Prevalence of Balance Impairment and Risk of Fall in Post-Stroke Patients; A Cross-Sectional Study

Balance Impairment in Post-Stroke Patients


  • Muhammad Abbas Shah Combined Military Hospital, Sialkot, Pakistan
  • Rimsha Tariq Hajvery University, Lahore, Pakistan
  • Hafiz Mohammad Dawood Community Medicine, Sahara Medical College, Narowal, Pakistan
  • Sajid Ullah Khan Community Medicine, Sahara Medical College, Narowal, Pakistan
  • Sumaira Yasmin Government College University, Sub Campus, Layyah, Pakistan
  • Afshan Maqbool Central Park College of Physiotherapy, Lahore, Pakistan



balance impairment, prevalence, risk of fall, stroke


Background: Stroke is considered the leading cause of long-term disability worldwide, which affects millions of people annually. Balance dysfunction and increased risk of falls has been recognized as the most common impairment following a stroke. Objective: This study aimed to evaluate the prevalence of balance impairment and risk of falls in post-stroke patients. Methods: This study is a cross-sectional study using a purposive sampling technique. Both male and female patients were recruited in this study. Patients who suffered their first stroke and ages ranging from 50 to 70 plus age were included in this study. Patients with at least one-year post-stroke and who reported walking with an assistive device up to 8 meters were prioritized to be recruited in this study. Patients who had a history of surgery, recent surgical treatment, patients having any recent trauma or any sort of systemic disease were not recruited in this study. The tools employed in this study were the Berg balance scale and the fall risk assessment tool. The results of this study were analyzed using Statistical Package for Social Sciences version 23. Frequency charts and percentages were plotted to represent the prevalence of balance impairment and risk of falls in post-stroke patients. Results: The results of this study show us that 40% of the patients recruited in the study suffered from moderate dependency after their first stroke while 60-80% of patients were observed with severe dependency and need of assistance to perform activities after their first stroke. P-value 0.0001 showed that there is a significant association between balance impairment and post-stroke spell. About 40- 60% of post-stroke patients reported scoring more than 13 points on the fall risk assessment tool, which represents a high risk of falls. Conclusion: The study concludes that post-stroke patients with an increased age are at a higher risk of falling and a significant association exists between the balance impairment and post-stroke patients. A higher percentage of post-stroke patients, 40-60% post-stroke patients scored more than 13 scores on the Fall Risk Assessment tool, which concludes that these patients are at higher risk of falling.


Gorst T, Rogers A, Morrison SC, et al. The prevalence, distribution, and functional importance of lower limb somatosensory impairments in chronic stroke survivors: a cross sectional observational study. Disability and rehabilitation 2019; 41(20): 2443-50.

Gorst T, Lyddon A, Marsden J, et al. Foot and ankle impairments affect balance and mobility in stroke (FAiMiS): the views and experiences of people with stroke. Disability and rehabilitation 2016; 38(6): 589-96.

Naseer B, Dastgir H, Sadiq A, Salik S, Abid N, Tayyab M. Factors Associated with Risk of Fall in Elderly Population: Risk of Fall in Elderly Population. The Healer Journal of Physiotherapy and Rehabilitation Sciences 2022; 2(3): 221-31. DOI:

Sullivan R, Harding K. Do patients with severe poststroke communication difficulties have a higher incidence of falls during inpatient rehabilitation? A retrospective cohort study. Topics in stroke rehabilitation 2019; 26(4): 288-93.

Esposito E, Shekhtman G, Chen P. Prevalence of spatial neglect post-stroke: A systematic review. Annals of Physical and Rehabilitation Medicine 2021; 64(5): 101459.

Schinkel-Ivy A, Huntley AH, Aqui A, Mansfield A. Does perturbation-based balance training improve control of reactive stepping in individuals with chronic stroke? Journal of Stroke and Cerebrovascular Diseases 2019; 28(4): 935-43.

Li J, Zhong D, Ye J, et al. Rehabilitation for balance impairment in patients after stroke: a protocol of a systematic review and network meta-analysis. BMJ open 2019; 9(7): e026844.

Arienti C, Lazzarini SG, Pollock A, Negrini S. Rehabilitation interventions for improving balance following stroke: An overview of systematic reviews. PloS one 2019; 14(7): e0219781.

Jia H, Lubetkin EI, DeMichele K, Stark DS, Zack MM, Thompson WW. Prevalence, risk factors, and burden of disease for falls and balance or walking problems among older adults in the US. Preventive medicine 2019; 126: 105737.

Teasell R, Salbach NM, Foley N, et al. Canadian stroke best practice recommendations: rehabilitation, recovery, and community participation following stroke. Part one: rehabilitation and recovery following stroke; update 2019. International Journal of Stroke 2020; 15(7): 763-88.

Luo J-M, Liu E-Z, Yang H-D, et al. Prevalence and factors associated with suicidal ideation in medical students with migraine. Frontiers in psychiatry 2021; 12: 683342.

Ronthal M. Gait disorders and falls in the elderly. Medical Clinics 2019; 103(2): 203-13. DOI:

Osoba MY, Rao AK, Agrawal SK, Lalwani AK. Balance and gait in the elderly: A contemporary review. Laryngoscope investigative otolaryngology 2019; 4(1): 143-53.

Green E, Huynh A, Broussard L, et al. Systematic review of yoga and balance: effect on adults with neuromuscular impairment. The American Journal of Occupational Therapy 2019; 73(1): 7301205150p1-p11.

Yang F, Butler AJ. Efficacy of controlled whole-body vibration training on improving fall risk factors in stroke survivors: a meta-analysis. Neurorehabilitation and Neural Repair 2020; 34(4): 275-88.

Saif I. Role of physical therapy on quality of life and level of satisfaction among patients with stroke. The Healer Journal of Physiotherapy and Rehabilitation Sciences 2022; 2(1): 104-9. DOI:

Goto Y, Otaka Y, Suzuki K, Inoue S, Kondo K, Shimizu E. Incidence and circumstances of falls among community‐dwelling ambulatory stroke survivors: A prospective study. Geriatrics & Gerontology International 2019; 19(3): 240-4.

Jahn K, Freiberger E, Eskofier BM, Bollheimer C, Klucken J. Balance and mobility in geriatric patients: Assessment and treatment of neurological aspects. Zeitschrift für Gerontologie und Geriatrie 2019;52(4).

Naama Karniel P, Eitan Raveh P, Schwartz I. Functional electrical stimulation compared with ankle-foot orthosis in subacute post stroke patients with foot drop: A pilot study. Assistive Technology 2019.

Medeiros GC, Roy D, Kontos N, Beach SR. Post-stroke depression: a 2020 updated review. General hospital psychiatry 2020; 66: 70-80.

Khan F, Chevidikunnan MF. Prevalence of balance impairment and factors associated with balance among patients with stroke. A cross sectional retrospective case control study. Healthcare; 2021: MDPI; 2021. p. 320.

Tyson SF, Hanley M, Chillala J, Selley A, Tallis RC. Balance disability after stroke. Physical therapy 2006; 86(1): 30-8.

Chang T, Gajasinghe S, Arambepola C. Prevalence of stroke and its risk factors in urban Sri Lanka: population-based study. Stroke 2015; 46(10): 2965-8.

Vincent-Onabajo G, Musa HY, Joseph E. Prevalence of balance impairment among stroke survivors undergoing neurorehabilitation in Nigeria. Journal of stroke and cerebrovascular diseases 2018; 27(12): 3487-92.

Khan FR, Chevidikunnan MF, BinMulayh EA, Gaowgzeh RA. Physical therapists’ perspectives on improving walking capacity in patients with stroke: a cross-sectional study from Saudi Arabia. Journal of Musculoskeletal & Neuronal Interactions 2020; 20(2): 223.

de Haart M, Geurts AC, Huidekoper SC, Fasotti L, van Limbeek J. Recovery of standing balance in postacute stroke patients: a rehabilitation cohort study. Archives of physical medicine and rehabilitation 2004; 85(6): 886-95.

Peurala SH, Könönen P, Pitkänen K, Sivenius J, Tarkka IM. Postural instability in patients with chronic stroke. Restorative neurology and neuroscience 2007; 25(2): 101-8.

Wilkins SS, Akhtar N, Salam A, et al. Correction: Acute post stroke depression at a Primary Stroke Center in the Middle East. PloS one 2019; 14(2): e0212919.

Spera R, Belviso I, Sirico F, et al. Jump and balance test in judo athletes with or without visual impairments. 2019.

Clarke DJ, Forster A. Improving post-stroke recovery: the role of the multidisciplinary health care team. Journal of multidisciplinary healthcare 2015: 433-42. DOI: 10.2147/JMDH.S68764

Zade R, Sahu P, Shende G, Phansopkar P, Dadgal R. Comprehensive physical therapy improves functional recovery in a rare case of stroke associated with asthma: A case report. Medical Science 2020; 24(105): 2893-9.




How to Cite

Shah, M. . A., Tariq, R., Dawood, H. M., Khan, S. U., Yasmin, S. ., & Maqbool, A. . (2023). Prevalence of Balance Impairment and Risk of Fall in Post-Stroke Patients; A Cross-Sectional Study: Balance Impairment in Post-Stroke Patients. The Healer Journal of Physiotherapy and Rehabilitation Sciences, 3(9), 806–814.