Balance status and their associated factors for the patients with subacute and chronic stroke

Abstract

Background: Stroke is a major global cause of long-term disability, often resulting in impaired balance and mobility. Balance deficits increase the risk of fall and impair functional independence. Understanding the factors associated with balance in subacute and chronic stroke patient is essential for effective rehabilitation planning. Objectives: This study aims to assess the balance status of patients with subacute and chronic stroke, gather sociodemographic data of the participants, investigate health and physical factors influencing balance, explore psychological and physiotherapy related factors, identify fall risk and explore association between balance status and various sociodemographic, health, physical, psychological and physiotherapy factors. Methodology: A cross sectional study design was utilized, selecting 120 convenient samples from CRP‘s Neurology unit in Savar. Data collection involved face to face interviews through semi structured questionnaire. Results: Among 120 participants, 56.7% had good balance (BBS 41–56) and 43.3% had poor balance (BBS ≤ 40). Balance was found to be significantly associated with gender (p=0.002), dwelling area (p=0.032), monthly income (p=0.007), and expenditure (p = 0.016). Health related factors such as sleep duration (p=0.019), past history of physical exercise (p<0.001) was also significant. Physical factors like muscle tone (p = 0.001), sensation (p = 0.002), and disability level (p < 0.001) showed strong association. Balance status were associated with both the use of walking aids (p<0.001) and the total number of physiotherapy sessions (p<0.001). Depression and anxiety were strongly associated with poorer balance (both p<0.001), as well as fall risk as assessed by the TUG test (p=0.003). Discussion: The findings suggest that post stroke balance recovery is significantly influenced by both psychological and physical factors. Especially, balancing results are strongly influenced by psychological health, muscle tone, sensory state, and therapy frequency. To enhance balance and lower the risk of falls in stroke survivors, future intervention should integrate comprehensive physiotherapy with mental health support and lifestyle modifications. Keywords: Stroke, Balance, Subacute, Chronic