Assessment of postural balance in patients with stroke

Abstract

The Cerebral Vascular Accident (CVA) results in disabilities of paretic limbs, but few studies have investigated the impacts of CVA on perception deficits as well as related functional changes. Motor function alterations caused by CVA, such as the presence of associated reactions, loss of postural control mechanisms, and tone disorders, shift the body's center of gravity, generating a risk of falls. The aim of the present study was to evaluate postural balance changes in patients affected by CVA using the POMA-Brazil Scale (Performance Oriented Mobility Assessment). A cross-sectional study was conducted to assess postural balance changes in patients diagnosed with CVA undergoing rehabilitation at the UNIT Health Center, CEMISE Physiotherapy Service, and Maria Virgínia Leite Franco Rehabilitation Center in Aracaju, Sergipe. The B-POMA subscale consists of 13 tasks (sitting balance, rising from a chair, immediate standing balance, standing balance, eyes closed balance, 360-degree turning balance, resistance to displacement (Nudge Test), neck turning, unipedal stance balance, spinal extension, reaching upward, leaning forward, and sitting), aimed at detecting fall risk factors in elderly individuals with disabilities or chronic illnesses. Descriptive statistics were used for numerical variables, frequency distribution for demographic and clinical variables, and individuals per task, with the application of the chi-square test and the Student's t-test. Among the tasks measured according to the B-POMA subscale, sitting balance was the most frequent qualitative response (97.5%), followed by immediate standing, eyes closed, and leaning forward. Unipedal stance balance was the least common normal task (25%), and 360-degree turning was the most adaptive (62.5%). Balance changes are associated with cerebral vascular accidents in terms of dynamic equilibrium. This study demonstrated that unipedal stance balance was the most affected task, 360-degree turning balance was the most adaptive, and sitting balance was the least affected. There were no significant differences in balance scores based on sex, age, and time of injury.