Mild Stroke, Serious Problems: Limitations in Balance and Gait Capacity and the Impact on Fall Rate, and Physical Activity.
Jolanda M B Roelofs, Sarah B Zandvliet, Ingrid M Schut and 8 others
PMID 37877724WHAT IT FOUND
People after mild stroke fell more often than healthy controls, had poorer balance and gait, lower confidence, and less intense activity, even when leg motor scores were normal.
Screen balance and gait after mild stroke.
Key findings
01Participants after mild stroke had 0.97 falls per person-year versus 0.43 in healthy controls, a 2.3-fold higher relative risk.
02People after mild stroke had poorer balance and gait scores and lower balance confidence than healthy controls.
03Even the subgroup with full motor recovery had poorer balance and gait and a higher fall rate than controls.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
This was an observational comparison, not a treatment trial, so it cannot show that balance or gait training would reduce falls. The researchers did not know participants' function before stroke, so some people with mild stroke may already have had balance or mobility problems. The sample was selected: all could walk independently, and people with severe cognitive problems, neglect, psychotropic medication, or other neurological or musculoskeletal conditions were excluded. Falls were self-reported on monthly calendars with phone follow-up, and the study did not collect detailed circumstances for each fall. The median balance test difference was 2 points, below the reported minimal clinically important change of 4 points, and 30% of participants with mild stroke were within 4 points of the top score, so the test may miss subtle problems. The study was not large enough to examine whether individual balance and gait scores were linked to individual falls.
Declared interests
The authors declared no potential conflicts of interest. Funding was from NWO and ZonMw research grants.
The easy way to misread this
Do not conclude that balance and gait limitations caused the higher fall rate. This was an observational comparison, not a treatment study, and it did not have enough data to link individual balance and gait scores to individual falls.