| Objective: To investigate the effects of the functional gait training (FGT) in the realistic environment to improve balance response and postural control ability on the activities of daily living (ADL) and the quality of life in the convalescent stroke patients with hemiplegia in the early community life, as well as the preventive effects of the fall events after discharge. Methods: Thirty two hemiplegic patients after stroke in the convalescent stage met the inclusion criteria, and were randomly divided into control group (16 cases) and experimental group (16 cases). Both the control group and the experimental group received routine rehabilitation training in the therapeutic rooms, 60 min per day, 5 days a week for 6 weeks. In addition, the experimental group was given the FGT in the realistic environment outside of the rehabilitation zone, 60 min per day, 5 days a week for 6 weeks. In all the patients the balance confidence was evaluated with the specific activity balance confidence scale (ABC) before, after 6 weeks of training, and in the third month of community life respectively; the instrumental activities of daily living (IADL) were assessed with functional activity questionnaire (FAQ) once a month for three months after discharge. All patients were followed up with phone or outpatient every month after discharge at least for three months, to collect the fall relevant data. Results: The ABC scores in both groups before training showed no significant difference (P>0.05). After six weeks of training, the scores were significantly increased as compared with those before training (P<0.01). As compared with the control group, the ABC scores in the experimental group were significantly increased (P<0.05), and the development results of the ABC were statistically significant (P<0.05). The follow-up fall related data had no significant difference between the two groups (P>0.05). The average FAQ scores were significantly lower and the ABC average scores were significantly higher in the experimental group than in the control group (P<0.05), and the ABC scores in patients with a fall were significantly lower and the FAQ scores were significantly higher (P<0.05). Conclusion: Combined with the rehabilitation in the therapeutic rooms, the FGT in the realistic environment to improve balance response and postural control ability is more effective to improve the balance confidence of stroke patients with hemiplegia, and has a positive effect on the activities of life in the community. |
