Balance and Stability–Focused Exercise Program Improves Stability and Balance in Patients After Acute Stroke in a Resource-poor Setting

ObjectiveTo compare the effect of a balance and stability–focused outpatient community-based rehabilitation and a regular physiotherapy program on balance, stability, and perceptions of improvement after acute stroke.DesignA randomized controlled trial in a community-based therapy center.ParticipantsFifty consecutive patients with a first stroke, who reported to a community-based therapy center over a 7-month period were allocated to the control group (regular physiotherapy) or the experimental group (balance and stability–focused rehabilitation).InterventionA program of physiotherapy focused on balance and stability exercises. The control group received the regular physiotherapy program.Main Outcome MeasurementsThe Postural Assessment Scale for Stroke Patients (PASS) and the Berg Balance Scale (BBS) monitored stability and balance. The normalized data (PASS and BBS) were analyzed by using analysis of covariance. Qualitative data were thematically described.ResultsInternal consistency of baseline PASS and BBS scores was high (Cronbach α, .964 and .974, respectively). PASS overall pretest scores increased from 21.96 ± 21.41 (mean ± standard deviation) and 21.52 ± 8.43 to 67.67 ± 28.42 and 80.16 ± 22.60 posttest in the control and experimental groups, respectively. Posttest scores were significantly different (P = .004). The effect size was medium (.490). The overall BBS scores showed overall mean (standard deviation) increases from 44.71 ± 22.24 and 43.43 ± 17.11 pretest to 48.71 ± 23.18 and 59.71 ± 18.20 posttest for the control and experimental groups, respectively. The effect size was considered medium (.532).ConclusionThe balance and stability–focused community-based rehabilitation program was more effective in improving stability and balance in patients with stroke compared with the regular physiotherapy program in resource-poor settings.