Abstract
Introduction. Improvement of postural stability is an important goal during poststroke rehabilitation. Since weight-bearing asymmetry (WBA) towards the nonparetic leg is common, training of weight-bearing symmetry has been a major focus in post-stroke balance rehabilitation. It is assumed that restoration of a more symmetrical weight distribution is associated with improved postural stability. Objective. To determine to what extent WBA is associated with postural instability in people after stroke. Methods. Electronic databases were searched (Cochrane, MEDLINE, EMBASE, and CINAHL) until March 2012. Main Eligibility Criteria. (1) Participants were people after stroke. (2) The association between WBA and postural stability was reported. Quality of reporting was assessed with the STROBE checklist and a related tool for reporting of confounding. Results. Nine observational studies met all criteria. Greater spontaneous WBA was associated with higher center of pressure (COP) velocity and with poorer synchronization of COP trajectories between the legs (two and one studies, resp.). Evidence for associations between WBA and performance on clinical balance tests or falls was weak. Conclusion. Greater WBA after stroke was associated with increased postural sway, but the current literature does not provide evidence for a causal relationship. Further studies should investigate whether reducing WBA would improve postural stability.
Highlights
Improvement of postural stability is an important goal during poststroke rehabilitation
Intervention studies aimed at restoring weight-bearing symmetry were only considered for inclusion if they reported on the association between weight-bearing asymmetry (WBA) and postural stability
Of each study we summarized the reported results regarding the association between postural stability and WBA, regardless whether this association was the focus of the original study or not (Table 1)
Summary
Improvement of postural stability is an important goal during poststroke rehabilitation. Further studies should investigate whether reducing WBA would improve postural stability. Falling is a very common complication after stroke, with as many as 50% to 70% of the people who return home from the hospital or rehabilitation center experiencing falls [5]. These falls can have severe consequences such as hip fractures and decreased physical activity due to fear of falling [4]. Improvement of postural stability is, an important goal in stroke rehabilitation [2, 3]. Explain the scientific background and rationale for the investigation being reported State specific objectives, including any prespecified hypotheses
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