Time since injury limits but does not prevent improvement and maintenance of gains in balance in chronic stroke

• Published in: Brain injury 2018-02, Vol.32 (3), p.303-309
• Main Authors: Llorens, Roberto, Noé, Enrique, Alcañiz, Mariano, Deutsch, Judith E.
• Format: Article
• Language: English
• Subjects: Aged; balance; chronic brain injury; Chronic Disease; Disease Progression; Female; Follow-Up Studies; Humans; Male; Middle Aged; Postural Balance - physiology; posture; rehabilitation; Sensation Disorders - etiology; Sensation Disorders - rehabilitation; Statistics, Nonparametric; Stroke; Stroke - complications; Stroke Rehabilitation - methods; Time Factors; time since injury; virtual reality
• ISSN: 0269-9052; 1362-301X
• DOI: 10.1080/02699052.2017.1418905

Objective: To determine the influence of time since injury on the efficacy and maintenance of gains of rehabilitation of balance after stroke. Method: Forty-seven participants were assigned to a least (6-12 months), a moderate (12-24 months), or a most chronic (>24 months) group. Participants trained for 20 one-hour sessions, administered three to five times a week, combining conventional physical therapy and visual feedback-based exercises that trained the ankle and hip strategies. Participants were assessed before, after the intervention, and one month later with a posturography test (Sway Speed and Limits of Stability) and clinical scales. Results: In contrast to other subjects, the most chronic participants failed to improve their sway and to maintain the benefits detected in the Limits of Stability after the intervention. Although all the participants improved in those clinical tests that better matched the trained skills, time since injury limited the improvement, and over all, the maintenance of gains. Conclusion: Time since injury limits but does not prevent improvement in chronic stages post-stroke, and this effect appears to be more pronounced with maintaining gains. These findings support that training duration and intensity as well as type of therapy may need to be adjusted based on time post-stroke.