ArticleRecovery of standing balance in postacute stroke patients: a rehabilitation cohort study1
Section snippets
Participants
All patients with a first hemispheric intracerebral infarction or hematoma admitted to our rehabilitation clinic from November 1998 until November 2000 for retraining motor skills and self-care abilities were eligible. Patients who on admission already walked safely and patients with medication or nonstroke-related sensory or motor impairments that could interfere with their postural regulation were excluded. Basing our decisions on practical assessment, we also excluded patients with
Cohort
Five follow-up assessments were completed in 37 stroke patients. Patients’ biologic characteristics are in table 1. At the start of the balance training, 24 patients (65%) had a disturbed sensibility in their paretic leg, 19 patients (51%) had an ankle clonus, and 22 patients (59%) had a disturbed trunk control. In 16 patients (43%), some degree of visuospatial hemineglect was found. As for the functional measures, the median Brunnstrom stage was IV (range, II-VI) at the start of the balance
Discussion
The primary goal of this study was to identify and interrelate both static (ie, related to COP position) and dynamic (ie, related to COP movement) characteristics of the restoration of standing balance in a representative group of first-ever stroke survivors during their inpatient rehabilitation in the Netherlands to better understand underlying mechanisms of functional recovery. Only 2 patients were coincidentally lost to follow-up.
As expected, the study sample was relatively young and
Conclusions
To our knowledge, this is the largest study aimed at the recovery of postural characteristics of first-ever stroke survivors during their inpatient rehabilitation. Our results indicate that these patients suffer from severe postural instability as well as from several (both static and dynamic) aspects of postural asymmetry during quiet standing in the frontal and sagittal planes. Functional improvements during rehabilitation appear to be most prominent in the frontal plane, as indicated by a
Acknowledgements
We thank Bart Nienhuis for his technical assistance, and the Department of Physical Therapy and Ilse van Nes for help during the posturographic assessments.
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