterns), balance sitting and standing training, constraint-induced motor therapy (SIMT) ergotherapeutic intervention, and exercises improving fine motor skills. MG patients used the same balance sitting and standing training, the goaloriented physical therapy and ergotherapy tasks and dual task activities.The therapy was performed 5 days a week for 14±4.2 days in the rehabilitation room. After that, therapy continued at home 3 times a week with the weekly supervision by the physical therapist for up to three months in both groups. The first assessment was performed on the BBS during the third verticalization of patients. The intermediate assessment done on the 14th day to obtain statistical intermediate results. Three months later, patients had a repeated, final assessment in all domains. Results The total score of the BBS comprised 20.0 (13.0; 25.0) pointsin all 58 patients. Thus, the mean value in the sample comprised 33.9% out of the maximum. Therefore, all the patients had a high rate of falls, since there was no higher score than 45.Total balance score in MG patients significantly increased from 19(12.5;24.7) points to 35(22.5;43.5) points (p<0.05), whereas CG patients showed positive balance dynamic on the BBS from 21(13;25) points to 40(32.5;46.5) points, however these changes were insignificant, p>0.05.At the time of intermediate assessment in both groups, 10.3% of patients scored 45 points and more. At final assessment, the share of such patients increased and comprised 17.2% in CG and 31.0% in MG (p>0.05). Conclusions: Thus, the study confirmed better efficiency of the the goal-oriented physical therapy and ergotherapy tasks and dual task activities, received by MG patients, its impact on balance and coordination restoration, if the balance training programs were the same.