Development trajectory of postural control in stroke patients with hemiplegia: a differential analysis of psycho-social adjustment.

OBJECTIVE

To explore the trajectory of postural control and its influencing factors in stroke patients with hemiplegia, and to explore the correlation between different trajectories and psycho-social adjustment.

METHODS

A cohort of 225 stroke patients with hemiplegia was assessed using the Postural Assessment Scale for Stroke Patients (PASS) and the Self-Report Psycho-social Adjustment to Illness Scale (PAIS-SR) at five time points from discharge to 6 months post-discharge (T1-T5), with data analyzed via latent class growth modeling, factor analysis, and ANOVA.

RESULTS

Three postural control trajectories were identified: C1 significant improvement group, C2 slow improvement group, and C3 no improvement group. There were significant differences in age (χ 2 = 15.486, p = 0.004), self - rated anxiety and depression (χ 2 = 7.791, p = 0.020), social support (χ 2 = 9.644, p = 0.047), psychological distress (χ 2 = 8.110, p = 0.017), and coping strategies (χ 2 = 7.545, p = 0.017) among different trajectory categories. Logistic regression analysis showed that age, anxiety and depression, social support, psychological distress, and coping strategies were the influencing factors of the trajectory of postural control in stroke patients with hemiplegia (p < 0.05). After stroke onset (T1 - T5), the scores of PAIS-SR in each group showed a downward trend (indicating improved adjustment, as higher adjustment corresponds to lower PAIS-SR scores) [C1: (F = 170.335, p < 0.001); C2: (F = 5.614, p = 0.005); C3: (F = 1.993, p = 0.186)]. At the T1 stage, there was no significant difference among the three groups. At the T2 - T3 stage, the PAIS-SR score of group C1 was significantly lower than that of group C2 and group C3 (p < 0.01). At the T4 - T5 stage, the PAIS-SR score of group C1 was significantly lower than that of group C2 and group C3 (p < 0.001), and the PAIS-SR score of group C2 was significantly lower than that of group C3 (p < 0.001).

CONCLUSION

For stroke patients with hemiplegia, an individualized rehabilitation program should be implemented, along with early intervention of postural control training and combined with psychosocial support intervention.