Postural control during quiet standing and voluntary stepping response tasks in individuals post-stroke: a case-control study

ABSTRACT

Background

Postural control impairments following a stroke have an impact on mobility, reduce independence, and increase the risk of falls. Assessing these impairments during tasks representative of real-life situations, such as quiet standing (QS) and voluntary stepping response (VSR), will enhance our understanding of how the postural control system is impaired in individuals post-stroke (IPS). It will also inform the development of a more targeted and effective rehabilitation to prevent falls in IPS.

Objectives

Identify the postural control impairments encountered by IPS during QS and VSR.

Methods

Twenty IPS and 16 healthy controls were recruited to perform QS and VSR tasks, while ground reaction forces and whole-body motion were measured. Displacement and speed variation of the COM, center of pressure (COP) displacement and spatiotemporal data were calculated and compared between groups.

Results

During QS, IPS exhibited greater maximal COP displacement in mediolateral direction, COM displacement in vertical direction and COM speed excursions compared to controls. During VSR, IPS exhibited smaller step length, braking force, posterior foot placement in relation to the pelvis and COM anteroposterior excursion compared to controls. IPS presented less static and dynamic postural stability compared to controls.

Conclusions

Greater postural sway during QS, smaller anteroposterior COM displacement before losing balance and altered voluntary recovering steps during VSR could place IPS at more risk of falling when they face a postural challenge in the community. These novel results will improve the current knowledge base and should be considered in IPS rehabilitation.

KEYWORDS:

• Biomechanics
• balance control
• stroke
• postural control
• quiet standing
• voluntary stepping response

Declaration of interest statement

The authors have no conflict of interest in this study.

Additional information

Funding

This study was funded by the Canadian Institutes of Health Research (CIHR) and the Fonds de Recherche du Québec-Santé (FRQS) through scholarship received by the first author and Thailand Research Fund through the Royal Golden Jubilee PhD program (grant number PHD/0076/2558) received by the second author;Canadian Institutes of Health Research;Thailand Research Fund through the Royal Golden Jubilee PhD program ;Fonds de recherche du Québec-Santé;