Postural abnormalities and contraversive pushing following right hemisphere brain damage

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Clinical Psychology

Background:

• Stroke often leads to motor and sensory deficits, impacting body awareness and posture.
• Postural abnormalities and altered spatial perception are common but not fully understood sequelae of brain injury.

Purpose of the Study:

• To investigate the relationship between brain damage laterality (left vs. right) and postural abnormalities in stroke patients.
• To explore the connection between perceived body position in space and objective postural measurements.

Main Methods:

• Hierarchical classes analysis (HICLAS) was used to classify stroke patients based on postural symptoms.
• Therapist judgment of posture-related symptoms was analyzed.
• Classification results were validated using measurements of center of gravity, head position, and subjective postural/visual verticality.

Main Results:

• A strong correlation was found between right brain damage and abnormal body geometry.
• Three distinct patient classes emerged: those without neglect/pushing, those with neglect but no pushing, and those with both neglect and contraversive pushing (predominantly right-brain damaged).
• Right-brain damaged patients with contraversive pushing resisted postural correction towards the midline.

Conclusions:

• Abnormal body geometry in stroke patients correlates with altered subjective postural and visual verticality, suggesting a spatial bias.
• Contraversive pushing after right brain damage indicates a higher-order spatial processing deficit.
• Right brain lesions are associated with a higher frequency and severity of axial postural abnormalities.