Immediate effect of standing and sit-to-stand training on postural vertical for backward disequilibrium following stroke: a case report

Background Effects of therapeutic interventions backward disequilibrium following stroke are scarcely reported.Objective To clarify the effects of standing and sit-to-stand/stand-to-sit training aimed at postural deviation in the anterior direction for backward disequilibrium and posterior deviation of subjective postural vertical.Case Description The participant presented with backward disequilibrium and pontine hemorrhage-associated sensory impairment of the extremities. Physical therapy included standing and sit-to-stand/stand-to-sit training, expected to bias the center of gravity in the anterior direction. We measured subjective postural vertical on the sagittal plane to assess vertical perception. Backward disequilibrium was evaluated using the Backward Disequilibrium Scale. Walking ability was assessed using the functional ambulation category. These outcomes were assessed before and at 3 days post-intervention.Outcomes Neurological findings were unchanged between pre- and post-intervention. Post-intervention, in subjective postural vertical, tilt direction modulated from −6.1° to 1.3°, variability changed from 5.9° to 3.3°, and Backward Disequilibrium Scale score improved from 7 to 1 point. Functional ambulation category changed from 2 to 3.Conclusion Standing and sit-to-stand/stand-to-sit training aimed at shifting center of gravity and subjective postural vertical in the anterior direction appeared to improve backward disequilibrium and correct tilt to the anterior direction for this participant. Long-term effects of the training for this participant were not determined.