Article

Reactive balance control, specifically performance of rapid stepping responses,
is associated with falls, but not routinely assessed in clinical practice.
Challenges to clinical assessment may include a lack of available methods that
are safe, standardized and able to quantify the balance responses. We implemented
a reactive balance control assessment, using lean-and-release methodology, in an
inpatient stroke rehabilitation program. Through retrospective chart review of
all admissions (n=183) over a 1-year period, we evaluated the clinical uptake and
patient-specific factors associated with its use. Seventy-seven of 183 (42%)
patients were administered the assessment, on average, 16.2 (SD 13.1) days
post-admission. Patients who received the assessment were younger, at an earlier
time post-stroke, with a shorter rehabilitation length of stay, with less
lower-limb impairment, higher levels of functional balance, less motor and
cognitive impairment, greater recovery of functional mobility, and were more
likely to have the capacity to walk (all measures p<0.0001), compared to those
who did not receive the assessment. This study demonstrates the potential for
clinical uptake of the lean-and-release assessment among patients with stroke,
who are progressing in their functional and mobility status over the course of
their inpatient rehabilitation. However, the results suggest limitations in
application to patients with greater disability or who demonstrate slower
recovery of functional mobility. Ongoing research is required to develop clinical
approaches to reactive balance control assessment that are effective, efficient
and relevant to clinical populations and feasible for clinical practice.
CI - Copyright (c) 2014 Elsevier B.V. All rights reserved.

Langue : ANGLAIS