Postural Control and Upper-Extremity Motor Impairment Associated with Functional Independence During Acute Stroke Hospitalization: A Cross-Sectional Study

Background and aim: Postural control and limb motor impairment are essential to functional status after stroke. We aimed to examine the associations of postural control and motor impairment with functional independence during acute stroke hospitalization, with particular attention to the relationship between postural control and upper-extremity motor impairment and whether these domains provide information regarding functional independence. Methods: In this single-center cross-sectional study, 51 adults with acute stroke were assessed 3–10 days after onset. Postural control, motor impairment, functional independence, and disability were evaluated using the Postural Assessment Scale for Stroke Patients (PASS), Fugl-Meyer Assessment (FMA), Barthel Index, and modified Rankin Scale (mRS), respectively. Associations were examined using Spearman correlations and multivariable regression. We separately examined the upper-extremity motor impairment using the FMA-UE, and an additional hierarchical regression model evaluated whether PASS provided explanatory information beyond FMA-UE. Results: We found that PASS was strongly associated with FMA-UE (ρ = 0.749, 95% CI 0.554–0.881; p < 0.001), while FMA-UE was associated with the Barthel Index (ρ = 0.799, p < 0.001). A model including age, assessment timing, and FMA-UE explained 83.8% of Barthel Index variance. The addition of PASS increased explained variance to 95.2% (ΔR2 = 0.114; p < 0.001), with both FMA-UE (B = 0.505, 95% CI 0.296–0.713; p < 0.001) and PASS (B = 1.955, 95% CI 1.469–2.441; p < 0.001) remaining independently associated with functional independence. Conclusions: Postural control and upper-extremity motor impairment were strongly related but provided complementary information regarding functional independence. Integrating postural assessment with upper-extremity motor assessment may improve early functional characterization and rehabilitation planning after stroke.