Subjective visual vertical perception relates to balance in acute stroke.

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Clinical Neurology

Background:

• Balance difficulties are a common and debilitating consequence of hemiplegia following stroke.
• The role of sensory misperceptions, specifically of verticality, in contributing to these balance deficits remains incompletely understood.

Purpose of the Study:

• To investigate whether misperception of the subjective visual vertical (SVV) is associated with balance impairments in patients with hemiplegia.
• To explore the relationship between SVV deviations and functional outcomes in this patient population.

Main Methods:

• A descriptive study involving 30 inpatients with recent hemiplegia.
• Subjective visual vertical (SVV) perception was assessed by having participants adjust a luminous line to vertical in a dark room.
• Balance was evaluated using the Postural Assessment Scale for Stroke (PASS) and a force platform, with functional outcomes measured by the FIM instrument.

Main Results:

• A significant proportion of patients (20 out of 30) exhibited abnormal SVV perception.
• Both SVV tilt and uncertainty demonstrated significant correlations with balance measures (PASS and Lx) and functional outcome (FIM).
• Specifically, poorer balance and functional scores were associated with greater SVV deviation and uncertainty.

Conclusions:

• Misperception of verticality is a relevant factor contributing to balance disorders in patients with hemiplegia.
• Assessment of SVV should be considered in the evaluation of balance deficits post-stroke.
• Incorporating SVV assessment into balance rehabilitation programs may improve patient outcomes.