Clinical correlates of between-limb synchronization of standing balance control and falls during inpatient stroke rehabilitation

Neurorehabil Neural Repair. 2012 Jul-Aug;26(6):627-35. doi: 10.1177/1545968311429688. Epub 2012 Jan 24.

Abstract

Background: Stroke-related sensorimotor impairment potentially contributes to impaired balance. Balance measures that reveal underlying limb-specific control problems, such as a measure of the synchronization of both lower limbs to maintain standing balance, may be uniquely informative about poststroke balance control.

Objective: This study aimed to determine the relationships between clinical measures of sensorimotor control, functional balance, and fall risk and between-limb synchronization of balance control.

Methods: The authors conducted a retrospective chart review of 100 individuals with stroke admitted to inpatient rehabilitation. Force plate-based measures were obtained while standing on 2 force plates, including postural sway (root mean square of anteroposterior and mediolateral center of pressure [COP]), stance load asymmetry (percentage of body weight borne on the less-loaded limb), and between-limb synchronization (cross-correlation of the COP recordings under each foot). Clinical measures obtained were motor impairment (Chedoke-McMaster Stroke Assessment), plantar cutaneous sensation, functional balance (Berg Balance Scale), and falls experienced in rehabilitation.

Results: Synchronization was significantly related to motor impairment and prospective falls, even when controlling for other force plate-based measures of standing balance control (ie, postural sway and stance load symmetry).

Conclusions: Between-limb COP synchronization for standing balance appears to be a uniquely important index of balance control, independent of postural sway and load symmetry during stance.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accidental Falls*
  • Adult
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Biomechanical Phenomena
  • Extremities / physiopathology*
  • Female
  • Functional Laterality
  • Humans
  • Inpatients
  • Male
  • Middle Aged
  • Movement / physiology*
  • Movement Disorders / etiology
  • Postural Balance*
  • Posture / physiology*
  • Psychomotor Performance / physiology
  • Retrospective Studies
  • Stroke / complications
  • Stroke Rehabilitation*
  • Time Factors