Balance and gait after first minor ischemic stroke in people 70 years of age or younger

A Prospective Observational Cohort Study

Charlotta Hamre, Brynjar Fure, Jorunn L Helbostad, Torgeir B Wyller, Hege Ihle-Hansen, Georgios Vlachos, Marie Ursin, Gro Gujord Tangen

Publisert i Physical Therapy, 100 (5), 2020.

Sammendrag på engelsk (abstract):

Background: Two-thirds of patients with stroke experience only mild impairments in the acute phase, and the proportion of patients < 70 years is increasing. Knowledge about balance and gait and predictive factors are scarce for this group.

Aims and method: The objective of this study was to explore balance and gait in the acute phase and after 3 and 12 months in patients ≤70 years with minor ischemic stroke (National Institute of Health Stroke Scale (NIHSS) score ≤3). This study also explored factors predicting impaired balance after 12 months.This study was designed as an explorative longitudinal cohort study. Patients were recruited consecutively from two stroke units. Balance and gait were assessed with the Mini-BESTest, Timed Up and Go (TUG), and preferred gait speed. Predictors for impaired balance were explored using logistic regression.This study included 101 patients. Mean (SD) age was 55.5 (11.4) years, 20% were female and mean (SD) NIHSS score was 0.6 (0.9) points.

Results: The Mini-BESTest, gait speed, and TUG improved significantly from the acute phase to 3 months, gait speed also improved from 3 to 12 months. At 12 months, 26% had balance impairments and 33% walked slower than 1.0 m/s. Poor balance in the acute phase (odds ratio =0.92, 95% CI = 0.85 – 0.95) was the only predictor of balance impairments (Mini-BESTest score ≤ 22) at 12 months post-stroke. Limitations include lack of information about pre-stroke balance and gait impairment, and post-stroke exercise. Few women limits the generalizability. This study observed improvements in both balance and gait during the follow-up, still about one third had balance or gait impairments at 12 months post-stroke. Balance in the acute phase predicted impaired balance at 12 months.