Effects of the Bad Ragaz Ring Method on muscle activation of the lower limbs and balance ability in chronic stroke: A randomised controlled trial

Background: Recovery of balance and walking abilities is important for the rehabilitation of stroke patients. Objectives: To evaluate the effects of the Bad Ragaz Ring method on functional recovery in chronic stroke patients. Methods: Twenty-two chronic stroke patients were randomly assigned to two groups: a Bad Ragaz Ring method group (the experimental group) or a control group. Stroke patients in the experimental group underwent Bad Ragaz Ring exercise and comprehensive rehabilitation therapy, whereas patients in the control group underwent comprehensive rehabilitation therapy alone. The participants in both groups received therapy 3 days per week for 6 weeks. Muscle activations, balance indices, and Timed Up and Go test results were assessed before and after the 6-week therapy period. Results: The experimental group showed significant improvements in activations of tibialis anterior and gastrocnemius muscles, balance index, and Timed Up and Go test results as compared with preintervention results (p < 0.05), whereas the control group showed significant improvement in Timed Up and Go test (p < 0.05). Significant differences in posttraining gains in the activations of tibialis anterior and gastrocnemius muscles and in balance index were observed between the experimental and control groups (p < 0.05). Effect sizes for gains in the experimental and control groups were strong for tibialis anterior and gastrocnemius muscles (effect sizes, 1.04 and 1.45 respectively). Conclusion: The Bad Ragaz Ring method may be beneficial for improving balance and leg muscle activation of chronic stroke patients. Copyright (C) 2017, Hong Kong Physiotherapy Association. Published by Elsevier (Singapore) Pte Ltd.