Relationship between balance and functional outcomes in stroke survivors

Abstract

Objective: Balance dysfunction is commonly observed following stroke. This study determined the relationship between balance dysfunction and functional status in stroke survivors. Materials and Methods: In prospective study 561 stroke survivors (66.1 (SN10.2) year, 51.1% women), using longitudinal data collected from consecutively admitted patients during 1995-2000 to the Klaipeda Hospital, were tested for functional independence by modified Rankin scale (MRS). The potential predictors (balance status, lesion side, function of limbs, mobility, age, and sex) were treated at discharge, at the 3, 6, and 12 mo follow-up after acute stroke. Results: MRS revealed significant improvement in total functional outcome between discharge and 3 mo follow-up scores (p<0.001). Functional independence significantly improved at 6 (p<0.001) and 12 (p<0.05) mo follow-up relative to previous follow-up period. Between 1 and 2 years after stroke no significant change was noted in functional outcome by MRS. Statistically significant changes of all indices, reflecting person’s function occurred between discharge and 3 mo follow-up: function of limbs (p<0.001), mobility (p<0.001), and balance status (p<0.001). Functional independence measured at 1 year was small correlated with balance at the time of discharge (r=0.12) and strong after 3 mo (r=0.75). Multiple regression analyses of functional independence at 1 year, controlling for earlier levels of functional independence, demonstrated that MRS at 3 mo and balance status at 3 mo were the most independent prognostic factors (R2=0.80). Age effects persisted when controlling for MRS at discharge (R2=0.53). Conclusion: Assessment of balance forms an important part of early management of the stroke patient.