Prediction of Balance After Inpatient Rehabilitation in Stroke Subjects with Severe Balance Alterations at the Admission

Gath, Christian; Gianella, Matias; Bonamico, Lucas; Olmos, Lisandro; Russo, María Julieta

doi:10.1016/j.jstrokecerebrovasdis.2021.105627

Cited by 9 publications

(5 citation statements)

References 26 publications

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“…discharge is weakly related to the balance at admission (Gath et al, 2021). Here, we demonstrate that balance recovery would be a factor strongly associated with gait without physical assistance recovery (as evinced in Model 1).…”

Section: Discussionsupporting

confidence: 53%

“…The degree of motor impairments at the beginning of the rehabilitation is related to gait recovery and has been reported in previous studies (Bland et al., 2012; Duarte et al., 2010; Gianella et al., 2019; Jenkin et al., 2021; Kwah et al., 2013; Lee et al., 2021; Liao et al., 2021; Louie & Eng, 2018; Makizako et al., 2015; Masiero et al., 2007; Smith et al., 2017, 2022; Veerbeek et al., 2011). However, if we focus on patients with initial severe impairments, the balance at inpatient discharge is weakly related to the balance at admission (Gath et al., 2021). Here, we demonstrate that balance recovery would be a factor strongly associated with gait without physical assistance recovery (as evinced in Model 1).…”

Section: Discussionmentioning

confidence: 99%

“…That was a way we could ensure that the patients analyzed were those not able to stand or to remain in the standing position. These patients are those in whom admission balance is weakly related to balance at discharge (Gath et al., 2021). Moreover, in the TWIST Study (Smith et al., 2022), a BBS score below 6 was a predictor chance of achieving independent gait.…”

Section: Discussionmentioning

confidence: 99%

“…The intention would be to influence the rehabilitation planning based on the initial post‐stroke conditions. However, it has been previously reported a low association between admission balance and balance at the end of a rehabilitation program in stroke patients with severe balance impairment at the beginning of a program (Gath et al., 2021). This concept is underestimated in the stroke rehabilitation literature.…”

Section: Introductionmentioning

confidence: 97%

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Association between balance recovery during inpatient rehabilitation and gait without physical assistance in severe subacute post‐stroke patients

CF,

MG,

et al. 2023

Physiotherapy Res Intl

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Background and PurposeStudies that analyze gait without physical assistance recovery post‐stroke are scarce. There are few of the studies that analyze longitudinally the recovery of balance during the subacute post‐stroke inpatient rehabilitation. The aim of the study was to analyze the association between balance recovery during subacute stroke inpatient rehabilitation and gait without physical assistance achievement. Secondarily, to analyze the association between balance at admission of inpatient rehabilitation and gait without physical assistance achievement.MethodsAn observational, longitudinal, and retrospective cohort study was conducted. Subacute stroke subjects with an admission Berg Balance Scale below or equal to 4 points were included (n = 164). Two logistic regression models were developed. Model 1 analyzes the association between balance recovery during inpatient rehabilitation and gait without physical assistance at discharge. Model 2 analyzes the association between balance at the admission and gait without physical assistance at discharge.ResultsOf 164 severe post‐stroke patients, 60 (36.5%) achieved gait without physical assistance. Although the two models developed a statistically significant association (p < 0.001), Model 1 evinced better discrimination performance (Model 1: area below the curve was of 0.987 ‐CI 95%: 0.975–0.998‐ vs. Model 2: area below the curve 2 was of 0.705 ‐CI 95%: 0.789–0.601‐).DiscussionBalance recovery during rehabilitation was strongly associated with gait without physical assistance achievement at the time of discharge in severe subacute post‐stroke patients.Implications for Physiotherapy PracticeThe longitudinal analysis of motor recovery in severe subacute post‐stroke patients may be helpful in the decision making process during inpatient rehabilitation.

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Section: Discussionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

See 2 more Smart Citations

Association between balance recovery during inpatient rehabilitation and gait without physical assistance in severe subacute post‐stroke patients

CF,

MG,

et al. 2023

Physiotherapy Res Intl

Self Cite

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“…Balance disorders are recurrent problems in stroke survivors, which could directly affect walking capacity, leading to a poor quality of life (QoL) (Kossi et al 2021;Schmid et al 2013). The main causes of poor balance after a stroke are impaired muscle coordination and loss of sensation on the affected side, especially in the legs and trunk (Aries et al 2022;Gath et al 2021). For patients with stroke and their families, achieving independence in activities of daily living (ADL) is often the primary concern (Saulle & Schambra 2016).…”

Section: Introductionmentioning

confidence: 99%

Exercise dosage to facilitate the recovery of balance, walking, and quality of life after stroke

Amanzonwe

Triccas

Codjo

et al. 2023

S. Afr. j. physiother.

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Background: Although aerobic training (AT) and resistance training (RT) are recommended after stroke, the optimal dosage of these interventions and their effectiveness on balance, walking capacity, and quality of life (QoL) remain conflicting.Objective: Our study aimed to quantify the effects of different modes, dosages and settings of exercise therapy on balance, walking capacity, and QoL in stroke survivors.Methods: PubMed, CINHAL, and Hinari databases were searched for randomised controlled trials (RCTs) evaluating the effects of AT and RT on balance, walking, and QoL in stroke survivors. The treatment effect was computed by the standard mean differences (SMDs).Results: Twenty-eight trials (n = 1571 participants) were included. Aerobic training and RT interventions were ineffective on balance. Aerobic training interventions were the most effective in improving walking capacity (SMD = 0.37 [0.02, 0.71], p = 0.04). For walking, capacity, a higher dosage (duration ≥ 120 min/week; intensity ≥ 60% heart rate reserve) of AT interventions demonstrated a significantly greater effect (SMD = 0.58 [0.12, 1.04], p = 0.01). Combined AT and RT improved QoL (SMD = 0.56 [0.12, 0.98], p = 0.01). Hospital located rehabilitation setting was effective for improving walking capacity (SMD = 0.57 [0.06, 1.09], p = 0.03) compared with home and/or community and laboratory settings.Conclusions: Our findings showed that neither AT nor RT have a significant effect on balance. However, AT executed in hospital-located settings with a higher dose is a more effective strategy to facilitate walking capacity in chronic stroke. In contrast, combined AT and RT is beneficial for improving QoL.Clinical implications: A high dosage of aerobic exercise, duration ≥ 120 min/week; intensity ≥ 60% heart rate reserve is beneficial for improving walking capacity.

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Explainable artificial intelligence on safe balance and its major determinants in stroke patients

Lee,

Lee

et al. 2024

Sci Rep

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Prediction of Balance After Inpatient Rehabilitation in Stroke Subjects with Severe Balance Alterations at the Admission

Cited by 9 publications

References 26 publications

Association between balance recovery during inpatient rehabilitation and gait without physical assistance in severe subacute post‐stroke patients

Association between balance recovery during inpatient rehabilitation and gait without physical assistance in severe subacute post‐stroke patients

Exercise dosage to facilitate the recovery of balance, walking, and quality of life after stroke

Explainable artificial intelligence on safe balance and its major determinants in stroke patients

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