Article

OBJECTIVE: To investigate the determinants of postural imbalance after stroke in
geriatric patients admitted for low-intensity rehabilitation in skilled nursing
facilities (SNFs), particularly the role of multimorbidity. DESIGN:
Cross-sectional study design. SETTING: Fifteen SNFs. PARTICIPANTS: All patients
who were admitted for rehabilitation after stroke in one of the participating
SNFs (N=378) were eligible. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES:
The Berg Balance Scale (BBS) was selected as a measure of standing balance and
the Functional Ambulation Categories (FAC) as a measure of walking balance.
RESULTS: Multimorbidity was present in 34% of the patients. The patients with
multimorbidity differed from the patients without multimorbidity with respect to
age, proprioception, and vibration sense, but not for any of the cognitive tests,
muscle strength, or sitting balance. Patients with multimorbidity had, on
average, lower scores on both outcome measures. In linear regression analyses,
both the BBS and FAC were best explained by multimorbidity, muscle strength, and
the interaction between muscle strength and static sitting balance (overall
explained variance 66% and 67%, respectively), while proprioception added only to
the variance of the FAC. CONCLUSIONS: Multimorbidity was independently related to
postural imbalance after stroke in patients admitted for rehabilitation in SNFs.
Muscle strength and the interaction of muscle strength with static sitting
balance were important determinants of both standing and walking balance,
indicating these factors as essential targets for rehabilitation.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS