Investigation of Balance, Upper Extremity and Body Awareness in Individuals With Stroke

Stroke is one of the leading causes of mortality and long-term disability worldwide and continues to represent a major public health problem. Motor, sensory, perceptual, and cognitive impairments that occur following stroke frequently result in limitations in functional independence and participation in daily life activities. Among these impairments, balance disorders and upper extremity dysfunction are particularly common and may significantly affect quality of life and rehabilitation outcomes.

Balance impairment after stroke is associated with postural instability, altered weight distribution, impaired trunk control, and an increased risk of falls. Changes in muscle tone, muscle weakness, impaired motor control, and deficits in sensory processing may negatively influence both static and dynamic balance. In addition, upper extremity impairments are observed in a large proportion of individuals with stroke and often persist into the chronic stage. Due to the complexity of upper extremity movements and the development of learned non-use, recovery of upper extremity function is generally slower and less complete than recovery of lower extremity function.

Previous studies have demonstrated associations between balance, trunk control, mobility, and upper extremity function in individuals with stroke. Impairments in upper extremity motor performance may influence postural control and balance strategies, while deficits in balance may limit functional use of the affected upper extremity. However, the interaction between these variables has not been fully clarified, particularly when functional upper extremity performance is evaluated using both clinical and objective measurement methods.

Body awareness has emerged as another important factor that may influence functional recovery following stroke. Body awareness is a multidimensional concept involving the perception and interpretation of bodily sensations, movements, and physiological states. It contributes to motor planning, movement execution, postural control, and interaction with the environment. Sensory deficits, perceptual disturbances, and motor impairments following stroke may negatively affect body awareness. Recent studies have suggested that body awareness may be associated with balance, walking ability, trunk control, upper extremity function, fear of falling, and independence in activities of daily living. Nevertheless, research examining body awareness in stroke populations remains limited.

A better understanding of the relationships among balance, upper extremity skills, and body awareness may provide valuable information for the development of individualized rehabilitation strategies. Identifying factors associated with functional performance may also contribute to the selection of appropriate assessment tools and treatment approaches in stroke rehabilitation.