Background and Purpose. Balance disability is common after stroke, but there is little detailed information about it. The aims of this study were to investigate the frequency of balance disability; to characterize different levels of disability; and to identify demographics, stroke pathology factors, and impairments associated with balance disability. Subjects. The subjects studied were 75 people with a first-time anterior circulation stroke; 37 subjects were men, the mean age was 71.5 years (SD=12.2), and 46 subjects (61%) had left hemiplegia. Methods. Prospective hospital-based cross-sectional surveys were carried out in 2 British National Health Service trusts. The subjects’ stroke pathology, demographics, balance disability, function, and neurologic impairments were recorded in a single testing session 2 to 4 weeks after stroke. Results. A total of 83% of the subjects (n=62) had a balance disability; of these, 17 (27%) could sit but not stand, 25 (40%) could stand but not step, and 20 (33%) could step and walk but still had limited balance. Subjects with the most severe balance disability had more severe strokes, impairments, and disabilities. Weakness and sensation were associated with balance disability. Subject demographics, stroke pathology, and visuospatial neglect were not associated with balance disability. Discussion and Conclusion. Subjects with the most severe balance disability had the most severe strokes, impairments, and disabilities. Subject demographics, stroke pathology, and visuospatial neglect were not associated with balance disability. [Tyson SF, Hanley M, Chillala J, et al. Balance disability after stroke. Phys Ther. 2006;86:30–38.]

Sensory impairments of all modalities are common after stroke, although tactile impairment is more frequent than proprioceptive loss, especially in the leg. They are associated with the degree of weakness and the degree of stroke severity but not demographics, stroke pathology, or neglect, and they are related to mobility, independence in activities of daily living, and recovery.

Initial balance disability is a strong predictor of function and recovery after stroke. These results demonstrate the predictive validity of the BBA.

Although group analysis showed that the leg was significantly stronger than the arm, individual analysis showed that most participants had a similar degree of weakness in both limbs. When there was a difference, the lower limb was more frequently the stronger. Proximal joints were not more severely affected than distal joints. Patient demographics and stroke pathology factors were not associated with weakness, but stroke-related impairments were.