Early posturographic changes as predictors of functional recovery after stroke: a proof of concept

BACKGROUND: Posturography could serve as an early predictor of recovery of postural control and balance, especially if structural parameters are identified. AIM: This study aimed to explore the predictive value of posturographic measures for motor recovery after stroke using post-hoc analysis of a clinical trial cohort, to generate hypotheses for future confirmatory studies. DESIGN: A post hoc analysis was conducted in a cohort of thirty-eight individuals with subacute post-stroke hemiparesis presenting with balance and gait impairments. SETTING: All participants were recruited from the Rehabilitation Department of the Rey Juan Carlos Hospital (Spain). POPULATION: Participants included in the study were individuals who had experienced a stroke. METHODS: Posturographic variables were collected at baseline and after 4 weeks, and their changes were correlated with functional outcomes at follow-up. Univariate and multivariate binary logistic regression models were used to examine whether improvements exceeding the minimum detectable change in mediolateral structural parameters were associated with better functional outcomes based on Berg Balance Scale (BBS) scores ("High response)". Internal validation of the model was performed using bias-corrected and accelerated (BCa) bootstrap resampling." RESULTS: Participants who showed significant improvements in all three structural parameters of the X-axis demonstrated a strong association with High response in the univariate model (OR=6.8; 95% CI: 1.20-35.56; P=0.03). This association remained independently significant in the multivariable analysis (adjusted OR 6.9; 95% CI: 1.13-42.09; P=0.04). In contrast, no significant associations were observed for anteroposterior parameters. CONCLUSIONS: X-axis-related posturographic variables may have potential as predictors of rehabilitation response after stroke; however, given the post hoc nature of this analysis, these findings should be considered exploratory and require confirmation in prospective studies. CLINICAL REHABILITATION IMPACT: Early improvements in mediolateral posturographic parameters may help identify individuals with stroke who are more likely to achieve meaningful balance recovery. However, given the exploratory, proof-of-concept nature of this study, these findings should be interpreted with caution and require confirmation in prospective studies, while potentially providing a starting point for future research in this area.