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Stroke Research and Treatment
Volume 2017 (2017), Article ID 6153714, 10 pages
Research Article

Impact of Spasticity on Balance Control during Quiet Standing in Persons after Stroke

1Spasticity Research Program, West Park Healthcare Centre, Toronto, ON, Canada
2School of Kinesiology and Health Science, York University, Toronto, ON, Canada
3Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, Toronto, ON, Canada
4Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada
5Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
6Division of Physiatry, University of Toronto, Toronto, ON, Canada
7Faculty of Health, York University, Toronto, ON, Canada
8Toronto Rehabilitation Institute, Toronto, ON, Canada

Correspondence should be addressed to Reza Rahimzadeh Khiabani

Received 9 February 2017; Revised 29 June 2017; Accepted 26 July 2017; Published 14 September 2017

Academic Editor: David Vaudry

Copyright © 2017 Reza Rahimzadeh Khiabani et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Balance impairments, falls, and spasticity are common after stroke, but the effect of spasticity on balance control after stroke is not well understood. Methods. In this cross-sectional study, twenty-seven participants with stroke were divided into two groups, based on ankle plantar flexor spasticity level. Fifteen individuals with high spasticity (Modified Ashworth Scale (MAS) score of ≥2) and 12 individuals with low spasticity (MAS score <2) completed quiet standing trials with eyes open and closed conditions. Balance control measures included centre of pressure (COP) root mean square (RMS), COP velocity, and COP mean power frequency (MPF) in anterior-posterior and mediolateral (ML) directions. Trunk sway was estimated using a wearable inertial measurement unit to measure trunk angle, trunk velocity, and trunk velocity frequency amplitude in pitch and roll directions. Results. The high spasticity group demonstrated greater ML COP velocity, trunk roll velocity, trunk roll velocity frequency amplitude at 3.7 Hz, and trunk roll velocity frequency amplitude at 4.9 Hz, particularly in the eyes closed condition (spasticity by vision interaction). ML COP MPF was greater in the high spasticity group. Conclusion. Individuals with high spasticity after stroke demonstrated greater impairment of balance control in the frontal plane, which was exacerbated when vision was removed.