Assessment of Balance in Patients with Stroke

Abstract

Ö Öz ze et tA Am ma aç ç: : ‹nmeli hastalarda dengenin de¤erlendirilmesi, dengenin demografik özelliklerle, üst ve alt ekstremite motor fonksiyonu ile iliflkisinin araflt›r›lmas›, denge bozuklu¤unun hastanede yat›fl süresi ve rehabilitasyon sonuçlar›na etkisinin belirlenmesidir. G Ge er re eç ç v ve e Y Yö ön nt te em m: : Çal›flmaya 42-75 yafllar› ars›nda toplam 158 (89 erkek, 69 kad›n) inmeli hasta al›nd›. Hastalar›n demografik verileri kaydedildi. Denge düzeyi ve postüral kontrol Berg Denge Skalas› (BDS) ve Gövde Kontrol Testi (GKT) ile, motor fonksiyon Brunnstrom Motor ‹yileflme Evrelemesi (BM‹E) ile, ambulasyon durumu Fonksiyonel Ambulasyon Skalas› (FAS) ile de¤erlendirildi. Fonksiyonel de¤erlendirmede ise Fonksiyonel Ba¤›ms›zl›k Ölçe¤i (FBÖ) kullan›ld›. B Bu ul lg gu ul la ar r: : BDS'ye göre hastaneye yat›flta hastalar›n %44,9'unda (n=71) dengenin bozuk oldu¤u, %41,1'inde (n=65) kabul edilebilir denge düzeyi-nin oldu¤u ve %13,9'unda (n=22) dengenin iyi oldu¤u saptand›. Demografik özelliklerden yaln›zca yafl›n BDS skorlar›n› etkiledi¤i; 65 yafl ve üze-ri hastalar›n (17,66±15,04) BDS skor ortalamalar›n›n 65 yafl alt›ndaki (24,14±14,67) hastalardan anlaml› flekilde daha düflük oldu¤u saptand› (p=0,007). Üst ve alt ekstremite motor fonksiyonlar› ile denge skalalar› aras›nda pozitif anlaml› korelasyon saptand›. Dengesi bozuk olan hastalar›n hastanede yat›fl süresinin di¤er iki gruba göre (kabul edilebilir denge düzeyi ve iyi dengesi olan hastalardan) anlaml› flekilde daha uzun oldu¤u saptand›. Yat›fl ve ç›k›fl FBÖ-motor skor ortalamalar›n›n denge bozuklu¤u olan grupta di¤er iki gruptan anlaml› flekilde daha düflük oldu¤u saptand›. S So on nu uç ç: : ‹nmeli hastalarda denge bozukluklar› s›k görülmekte, hem oturma hem de ayakta durma dengesinde bozukluk olabilmektedir. Denge bozuklu¤u nedeniyle hastalar›n hastanede yat›fl süreleri uzamakta ve rehabilitasyon program›ndan kazançlar› daha az olmaktad›r. Bu nedenle inmeli hastalar, rehabilitasyon program›na bafllamadan önce denge yönünden ayr›nt›l› olarak de¤erlendirilmeli ve rehabilitasyon hedefleri belirlenirken denge bozuklu¤unun olup olmad›¤› göz önünde bulundurulmal›d›r. Türk Fiz T›p Rehab Derg 2010;56:56-61. A An na ah ht ta ar r K Ke el li im me el le er r: : ‹nme, Berg Denge Skalas›, Gövde Kontrol Testi, yat›fl süresi S Su um mm ma ar ry y O Ob bj je ec ct ti iv ve e: : Assessment of balance in patients with stroke, finding out the relation between balance and demographic characteristics and motor functions of lower and upper extremities and determining the effect of balance impairment on hospital length of stay and the rehabilitation results. M Ma at te er ri ia al ls s a an nd d M Me et th ho od ds s: : The study included a total of 158 patients (89 men, 69 women) with stroke aged between 42 and 75. Patients' demographic data were recorded. Level of balance and postural control were assessed using Berg Balance Scale (BBS) and Trunk Control Test (TCT), motor function was evaluated by Brunnstrom Motor Improvement Staging (BMIS) and ambulation by Functional A...

Evaluation of the Development in Balance in Patients with Stroke in the Rehabilitation Program in the Early Period

“…The patients with balance impairment have longer duration of hospitalization and poor outcome of rehabilitation program. 20 Our data support the literature that, TCT and BBS were positively correlated with BRS of hand, BRS of upper extremity, and BRS of lower extremity. [21][22][23] All of four extremities move in a coordination in a normal walking cycle, so that the swing of the arms is in harmony with the step frequency.…”

“…Achieving postural control and balance during sitting and standing are very important steps for independence in ADL and ability of walking after stroke. 19,20 Balance control provides walking safely with decreasing the fall risk. BBS was used for evaluating standing and walking balance in this study.…”

“…Balance impairment, which is the main reason of fall, is a common problem in post-stroke patients. 20,21,25 Although falls are more common in poststroke patients compared to healthy individuals of the same age, falls are seen in especially in late stage of the disease. During walking, 90% of chronic poststroke patients have balance impairment which causes an increase in fall risk and restrictions in ADL.…”

“…3 Therefore, determining the reasons of balance impairment gains importance for specifying the rehabilitation program. 20 Asymmetric weight distribution and lateral postural instability, which are caused by neurologic damage and changed postural mechanisms including asymmetric body weight, re-control of each lower extremities, affects balance negatively. 10 The change of center of gravity while standing on healthy extremity is more than during standing on hemiparetic extremity in post-stroke patients.…”

Effectiveness of Wii-based rehabilitation in stroke: A randomized controlled study

“…S troke is one of the leading causes of disability (1). In stroke patients, balance can be affected by various factors, such as muscular weakness, abnormal muscle tone, deficits in visual and sensory function or disturbances in vestibular mechanisms (2). Since balance dysfunction is associated with increased risk of falling, balance exercises are a critical component of the rehabilitation of stroke patients.…”