A cohort study on longitudinal changes in postural balance during the first year after stroke

Area of Science:

• Neurology
• Rehabilitation Medicine
• Biomedical Engineering

Background:

• Stroke often leads to impaired postural balance, increasing fall risk.
• Understanding balance recovery in stroke survivors, especially those with mild paresis, is crucial for effective rehabilitation.
• Optimizing rehabilitation timing and type can prevent falls and improve patient outcomes.

Purpose of the Study:

• To investigate longitudinal changes in postural balance during the first year post-stroke.
• To analyze how stroke severity influences the trajectory of balance recovery.
• To identify factors affecting postural balance recovery after stroke.

Main Methods:

• Postural balance assessed using Berg Balance Scale (BBS) at multiple time points up to 1 year post-stroke.
• Stroke severity stratified using cluster analysis of multidimensional baseline measures.
• Longitudinal mixed-effects modeling analyzed balance changes over time by stroke severity.

Main Results:

• Moderate stroke patients (48% recovery) showed significant improvement by 1 year, unlike mild stroke patients.
• Maximal balance recovery for both groups occurred at 3 months, with moderate stroke patients deteriorating thereafter.
• Higher age and poorer cognition correlated with more severe balance impairments.

Conclusions:

• Postural balance improvements plateau at 3 months post-stroke for both mild and moderate severity groups.
• Patients with moderate strokes experience significant balance deterioration after the 3-month mark.
• Age and cognitive status are key predictors of balance impairment severity and recovery trajectory.