A cohort study on longitudinal changes in postural balance during the first year after stroke.
Introduction: Many patients with strokes report increased incidence of fall that can be due to impaired postural balance. The recovery of balance in patients with varying degrees of impairments and activity limitations is less studied, and whether individuals with mild paresis can recover their bala...
| Published in: | BMC Neurology Vol. 22; no. 1; pp. 1 - 13 |
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| Main Authors: | , , , |
| Format: | Journal Article |
| Published: |
BioMed Central
8/30/2022
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=158813858&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 158813858 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14712377 1CI7 jtl: BMC Neurology issn: 14712377 maglogo: N pubinfo: dt: 8/30/2022 vid: 22 iid: 1 pid: 24147 pub: BioMed Central artinfo: ui: 158813858 158813858 NLM36042404 10.1186/s12883-022-02851-7 NLM36042404 158813858 ppf: 1 ppct: 12 formats: tig: atl: A cohort study on longitudinal changes in postural balance during the first year after stroke. aug: au: Buvarp, Dongni Rafsten, Lena Abzhandadze, Tamar Sunnerhagen, Katharina S. affil: Rehabilitation Medicine Research Group, Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, University of Gothenburg, Per Dubbsgatan 14, 40530, Gothenburg, Sweden sug: subj: Stroke Complications Prospective Studies Accidental Falls Balance, Postural Scales ab: Introduction: Many patients with strokes report increased incidence of fall that can be due to impaired postural balance. The recovery of balance in patients with varying degrees of impairments and activity limitations is less studied, and whether individuals with mild paresis can recover their balance faster is unclear. Better knowledge about factors influencing the recovery of postural balance can be used to guide clinical management after stroke to provide the right rehabilitation to the right person at the right time, and thus to avoid potential fall incidences.Objective: This study aims to examine longitudinal changes in postural balance during the first year after stroke.Methods: Postural balance was assessed using the Berg Balance Scale (BBS) within 5 days, 1, 2, and 3 months and 1-year post-stroke. Stroke severity was stratified using a cluster analysis by including multidimensional baseline measures. A longitudinal mixed-effect model was constructed to analyze changes in proportional balance impairment by stroke severity over time. Individuals with a cut-off of BBS below 45 scores were identified through a classification algorithm using baseline predictors.Results: A total of 135 patients were stratified to mild stroke (77 [57%] patients) or moderate stroke (58 [43%] patients). Ninety-three patients were included in the longitudinal analysis. Significant recovery was found at 1-year for moderate stroke (48% recovery from the initial impaired postural balance, adjusted P < 0.001), but not for mild stroke, after adjusting for age and cognition. Both stroke severities had a maximal recovery in postural balance at 3 months post-stroke, but the moderate stroke group deteriorated after that. Patients with higher age and worse cognition had more severe balance impairments. The classification model achieved a sensitivity of 0.95 (95% confidence interval [CI]: 0.91-0.98) and a specificity of 0.99 (95% CI: 0.98-1.0) for classifying individuals with BBS below 45 points.Conclusions: This study indicates that continuous improvements in postural balance ends at 3 months regardless for mild or moderate stroke groups, and patients with moderate stroke significantly deteriorate in postural balance after 3 months. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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