Our Experience with Posturography in Hemiparetic Patients after Stroke in Kuwait

Objectives: To study the Berg Balance Scale (BBS) as balance functional impairment of hemiparetic stroke patients from 4 to 20 weeks after onset of stroke. To quantitatively assess control of balance under static and dynamic conditions (static & dynamic postural stability) by computerized dynamic posturography (CDP) in hemiparetic patients with stoke. To correlate composite equilibrium score (ES) with of sex, side of lesion and type of stroke in the stroke patients. Also, to correlate composite equilibrium score (ES) with static& dynamic posturography in hemiparetic stroke patients. Setting: Balance neurocom clinic, physical medicine and rehabilitation hospital, Kuwait. Materials and Methods: A total of 21 hemiplegic but ambulatory stroke patients and 19 age-matched healthy individuals as control group admitted to balance neurocom clinic, were recruited for this study. All patients & healthy individuals were evaluated clinically with brief neurological examination and a study of postural stability and balance using the Berg Balance Scale and computerized dynamic posturography. The Sensory Organization Test (SOT) was performed and included six tests conditions. The first three conditions (SOT 1, SOT 2, SOT 3) involved the patient standing on a fixed platform called static posturography. While the other three conditions (SOT 4, SOT 5, SOT 6) involved the patient standing on a platform moving called dynamic posturography. Results: Berg balance scale scores of stroke was below the lower limit of normal control group (P<0.001). Significant reduction was observed for composite equilibrium score (ES) of stroke patients as compared with contro group. No significant difference of static balance function was observed between patients and controls (p>0.01). However, significant reduction of dynamic balance function(SOT 4, SOT5, SOT6) was observed in stroke patients as compared with contro group (p<0.05). In linear regression correlation (r-) of stroke patients, No significant correlation was observed of ES with static balance function (SOT1, SOT2, SOT3) in hemiparetic stroke patients (p>0.05). However, there was a direct significant correlation ES with dynamic balance function including SOT4, SOT5 and SOT6 (r=-0.71; p<01), (r=0.761, P<0.01) and (r=-.761, P<0.05) respectively in hemiparetic stroke patients. Conclusions: The our results suggest that impaired dynamic equilibrium in stroke patients is likely to reflect reduction of muscle strength of paretic side along with the possible impairment of sensory organization which may be the main cause for postural instability of the patients in this study.