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Master Thesis

Weight-bearing asymmetry: recovery or not?

Abstract : Objectives. Little is known about the evolution of the weight-bearing asymmetry (WBA) after stroke. Our objectives were to describe and analyze the evolution of the weight bearing distribution in the subacute phase after stroke, and to explore the relationship between the recovery of balance ability in daily life, assessed by the Postural Assessment Scale for Stroke (PASS), and the recovery of WBA. Methods. Cohort study of 31 individuals admitted to rehabilitation after a first hemispheric stroke. Weight-bearing distribution and instability were measured twice with a dual force platform, with vision. Clinical deficits and functional abilities were also assessed. WBA was diagnosed when the paretic leg was under-loaded less than 41% of body weight or over-loaded more than 59% of body weight. Strong WBA recovery was defined as an improvement greater than the Minimal Detectable Change (5%). We compared the characteristics between the individuals who showed a strong recovery of WBA and those who didn’t. Results. The first assessment was performed at a median time of 41 (32;70) days post-stroke and the second assessment 82 (59;95) days post-stroke. Weight-bearing distribution was more symmetric at the second assessment (from 6.8 to 4.1% of body weight; p=0.040). According to our threshold criteria, 10/31 (32%) patients were considered asymmetric (9 under-loading and 1 over-loading the paretic leg). Among them, the recovery of WBA was significant (p=0.004) and was highly correlated to balance recovery (R=-0.81; p=0.005). Whatever the WBA type, 4/10 (40%) showed a strong WBA recovery (median improvement of 11.3% of body weight). They presented more severe deficits at first assessment, especially regarding the lower limb motor command (p=0.019). Conclusion. Weight-bearing distribution becomes more symmetric among patients in the subacute phase post stroke during their inpatient rehabilitation. A strong WBA recovery was found especially among individuals who had a more severe initial profile, so a wider potential for improvement. The recovery of balance and WBA are closely associated. This suggests that a recovery of weight-bearing asymmetry is needed to improve balance in daily life. This finding strengthens the relevance of a specific WBA rehabilitation.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03629370
Contributor : Jean-Hugues Morneau Connect in order to contact the contributor
Submitted on : Monday, April 4, 2022 - 12:20:22 PM
Last modification on : Wednesday, April 6, 2022 - 3:33:12 AM

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Ophélie Folmer. Weight-bearing asymmetry: recovery or not?. Human health and pathology. 2021. ⟨dumas-03629370⟩

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