Influences of visual and supporting surface conditions on standing postural control and correlation with walking ability in patients with post-stroke hemiplegia.

Abstract

[Purpose] To quantify the influence of visual and under-foot-surface conditions on standing balance in patients with post stroke hemiplegia and examine associations of this ordinal score with somatosensory disturbance and walking ability. [Subjects] Sixty-six patients with post-stroke hemiplegia. [Methods] Standing balance was tested in 4 conditions (firm floor or foam rubber surface with eyes open or eyes closed) for 30 s per condition and scored using a 5-category ordinal scale. The accuracy of the standing balance score to distinguish patients above/below cut-offs for the timed up-and-go test (14 s) and functional ambulation category (4) was determined. [Results] Standing balance score was correlated with sensory impairments (tactile and vibration perception) and walking ability (up-and-go and functional ambulation category). The standing balance score distinguished patients with up-and-go times ≤14 and >14 s with moderate sensitivity and specificity, and distinguished patients with functional ambulation category <4 and ≥4 with high sensitivity and specificity. [Conclusion] Patients with post-stroke hemiplegia may be unable to adapt to changing visual or surface conditions. Therapists should perform comprehensive balance tests. The standing balance ordinal scale score was moderately correlate with walking ability, distinguishing patients according to walking ability. This scale’s validity and reliability must be assessed in clinical settings.