Indicators of sitting balance ability and its association with fall risk in early stroke patients

Abstract

Background & Objectives: There is insufficient data establishing correlates of sitting balance performance and its association with fall risk in patients with stroke (PwS). The primary aim of this study was to examine the indicators of sitting balance in early stroke. The secondary aim was to investigate the association between sitting balance and fall risk.

Methods: Thirty-three healthy subjects and 52 PwS in early stage (acute and subacute) were included. Trunk muscle strengths, trunk repositioning error, and the presence of core stabilization were recorded in both groups. Stroke patients were additionally assessed with Motricity Index (MI), Trunk Impairment Scale (TIS), and Stroke Assessment of Fall Risk (SAFR).

Results: In the stroke group, all trunk muscle groups’ strength and the ratio of presence of core stabilization were statistically lower than healthy participants’ (p<0.001), whereas trunk repositioning error was found higher (p<0.001). Age (β:-0.301, p=0.01), core stabilization (β:-0.291, p=0.017), proprioception (β:-0.236, p=0.036) and MI (β:0.371, p=0.003) were found to be indicators of TIS. There was a significant association between TIS and SAFR (β:-0,713; p<0,001). The strength of trunk lateral flexors (p=0,049) and extremities on the impaired side (p=0.012) were moderators of this association.

Conclusion: The trunk control in sitting was linked to core stabilization and proprioception of the trunk in PwS. The strength of trunk lateral flexors and extremities on the impaired side were moderators of the association between sitting balance and fall risk. The roles and importance of these factors in designing rehabilitation interventions need to be investigated in future studies.