Medina-Rincón A1,2, Bagur-Calafat C1, Perez LM2, Girabent-Farrés M1
1Universitat Internacional de Catalunya, Physical Therapy, Barcelona, Spain, 2Hospital Sociosanitari Pere Virgili, Rehabilitation, Barcelona, Spain
Background: Balance impairment is post-stroke one of the most frequent and disabling post-stroke consequences. Despite the complexity of post-stroke balance disorders, current evidence are focused on the effectiveness of exercises or techniques on specific aspects of balance. Nowadays, there is no evidence on the effectiveness of an integral approach of post-stroke balance impairments.
Purpose: To assess if the implementation of a clinical guideline that address post-stroke balance impairments focusing on the equilibrium systems, improves the deficit and the patients autonomy, and also decreased the risk of falls.
Methods: Randomized control trial on post-stroke patients (Clinical Trials ID: NCT 03406026) admitted to a geriatric rehabilitation unit. A total of 65 patients were included (experimental n=33, control n=32). Experimental group has received 45 min of usual physiotherapist treatment plus 15 min of the clinical guideline proposed. The control group has received 60 min of usual physiotherapist. Sociodemographic, clinical (balance and gait impairment, falls risk, stroke characteristics) and functional data was collected at baseline and 30 day, at the end of treatment. The statistical analysis was carried out by Mann-Whitney U test with SPSS 22.0 software. The significance level was 5%.
Results: After the treatment, in reference to balance and gait, the experimental group improved significantly more than the control group in all subscales of Mini BESTest. Total score was 6.4 points higher in the experimental group (p-value= 0.002). In addition, the experimental group had improved more than the control group in dynamic balance and falls risk assessed with Berg Balance Scale (p-value= 0.08). Consecuently, the patients of the experimental group at the end of the treatment were more autonomous according to Barthel Index.
Conclusion(s): This study provides strong evidence of the effectiveness of balance training through an exercise protocol based on balance systems to improve balance, gait, autonomy and risk of falls in subacute phase stroke patients.
Implications: This balance exercises protocol provide an effective standardized treatment to improve the autonomy of patients with stroke and supposes a reduction in socio-health costs.
Keywords: Stroke rehabilitation, Balance, Protocol
Funding acknowledgements: This work was not funded.
Purpose: To assess if the implementation of a clinical guideline that address post-stroke balance impairments focusing on the equilibrium systems, improves the deficit and the patients autonomy, and also decreased the risk of falls.
Methods: Randomized control trial on post-stroke patients (Clinical Trials ID: NCT 03406026) admitted to a geriatric rehabilitation unit. A total of 65 patients were included (experimental n=33, control n=32). Experimental group has received 45 min of usual physiotherapist treatment plus 15 min of the clinical guideline proposed. The control group has received 60 min of usual physiotherapist. Sociodemographic, clinical (balance and gait impairment, falls risk, stroke characteristics) and functional data was collected at baseline and 30 day, at the end of treatment. The statistical analysis was carried out by Mann-Whitney U test with SPSS 22.0 software. The significance level was 5%.
Results: After the treatment, in reference to balance and gait, the experimental group improved significantly more than the control group in all subscales of Mini BESTest. Total score was 6.4 points higher in the experimental group (p-value= 0.002). In addition, the experimental group had improved more than the control group in dynamic balance and falls risk assessed with Berg Balance Scale (p-value= 0.08). Consecuently, the patients of the experimental group at the end of the treatment were more autonomous according to Barthel Index.
Conclusion(s): This study provides strong evidence of the effectiveness of balance training through an exercise protocol based on balance systems to improve balance, gait, autonomy and risk of falls in subacute phase stroke patients.
Implications: This balance exercises protocol provide an effective standardized treatment to improve the autonomy of patients with stroke and supposes a reduction in socio-health costs.
Keywords: Stroke rehabilitation, Balance, Protocol
Funding acknowledgements: This work was not funded.
Topic: Neurology: stroke; Disability & rehabilitation
Ethics approval required: Yes
Institution: Universitat Autònoma de Catalunya
Ethics committee: Committee of Ethics in Animal and Human Experimentation
Ethics number: 3669
All authors, affiliations and abstracts have been published as submitted.
