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. 2012 Jul-Aug;26(6):627-35.
doi: 10.1177/1545968311429688. Epub 2012 Jan 24.

Clinical correlates of between-limb synchronization of standing balance control and falls during inpatient stroke rehabilitation

Avril Mansfield  1 , George Mochizuki, Elizabeth L Inness, William E McIlroy
Affiliations

Clinical correlates of between-limb synchronization of standing balance control and falls during inpatient stroke rehabilitation

Avril Mansfield et al. Neurorehabil Neural Repair. 2012 Jul-Aug.

Abstract

Background: Stroke-related sensorimotor impairment potentially contributes to impaired balance. Balance measures that reveal underlying limb-specific control problems, such as a measure of the synchronization of both lower limbs to maintain standing balance, may be uniquely informative about poststroke balance control.

Objective: This study aimed to determine the relationships between clinical measures of sensorimotor control, functional balance, and fall risk and between-limb synchronization of balance control.

Methods: The authors conducted a retrospective chart review of 100 individuals with stroke admitted to inpatient rehabilitation. Force plate-based measures were obtained while standing on 2 force plates, including postural sway (root mean square of anteroposterior and mediolateral center of pressure [COP]), stance load asymmetry (percentage of body weight borne on the less-loaded limb), and between-limb synchronization (cross-correlation of the COP recordings under each foot). Clinical measures obtained were motor impairment (Chedoke-McMaster Stroke Assessment), plantar cutaneous sensation, functional balance (Berg Balance Scale), and falls experienced in rehabilitation.

Results: Synchronization was significantly related to motor impairment and prospective falls, even when controlling for other force plate-based measures of standing balance control (ie, postural sway and stance load symmetry).

Conclusions: Between-limb COP synchronization for standing balance appears to be a uniquely important index of balance control, independent of postural sway and load symmetry during stance.

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Conflict of interest statement

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1
Figure 1
Sample center of pressure (COP) time series: panels A and B show trials with high synchronization (anteroposterior [AP] ρ0 = 0.99; mediolateral [ML] ρ0 = −0.94), and panels C and D show trials with low synchronization (AP ρ0 = −0.02; ML ρ0 = −0.01). Stance load symmetry is similar for all trials (35%–40% body weight on the right leg).
Figure 2
Figure 2
Comparison of synchronization measures between fallers and nonfallers: values illustrated are means with standard deviation error bars. The P value is for the 1-way ANOVA comparing groups within each variable. The comparison marked with an asterisk was investigated further in multivariate analyses (adjusted α = .0024; Table 4). Abbreviations: ML, mediolateral; AP, anteroposterior.
See this image and copyright information in PMC

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