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Original Research ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Neurol. | doi: 10.3389/fneur.2019.00912

Impaired motor function in the affected arm predicts impaired postural balance after stroke: a cross sectional study

 Lena Rafsten1*, Cristiane Meirelles2,  Anna Danielsson1 and Katharina Stibrant Sunnerhagen1
  • 1University of Gothenburg, Sweden
  • 2Department of Therapy Services, University of Chicago Medical Center, United States

Background: Impaired postural balance is a common symptom after stroke and a common cause of falling. Arm and hand movements are used in most common daily tasks. Impairment in an upper extremity is a common symptom that affects 50-80% in the acute phase after stroke, and 40-50% in the sub-acute phase. Several studies show that the leg function impacts postural balance, but few studies have shown the importance of arms on postural balance. The goal of this cross sectional study is therefore to explore if there is any association between arm function and postural balance after stroke.
Method: In total 121 adults (mean age: 70 ± 12.3 years, 72 men) from an accessibility population were included. Eighty nine came from the stroke unit and 32 came from the Rehabilitation Clinic. The dependent outcomes were Bergs Balance scale (BBS) and Time Up and Go (TUG) both dichotomized to impaired postural balance and not impaired postural balance. As independent variables, the Fugl-Meyer Assessment-Upper Extremity (FMA-UE) scale was used. The FMA-UE was presented with the total score.

Results: Time since stroke ranged from 1-13 years. The motor function in the arm affected after stroke onset correlated with postural balance both measured with the BBS (0.321, p<0.001) and the TUG (-0.315, p=0.001). Having impaired motor function in the arm were significant associated with impaired postural balance assessed with the BBS with OR= 0.879. Regression analysis with the TUG showed the same result, OR= 0.868 for FM-UE.

Conclusion: The muscular function of the affected arm significant associate with impaired postural balance post stroke assessed with BBS or TUG. It can be of clinical importance to be aware of the fact that not only lower extremity impairment, but also arm function can have an impact on postural balance in late stage after stroke.

Trial registration: VGFOUGSB-669501

Keywords: Arm, upper extremity (arm), outcome measure (MeSH: outcome assessment), Stroke, Postural balance [MeSH]

Received: 06 Mar 2019; Accepted: 06 Aug 2019.

Edited by:

Olivier DETANTE, Centre Hospitalier Universitaire de Grenoble, France

Reviewed by:

Erwin Van Wegen, VU University Medical Center, Netherlands
Kathryn S. Hayward, Florey Institute of Neuroscience and Mental Health, Australia  

Copyright: © 2019 Rafsten, Meirelles, Danielsson and Stibrant Sunnerhagen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Mrs. Lena Rafsten, University of Gothenburg, Gothenburg, Sweden,