To Örebro University

BACKGROUND: Two-thirds of patients with stroke experience only mild impairments in the acute phase, and the proportion of patients < 70 years is increasing. Knowledge about balance and gait and predictive factors are scarce for this group.

OBJECTIVE: The objective of this study was to explore balance and gait in the acute phase and after 3 and 12 months in patients ≤70 years with minor ischemic stroke (National Institute of Health Stroke Scale (NIHSS) score ≤3). This study also explored factors predicting impaired balance after 12 months.

DESIGN: This study was designed as an explorative longitudinal cohort study.

METHODS: Patients were recruited consecutively from two stroke units. Balance and gait were assessed with the Mini-BESTest, Timed Up and Go (TUG), and preferred gait speed. Predictors for impaired balance were explored using logistic regression.

RESULTS: This study included 101 patients. Mean (SD) age was 55.5 (11.4) years, 20% were female and mean (SD) NIHSS score was 0.6 (0.9) points. The Mini-BESTest, gait speed, and TUG improved significantly from the acute phase to 3 months, gait speed also improved from 3 to 12 months. At 12 months, 26% had balance impairments and 33% walked slower than 1.0 m/s. Poor balance in the acute phase (odds ratio =0.92, 95% CI = 0.85 - 0.95) was the only predictor of balance impairments (Mini-BESTest score ≤ 22) at 12 months post-stroke.

LIMITATIONS: Limitations include lack of information about pre-stroke balance and gait impairment, and post-stroke exercise. Few women limits the generalizability.

CONCLUSIONS: This study observed improvements in both balance and gait during the follow-up, still about one third had balance or gait impairments at 12 months post-stroke. Balance in the acute phase predicted impaired balance at 12 months.