The effect of brief,repetitive balance training on balance and fall risk in older people with stroke: A randomized controlled trial

Abstract

Objective

To evaluate the effect of integrating a specific balance-training program focused on static balance to the conventional rehabilitation program on dynamic balance, risk of falls, and activities of daily living (ADLs) in older adults post-stroke.

Design

A single-blinded randomized controlled trial.

Setting

Institutional Intermediate Care Hospital.

Subjects

Post-stroke older adults in a subacute phase without cognitive impairment, aged 65 years and older, exhibiting trunk control in a seated position for 30 seconds without supporting the arms.

Intervention

The control group underwent the usual treatment, consisting of 60-minute physiotherapy sessions, 5 days per week, for 30 days. The experimental group integrated into the usual treatment 15 minutes of the balance-training program (45 min + 15 min).

Main measures

Balance impairment (Mini-BESTest and Berg Balance Scale (BBS), risk of falls (BBS), and independence for ADLs (Barthel Index)) were assessed at baseline, 15 and 30 days after the start of interventions.

Results

Seventy-one post-stroke patients (77.7 ± 9.0 years, 49.2% women) were randomized into the experimental (n = 35) or control (n = 36) groups. The experimental group showed improved dynamic balance at day 15 (Mini-BESTest: 2.90 [1.05–4.77], p = 0.003; BBS: 4.31 [1.41–7.23], p = 0.004) and day 30 (Mini-BESTest: 6.06 [2.85–9.27], p < 0.001; BBS: 8.24 [2.96–13.53], p = 0.003), as well as greater independence levels (11 [2.75–19.23], p = 0.010) compared to the control group. The control group showed higher risk of falls on day 15 (p = 0.035) and day 30 (p = 0.003) than the experimental group.

Conclusions

A simple, easily reproducible approach designed by and for the older adult to rehabilitate post-stroke impairments effectively improved balance, functional gait, risk of falls, and ADLs.