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Related Experiment Video

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Quantitative Static and Dynamic Assessment of Balance Control in Stroke Patients
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Maintaining Trunk and Head Upright Optimizes Visual Vertical Measurement After Stroke.

Celine Piscicelli1, Julien Barra2, Brice Sibille3

  • 1Grenoble University Hospital, Grenoble, France Grenoble-Alpes University, Grenoble, France.

Neurorehabilitation and Neural Repair
|April 24, 2015
PubMed
Summary

Visual vertical (VV) measurement is crucial for spatial cognition. Maintaining upright trunk and head positions improves VV accuracy in stroke patients with postural disorders, while unmaintained positions are suitable for those with good balance.

Keywords:
body orientationlateropulsionpostural disordersstrokeuprightnessverticality perceptionvisual vertical

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Area of Science:

  • Neuroscience
  • Rehabilitation Medicine
  • Clinical Assessment

Background:

  • Visual vertical (VV) assessment is integral to understanding spatial cognition and evaluating postural disorders.
  • Standardized clinical guidelines for VV measurement in stroke patients, particularly those with difficulties maintaining an upright posture, are lacking.

Purpose of the Study:

  • To investigate the necessity of controlling body orientation during visual vertical (VV) estimation in stroke patients.
  • To determine the impact of different body support settings on VV measurement accuracy and reliability.

Main Methods:

  • Assessed VV orientation and variability in 20 healthy controls and 36 subacute stroke patients.
  • Evaluated three body support settings: non-maintained (trunk/head free), partially maintained (trunk supported, head free), and fully maintained (trunk/head supported).
  • Analyzed VV relative to quantified trunk and head tilt angles.

Main Results:

  • Body support settings significantly influenced VV orientation and variability in stroke patients with contralesional trunk tilt.
  • Upright trunk and head positioning improved VV orientation validity and within-subject variability.
  • Non-maintained settings showed reduced mean bias but higher variability, while maintained settings yielded more consistent results.
  • VV measurement without body support was valid only for patients with adequate sitting balance.

Conclusions:

  • Standardized body positioning during VV measurement is essential for stroke patients with postural deficits.
  • Maintaining an upright trunk enhances VV orientation accuracy, while maintaining an upright head improves the reliability of within-subject variability measures.
  • VV assessment without postural support is appropriate for stroke survivors with good independent sitting balance.