Jayne Garland – Abstract

Do reactions to balance perturbations improve with Fast muscle Activation and Stepping Training (FAST) in sub-acute stroke?

Garland SJ[1,2,] Ivanova TD[1], Siedlecki P[3], Peters S[4], Hunt M[4]. Pollock C[4]. and Miller K[5].
1. Faculty of Health Sciences, Western University
2. Department of Physiology and Pharmacology, Western University
3. School of Kinesiology, Western University
4. Department of Physical Therapy, University of British Columbia
5. Childrens Hospital of British Columbia

Postural reactions to balance perturbations are known to be impaired following stroke (1). A Fast muscle Activation and Stepping Training (FAST) protocol was designed to improve the speed of postural reactions and tested using a randomized controlled trial (2). Sixty-five participants received 12 sessions of outpatient physical therapy following discharge from in-patient rehabilitation and were randomly assigned to either FAST or usual care. Clinical measures of balance (Community Balance and Mobility Scale, Berg Balance Scale) and strength, as well as physiological balance measures (EMG, kinetic and kinematic data during internal arm-raise perturbations and external perturbations) were collected before, immediately after, and after 4 weeks retention. We hypothesized that while FAST and usual care would both produce improvements in clinical measures of balance, FAST would produce more effective postural reactions to balance perturbations than usual care. We also explored whether there was a relationship between clinical characteristics and responders/non-responders to the FAST treatment. Preliminary data analysis suggests that EMG measures may be too variable to be used as a primary outcome but biomechanical variables, which may be easier for clinicians to collect and interpret show more promise.

1. Garland et al. Motor Control 13: 387-411, 2009
2. Miller et al. BMC Neurology 14: 187, 2014