The effect of combined isometric and isotonic exercises on brain stroke patients’ static balance

Document Type : Original Quantitative and Qualitative Research Paper


1 Professor in Physical Education and Sport Sciences, Ferdowsi University of Mashhad, Iran

2 Assistant Professor in Neurology, Islamic Azad University of Mashhad, Iran

3 MSc in Physical Education and Sport Sciences, Ferdowsi University of Mashhad, Iran


Background: Balance in stroke patients because of damage to muscles and control centers of the body are disrupted.
Aim: To determine the effect of combined isometric and isotonic exercises on brain stroke patients’ static balance.
Method: In this clinical trial, 30 male patients with brain stroke were randomly allocated to one of experimental or control groups. An 8-week combined isometric and isotonic exercise program was performed at Ferdowsi University of Mashhad.  The program was performed for an hour three times a week. Before and after implementation of exercise program, the status of  subjects’ balance was measured by Biodex Stability System. The data were analyzed using independent and paired t-test ().
Results: The mean age of men in the experimental and control group was 55.07±6.11 and 52.67±5.67, respectively.  There was a significant difference in the score of static (p=0.876), lateral (p=0.001) and anterior-posterior (p=0.805) balance in the experimental group after exercise program compared to the beginning of the study.  But no significant difference was seen in this score in the control group after intervention.
Conclusion: The combined isometric and isotonic exercises have positive effect on the brain stroke patients’ static balance. Nurses can use of these exercises without any need to special equipments.


1. Akbari A, Karimi H, Ghabaei M. Effective practice on the lower limb muscles concentric antiseptor posture in patients
with chronic hemi paresis after stroke. J Research grace. 2006; 10(1):21-7 (Persian).
2.Nurian K, Kazemian A, Aslani U, masome A. Rehabilitation measures impact on quality of life of patients with
stroke. J Zanjan University of medical sciences. 2005; 13(50):22-7(Persian).
3. Sze K, Wong E, Leung H, Woo J. Falls among Chinese stroke patients during rehabilitation, J arch Phys Med Rehabil.
2001; 82(12): 19-25.
4. Hesse S, Konrad M, Uhlenbrock D. Treadmill walking with partial body weight support versus floor walking in
hemi paretic subjects. J arch Phys Med Rehabil. 1999; 80(4): 421-7.
5. Akbari A, Karimi H, Ghabaei M. Effect strengthening exercise on muscle strength and ability to move the lower
extremities in patients with chronic hemi paresis due to stroke. J two south medical. 2009; 8(1): 22-30(Persian).
6. Bohannon R, Leary K. Standing balance and function over the course of acute rehabilitation. J arch Phys Med Rehabil.
1995; 76(11):994-6.
7. Harris J, Eng J, Marigold D, Tokuno C, Louis C. Relationship of balance and mobility to fall incidence in people
with chronic stroke. J phys Ther. 2005; 85(2): 150-8.
8.Fahimi A, Karimi H, Rahbar S, Ashayeri H, Faghihzade S. Balance between independence in activities of daily living
in stroke patients to treatment centers in Tehran in 2002, J Rafsanjan university of medical sciences. 2006; 5(3):
9. Donato SM, Pulaski KH. Over view of balance impairment: Functional implications, In: gillen G, burkhardt, stroke
rehabilitional: a functional based approach. 2nd ed. Usa:mosby. 2004;145-63.
10. Hork FB, Henry S, Shumray A. Postural perturbation: New insight for treatment of balance disorders. J phys ther.
1999; 77(5): 159-72.
11. Paillex R, So A. Changes in the standing posture of stroke patients during rehabilitation. J gait Posture. 2005;
21(4): 403-9.
12. Tyson S, Hanley M, Chillala J, Selley A, Tallis RC. Balance disabilityafter stroke. JSports Phys Ther. 2006; 86(1):
13. Pedretti L.W. Occupational therapy, practice skill for physical dysfunction. Fourth Edition. copyright © 1996.
Mosby – year beck, Inc.843-80.
14. Nashner L. Adapting reflexes controlling the human posture. J exp brain Res. 1976; 26(1): 59-72.
15. Fu-Ling Tung, Cheng Hsin, Shih-Pai. Balance outcomes after additional sit-to-stand training insubjects with
stroke: a randomized controlled trial, J clin rehabil. 2010; 24(6): 533–42.
16. Srivastava A, Arun B, Taly, Anupam G, Senthil K, Thyloth M. Post-stroke balance training: Role of force platform
with visual feedback technique. J Neurol Sci. 2009; 287(1-2): 89–93.
17. Ghasemi E, Shayegannejad V, Bakhshizade F, Hosseinpour A, A comparative study of exercise therapy on functional
gait and balance in people with hemiplegic on the right and the left,J research rehabilitation science. 2007;
18. Salavat M, Moghadam M, Ebrahimi I, Arab A. Changes in postural stability with fatigue of lowerextremity frontal
and sagittal plane movers. J gait Posture. 2007; 26(2): 214–8(Persian).
19.Zandi M. The effect of combined isometric and isotonic exercises on brain stroke patients’ static balance and
muscle strength,(Thesis Physical Education & Sport Science), mashhad of school Physical Education & Sport
Science of mashhsd Ferdowsi University;1390.
20. Gerald V, Smith, Larry W, Forrester, Kenneth H, Richard F. Effects of treadmill training on
Translational balance perturbation responses in chronic hemi paretic stroke patients. J Stroke Cerebrovasc Dis. 2000;
21. Akbari A, Karimi H, Kazemnejad A, Ghabaei M. Motor dysfunction in patients with hemi paresis and the exercise
protocol in the treatment of these disorders FBS. J Shahed University Scientific – Research. 2005; 12(56):1-12
22. Vearrier L, Jeanne L, Anne S, Marjorie W. An intensive massed practice approach to retraining balance poststroke.
J Stroke Cerebrovasc Dis. 2000; 9(5): 238-45.