Balancing act: Measuring and optimizing the challenge point in rehabilitation to improve walking balance after stroke

Up to 73% of people who are able to walk post-stroke suffer a fall, commonly within the first few months after discharge home. Optimizing the approach to rehabilitation of walking balance remains vital to long-term outcomes post-stroke.  A fall poses a significant risk of injury and erodes confidence. The loss in confidence alone can lead to decreased activity levels, loss of independence and social isolation that affect quality of life and overall health, even hastening death.

After stroke, much of the focus of rehabilitation is on improving balance and walking. However, no objective measures are available to assist clinicians in making important treatment decisions such as walking balance task type or intensity of the challenge.  Unlike retraining of walking endurance that uses established measures such as heart rate to monitor and plan progression of walking endurance, there are no objective measures to guide progression of rehabilitation of walking balance.

To address this issue I am working with clinicians and people with stroke to:

1. develop clinically useful balance measurement technology for use during rehabilitation;
2. better understand the interaction between physical ability and confidence during rehabilitation of walking post-stroke; and
3. incorporate this new technology together with algorithms that model rates of change to personalize the level of challenge of walking interventions and assure the best outcome for each individual with stroke.