Characteristics of walking and static standing in stroke patients with or without vestibular symptoms

Abstract

Objective To investigate the difference between walking and static standing characteristics in stroke patients with and without vestibular symptoms. Methods A total of 82 stroke patients who received rehabilitation treatment in Tianjin Huanhu Hospital, Tianjin University from May 2020 to December 2021, and 49 controls with the matched gender, age and education level were included. The stroke patients were divided into vestibular symptom group (n=51) and vestibular symptomless group (n=31) according to the condition of vestibular symptoms. The walking stability was evaluated by 7⁃Meter Walking Test, and the stability of static standing balance was evaluated by the Clinical Test of Sensory Interaction and Balance (CTSIB). Results The results of the 7⁃Meter Walking Test showed that there were statistically significant differences in the spatial and temporal parameters of gait, the coronal plane swing angle of trunk, swing area and the root mean square of coronal plane posture swing among 3 groups (P=0.000, for all). The stride length, stride speed and stride frequency of the vestibular symptoms group and the vestibular symptomless group were lower than those of the control group (P=0.000, for all), and the time parameters of the double brace phase time and the terminal double brace phase time were higher than those of the control group (P=0.000, for all). The stride length, stride speed and stride frequency of the vestibular symptoms group were lower than those of vestibular symptomless group (P＜0.05, for all), and the time of dual brace phase and terminal dual brace phase were higher than those of vestibular symptomless group (P=0.000, for all). The trunk coronal plane swing angle (P＜0.01, for all), swing area (P=0.000, for all) and root mean square of coronal plane posture swing (P=0.000, for all) in vestibular symptoms group and vestibular symptomless group were greater than those in control group. The coronal plane swing angle of trunk and the root mean square of coronal plane posture swing of vestibular symptoms group were also greater than those of vestibular symptomless group (P=0.000, for all). The results of CTSIB showed there were statistically significant differences in trunk swing area, root mean square of coronal and sagittal plane postural swing among 3 groups (P=0.000, for all). In vestibular symptom group and vestibular symptomless group, the root mean square of coronal and sagittal plane postural swing were greater than those of the control group under the 4 test conditions of eyes open on firm, eyes closed of firm, eyes open on foam, eyes closed on foam (P＜0.01, for all). In vestibular symptom group and vestibular symptomless group, the trunk swing area was greater than that in control group under 3 test conditions of eyes open on firm, eyes closed on firm and eyes closed on foam (P=0.000, for all). The trunk swing area in vestibular symptom group was greater than that in control group (P=0.000), but less than that in vestibular symptomless group (P=0.000). There was no statistical significance between vestibular symptoms group and vestibular symptomless group under 4 test conditions (P＞0.05, for all). Conclusions The walking parameters of stroke patients with vestibular symptoms were significantly changed than those of vestibular symptomless, which can provide important clinical value for the implementation of precise rehabilitation treatment.

Keywords

• stroke
• vestibular labyrinth
• walking
• postural balance
• rehabilitation