Balance Disability After Stroke

Abstract

Background and Purpose. Balance disability is common after stroke, but there is little detailed information about it. The aims of this study were to investigate the frequency of balance disability; to characterize different levels of disability; and to identify demographics, stroke pathology factors, and impairments associated with balance disability. Subjects. The subjects studied were 75 people with a first-time anterior circulation stroke; 37 subjects were men, the mean age was 71.5 years (SD=12.2), and 46 subjects (61%) had left hemiplegia. Methods. Prospective hospital-based cross-sectional surveys were carried out in 2 British National Health Service trusts. The subjects’ stroke pathology, demographics, balance disability, function, and neurologic impairments were recorded in a single testing session 2 to 4 weeks after stroke. Results. A total of 83% of the subjects (n=62) had a balance disability; of these, 17 (27%) could sit but not stand, 25 (40%) could stand but not step, and 20 (33%) could step and walk but still had limited balance. Subjects with the most severe balance disability had more severe strokes, impairments, and disabilities. Weakness and sensation were associated with balance disability. Subject demographics, stroke pathology, and visuospatial neglect were not associated with balance disability. Discussion and Conclusion. Subjects with the most severe balance disability had the most severe strokes, impairments, and disabilities. Subject demographics, stroke pathology, and visuospatial neglect were not associated with balance disability. [Tyson SF, Hanley M, Chillala J, et al. Balance disability after stroke. Phys Ther. 2006;86:30–38.]

Fear of Falling in People With Chronic Stroke

“…Balance is commonly impaired after stroke (Corriveau, Hébert, Raîche, & Prince, 2004;Tyson et al, 2006). We found that people with FoF had significantly decreased balance compared with people without FoF (p < .001).…”

“…Each year, approximately 795,000 people experience a stroke (Go et al, 2014), which often has negative consequences. For example, balance impairment has been found to affect 83% of people with acute stroke (Tyson, Hanley, Chillala, Selley, & Tallis, 2006). Anxiety and depression are frequently observed in people with stroke (McGinnes, 2009), and depression has been found to be strongly associated with poor functional outcomes (Fure, Wyller, Engedal, & Thommessen, 2006;Hackett, Yapa, Parag, & Anderson, 2005;Pohjasvaara, Vataja, Leppävuori, Kaste, & Erkinjuntti, 2001;Schmid, Kroenke, et al, 2011).…”

A Single Trial of Transcutaneous Electrical Nerve Stimulation (TENS) Improves Spasticity and Balance in Patients with Chronic Stroke

“…Impaired balance in stroke patients is related to diminished ankle proprioception (Tyson et al 2006). In the present study, the TENS group (16%) and the placebo-TENS group (9.5%) showed similar percentage improvements in postural sway with eyes open condition on stable and unstable surfaces, the latter of which hinders proprioception for postural orientation.…”

Posturography using the Wii Balance Board™

“…The high incidence and prevalence of balance disorders after stroke and their implications for most daily activities make assessment and rehabilitation of balance a priority [1]. Severity of balance deficits have been traditionally assessed using clinical scales [2], which are usually easy to administer in the clinic and not time-consuming.…”