Recovery of standing balance and health-related quality of life after mild or moderately severe stroke

OBJECTIVE: To examine the physiologic and functional recovery of standing balance and health-related quality of life (HRQOL) in people after mild and moderate stroke. DESIGN: Inception cohort study with evaluations at 1 month and 3 months poststroke. SETTING: Laboratory. PARTICIPANTS: Twenty-nine volunteers who had sustained a stroke. Subjects were categorized into mild and moderate groups. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Functional balance was assessed (Clinical Outcome Variables Scale [COVS]) and physiologic measures (electromyography, postural sway) were taken when subjects stood quietly on a force platform and when they performed a rapid unilateral arm-raise perturbation. The Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) was administered to evaluate HRQOL. RESULTS: Subjects in the mild group were approaching maximal scores on the COVS (87.7+/-4.1/91) at 3 months poststroke, yet had significant impairment in paretic muscle activation patterns when compared with healthy subjects. Subjects in the moderate group had increased paretic muscle activation over the 2 months, accompanied by significant increases of 10.7+/-5.9 points on the COVS. For both groups, there was significantly less postural sway on the paretic than the nonparetic leg and significant improvements in the SF-36 (physical component) over time. CONCLUSIONS: Subjects recovering from a stroke showed a significant improvement in physical HRQOL and functional and physiologic balance, yet the physiologic balance recovery was not complete even in the mild group.