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| Dean Reinke Deans' Stroke Musing |
So if sensorimotor impairment may cause falls, what therapy is needed to bring it back to normal? Its a simple question. I was tested in one of these called a Balance Master 4 weeks post-stroke. The force plates I was standing on could move side to side, front to back and tilt in various directions, all the while the three sides; front of you and each side were moving around. You were strapped into a harness to catch you when you fall. After it was all done my PT ran my scores thru the universe of results and at that time my age of 50 results were better than the average 50 year old male. I just told him I would really have enjoyed that testing challenge when I was healthy. Its like kneeling on a yoga ball for balance practice. This was all absolutely necessary for keeping upright in a squirrely whitewater canoe. My favorite was a Mad River Outrage. Ok, feeling sorry for myself again.
Sage Journals - Abstract etoc
ABSTRACT
Background. Stroke-related sensorimotor impairment potentially contributes to impaired balance. Balance measures that reveal underlying limb-specific control problems, such as a measure of the synchronization of both lower limbs to maintain standing balance, may be uniquely informative about poststroke balance control. Objective. This study aimed to determine the relationships between clinical measures of sensorimotor control, functional balance, and fall risk and between-limb synchronization of balance control. Methods. The authors conducted a retrospective chart review of 100 individuals with stroke admitted to inpatient rehabilitation. Force plate–based measures were obtained while standing on 2 force plates, including postural sway (root mean square of anteroposterior and mediolateral center of pressure [COP]), stance load asymmetry (percentage of body weight borne on the less-loaded limb), and between-limb synchronization (cross-correlation of the COP recordings under each foot). Clinical measures obtained were motor impairment (Chedoke-McMaster Stroke Assessment), plantar cutaneous sensation, functional balance (Berg Balance Scale), and falls experienced in rehabilitation. Results. Synchronization was significantly related to motor impairment and prospective falls, even when controlling for other force plate–based measures of standing balance control (ie, postural sway and stance load symmetry). Conclusions. Between-limb COP synchronization for standing balance appears to be a uniquely important index of balance control, independent of postural sway and load symmetry during stance.
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