Prevalence of Saccadic and Vestibular Dysfunction in Post-Stroke Patients Affecting their Activities of Daily Living: A Cross-Sectional study

Abstract

Background: Stroke is a major cause of long-term disabilities and sensory-motor impairments, which hinder functional independence in the world. Among these, oculomotor and vestibular dysfunctions, including saccadic abnormalities, overlooked despite their significant contribution to balance impairment and restrictions in ADLs. The objectives of this study were to evaluate the frequency of saccadic and vestibular dysfunction in post stroke patientsnd to examine their associations with functional independence.

Methods: This cross-sectional study involved 80 participants diagnosed with Ischemic or Hemorrhagic stroke, recruited between July and December 2024 from PSRD Hospital and Hijaz Hospital in Lahore, Pakistan. Academically supervised by Hajvery University (Ethical Approval No: HU-ECRB-DPT-2025-62), the study included stroke survivors aged 50–75 years who were at least one-year post-stroke and provided written informed consent. Saccadic and vestibular assessments were conducted via standardized clinical protocols focusing on rapid eye movement accuracy and symptomatic responses to the Dix-Hallpike maneuver. Functional dependency was strictly categorized into Severe, Moderate, or Minimal groups based on validated Barthel Index (BI) scores. Data analysis performed in SPSS version 27 using the Pearson Chi-square test revealed a highly significant association between dual sensory-motor dysfunction and dependency levels (x2 = 39.725, df = 2, p < 0.001). These results indicate that the combined presence of saccadic and vestibular impairments serves as a strong predictor of severe dependency in activities of daily living among stroke survivors.

Results: Out of 80 participants 52.5% were maleand 86.3% had ischemic stroke. Combined saccadic and vestibular dysfunction was found in 40% of patients. Among these, 84.4% were classified as severely dependent on the Barthel Index, while 37.5% of participants without dysfunction were minimally dependent or independent. A statistically significant association was observed between dysfunction and dependency level (p < 0.001).

Conclusion: Saccadic and vestibular abnormalities are frequently observed in patients’ post-stroke patients and are strongly associated with impaired function outcomes. Identifying these impairments at an early stage and rehabilitation with particular attention to them might improve the ADL performance and quality of life.