Relationships Between Affected-Leg Motor Impairment, Postural Asymmetry, and Impaired Body Sway Control After Unilateral Supratentorial Stroke.
Jolanda M B Roelofs, Kirsten van Heugten, Digna de Kam and 2 others
PMID 30411675WHAT IT FOUND
Stroke survivors with good leg motor scores often still have asymmetric balance control.
They shift weight to the less-affected leg to compensate. This hides the problem in standard walking tests. Therapists should suspect hidden deficits in complex tasks like single-leg stance or hopping.
Key findings
0121% of participants with high leg motor recovery scores still showed significant dynamic control asymmetry.
02Dynamic control asymmetry was not significantly correlated with anterior-posterior body sway, likely due to compensation by the less-affected leg.
03Weight-bearing asymmetry was significantly correlated with dynamic control asymmetry, indicating that patients shift weight to the less-affected leg to compensate.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study was cross-sectional, so it cannot prove that the asymmetry causes future falls or problems, only that it exists. Participants were recruited from outpatient clinics and advertisements, which may skew the sample toward those with better recovery (76% had high motor scores). The study used a standardized foot position, which might not reflect how patients stand in daily life. There was no age-matched healthy control group in the current study; comparisons were made to previous data.
Declared interests
The authors declared no potential conflicts of interest. Funding was provided by the Netherlands Organisation for Health Research and Development.
The easy way to misread this
Do not interpret normal quiet standing sway as evidence of normal bilateral leg control. The study found that patients can compensate for an affected leg by shifting weight to the less-affected leg, which masks the deficit in simple standing tasks but may leave them vulnerable in more complex movements.