Prediction of functional ambulation with sitting posturography in patients with subacute hemiplegic stroke

Abstract

The purpose of this study is to investigate the usefulness of sitting posturography in stroke patients. A retrospective review of medical records was performed for subacute hemiplegic stroke patients admitted to the university hospital from December 1, 2016 to May 31, 2017. Twenty-nine patients (17 males and 12 females; average age, 63.41 ± 15.44 years) were evaluated for balance ability using sitting posturography and clinical assessment of balance, such as Scale for the Assessment and Rating of Ataxia (SARA, using balance categories) and Berg Balance Scale (BBS). Posturography parameters are consisted of percentages of weight bearing distribution (WBD), static stability and dynamic stability. Static stability index was obtained by measuring sway of surface area and length from the center of pressure. The limit of stability (LOS), representing the dynamic stability. In addition, gait status were also assessed by Functional Ambulatory Categories (FAC) after 4 weeks of conventional treatment. Collected data were statistically processed using Pearson correlation coefficients to investigate the relationships between posturography parameters and the clinical assessment of balance (BBS, SARA). Multiple regression analysis was used to find independent variables related to FAC after 4 weeks of conventional rehabilitation. The average ratio of percentages of WBD and ratio of LOS were 0.852 ± 0.09, 0.766 ± 0.23, respectively. A strong relationships were found in posturography parameters (ratio of percentages of WBD, ratio of LOS) in regards to BBS ( r = 0.761, r = 0.781, P < 0.01) and SARA ( r = −0.852, r = −0.804, P < 0.01) scores. The ratio of LOS statistically significantly predicted FAC after 4 weeks (b = 1.89, SE = 0.72, 95% CI = 3.38, 0.40, P < 0.01). In patients with subacute hemiplegic stroke, sitting balance parameters of posturography correspond well with SARA and BBS. Furthermore, our data suggest that the ratio of LOS, which evaluated in sitting position, can significantly predict FAC after 4 weeks of rehabilitation.