Balance evaluation techniques and physical therapy in post-stroke patients: A literature review

Abstract

A stroke (cerebrovascular accident - CVA) is a significant social-economic issue. Approximately 15-30% of all patients develop life-long disability, 20% require over 3 months of specialized care in healthcare institutions, and the majority of the patients never recover the ability to maintain a proper vertical position. Such CVA sequelae as balance disturbances not only negatively affect patients' daily physical activity, but also result in social isolation. A number of standardized clinical scales, tests, and instrumental examination techniques have been proposed for evaluating not only post-CVA balance function, but also any changes in this function following various interventions. Even though scientific literature lists numerous methods and instruments for the improvement of balance after a CVA, not all of them are equally effective, and there have been rather controversial evaluations of some techniques. Nevertheless, the application of the majority of the techniques as complementary or alternative measures to traditional physical therapy (PT) frequently yields better results.

Effects of Cerebellar Transcranial Direct Current Stimulation (tDCS) on Timed Up and Go Test with Foot Placement in Chronic Stroke Patients

“…The imbalance is the most important complication after a stroke (1). Reduced muscle strength, decreased range of motion, poor motor coordination, and sensory system disorders can cause imbalance (1).…”

“…The imbalance is the most important complication after a stroke (1). Reduced muscle strength, decreased range of motion, poor motor coordination, and sensory system disorders can cause imbalance (1). Changing the position from sitting to standing is one of the essential activities of daily life (2), which is the basis of transitional activities from bed to the chair and chair to the toilet (3).…”

Role of Spasticity Severity in the Balance of Post-stroke Patients

“…The Activities-Specific Balance Confidence (ABC) questionnaire was used to assess the balance confidence ( Salbach et al, 2006 ; Azad et al, 2016 ) and includes16 questions asking subjects to score their confidence in performing their activities in daily living from 0% (no confidence) to 100% (complete confidence). Posturography was used to assess the static balance ( Sawacha et al, 2013 ; Lendraitienë et al, 2017 ) using two force plates which were placed together without spaces between to measure the postural sway of affected and less affected limbs independently. The examiner asked each patient to stand on the force plate with bare feet, heel spacing to be 9 cm, the angle between the two feet being 30 degrees, and upper limbs alongside the body.…”

Efeito Da Terapia Com Realidade Virtual No Equilíbrio Dinâmico De Indivíduos Pós-Acidente Vascular Encefálico

“…Diante disso, a fisioterapia expõe importante responsabilidade no tratamento dos indivíduos com sequelas de AVE, desde a minuciosa avaliação à escolha adequada dos recursos ou modalidades terapêuticas a serem utilizadas. O tratamento fisioterapêutico muitas vezes se refere à busca pela manutenção ou restauração da funcionalidade e potencial máximo que pode ser atingido pelos indivíduos 5,8 . No entanto, geralmente o processo de recuperação desta população costuma ser longo, e pode se tornar desmotivador e difícil devido à repetitividade das atividades 5 .…”