Association between balance recovery during inpatient rehabilitation and gait without physical assistance in severe subacute post-stroke patients

FYI.  What is your therapist's  EXACT REHAB PROTOCOL for balance recovery? Mine was to do the most challenging walks where perturbations(rocks, roots, mud) were common. My therapist never challenged my walking, that was a mistake, leading to delayed recovery.

Association between balance recovery during inpatient rehabilitation and gait without physical assistance in severe subacute post-stroke patients

Gath CF, Gianella MG, Bonamico L, Russo MJ

First published: 18 June 2023

https://doi.org/10.1002/pri.2029

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Abstract

Background and Purpose

Studies that analyze gait without physical assistance recovery post-stroke are scarce. There are few of the studies that analyze longitudinally the recovery of balance during the subacute post-stroke inpatient rehabilitation. The aim of the study was to analyze the association between balance recovery during subacute stroke inpatient rehabilitation and gait without physical assistance achievement. Secondarily, to analyze the association between balance at admission of inpatient rehabilitation and gait without physical assistance achievement.

Methods

An observational, longitudinal, and retrospective cohort study was conducted. Subacute stroke subjects with an admission Berg Balance Scale below or equal to 4 points were included (n = 164). Two logistic regression models were developed. Model 1 analyzes the association between balance recovery during inpatient rehabilitation and gait without physical assistance at discharge. Model 2 analyzes the association between balance at the admission and gait without physical assistance at discharge.

Results

Of 164 severe post-stroke patients, 60 (36.5%) achieved gait without physical assistance. Although the two models developed a statistically significant association (p < 0.001), Model 1 evinced better discrimination performance (Model 1: area below the curve was of 0.987 -CI 95%: 0.975–0.998- vs. Model 2: area below the curve 2 was of 0.705 -CI 95%: 0.789–0.601-).

Discussion

Balance recovery during rehabilitation was strongly associated with gait without physical assistance achievement at the time of discharge in severe subacute post-stroke patients.

Implications for Physiotherapy Practice

The longitudinal analysis of motor recovery in severe subacute post-stroke patients may be helpful in the decision making process during inpatient rehabilitation.