Title
Mild Stroke, Serious Problems: Limitations in Balance and Gait Capacity and the Impact on Fall Rate, and Physical Activity
Author
Roelofs, Jolanda M.B. (Radboud University Medical Center)
Zandvliet, Sarah B. (Radboud University Medical Center)
Schut, I.M. (TU Delft Biomechatronics & Human-Machine Control)
Huisinga, Anouk C.M. (Rehabilitation Centre Klimmendaal)
Schouten, A.C. (TU Delft Biomechanical Engineering; University of Twente) 
Hendricks, Henk T. (Rijnstate Hospital)
de Kam, Digna (Radboud University Medical Center)
Aerden, Leo A.M. (Reinier de Graaf Gasthuis)
Bussmann, J.B.J. (Erasmus MC)
Geurts, Alexander C.H. (Radboud University Medical Center; Sint Maartenskliniek, Nijmegen)
Weerdesteyn, Vivian (Radboud University Medical Center; Sint Maartenskliniek, Nijmegen)
Department
Biomechanical Engineering
Date
2023
Abstract
Background: After mild stroke persistent balance limitations may occur, creating a risk factor for fear of falling, falls, and reduced activity levels. Objective. To investigate whether individuals in the chronic phase after mild stroke show balance and gait limitations, elevated fall risk, reduced balance confidence, and physical activity levels compared to healthy controls. Methods: An observational case-control study was performed. Main outcomes included the Mini-Balance Evaluation Systems Test (mini-BEST), Timed Up and Go (TUG), 10-m Walking Test (10-MWT), and 6-item version Activity-specific Balance Confidence (6-ABC) scale which were measured in 1 session. Objectively measured daily physical activity was measured for 7 consecutive days. Fall rate in daily life was recorded for 12 months. Individuals after a mild stroke were considered eligible when they: (1) sustained a transient ischemic attack or stroke longer than 6 months ago, resulting in motor and/or sensory loss in the contralesional leg at the time of stroke, (2) showed (near-) complete motor function, that is, ≥24 points on the Fugl-Meyer Assessment—Lower Extremity (range: 0-28). Results: Forty-seven healthy controls and 70 participants after mild stroke were included. Participants with stroke fell more than twice as often as healthy controls, had a 2 point lower median score on the mini-BEST, were 1.7 second slower on TUG, 0.6 km/h slower on the 10-MWT, and had a 12% lower 6-ABC score. Intensity for both total activity (8%) as well as walking activity (6%) was lower in the participants with stroke, while no differences were found in terms of duration. Conclusions: Individuals in the chronic phase after a mild stroke demonstrate persistent balance limitations and have an increased fall risk. Our results point at an unmet clinical need in this population.
Subject
accidental falls
gait
postural balance
stroke
stroke rehabilitation
transient ischemic attack
To reference this document use:
http://resolver.tudelft.nl/uuid:0acc81b0-244c-4707-a223-90caba885063
DOI
https://doi.org/10.1177/15459683231207360
ISSN
1545-9683
Source
Neurorehabilitation and Neural Repair, 37 (11-12), 786-798
Part of collection
Institutional Repository
Document type
journal article
Rights
© 2023 Jolanda M.B. Roelofs, Sarah B. Zandvliet, I.M. Schut, Anouk C.M. Huisinga, A.C. Schouten, Henk T. Hendricks, Digna de Kam, Leo A.M. Aerden, J.B.J. Bussmann, Alexander C.H. Geurts, Vivian Weerdesteyn