INTRODUCTIONAn observational study was carried out to estimate the strength of the relationships among balance, mobility and falls in hemiplegic stroke inpatients. The objective was to examine factors that may aid in the prediction of the likelihood of falls in stroke patients.METHODS A total of 53 stroke patients (30 male, 23 female) aged 67.0 ± 11.1 years were interviewed regarding their fall history. Physical performance was assessed using the Berg Balance Scale (BBS) and the Functional Independence Measure (FIM) scale. Variables that differed between fallers and non-fallers were identified, and a discriminant function analysis was carried out to determine the combination of variables that effectively predicted fall status. RESULTSOf the 53 stroke patients, 19 were fallers. Compared with the non-fallers, the fallers scored low on the FIM, and differed with respect to age, time from stroke onset, length of hospital stay, Brunnstrom recovery stage and admission BBS score. Discriminant analysis for predicting falls in stroke patients showed that admission BBS score was significantly related to the likelihood of falls. Moreover, discriminant analysis showed that the use of a significant BBS score to classify fallers and non-fallers had an accuracy of 81.1%. The discriminating criterion between the two groups was a score of 31 points on the BBS. CONCLUSIONThe results of this study suggest that BBS score is a strong predictor of falls in stroke patients. As balance is closely related to the risk of falls in hospitalised stroke patients, BBS might be useful in the prediction of falls.

In this study, we performed 6-minutes walking tests using a portable gas analyzer in patients with post-stroke hemiparesis, and examined the effects of ankle-foot orthosis (AFO) application on the walking ability and energy expenditure during walking. The subjects were 18 patients with post-stroke hemiparesis, who were admitted to the rehabilitation care unit of our rehabilitation center, and could walk. We performed 6-min walking tests with and without AFO application in these patients, and examined the walking distance and velocity, oxygen consumption (VO2), and heart rate (HR) during walking. The oxygen consumption per meter (VO2m −1 ) and physiological cost index (PCI) were determined as the efficiency of kinetic energy. The difference in the VO2 during walking was not significant between application and non-application of the AFO, but the differences in the walking distance and velocity and the VO2m −1 and PCI were significant. It was suggested that improvement of the walking ability and reduction of energy expenditure during walking were possible in motion-impaired patients with post-stroke hemiparesis by AFO application.

[Purpose] This study examined the quality of life (QOL) of homebound elderly hemiparetic stroke patients and factors that affect it. [Subjects] The subjects of the study were 21 homebound elderly hemiparetic stroke patients who were 65 years old or over and required care for daily living (12 males and 9 females, average age: 79.3 ± 8.4 years old). Their physical and psychological conditions, QOL, and other characteristics were researched. [Methods] The Functional Independence Measure (FIM) was used for the activities of daily living (ADL) assessment, and the MOS 36-Item Short-Form Health Survey (SF-36, Japanese version 1.2) was used for the QOL assessment. [Results] No correlations were observed between the QOL of homebound elderly hemiparetic stroke patients and their age and gender. However, the results showed that their QOL was affected by their independence in ADL, bedridden degree, and care-need level. [Conclusion] These results suggest that in order to improve the QOL of homebound elderly hemiparetic stroke patients, ongoing rehabilitation to improve independence in ADL and lower the bedridden degree and care-need level is required.

Adding WBV to a trunk-muscle-strengthening program may improve trunk-flexor isometric strength and anterior reach during the Y-test more than training without WBV. The WBV protocol used in this study had no significant impact on FMS scores, squat jumping, countermovement jumping, trunk-extensor isometric strength, or trunk flexor:extensor ratio.

The purpose of this study was to investigate the relationship between daily physical activity and physical fitness in twenty ambulatory post-stroke patients. The pedometric measurement was made using a caloriecounter in daily life at home and assessed to quantify the time constant (τ on) of oxygen uptake (V • O 2 ) and oxygen deficit with gas analysis using a bicycle ergometer. There were negative correlations between the amount of daily walking steps and τ on, as well as the oxygen deficit at the onset of exercise (τ on; r=-0.52, p<0.05, oxygen deficit ; r=-0.61, p<0.01 ), and positive correlations between the amount of daily walking steps and peak V • O 2 , as well as the maximal work load with gas analysis (peakV • O 2 ; r=0.61, p<0.01, maximal work load ; r=0.69, p<0.01 ). These results suggest that gait performance of daily physical activity at home was generally related with exercise endurance in ambulatory post-stroke hemiplegia.