Protocol
This study was observer-blinded and a pilot randomized controlled
trial (RCT) design. The patients included in the study were
randomly assigned to the WST or control group by randomly selecting
from a sealed envelope for allocation. Subjects in the WST group
participated in weight-shift training on an unstable surface using a
Balance Pad (Airex®, Aalen, Germany) and Dynamic Ball Cushion
(Dynair® ball cushion Deko, TOGU, Germany) for 30 min, five times
a week for four weeks while those in the control group participated in
a conventional exercise program for the same amount of time. All
subjects in this study received a conventional exercise program provided
by the rehabilitation hospital for 30 min, five times a week for
four weeks. The conventional exercise program was patient-specific
and consisted physiotherapy including stretching, strengthening, and
stationary bicycle. Therapists combined elements from different neurological
treatment concepts, but the main emphasis was on the neurodevelopmental
treatment concept and on motor relearning. Data
collection included trunk reposition error (TRE), Trunk Impairment
Scale (TIS), and the Timed Up and Go (TUG) test before and after
the four-week exercise period. Tests were conducted in a quiet and
well-organized therapy room and participants were given the standard
verbal instructions for the testing procedures.