Authors (including presenting author) :
Law HYS(1), Lau HLM(1), Chung HYH(1), Leung KLK(1)
Affiliation :
(1)Physiotherapy Department, Kowloon Hospital
Introduction :
Impaired balance, reduced mobility and fear of fall are common in stroke survivors. Although there has been well-established evidence on effectiveness of physiotherapy in enhancing balance and gait in stroke patients, the effect of age on stroke rehabilitation remains controversial. Some studies suggested age as a crucial factor of post-stroke clinical outcomes with younger patients demonstrating better recovery in general, while other literatures reported that age alone has limited role in explaining the variations in functional outcomes.
Objectives :
To investigate the effects of physiotherapy in balance, functional mobility and balance confidence in chronic stroke patients of different age groups.
Methodology :
Chronic stroke patients (disease onset≥6 months) who could walk without manual assistance, were recruited from the out-patient physiotherapy unit of Kowloon Hospital. Participants who were ≤50 years old and >50 years old were classified into younger and older groups respectively. A 12-week physiotherapy program, consisting of 3 sessions of 60-minute land-based training and 2 sessions of 30-minute hydrotherapy training per week, was provided to both groups. Assessments were conducted at baseline and upon completion of the training program. Outcome measures included posturography study by Sensory Organization Test, Berg Balance Scale for fall risk and balance assessment, Time Up and Go Test for functional mobility performance, and Cantonese version of the Activities-specific Balance Confidence Scale for self-perceived balance confidence. Wilcoxon Signed-Rank test and Mann-Whitney U test were used to evaluate the treatment effects. The correlations between changes in outcomes and age were analyzed by bivariate correlations.
Result & Outcome :
45 stroke patients were recruited (younger group n=22, mean age=38.9±8.2 years old; older group n=23, mean age=58.4±5.0 years old). Both groups demonstrated significant post-training improvement in all outcome measures. There was no significant between-group difference in all outcome measures. Bivariate correlations revealed insignificant correlation between age of the stroke patients and improvement in all outcomes. The results suggested that physiotherapy can be effective in improving balance, functional mobility and balance confidence in chronic stroke patients regardless of their ages. Design of rehabilitation training should be based on the ability and rehabilitation potential of patients but not solely on their ages. Nevertheless, it is important to take the potential decline in physical condition in older patients into consideration when implementing a safe and effective stroke rehabilitation program.
