Investigation of the Effects of Vestibular Rehabilitation and Dynamic Neuromuscular

Investigation of the Effects of Vestibular Rehabilitation and Dynamic Neuromuscular Stabilization Exercises on Balance and Mobility in Patients With Hemiplegia

This study will aim to investigate the effects of vestibular rehabilitation, dynamic neuromuscular stabilization (DNS), and conservative rehabilitation exercises on balance and mobility in hemiplegic patients, and to compare the exercise programs with one another. Evaluation tools include the Brunnstrom Motor Staging, Fugl-Meyer Upper Extremity Motor Function Scale, Modified Ashworth Scale, Mini-Mental State Examination, Berg Balance Scale, Stroke Impact Scale, and Timed Up and Go test.

This study will aim to investigate the effects of vestibular rehabilitation, dynamic neuromuscular stabilization (DNS), and conservative rehabilitation exercises on balance and mobility in hemiplegic patients, and to compare the exercise programs with one another. A total of 45 hemiplegic patients will enrolled and randomized into three groups: Conventional Exercise Group (CEG, n = 15), Dynamic Neuromuscular Stabilization Group (DNSG, n = 15), and Vestibular Rehabilitation Group (VRG, n = 15). Each group will be participated in specialized exercise programs twice a week for six weeks. All groups will be underwent assessments before and after treatment. Evaluation tools include the Brunnstrom Motor Staging, Fugl-Meyer Upper Extremity Motor Function Scale, Modified Ashworth Scale, Mini-Mental State Examination, Berg Balance Scale, Stroke Impact Scale, and Timed Up and Go test.

Inclusion Criteria:

• Being 18 years of age or older
• Having experienced at least one stroke and presenting with hemiplegic symptoms
• Having passed at least one year since the stroke even
• Scoring at least 24 points on the Mini-Mental State Examination (MMSE)
• Being able to walk independently for at least 30 meters without assistance
• Being able to comply with and participate in the exercise program

Exclusion Criteria:

• Individuals with chronic pulmonary and/or cardiac diseases
• Presence of uncontrolled hypertension
• Conditions accompanied by peripheral nerve injury or lower motor neuron disorders
• Presence of additional neurological disorders such as ataxia, dyskinesia, or dystonia
• Severe spasticity, peripheral lesions, pressure ulcers, marked muscle atrophy, obesity, skin irritation, or use of a cardiac pacemaker
• Presence of vestibular symptoms such as vertigo or dizziness