Short-term and long-term predictors of balance function in stroke patients: a 6-month follow-up study

Abstract

We aimed to determine early predictors of balance function (Berg Balance Scale, BBS) at 3 and 6 months after stroke using clinical, neurophysiological, and neuroimaging variables. Seventy-nine patients with hemiparesis after a stroke were included. Demographics, stroke characteristics, and clinical variables [Mini-Mental State Examination, BBS, strength in the hemiparetic hip, knee, and ankle muscles, and Fugl-Meyer Assessment Lower Extremity (FMA-LE)] were evaluated 2 weeks poststroke, on average. Somatosensory-evoked potentials (SEP) from both tibial nerves and diffusion tensor imaging data were collected respectively within 3 weeks and 4 weeks post-onset to calculate the SEP amplitude ratio and the laterality index of fractional anisotropy of the corticospinal tract. In multiple linear regression analysis, younger age, higher FMA-LE score, and stronger hemiparetic hip extensors were independent predictors of higher BBS at 3 months post-stroke (adjusted R 2 = 0.563, P < 0.001). At 6 months post-stroke, significant predictors of higher BBS were younger age, higher FMA-LE, stronger hemiparetic hip extensors, and larger SEP amplitude ratio (adjusted R 2 = 0.552, P < 0.001), although the incremental contribution of the latter was rather small (R 2 = 0.019). We conclude that age and the initial motor impairment of the affected lower limb can inform the state of balance function at 3 and 6 months after stroke.

Balance function in critical illness survivors and evaluation of psychometric properties of the Mini-BESTest

“…We found that muscle strength, cognitive function, the presence of CIP/CIM, the primary diagnosis cerebral disease, and depression were the key factors associated with balance. This is partly in line with previous study results, as higher muscle strength was also reported as an independent predictor for enhanced balance function in patients with chronic stroke 26 and in older hip fracture patients after motor rehabilitation 75 . However, no such association was found in healthy individuals 76 .…”

“…Hence, it is essential to tackle balance impairments. Alongside balance training, targeting factors linked to balance (such as muscle strength, cognitive function, and mental health 26 – 28 ) may provide an opportunity for enhancing balance. However, neither balance nor associated factors were so far evaluated in ICU survivors.…”

A Computer Vision-Based System to Help Health Professionals to Apply Tests for Fall Risk Assessment

“…In the first capture, a straight position offers values lower than 5 • , while in the second capture there is a marked trunk swing with angles greater than 35 • (in this case, the pose has been forced for simulating a strong swing of the trunk). 15 9 of 22 patient. For instance, a person who needs to use the arms to get seated probably should get a worse score than who does not need them.…”

“…Once the problem of falls has been exposed and contextualized, it is important to review the clinical tools available to assess this risk. In the recent literature, the most used methods are the Tinetti test [ 13 , 14 ], the Berg scale [ 15 , 16 ], the Dynamic gait index [ 17 , 18 , 19 ], the test timed up-and-go (TUG) [ 20 , 21 ], the four-square test [ 22 , 23 ], the functional reach test [ 24 , 25 ], and the single leg stance test [ 26 , 27 ]. All of them have in common that they require the presence of a therapist responsible for evaluating and supervising the process [ 28 ].…”