Clinical Balance Recovery Profiles Based on the Berg Balance Scale and Associated Lesion Characteristics in Patients with Subacute Stroke

Abstract

Background

Stroke frequently impairs balance, which critically affects mobility, independence, and fall risk during rehabilitation. However, heterogeneous patterns of balance recovery and their neural substrates remain poorly understood.

Objective

To identify inpatient balance recovery profiles using initial performance and subsequent improvement across the 14 Berg Balance Scale items, and to examine associations with lesion characteristics to inform prognostic stratification during neurorehabilitation

Methods

We used data from a retrospective cohort of 115 patients with a first-ever stroke. Berg Balance Scale item-level scores at admission and discharge were standardized, and principal component analysis was applied to identify three underlying components. Recovery patterns were then derived from initial scores and rates of improvement, followed by clustering analysis and lesion overlap analyses to characterize the neuroanatomical features of each profile.

Results

Cluster analysis based on principal component scores identified five distinct recovery profiles. The profile with severe balance impairment at admission and minimal improvement showed extensive lesions extending from the peri-Rolandic region into the parietal area, whereas no consistent parietal involvement was observed in other profiles.

Conclusions

Item-level Berg Balance Scale data revealed heterogeneous inpatient balance recovery profiles after stroke. The poorest recovery profile was characterized by extensive peri-rolandic and parietal lesions, suggesting the involvement of sensorimotor regions in severe balance dysfunction. These findings may improve our understanding of heterogeneity in post-stroke balance recovery and may help inform rehabilitation planning and risk management; however, their direct implications for treatment selection remain exploratory and require prospective validation.