Gait and balance one year after stroke; relationships with lesion side, subtypes of cognitive impairment and neuroimaging findings-a longitudinal, cohort study

Abstract

Objectives: The aims of this study are to investigate impairments of balance and gait in various types of dementia and cognitive impairment, and neuroimaging correlates in patients one year after first-ever stroke or transient ischemic attack.

Design: This is a longitudinal cohort study.

Participants: 180 participants were included and a total of 156 participated in the assessments at the one-year follow-up.

Main outcome measures: Measurements of balance and gait comprised the Berg Balance Scale (BBS) and the 10meter walk test (10MWT). Dementia was diagnosed with the International Classification of Diseases 10th revision. Magnet Resonance Imaging assessed vascular and degenerative changes in the brain. Multivariate linear regressions were conducted regarding associations between the motoric test performances, white matter lesions, lesion of the stroke and cognition.

Results: Cognitive impairment was significant associated with BBS (β=-7.28, P=0.005) and MWS (β=1.89, P=0.046) in the linear regression analyses. An association between 10MWT to living arrangements (β=1.58, P=0.049) and lesion side of the stroke (β=-1.50, P=0.037) was also observed. Pairwise associations with Mann-Whitney U test showed that participants with mixed pathology differed significantly from degenerative pathology (P=0.04, z=-2.1) with more impaired balance measured by BBS.

Conclusions: Impaired balance and gait are associated with cognitive impairment, and a lesion in the right hemisphere is related to impaired gait in this cohort of stroke survivors.

Keywords: Balance; Dementia; Gait; Stroke.