Recovery of Postural Control and Gait After a Severe Stroke. A Descriptive Study

Abstract

Background and purpose: Research into recovery of postural control after a severe stroke needs to be improved. The objective is to describe postural control at admission and the recovery of postural control during rehabilitation according to gait assistance required at discharge of subacute rehabilitation in subjects with severe motor impairment after a stroke. Methods: A descriptive longitudinal retrospective study was conducted. Subacute post-stroke patients who could not walk without physical assistance at admission were included (n = 151). Recovery during rehabilitation is described in terms of Absolute Recovery (AR) and Relative Recovery (RR). AR and RR were calculated with Berg Balance (BBS) at admission and at discharge. Gait performance was assessed using the Functional Ambulation Category. A secondary analysis was conducted in the subgroup of subjects with an admission BBS less than 6 (n = 106). Results: Postural control at admission, AR and RR showed statistically significant differences between groups according to gait assistance requirement at discharge (p < 0.05). In subjects with BBS less than 6 at admission, differences were similar for RA and RR (p < 0.05). For BBS at admission, statistically significant differences were found between assisted gait group with supervised or independent group; however, statistical differences were not found (p > 0.05) between those patients that achieved a supervised gait and independent gait at discharge. Discussion: The results of this study could be a new step to evince why longitudinal analysis is needed during stroke rehabilitation in subjects with severe motor impairments after a stroke. The clinical relevance of BBS at admission in this population may be rethought.