Schinkel-Ivy Alison, Wong Jennifer S, Mansfield Avril
Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada.
Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada.
J Stroke Cerebrovasc Dis. 2017 Feb;26(2):237-245. doi: 10.1016/j.jstrokecerebrovasdis.2016.07.022. Epub 2016 Dec 7.
Reduced balance confidence is associated with impairments in features of balance and gait in individuals with subacute stroke. However, an understanding of these relationships in individuals at the chronic stage of stroke recovery is lacking. This study aimed to quantify the relationships between balance confidence and specific features of balance and gait in individuals with chronic stroke.
Participants completed a balance confidence questionnaire and clinical balance assessment (quiet standing, walking, and reactive stepping) at 6 months postdischarge from inpatient stroke rehabilitation. Regression analyses were performed using balance confidence as a predictor variable, and quiet standing, walking, and reactive stepping outcome measures as the dependent variables.
Walking velocity was positively correlated with balance confidence, whereas mediolateral center of pressure excursion (quiet standing) and double support time, step width variability, and step time variability (walking) were negatively correlated with balance confidence.
This study provides insight into the relationships between balance confidence and balance and gait measures in individuals with chronic stroke, suggesting that individuals with low balance confidence exhibited impaired control of quiet standing as well as walking characteristics associated with cautious gait strategies. Future work should identify the direction of these relationships to inform community-based stroke rehabilitation programs for individuals with chronic stroke, and determine the potential utility of incorporating interventions to improve balance confidence into these programs.
平衡信心降低与亚急性中风患者的平衡和步态特征受损有关。然而,目前尚缺乏对中风恢复慢性期患者这些关系的了解。本研究旨在量化慢性中风患者平衡信心与平衡和步态特定特征之间的关系。
参与者在住院中风康复出院后6个月完成平衡信心问卷和临床平衡评估(安静站立、行走和反应性跨步)。以平衡信心作为预测变量,安静站立、行走和反应性跨步结果测量作为因变量进行回归分析。
步行速度与平衡信心呈正相关,而静立状态下的压力中心左右偏移以及双支撑时间、步幅宽度变异性和步幅时间变异性(行走时)与平衡信心呈负相关。
本研究深入探讨了慢性中风患者平衡信心与平衡及步态测量之间的关系,表明平衡信心低的患者在安静站立控制以及与谨慎步态策略相关的行走特征方面存在受损。未来的工作应确定这些关系的方向,为慢性中风患者的社区中风康复计划提供参考,并确定将改善平衡信心的干预措施纳入这些计划的潜在效用。