A pilot study of attention deficits, balance control and falls in the subacute stage following stroke

Objectives: To (1) identify and monitor changes in deficits of attention an d balance in the subacute stage following stroke, (2) investigate fall even ts, (3) explore relationships between deficits of attention, balance and fa lling post stroke. Design: A prospective observational study. Setting: Hospitalized patients with stroke were recruited from a rehabilita tion ward. Subjects: Fourteen subjects were recruited, 13 subjects (age 21-80 years) c ompleted all assessments. Ten had right and three had left hemispheric lesi ons. Eight subjects were male. Main outcome measures: Subjects were assessed on two occasions during a six -week period. Standardized tests were used to measure unilateral visual neg lect, sustained and selective attention and balance. Fall histories were co llected by chart review and semi-structured interview. Results: At the initial assessment six subjects had sustained auditory atte ntion deficit, eight had deficits of auditory selective attention, 12 had v isual selective attention deficits and seven subjects presented with visual inattention. Scores for visual inattention and visual selective attention improved over time (p=0.006, p=0.026 respectively) as did scores for balanc e control (p=0.001). Auditory selective attention scores at the first asses sment were found to correlate with measures of balance (p<0.01), subjects w ith normal attention scores achieved better balance scores. Four subjects f ell at least once during the six weeks. Scores for attention and balance of fallers were not found to be significantly different from the scores of no nfallers. Conclusions: The sample size was small but high levels of attention deficit were identified. Findings suggest a weak or no relationship between attent ion deficits and falls. Further studies are required to explore the extent of attention deficits post stroke and its impact on balance control and fal ling.