Clinical evaluation of balance in hemiparetic adults: a systematic review

Abstract

Introduction Hemiparesis is a common post-stroke impairment often associated with balance deficits. Standardized instruments for balance assessment may be useful in identifying individuals at risk of falling and evaluating intervention outcomes. Objectives To identify instruments with adequate psychometric properties and clinical application to assess balance in hemiparetic cases within the scope of physiotherapy and to verify tools most frequently used in studies that evaluated the effects of therapeutic interventions in order to improve the balance of hemiparetic patients. Methods A search was conducted in the Medline, Lilacs, PEDro, and Web of Science databases by two independent researchers, who selected and analyzed studies that evaluated the reliability and validity of balance assessment instruments and intervention results. Results and discussion The Berg Balance Scale was the most frequently used instrument in the intervention studies. Nine single-task tests (timed up and go, functional reach test, step test, four-square step test, side step test, supported standing balance, standing arm raise, static tandem standing, and weight shifting) and six multiple-task tests (Berg balance scale, Brunel balance assessment, Fugl-Meyer Assessment/balance section, mini balance evaluation systems test, and postural assessment scale for stroke patients) demonstrated adequate psychometric properties and clinical applications to assess balance in hemiparetic individuals. Conclusions The Berg Balance Scale had the most widely studied psychometric properties and was the most frequently used scale in the intervention studies. Further studies are required to validate and adapt other instruments for the Brazilian population.

Effect of Physiotherapy Treatment with Immersive Virtual Reality in Subjects with Stroke: A Protocol for a Randomized Controlled Trial

“…The most common alterations caused by stroke are associated with impairment of the motor components of movement, hemiparesis and balance disorders [56]. Static balance in these subjects is essential for activities such as standing, and dynamic balance for walking and climbing stairs.…”

Effects of Immersive and Non-Immersive Virtual Reality on the Static and Dynamic Balance of Stroke Patients: A Systematic Review and Meta-Analysis

“…The most common disabilities caused by stroke are associated with impaired motor components, hemiparesis, and balance disorders. In addition, these changes compromise the safe walking of patients at home and in the community, increasing the probability of falls [ 7 ].…”

The Effectiveness of Telerehabilitation on Balance and Functional Mobility in Patients with Stroke: A Systematic Review and Meta-Analysis

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Globally, stroke is one of the major causes of mortality and long-term disabilities (Bevan et al, 2012). One of the most frequent stroke deficits is balance impairment, which makes it difficult for patients to walk safely and increases the risk of falls which can lead to serious injuries and complications (Bambirra et al, 2015), so it is crucial to enhance stroke survivors' ability to regain their balance (Junata et al, 2021). Moreover, a patient's ability to be balanced is necessary to perform tasks like standing, walking, and climbing stairs, hence it plays a significant role in determining one's quality of life (Cho & Kim, 2020).After hospital discharge, stroke survivors commonly experience secondary physical and functional problems.

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