And why would any stroke survivor care about a prediction? What stroke protocol are you suggesting to cure the affected arm? THAT is the only thing survivors want to know. Have you never talked to survivors?
Impaired Motor Function in the Affected Arm Predicts Impaired Postural Balance After Stroke: A Cross Sectional Study
Lena Rafsten
Christiane Meirelles
Anna Danielsson
Katharina S. Sunnerhagen1,2‡- 1Department of Clinical Neuroscience and Rehabilitation Medicine, Institute of Neuroscience and Physiology, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden
- 2Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
- 3Department of Therapy Service, University of Chicago Medical Center, Chicago, IL, United States
- 4Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden
Background: Impaired postural balance
is a common symptom after stroke and a common cause of falling. Most
common daily tasks use arm and hand movements. Impairment in an upper
extremity is a common stroke symptom, affecting 50–80% in the acute
phase after stroke, and 40–50% in the sub-acute phase. The impact of leg
function on postural balance has been investigated in several studies,
but few have stressed the importance of arm function on postural
balance.
Objective: To explore whether there is any association between arm function and postural balance after stroke.
Method: A cross sectional study where
121 adults (mean age: 70 ± 12.3 years, 72 men) from two different data
sources, Gothenburg Very Early Supported Discharge (GOTVED), and a study
by Carvalho et al. were merged. Time for assessments ranged from 1 to
13 years when the patients were in the chronic phase. The dependent
variables were Berg Balance scale (BBS) and Time Up and Go (TUG) both
dichotomized to “impaired postural balance” and “not impaired postural
balance.” As independent variables, the Fugl-Meyer Assessment-Upper
Extremity (FMA-UE) scale was used. The FMA-UE was presented with the
total score.
Results: The motor function in the arm affected after stroke onset correlated with postural balance both measured with the BBS (0.321, p < 0.001) and the TUG (−0.315, p = 0.001).
Having impaired motor function in the arm was significantly associated
with impaired postural balance assessed with the BBS with OR = 0.879 (CI
0.826–0.934, p < 0.001). Regression analysis with the TUG showed the same result, OR = 0.868 (CI 0.813–0.927, p < 0.001) for FM-UE.
Conclusion: The motor function of the
affected arm was significantly associated with impaired postural balance
post stroke, as assessed by BBS or TUG. It could be of clinical
importance to be aware of the fact that not only lower extremity
impairment, but also arm function can have an impact on postural balance
in a late stage after stroke.
Trial Registration: VGFOUGSB-669501.
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