Revista de fisioterapia y rehabilitación física

Can Quantitative Balance Measures discriminate between Functional Ambulation Categories in Chronic Stroke Survivors?

Abstract

Isha S. Akulwar

Title: Can Quantitative Balance Measures discriminate between Functional Ambulation Categories in Chronic Stroke Survivors?

Background: The limited walking ability that follows a stroke restricts a patient’s independent mobility about the home and community, a significant social handicap. This study investigated the relationship between quantitative balance indices and functional ambulation level in stroke patients. The purpose was to explore whether we could provide supportive laboratory evidence for the association between balance and ambulatory level in stroke patients based on computerized dynamic post urography.

Study design: Cross-sectional, observational, descriptive study

Setting: Physiotherapy department in a tertiary care center in Mumbai

Participants: 40 ambulatory stroke patients (mean age = 54.07 ± 11.9 years)

Main outcome measures:

1) Static and dynamic balance was assessed using computerized force plate system

2) Functional ambulation level was determined using Modified Hoffer functional ambulation classification (FAC).

Results: According to FAC, 29.26% of the patients were community walkers. One way ANNOVA showed that static and dynamic balance indices were significantly different with functional ambulation categories. Weight bearing asymmetry during quiet stance (p<0.04); COG sway velocity (p<0.04), weight transfer time (p<0.04) and rising index (p< 0.02) during sit to stand can discriminate between household and community ambulators.

Conclusion: Balance is a significant factor in the attainment of independent functional ambulation in chronic stroke patients. The functional mobility capability of stroke patients may be quantified analytically using static and dynamic balance indices. The key balance factors identified through this study need to be specifically targeted for training and as outcome measures while monitoring the progress of patients through different functional ambulation categories. Results of this study offer a quantitative method of relating the social disadvantage of stroke patients to the impairments.