The biomechanical investigation of the relationship between balance and muscular strength in people with chronic stroke: a pilot cross-sectional study

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Abstract
Background: Impaired balance and weak muscle strength are common deficits associated with stroke. Limited research has examined the relationship between balance and strength in people post-stroke. Objective: To investigate the association between balance and muscular strength in people post-stroke. Methods: A total of 11 people with chronic stroke, who were community dwelling and ambulatory, completed balance and strength assessments. A computerized dynamic posturography system was used for Limits of Stability (LOS) test, Sit-to-Stand (STS) test, and the Modified Clinical Test of Sensory Interaction on Balance (mCTSIB). Additionally, a computerized dynamometer was used to assess the isometric muscle strength of flexion/extension in the core (the trunk) and the leg (the hip, knee, and ankle). Pearson correlation analysis was used to investigate the relationship between balance and muscle strength measurements. Results: Endpoint excursion (EPE) (r = .646; p < 0.032) and maximum excursion (MXE) (r = .613; p < 0.045) of LOS test were positively correlated with core and leg strength (C&L). Specifically, both EPE (r = −.792; p < 0.004) and MXE (r = −.623; p < 0.041) in backward direction had strong correlations with C&L. Core strength also showed a positive correlation with EPE of LOS test (r = .636; p < 0.035) while the composite leg strength did not. Lastly, STS and mCTSIB tests did not demonstrate significant associations with muscle strength. Conclusions: The results indicate that the C&L have a strong relationship with the ability to shift body weight in multiple directions, particularly backward, among people post-stroke. However, static balance and STS performance do not appear to be related to muscle strength.

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