Predicting independence of gait by assessing sitting balance through sitting posturography in patients with subacute hemiplegic stroke

ABSTRACT

Background

Post-stroke sitting balance is a known predictor of independence of gait after stroke. However, previous studies used only qualitative scales or measured static or dynamic sitting balance alone.

Objectives

To investigate whether quantitative parameters of sitting posturography at post-stroke 1 month can predict independent gait.

Methods

In this prospective cohort study, we enrolled patients with first-ever stroke who could hold a sitting posture at post-stroke 1 month. Sitting balance was assessed using posturography at post-stroke 1 month. Independence of gait was assessed using functional ambulation categories at post-stroke 2 months. We predicted mobility independence at post-stroke 2 months according to sitting balance at post-stroke 1 month. We also assessed the correlation between sitting posturography parameters and clinical scales.

Results

We enrolled 27 patients. The limit of stability deviation predicted independent gait at post stroke 2 months (cutoff, 78.4%). Further, there was a high degree of correlation between sitting posturography parameters (weight-bearing distribution deviation and limit of stability deviation) and Berg Balance Scale (ρ = 0.763, ρ = 0.777; p < .001, respectively), Scale for Assessment and Rating of Ataxia (ρ = −0.853, ρ = −0.929; p < .001, respectively), and Fugl-Meyer Assessment scale (upper extremities: ρ = 0.520, ρ = 0.480 [p = .005, p = .011, respectively]; lower extremities: ρ = 0.744, ρ = 0.564 [p < .001, p = .002, respectively]) scores.

Conclusions

Sitting posturography parameters is clinically useful because they can quantitatively assess post-stroke balance and neurological impairment and predict post-stroke independence of gait even when patients cannot reach their arms forward or stand upright.

KEYWORDS:

• Stroke
• sitting posturography
• balance
• gait
• prediction

Disclosure of interest

The authors declare that there are no potential conflicts of interest to disclose.

Credit author statement

JM-L participated in the conceptualization and coordination of the study. HH-L analyzed the collected clinical data and wrote the main manuscript. JW-L collected raw data and participated in analyzing the collected clinical data. JM-L, BR-K, HJ-J, and DH-C performed critical revision of the manuscript. All authors read and approved the final manuscript.