Factors associated with balance impairments amongst stroke survivors in northern Benin: A cross-sectional study

Abstract

Background: Balance impairment is the predominant risk factor for falls in stroke survivors. A fear of falling after stroke can contribute to sedentary lifestyles, increased disability and risk of recurrence, leading to poor quality of life.Objective: To determine the frequency and factors associated with balance impairments amongst stroke survivors at the University Hospital of Parakou.Method: This cross-sectional study included adult stroke survivors. Stroke survivors after discharge were enrolled at the University Hospital of Parakou between 01 January 2020 and 30 September 2020. Balance impairments were measured by using the Berg Balance Scale (BBS), the Timed Up and Go (TUG) and the Get Up and Go (GUG) tests.Results: A total of 54 stroke survivors were included, with a mean age of 58.37 ± 12.42 years and a male predominance of 68.52%. The mean BBS score was 36.87 ± 14.34 with a minimum and a maximum of 10 and 56, respectively. Thirteen (24.07%) had balance impairments (BBS score ≤ 20), 34 (62.96%) had a TUG score ≥ 14 s (abnormal), 9 (16.67%) presented a moderate risk of falling and 6 (11.11%) presented high risk of fall with the GUG test. Post-stroke duration (odds ratio [OR] = 0.04; 95% CI: 0.04–0.30; p 0.01), severity of disability (OR = 8.33; 95% CI: 1.03–67.14; p = 0.03) and the number of physiotherapy sessions (OR = 0.18; 95% CI: 0.03–0.93; p = 0.02) were significantly associated with balance impairments.Conclusion: Our results showed that almost one quarter of stroke survivors after discharge at the University Hospital of Parakou had balance impairments. Post-stroke duration, severity of disability and the number of physiotherapy sessions were significantly associated with balance impairments.Clinical implications: [AQ1] Balance should be regularly assessed in people post-stroke. Further studies should document the content of rehabilitation and any rehabilitative efforts to improve balance in people post-stroke in Benin.

Relationships between walking speed, activities and participation in people with chronic stroke in Burundi

“…and equitably accessible rehabilitation services in low-and middle-income countries (Bernhardt et al 2020). Studies examining the frequency of balance impairments following a stroke (Chang, Gajasinghe & Arambepola 2015;Kossi et al 2021;Vincent-Onabajo, Musa & Joseph 2018) have reported prevalence rates ranging from 16.7% (Vincent-Onabajo et al 2018) to as high as 83% (Chang et al 2015;Kossi et al 2021).…”

“…Stroke is the second leading cause of death and a major cause of disability worldwide (Katan & Luft 2018). Disability because of stroke is still very common up to three years after the event (Kossi et al 2021). In a 2016 meta-analysis, the total prevalence rate for stroke in Africa was estimated to be 3.5 cases per 1000 people, with an annual increasing trend of 12.0% (Ezejimofor et al 2016).…”

“…Walking is often severely affected after stroke and the high prevalence of balance impairments remains a problem (Kossi et al 2021;Pinto et al 2014). People tend to reduce their walking speed to prevent the risk of falling, and a slow walking speed may limit one's ability to perform the activities of daily living (ADLs) and limit one's participation in family and community life (Faria-Fortini et al 2019;Wang et al 2020).…”

Exercise dosage to facilitate the recovery of balance, walking, and quality of life after stroke

“…Balance disorders are recurrent problems in stroke survivors, which could directly affect walking capacity, leading to a poor quality of life (QoL) (Kossi et al 2021;Schmid et al 2013). The main causes of poor balance after a stroke are impaired muscle coordination and loss of sensation on the affected side, especially in the legs and trunk (Aries et al 2022;Gath et al 2021).…”

Content and Effectiveness of Community-Based Rehabilitation on Quality of Life in People Post Stroke: a Systematic Review with Meta-Analysis

“…However, the number of persons with disabilities who experience stroke is gradually increasing (Adoukonou et al, 2020). Loss of balance while walking is common after stroke (Chang et al, 2021;Kossi et al, 2021), with about 70% of people living at home post stroke reporting a fall within a year of their stroke (Beyaert et al, 2015;Kossi et al, 2021). Limited walking capacity restricts the person's independent mobility and can contribute to a sedentary lifestyle, increased disability and risk of recurrence, resulting in a poorer quality of life (Nindorera et al, 2021;Schmid et al, 2013).Previous studies have shown that motor function, balance, walking capacity and independence in activities of daily living are of importance for perceived health-related QoL (Langhammer et al, 2008(Langhammer et al, , 2014Nindorera et al, 2021).Better quality of life has been reported to be associated with greater independence in daily living and mobility (Heikinheimo & Chimbayo, 2015).…”