Poor balance is a critical issue in stroke recovery, affecting mobility, independence, and quality of life. Research consistently supports the importance of Specialist physiotherapy, neuroplasticity, and emerging technologies in improving balance post-stroke. Ongoing research into both rehabilitation strategies and the role of cognition in balance recovery holds promise for improving outcomes for stroke survivors.
Stroke remains a significant health concern in Scotland, with Glasgow experiencing some of the highest mortality rates in the UK and Europe. In the year ending 31 March 2024, Scotland recorded 3,806 deaths where cerebrovascular disease, including stroke, was the underlying cause. Over the past decade, the incidence rate for cerebrovascular disease decreased by 9%, from 262 cases per 100,000 population in 2014/15 to 239 per 100,000 in 2023/24. The death rate for cerebrovascular disease in the most deprived areas was 62% higher than in the least deprived areas in 2023, highlighting significant health inequities.
Glasgow has been identified as having the highest mortality rates in the UK and among the highest in Europe. As of 2016, life expectancy at birth in Greater Glasgow was 71.6 years for men and 78 years for women, both below the national averages. The city faces elevated rates of stroke, respiratory diseases, cardiovascular diseases, and cancers. Contributing factors include socioeconomic deprivation, lifestyle choices, and environmental influences.
This alarming statistic underscores the urgent need for effective rehabilitation strategies, particularly physiotherapy, to address balance deficits post-stroke.
Balance impairment is a common consequence of stroke, significantly affecting individuals’ ability to perform daily activities and increasing the risk of falls. Physiotherapy plays a crucial role in addressing these balance issues, employing various interventions to enhance stability and functional independence.
Stroke survivors often experience deficits in coordination, strength, sensation, and proprioception, all of which can contribute to poor balance. Physiotherapy interventions for stroke-related balance impairments typically include exercises focused on improving strength, coordination, proprioception, and posture. These exercises may involve weight shifting, standing on uneven surfaces, walking on different terrains, and practicing functional tasks such as reaching and bending. One of the key principles of Specialist home physiotherapy for stroke-related poor balance is task-specific training. This involves practicing specific tasks that the individual wants or needs to improve on, such as walking, standing up from a chair, or reaching for an object. By targeting these functional activities, physiotherapists can help stroke survivors regain confidence in their ability to perform daily tasks and improve overall balance and stability.
Physiotherapy may also involve gait training for stroke survivors with poor balance. Gait training focuses on improving the individual’s ability to walk safely and efficiently, addressing foot placement, weight shifting, and stride length issues. By incorporating exercises to improve gait mechanics and strengthen the lower extremities, physiotherapists can help stroke survivors achieve a more natural and efficient walking pattern, improving overall balance and mobility.
References:
Rehabilitation for balance impairment in patients after stroke: a systematic review
Source: BMJ Open
Summary: This systematic review evaluates the effectiveness of different rehabilitation interventions aimed at improving balance in post-stroke patients. The study analyses various therapies, including physical therapy, virtual reality, and electromechanical devices, providing insights into their efficacy and safety.
Rehabilitation interventions for improving balance following stroke: an overview of systematic reviews
Source: PLOS ONE
Summary: This overview consolidates findings from multiple systematic reviews on balance rehabilitation post-stroke. It highlights the effectiveness of various interventions, such as physical therapy, virtual reality, and Tai Chi, in enhancing balance and postural control.
Current trends in balance rehabilitation for stroke survivors: a scoping review
Source: International Journal of Environmental Research and Public Health
Summary: This scoping review identifies and discusses contemporary approaches in balance rehabilitation for stroke survivors, emphasizing the importance of tailored interventions to enhance recovery outcomes.
Stroke: Physiotherapy Treatment Approaches
Source: Physiopedia
Summary: This article outlines various physiotherapy strategies for managing balance difficulties post-stroke, including balance training and exercises to improve trunk control and reduce the risk of falls.
Regaining Balance After Stroke: 5 Effective Methods for Boosting Stability
Source: Flint Rehab
Summary: This article discusses five evidence-based methods for improving balance after a stroke, including targeted exercises and rehabilitation techniques.
Core Stability Exercises in Addition to Usual Care Physiotherapy Improve Postural Balance in Stroke Patients: A Randomized Controlled Trial
Source: Archives of Physical Medicine and Rehabilitation
Summary: This randomized controlled trial investigates the effects of incorporating core stability exercises into standard physiotherapy care, demonstrating significant improvements in postural balance among stroke patients.
Equilivest: A Robotic Vest to Aid in Post-Stroke Dynamic Balance Rehabilitation
Source: arXiv
Summary: This research introduces a robotic vest designed to assist in dynamic balance rehabilitation for post-stroke patients, utilizing biofeedback mechanisms to enhance motor function recovery.
These articles provide comprehensive insights into the challenges of balance impairment following a stroke and the various physiotherapy interventions employed to address these issues. They serve as valuable resources for understanding current rehabilitation strategies aimed at improving balance and reducing fall risk in stroke survivors.
