Association Between Lower Limb Dominance, Balance, and Motor Function Among Stroke Survivors In Lagos State, Nigeria: A Cross-Sectional Analytical Study
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Introduction: Stroke is often characterized by disturbance in balance and mobility among stroke survivors. Detecting lower limb dominance effects on motor behavior, particularly during balancing exercises has proven difficult. It remains unclear if balance status and level of motor impairment are related to lower limb dominance. This study aimed to determine the association among balance, motor function and lower limb dominance in stroke survivors.
Methods: A cross-sectional study including 121 stroke survivors recruited using convenient sampling from five out-patient physiotherapy clinic in Lagos, Nigeria. The Waterloo Footedness Question- Revised (WFQ-R) was used to determine the lower limb dominance of the participants. Static and dynamic balance and motor function were assessed using the Static Balance Test (SBT), Dynamic Gait Index (DGI) and the Fugl-Meyer Assessment of Lower Extremity (FMA-LE), respectively. Statistical Package for Social Sciences (SPSS) version 26 was used for data analysis. Data were summarized with descriptive statistics of mean, standard deviation, frequency, and percentages. Chi-square was used to determine the association between lower limb dominance and the scores of participants from the SBT, DGI and FMA-LE.
Results: The mean age of the participants was 54.6±11.78. 81% had stroke onset greater than 6 months, 93% had their right lower limb as their dominant limb, 55.4% participants had left-sided hemiplegia/hemiparesis. The mean score for DGI=16.99±2.91, FMA-LE=23.49±2.97, and SBT=14.26±1.83. There was a statistically significant association between DGI scores and lower limb dominance of the participants (=3.89; p=0.049).
Conclusion: Stroke survivors who had their non-dominant lower limb affected showed similar level of motor function in their lower limb as those with dominant lower limb affectation. Although lower limb dominance demonstrated a significant association with dynamic balance, it did not independently predict balance or motor function outcomes.
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Ali, M. U., Garba, A. Y., Oyeyemi, A. L., Masta, M. A., Gujba, F. K., & Modu, A. A. (2020). Socio-demographic and clinical correlates of community reintegration of stroke survivors in Nigeria. International Neuropsychiatric Disease Journal, 14(3), 1–7.
Aslam, A., Khan, U., Niazi, F., & Anwar, I. (2022). Etiology and risk factors of stroke in young adults: A multicentric study. Annals of Medicine and Surgery, 82.
Balasubramanian, S. (2015). Motor impairments following stroke. Frontiers in Human Neuroscience, 30, 406–413.
Borode, A. O., Awotidebe, T. O., Ademoyegun, A. B., Falokun, I. G., Omisore, O. B., & Adedoyin, R. A. (2023). Interrelationship among fear of falling, gait characteristics and dynamic balance in stroke survivors: A case-control study. Turkish Journal of Neurology, 29(4), 241–248.
Choi, W. (2022). Effects of robot-assisted gait training with body weight support on gait and balance in stroke patients. International Journal of Environmental Research and Public Health, 19(10), 5814.
Fujita, T., Ohashi, Y., Kurita, M., Yamane, K., Yamamoto, Y., Sone, T., & Iokawa, K. (2020). Functions necessary for gait independence in patients with stroke: A study using decision tree. Journal of Stroke and Cerebrovascular Diseases, 29(8), 104998.
Greve, J., Alonso, A., Bordini, A. C. P., & Camanho, G. L. (2007). Correlation between body mass index and postural balance. Clinics, 62, 717–720.
Hoffman, M., Schrader, J., Applegate, T., & Koceja, D. (1998). Unilateral postural control of the functionally dominant and nondominant extremities of healthy subjects. Journal of Athletic Training, 33(4), 319.
Howard, G., Banach, M., Kissela, B., Cushman, M., Muntner, P., Judd, S. E., & Howard, V. J. (2023). Age-related differences in the role of risk factors for ischemic stroke. Neurology, 100(14), e1444–e1453.
Lee, K., & Lee, G. (2023). The test–retest reproducibility, standard error measurement, and smallest real difference of dynamic balance tests in chronic stroke survivors. Applied Sciences, 13(11), 6358.
Li, J., Zhang, P., Liu, Y., Chen, W., Yi, X., & Wang, C. (2021). Stroke lateralization in large hemisphere infarctions: Characteristics, stroke-related complications, and outcomes. Frontiers in Neurology, 12, 774247.
Li, J., Zhong, D., Ye, J., He, M., Liu, X., Zheng, H., & Zhang, S. L. (2019). Rehabilitation for balance impairment in patients after stroke: A protocol of a systematic review and network meta-analysis. BMJ Open, 9(7), e026844.
McGrath, T. M., Waddington, G., Scarvell, J. M., Ball, N. B., Creer, R., Woods, K., & Smith, D. (2016). The effect of limb dominance on lower limb functional performance: A systematic review. Journal of Sports Sciences, 34(4), 289–302.
Menezes, K. K., Faria, C. D., Scianni, A. A., Avelino, P. R., Faria-Fortini, I., & Teixeira-Salmela, L. F. (2016). Previous lower limb dominance does not affect measures of impairment and activity after stroke. European Journal of Physical and Rehabilitation Medicine, 53(1), 24–31.
Obembe, A. O., Olaogun, M. O., & Adedoyin, R. (2014). Gait and balance performance of stroke survivors in South-Western Nigeria: A cross-sectional study. Pan African Medical Journal, 17(Suppl 1), 6.
Olawale, O. A., Usman, J. S., Oke, K. I., & Osundiya, O. C. (2018). Evaluation of predictive factors influencing community reintegration in adult patients with stroke. Journal of Neurosciences in Rural Practice, 9(1), 6.
Ostwald, S. K., Wasserman, J., & Davis, S. (2006). Medications, comorbidities, and medical complications in stroke survivors: The CAReS study. Rehabilitation Nursing, 31(1), 10–14.
Pickenbrock, H. M., Diel, A., & Zapf, A. (2016). A comparison between the Static Balance Test and the Berg Balance Scale: Validity, reliability, and comparative resource use. Clinical Rehabilitation, 30(3), 288–293.
Roelofs, J. M., Zandvliet, S. B., Schut, I. M., Huisinga, A. C., Schouten, A. C., Hendricks, H. T., & Weerdesteyn, V. (2023). Mild stroke, serious problems: Limitations in balance and gait capacity and the impact on fall rate and physical activity. Neurorehabilitation and Neural Repair, 37(11–12), 786–798.
Schorderet, C., Hilfiker, R., & Allet, L. (2021). The role of the dominant leg while assessing balance performance: A systematic review and meta-analysis. Gait & Posture, 84, 66–78.
Schröder, J. (2023). Dynamics of lower limb and standing balance recovery early post-stroke: Measurement, mechanisms and treatment (Doctoral dissertation).
Shebl, A. M., & Abd Elhameed, S. H. (2014). Impact of informal caregivers training program on geriatric patients' functional status and post-stroke depression. IOSR Journal of Nursing and Health Science, 3(4), 45–53.
Teo, I., Thompson, J., Neo, Y. N., & Lundie, S. (2018). Lower limb dominance and volume in healthy individuals. Lymphology, 50(4).
Vincent-Onabajo, G., Joseph, E., & Musa, H. Y. (2018). Impact of balance on functional independence after stroke: A cross-sectional study at rehabilitation settings in Nigeria. NeuroRehabilitation, 42(4), 499–504.