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van der Waal C, Saeys W, Truijen S, Embrechts E. Clinical Assessment of Subjective Visual and Haptic Vertical Norms in Healthy Adults. Arch Clin Neuropsychol 2024:acae049. [PMID: 38940374 DOI: 10.1093/arclin/acae049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 05/08/2024] [Accepted: 05/14/2024] [Indexed: 06/29/2024] Open
Abstract
BACKGROUND AND OBJECTIVE Accurate verticality perception is essential for daily life activities, such as correctly estimating object orientation in space. This study established normative data for the subjective visual vertical (SVV) and subjective haptic vertical (SHV) using the portable and self-constructable modified Bucket test and Rotating-Column test. Additionally, the contribution of age, sex, and starting position of the line/ column on SVV and SHV accuracy were evaluated. METHOD This study, part of the PRECISE project (ClinicalTrials.gov ID NCT05978596), was conducted following the STROBE guidelines. Healthy adults without visual/neurological/vestibular disorders were recruited. Subjective visual vertical and SHV accuracy were described in terms of constant errors (i.e., mean deviation from 0° [true vertical] respecting its direction), unsigned errors (i.e., mean deviation from 0° irrespective of direction), and variability (i.e., intra-individual standard deviation). RESULTS Sixty participants were evaluated (mean age: 41.14 [SD = 16.74] years). Subjective visual vertical constant errors between -2.82° and 2.90°, unsigned errors up to 2.15°, and variability up to 1.61° are considered normal. Subjective haptic vertical constant errors ranged from -6.94° to 8.18°, unsigned errors up to 6.66° and variability up to 4.25°. Higher ages led to higher SVV unsigned errors and variability. SHV variability was higher in females compared to males. Certain starting positions led to higher SVV and SHV constants and SVV unsigned errors. DISCUSSION Normative data are provided for affordable, self-constructable, and portable SVV and SHV tools. These norms are consistent with more sophisticated equipment and can be used to distinguish between normal and abnormal values.
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Affiliation(s)
- Charlotte van der Waal
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Wim Saeys
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Wilrijk, Belgium
- Department of Neurorehabilitation, RevArte Rehabilitation Hospital, Edegem, Belgium
| | - Steven Truijen
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Elissa Embrechts
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
- Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Wilrijk, Belgium
- Department of Experimental Neuropsychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
- Rehabilitation Research Group, Vrije Universiteit Brussel, Brussel, Belgium
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Czarnolewski MY. Rod and frame test parameters for neuropsychology studies. J Clin Exp Neuropsychol 2024:1-22. [PMID: 38873989 DOI: 10.1080/13803395.2024.2356297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 05/13/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND The rod and frame test (RFT), a measure of field dependence-independence, recently has reemerged as a measure of research interest and potential diagnostic value in neuropsychology. In the standard RFT, the subject experiences offsetting visual cues from a frame surrounding an embedded rod, while the subject's postural/vestibular cues provide the sense of verticality as the subject attempts to set the rod to vertical. The paper shows that RFTs not adhering to RFT parameters can reduce the test's visual framework impact experienced by the subject. Comparisons of neuropsychological studies will highlight that correct adherence to RFT testing conditions can strengthen RFT effects. METHOD This review presents the parameters that have been studied which impact on subject performance on the RFT. It identifies how computer administered RFTs have been applied to enhance the study of the RFT parameters and make the RFT more accessible to the study of different diagnostic groups. The article also critiques studies by identifying how the RFT's parameters, study's design and statistical analysis may have diminished identifying the full effects of the RFT experience. RESULTS Parameters impacting judgments of verticality of the rod can include: perceived size of rod and frame, the gap between the ends of the rod and surrounding frame, presentation of the rod within an encompassing 3D visual framework that visually blocks out the surrounding environment, a dark room, instructions stressing egocentric vs allocentric strategies, double frame surrounding the rod to assess global perception effects, etc. Details are presented how gap size likely affected results in neuropsychology studies. Potentially, these and other experiments may be studied using computer administered RFTs. CONCLUSIONS Based on the descriptions of computer administered RFTs, this article suggested that incorporating these technologies can provide better understanding underlying the RFT, and in turn, understanding neuropsychology processes.
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Inoue M, Amimoto K, Chiba Y, Sekine D, Fukata K, Fujino Y, Takahashi H, Makita S. Analyses of weight-bearing asymmetry pattern for standing in the early phase after stroke: a cross-sectional study. Physiother Theory Pract 2024; 40:1241-1248. [PMID: 36593735 DOI: 10.1080/09593985.2022.2163860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 12/26/2022] [Accepted: 12/26/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND How the weight-bearing asymmetry pattern and related maximum lateral weight-bearing capacity, physical functions, balance, and mobility involved in weight-bearing asymmetry and lesions are related to weight-bearing asymmetry in patients with early-onset stroke remains unclear. OBJECTIVE To investigate the difference between weight-bearing in the early phase after stroke categorized as symmetrical or nonsymmetrical regarding impairments, balance, walking, and independence, and any lesion location difference. METHODS This cross-sectional study included 46 persons with hemiparetic stroke within 3 weeks from onset undergoing inpatient rehabilitation and classified into symmetrical, paretic, and non-paretic groups. We performed posturographic, functional, mobility, and lesion location assessments on participants once the evaluation was possible. RESULTS The symmetrical, paretic, and non-paretic groups included 14, 11, and 21 patients, respectively. The non-paretic group had lesser mean % body weight in maximum lateral weight-bearing to the paretic direction (79% versus 55%, p < .001), motor function of the hip lower limb (64 versus 58, p = .003) per the Stroke Impairment Assessment Set, Trunk Impairment Scale (18 versus 15, p = .020), and Berg Balance Scale (42 versus 32, p = .047) than the paretic group with more lesions in the insula (55% versus 0%, p < .001) and parietal cortex (36% versus 0%, p = .009) than the non-paretic group. CONCLUSION The non-paretic group had low dynamic balance, severe motor paresis, and trunk dysfunction. The paretic group had lesions in the insula or parietal cortex.
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Affiliation(s)
- Masahide Inoue
- Department of Rehabilitation, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, Japan
- Department of Physical Therapy, Tokyo Metropolitan University, 7-2-10 Higashiogu, Arakawa-ku, Tokyo, Japan
| | - Kazu Amimoto
- Department of Physical Therapy, Tokyo Metropolitan University, 7-2-10 Higashiogu, Arakawa-ku, Tokyo, Japan
| | - Yuya Chiba
- Department of Rehabilitation, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, Japan
| | - Daisuke Sekine
- Department of Rehabilitation, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, Japan
- Department of Physical Therapy, Tokyo Metropolitan University, 7-2-10 Higashiogu, Arakawa-ku, Tokyo, Japan
| | - Kazuhiro Fukata
- Department of Rehabilitation, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, Japan
| | - Yuji Fujino
- Department of Physical Therapy, Juntendo University, 3-2-12, Hongo, Bunkyo-ku, Tokyo, Japan
| | - Hidetoshi Takahashi
- Department of Rehabilitation, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, Japan
| | - Shigeru Makita
- Department of Rehabilitation, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, Japan
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Birnbaum M, Brock K, Clark R, Burton E, Hill KD. Six-month outcomes and patterns of recovery for people with lateropulsion following stroke. Disabil Rehabil 2024; 46:2405-2413. [PMID: 37312557 DOI: 10.1080/09638288.2023.2222644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 06/02/2023] [Indexed: 06/15/2023]
Abstract
PURPOSE This study investigated the (1) six-month outcomes of individuals with lateropulsion; (2) the relationship between baseline measures (from in-patient hospitalisation) and six-month functional abilities; and (3) recovery patterns for lateropulsion in stroke survivors. MATERIALS AND METHODS Forty-one individuals with lateropulsion participated in this study. Measures of lateropulsion, postural function, and weight-bearing asymmetry in standing were taken initially and fortnightly over eight weeks. Functional independence and walking abilities were assessed at six months post-stroke. RESULTS Compared to individuals with moderate to severe lateropulsion, those with mild lateropulsion achieved higher levels of functional outcome at six months. However, there were a wide range of scores. Baseline lateropulsion severity explained 26% of the variation in functional outcome. A stronger correlation with functional outcome was observed for lateropulsion (-0.526) than function independence at baseline (0.384). For the task of standing with arm support, patterns of asymmetry were divergent at baseline, favouring either the paretic or non-paretic leg. Over the eight-week period, asymmetry moved towards the non-paretic leg and lateropulsion reduced consistently. CONCLUSIONS Individuals with lateropulsion can recover from lateropulsion and make meaningful functional gains, including some individuals with more severe lateropulsion. Lateropulsion severity is a key indicator of functional outcome post-stroke.IMPLICATIONS FOR REHABILITATIONIndividuals with lateropulsion can make significant gains in terms of mobility and functional abilities by six months post-stroke, learning to compensate for their verticality impairment in standing by loading their non-paretic leg.It is important that stroke survivors with lateropulsion, including those with moderate and severe lateropulsion, are provided with adequate rehabilitation to optimise their longer-term mobility and functional abilities.Routine screening of acute stroke survivors for lateropulsion is recommended, given lateropulsion may negatively impact longer-term functional outcomes in stroke survivors.Therapists should carefully analyse the weight-bearing pattern which an individual with lateropulsion adopts in standing and subsequently tailor treatment to target this.
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Affiliation(s)
- Melissa Birnbaum
- Physiotherapy Department, St. Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Kim Brock
- Physiotherapy Department, St. Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
| | - Ross Clark
- School of Health and Behavioural Science, University of the Sunshine Coast, Queensland, Australia
| | - Elissa Burton
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
- enAble Institute, Curtin University, Perth, Western Australia, Australia
| | - Keith D Hill
- Rehabilitation Ageing and Independent Living (RAIL) Research Centre, School of Primary and Allied Health Care, Monash University, Frankston, Victoria, Australia
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Cao W, Chu H, Hanson T, Siegel L. A Bayesian nonparametric meta-analysis model for estimating the reference interval. Stat Med 2024; 43:1905-1919. [PMID: 38409859 DOI: 10.1002/sim.10001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 10/24/2023] [Accepted: 12/17/2023] [Indexed: 02/28/2024]
Abstract
A reference interval represents the normative range for measurements from a healthy population. It plays an important role in laboratory testing, as well as in differentiating healthy from diseased patients. The reference interval based on a single study might not be applicable to a broader population. Meta-analysis can provide a more generalizable reference interval based on the combined population by synthesizing results from multiple studies. However, the assumptions of normally distributed underlying study-specific means and equal within-study variances, which are commonly used in existing methods, are strong and may not hold in practice. We propose a Bayesian nonparametric model with more flexible assumptions to extend random effects meta-analysis for estimating reference intervals. We illustrate through simulation studies and two real data examples the performance of our proposed approach when the assumptions of normally distributed study means and equal within-study variances do not hold.
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Affiliation(s)
- Wenhao Cao
- Division of Biostatistics and Health Data Science, University of Minnesota, Minneapolis, Minnesota, USA
| | - Haitao Chu
- Division of Biostatistics and Health Data Science, University of Minnesota, Minneapolis, Minnesota, USA
- Statistical Research and Data Science Center, Pfizer Inc., New York, New York, USA
| | - Timothy Hanson
- Enterprise CRMS, Medtronic Plc, Mounds View, Minnesota, USA
| | - Lianne Siegel
- Division of Biostatistics and Health Data Science, University of Minnesota, Minneapolis, Minnesota, USA
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Obrero‐Gaitán E, Fuentes‐Núñez D, Moral‐García MD, López‐Ruiz MDC, Rodríguez‐Almagro D, Lomas‐Vega R. Misperception of body verticality in neurological disorders: A systematic review and meta-analysis. Brain Behav 2024; 14:e3496. [PMID: 38688878 PMCID: PMC11061201 DOI: 10.1002/brb3.3496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 02/22/2024] [Accepted: 04/06/2024] [Indexed: 05/02/2024] Open
Abstract
INTRODUCTION The internal representation of verticality could be disturbed when a lesion in the central nervous system (CNS) affects the centers where information from the vestibular, visual, and/or somatosensory systems, increasing the risk of falling. OBJECTIVE The aim was to evaluate the vestibular and somatosensory contribution to the verticality pattern in patients with stroke and other neurological disorders. METHODS A literature search was performed in PubMed, Scopus, Web of Science, and CINAHL databases. Cross-sectional, case-control, and cohort studies comparing body verticality in patients with stroke or CNS diseases (CNSD) versus healthy controls were selected. Subjective postural vertical (SPV) in roll and pitch planes was used as the primary variable. RESULTS Ten studies reporting data from 390 subjects were included. The overall effect for CNSD patients showed a misperception of body verticality in roll (standardized mean difference [SMD] = 1.05; 95% confidence interval [CI] .84-1.25) and pitch planes (SMD = 1.03; 95% CI .51-1.55). In subgroup analyses, a high effect was observed in the perception of SPV both in roll and pitch planes in stroke (p = .002) and other CNSD (p < .001). CONCLUSION These findings suggest a potential misperception of SPV in patients with stroke and other neurological disturbances. Patients with CNSD could present an alteration of vestibular and somatosensory contribution to verticality construction, particularly stroke patients with pusher syndrome (PS), followed by those with PS combined with hemineglect.
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van der Waal C, Embrechts E, Truijen S, Saeys W. Do we need to consider head-on-body position, starting roll position and presence of visuospatial neglect when assessing perception of verticality after stroke? Top Stroke Rehabil 2024; 31:244-258. [PMID: 37671676 DOI: 10.1080/10749357.2023.2253622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 08/27/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND AND OBJECTIVE Considering various factors that influence the accuracy of the Subjective Visual Vertical (SVV) and Subjective Postural Vertical (SPV), standardization of assessment methods is needed. This retrospective study examined the contribution of Head-on-Body (HOB) position, starting roll position (SRP) and visuospatial neglect (VSN) to SVV and SPV constant errors (i.e. deviation from true vertical). Also, the contribution of HOB position and VSN presence to SVV and SPV variability (i.e. intra-individual consistency between trials) was assessed. METHODS First-ever unilateral hemispheric stroke survivors (<85 years; <100 days post-stroke) were assessed with three HOB positions (neutral, contralesional, and ipsilesional) and seven starting positions (20°Contralesional to 20° ipsilesional) of the laser bar and tilt chair. Linear mixed models were selected to evaluate the contribution of HOB, SRP, and VSN to SVV/SPV constant errors and variability. RESULTS Thirty-four subjects (24 VSN-/10 VSN+) were assessed. A tilted HOB position led to significantly higher constant errors for the SVV and SPV (the latter only in the VSN- group), and an increased SVV variability. SRP only significantly contributed to the SVV constant errors and only in the VSN- group. Furthermore, the presence of VSN resulted in a significantly higher SVV and SPV variability. CONCLUSIONS HOB position and the presence of SRP and VSN are important factors to consider during SVV and SPV measurements. Assessment with a neutral HOB position leads to more accurate results. HOB position and SRP influence the results of SVV and SPV differently in individuals with and without VSN, which highlights the relevance of VSN assessment.
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Affiliation(s)
- Charlotte van der Waal
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
- Research Group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Elissa Embrechts
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
- Research Group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
- Department of Experimental Neuropsychology, Helmholtz Institute, Utrecht University, Utrecht, Netherlands
| | - Steven Truijen
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
- Research Group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Wim Saeys
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
- Research Group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
- Department of Neurorehabilitation, RevArte Rehabilitation Hospital, Edegem, Belgium
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Embrechts E, Loureiro-Chaves R, Nijboer TCW, Lafosse C, Truijen S, Saeys W. The Association of Personal Neglect with Motor, Activities of Daily Living, and Participation Outcomes after Stroke: A Systematic Review. Arch Clin Neuropsychol 2024; 39:249-264. [PMID: 37591497 DOI: 10.1093/arclin/acad063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2023] [Indexed: 08/19/2023] Open
Abstract
Despite its potential clinical impact, the association of personal neglect (PN) with motor, activities of daily living (ADL), and participation outcomes after stroke is not well-understood. This first-ever systematic review on the topic therefore evaluates this association, taking into account suggested subtypes of PN, including body representation neglect, somatosensory neglect, motor neglect, and premotor neglect. A systematic literature search was conducted on February 17, 2023 in PubMed, Web of Science, Scopus, PubPsych, and PsycArticles databases. The study adheres to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses, and its protocol was registered on PROSPERO (CRD42020187460). Eleven observational studies were included, gathering 1,400 individuals after stroke (429 showed PN). Results show that individuals with body representation neglect after stroke have significantly decreased movement control and motor strength, lower functional mobility, and ADL independency compared with those without body representation neglect after stroke. Individuals with motor neglect after stroke showed worse motor function and spasticity than to those without motor neglect after stroke. Nonspecified PN (i.e., PN evaluated with an outcome measure that does not allow subcategorization) was related to worse lateropulsion with pushing, longer length of stay and greater odds of being discharged to somewhere other than home. No study evaluated somatosensory and premotor neglect. This review highlights the limited research in this area and emphasizes the need for a more comprehensive PN assessment. However, currently available assessment tools show limited ability to accurately diagnose PN subtypes and future research should prioritize the development of comprehensive diagnostic test batteries.
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Affiliation(s)
- Elissa Embrechts
- Research Group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
| | - Renata Loureiro-Chaves
- Research Group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Tanja C W Nijboer
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
- Center of Excellence for Rehabilitation Medicine, UMC Brain Center, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Christophe Lafosse
- Department of Neurorehabilitation, RevArte Rehabilitation Hospital, Edegem, Belgium
| | - Steven Truijen
- Research Group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Wim Saeys
- Research Group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
- Department of Neurorehabilitation, RevArte Rehabilitation Hospital, Edegem, Belgium
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Dai S, Piscicelli C, Marquer A, Lafitte R, Clarac E, Detante O, Pérennou D. Improving orientation with respect to gravity enhances balance and gait recovery after stroke: DOBRAS cohort. Ann Phys Rehabil Med 2024; 67:101767. [PMID: 38266575 DOI: 10.1016/j.rehab.2023.101767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 04/03/2023] [Accepted: 04/27/2023] [Indexed: 01/26/2024]
Abstract
BACKGROUND Lateropulsion is a deficit in body orientation with respect to gravity, frequent after stroke. Although it is a primary factor affecting mobility, the impact of its attenuation on balance and gait recovery has never been investigated. Moreover, most studies on the lateropulsion time-course focus on severe forms suspected to have a poor recovery, which is not proven. OBJECTIVES To investigate lateropulsion attenuation and test 2 hypotheses: 1) lateropulsion attenuation greatly contributes to balance and gait recovery and 2) severe forms of lateropulsion recover slower than moderate forms. METHODS This longitudinal study involved individuals included in the Determinants of Balance Recovery After Stroke (DOBRAS) cohort, after a first-ever hemispheric stroke, with data collected on day 30 (D30), D60 and D90 post-stroke. Body orientation with respect to gravity was assessed using the Scale for Contraversive Pushing (both scores and severity grouping), in parallel with balance (Postural Assessment Scale for Stroke) and gait (modified Fugl-Meyer Gait Assessment). RESULTS Among the 106 eligible individuals (mean age 66.5 [SD 9.7] years), on D30, 43 (41%) were considered upright and 63 (59%) showed lateropulsion: 30 (28%) moderate and 33 (31%) severe. Most individuals with lateropulsion (73%) improved their body orientation, progressing from severe to moderate lateropulsion, or becoming upright. However, half were still not upright on D90. The improvement in body orientation had a large impact on mobility, especially in individuals with severe lateropulsion, in whom it explained about 50% of balance and gait recovery between D30 and D60, then 20% (D60-D90). For moderate lateropulsion, its attenuation explained about 20% of balance and gait recovery until D90. Lateropulsion attenuation was not slower in individuals with severe forms. CONCLUSIONS Lateropulsion attenuation enhances balance and gait recovery in individuals after stroke suggesting that specific rehabilitation of body orientation with respect to gravity might help to recover mobility. REGISTRATION NCT03203109.
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Affiliation(s)
- Shenhao Dai
- University Grenoble Alpes, UMR CNRS 5105 Neuropsychology and NeuroCognition, CHU Grenoble Alpes, Dept of NeuroRehabilitation South Hospital, Cs 10217 - 38043 Grenoble cedex 9, France
| | - Céline Piscicelli
- University Grenoble Alpes, UMR CNRS 5105 Neuropsychology and NeuroCognition, CHU Grenoble Alpes, Dept of NeuroRehabilitation South Hospital, Cs 10217 - 38043 Grenoble cedex 9, France
| | - Adélaide Marquer
- University Grenoble Alpes, UMR CNRS 5105 Neuropsychology and NeuroCognition, CHU Grenoble Alpes, Dept of NeuroRehabilitation South Hospital, Cs 10217 - 38043 Grenoble cedex 9, France
| | - Rémi Lafitte
- University Grenoble Alpes, UMR CNRS 5105 Neuropsychology and NeuroCognition, CHU Grenoble Alpes, Dept of NeuroRehabilitation South Hospital, Cs 10217 - 38043 Grenoble cedex 9, France
| | - Emmanuelle Clarac
- University Grenoble Alpes, UMR CNRS 5105 Neuropsychology and NeuroCognition, CHU Grenoble Alpes, Dept of NeuroRehabilitation South Hospital, Cs 10217 - 38043 Grenoble cedex 9, France
| | - Olivier Detante
- Stroke Unit, Neurology Department, Grenoble Alpes University Hospital, 38043 Grenoble, France; University Grenoble Alpes, Grenoble Institute of Neurosciences, 38042 Grenoble, France
| | - Dominic Pérennou
- University Grenoble Alpes, UMR CNRS 5105 Neuropsychology and NeuroCognition, CHU Grenoble Alpes, Dept of NeuroRehabilitation South Hospital, Cs 10217 - 38043 Grenoble cedex 9, France.
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Embrechts E, Schröder J, Nijboer TCW, van der Waal C, Lafosse C, Truijen S, Saeys W. Does visuospatial neglect contribute to standing balance within the first 12 weeks post-stroke? A prospective longitudinal cohort study. BMC Neurol 2024; 24:37. [PMID: 38254026 PMCID: PMC10801963 DOI: 10.1186/s12883-023-03475-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 11/24/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Visuospatial neglect (VSN) has been suggested to limit standing balance improvement post-stroke. However, studies investigating this association longitudinally by means of repeated within-subject measurements early post-stroke are lacking. This prospective longitudinal cohort study evaluates the longitudinal association of egocentric and allocentric VSN severity with 1) standing balance independence and 2) postural control and weight-bearing asymmetry (WBA) during quiet standing, in the first 12 weeks post-stroke. METHODS Thirty-six hemiplegic individuals after a first-ever unilateral stroke were evaluated at weeks 3, 5, 8 and 12 post-stroke. Egocentric and allocentric VSN severity were evaluated using the Broken Hearts Test. The standing unperturbed item of the Berg Balance Scale (BBS-s) was used to clinically evaluate standing independence. Posturographic measures included measures of postural control (mediolateral (ML)/anteroposterior (AP) net center-of-pressure velocities (COPvel)) and WBA during quiet standing. A linear mixed model was used to examine longitudinal associations between egocentric and allocentric VSN, and BBS-s, COPvel-ML, COPvel-AP and WBA within the first 12 weeks post-stroke. RESULTS Egocentric (β = -0.08, 95%CI[-0.15;-0.01], P = .029) and allocentric VSN severity (β = -0.09, 95%CI[-0.15; -0.04], P = .002) were significant independent factors for BBS-s scores in the first 12 weeks post-stroke. Egocentric and allocentric VSN were no significant independent factors for COPvel-ML, COPvel-AP and WBA in the first 12 weeks post-stroke. CONCLUSIONS Allocentric and egocentric VSN severity were significantly associated with decreased standing independence, but not impaired postural control or greater asymmetric weight-bearing, in the early subacute post-stroke phase. This may involve traditional VSN measures being not sensitive enough to detect fine-grained VSN deficits due to a ceiling effect between 5 and 8 weeks post-stroke, once the individual regains standing ability. Future studies may require more sensitive VSN measurements to detect such deficits. Trial registration Clinicaltrials.gov. unique identifier NCT05060458.
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Affiliation(s)
- Elissa Embrechts
- Department of Rehabilitation Sciences and Physiotherapy (REVAKI), Research Group MOVANT, University of Antwerp, Wilrijk, Belgium.
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands.
| | - Jonas Schröder
- Department of Rehabilitation Sciences and Physiotherapy (REVAKI), Research Group MOVANT, University of Antwerp, Wilrijk, Belgium
| | - Tanja C W Nijboer
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
- Center of Excellence for Rehabilitation Medicine, UMC Brain Center, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Charlotte van der Waal
- Department of Rehabilitation Sciences and Physiotherapy (REVAKI), Research Group MOVANT, University of Antwerp, Wilrijk, Belgium
| | - Christophe Lafosse
- Department of Neurorehabilitation, RevArte Rehabilitation Hospital, Edegem, Belgium
| | - Steven Truijen
- Department of Rehabilitation Sciences and Physiotherapy (REVAKI), Research Group MOVANT, University of Antwerp, Wilrijk, Belgium
| | - Wim Saeys
- Department of Rehabilitation Sciences and Physiotherapy (REVAKI), Research Group MOVANT, University of Antwerp, Wilrijk, Belgium
- Department of Neurorehabilitation, RevArte Rehabilitation Hospital, Edegem, Belgium
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11
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Salazar López E, Krewer C, Bergmann J, Möhwald K, Müller F, Jahn K. Lateropulsion in Right-Sided Stroke: Brain Anatomical Correlates of Severity and Duration. J Neurol Phys Ther 2024; 48:38-45. [PMID: 37306456 DOI: 10.1097/npt.0000000000000446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND AND PURPOSE Lateropulsion (LP) is a profound disorder of postural control that has a significant impact on neurorehabilitation. Knowledge of relevant brain areas could guide decisions on appropriate intervention methods. Although LP severity and duration are highly variable in individuals with LP, imaging studies on LP have not sufficiently considered these aspects. The aim of this study was to investigate the lesion location in individuals after stroke and the correlation with LP duration and severity. METHODS A retrospective case-control study using voxel lesion symptom mapping (VLSM) in 74 individuals with right-sided brain lesion (49 with and 25 without LP) was performed to analyze the correlation between lesion location and LP severity. Duration was investigated in a subsample of 22 individuals with LP. LP was diagnosed by means of the Scale for Contraversive Pushing. RESULTS Individuals with LP showed significantly larger lesion sizes compared with the individuals with no LP. VLSM analysis of LP severity did not reveal statistically significant results. VLSM analysis showed a statistically significant association with longer LP duration for the inferior frontal gyrus, the hippocampus, the inferior parietal gyrus, the supramarginal gyrus, the angular gyrus, the temporal cortex, the sagittal stratum, and the superior longitudinal fasciculus. DISCUSSION AND CONCLUSION LP-relevant areas are located in the multisensory network. Areas of the frontoparietal network, which are related to spatial cognition, memory, and attention, were found to be relevant for duration and severity. The findings, especially those regarding duration involving the middle temporal cortex, could explain the better intervention outcomes for methods based more on implicit than on explicit knowledge of verticality.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1 available at: http://links.lww.com/JNPT/A433 ).
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Affiliation(s)
- Elvira Salazar López
- German Center for Vertigo and Balance Disorders (DSGZ) (E.S.L., C.K., J.B., K.M., F.M., K.J.), Ludwig-Maximilians University of Munich, Munich, Germany; Department of Neurology (C.K., J.B., F.M., K.J.), Schoen Clinic Bad Aibling, Bad Aibling, Germany; Department of Sports and Health Sciences - Chair of Human Movement Science (C.K.), Technical University of Munich, Munich, Germany; and Department of Neurology (K.M.), Ludwig-Maximilians University of Munich, Munich, Germany
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12
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Nakamura J, Nishimae T, Uchisawa H, Okada Y, Shiozaki T, Tanaka H, Ueta K, Fujita D, Tsujimoto N, Ikuno K, Shomoto K. Effects of postural-control training with different sensory reweightings in a patient with body lateropulsion: a single-subject design study. Physiother Theory Pract 2023:1-11. [PMID: 37916486 DOI: 10.1080/09593985.2023.2274943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 10/18/2023] [Indexed: 11/03/2023]
Abstract
INTRODUCTION Body lateropulsion (BL) is an active lateral tilt of the body during standing or walking that is thought to be affected by a lesion of the vestibulospinal tract (VST) and the subjective visual vertical (SVV) tilt. Interventions for BL have not been established. OBJECTIVE We examined the effects of postural-control training with different sensory reweighting on standing postural control in a patient with BL. METHODS The patient had BL to the left when standing or walking due to a left-side medullary and cerebellar infarct. This study was a single-subject A-B design with follow-up: Phase A was postural-control training with visual feedback; phase B provided reweighting plantar somatosensory information. Postural control, VST excitability, and SVV were measured. RESULTS At baseline and phase A, the patient could not stand with eyes-closed on a rubber mat, but became able to stand in phase B. The mediolateral center of pressure (COP) position did not change significantly, but the COP velocity decreased significantly during phase B and the follow-up on the firm surface. VST excitability was lower on the BL versus the non-BL side, and the SVV deviated to the right throughout the study. CONCLUSION Postural-control training with reweighting somatosensory information might improve postural control in a patient with BL.
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Affiliation(s)
- Junji Nakamura
- Department of Rehabilitation Medicine, Nishiyamato Rehabilitation Hospital, Nara, Japan
- Graduate School of Health Sciences, Kio University, Nara, Japan
| | - Takuma Nishimae
- Department of Rehabilitation Medicine, Nishiyamato Rehabilitation Hospital, Nara, Japan
| | - Hidekazu Uchisawa
- Department of Rehabilitation Medicine, Nishiyamato Rehabilitation Hospital, Nara, Japan
| | - Yohei Okada
- Graduate School of Health Sciences, Kio University, Nara, Japan
- Neurorehabilitation Research Center of Kio University, Nara, Japan
| | - Tomoyuki Shiozaki
- Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, Kashihara-City, Nara, Japan
| | - Hiroaki Tanaka
- KMU Day-care Center Hirakata, Kansai Medical University Hospital, Hirakata-City, Osaka, Japan
- Department of Physical Medicine and Rehabilitation, Kansai Medical University, Osaka, Japan
| | - Kozo Ueta
- Graduate School of Health Sciences, Kio University, Nara, Japan
- Department of Rehabilitation Medicine, Shiga Hospital, Otsu-Shi, Shiga, Japan
| | - Daiki Fujita
- Department of Rehabilitation Medicine, Nishiyamato Rehabilitation Hospital, Nara, Japan
| | - Naohide Tsujimoto
- Department of Rehabilitation Medicine, Nishiyamato Rehabilitation Hospital, Nara, Japan
| | - Koki Ikuno
- Department of Rehabilitation Medicine, Nishiyamato Rehabilitation Hospital, Nara, Japan
- Graduate School of Health Sciences, Kio University, Nara, Japan
| | - Koji Shomoto
- Graduate School of Health Sciences, Kio University, Nara, Japan
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13
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Jafari M, Shaabani M, Hosseini SR, Ashayeri H, Bakhshi E, Haghgoo HA. Modification of cortical electrical activity in stroke survivors with abnormal subjective visual vertical: An eLORETA study. Heliyon 2023; 9:e22194. [PMID: 38027645 PMCID: PMC10661540 DOI: 10.1016/j.heliyon.2023.e22194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 09/16/2023] [Accepted: 11/06/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives Balance impairment is among the main complications of stroke. The gravity-based subjective vertical (SV) is considered an important reference for upright posture and navigation affected by stroke. The correlation between injury location and pathological perception of verticality remains controversial. This study aimed to evaluate the cortico-cortical network of vertical perception among patients with the right hemisphere stroke and abnormal visual-vertical perception compared with healthy individuals. Materials and methods This observational cross-sectional study included 40 patients with the right hemisphere stroke and 35 healthy participants. All patients had abnormal visual-vertical perception. The EEG connectivity analysis was conducted through the exact low-resolution brain electromagnetic tomography analysis (eLORETA). Results Stroke survivors manifested a power spectral density that reduced within the beta-2 frequency band in the left hemisphere and increased within the beta-3 frequency band in the right hemisphere compared with controls (p < 0.01). The lagged-phase synchronization was increased within alpha-1, beta-2, and beta-3 bands and decreased in stroke survivors compared with controls in the vestibular network involved in visual-vertical perception (p < 0.01). Conclusion The results of this study demonstrated variations in the function and functional connectivity of cortical areas involved in the visual-vertical perception that are mainly located in the vestibular cortex.
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Affiliation(s)
- Meymaneh Jafari
- Department of Audiology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Moslem Shaabani
- Department of Audiology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Seyed Ruhollah Hosseini
- Department of Psychology, Faculty of Education Sciences and Psychology, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Hassan Ashayeri
- Rehabilitation Research Center, Department of Basic Sciences, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Enayatollah Bakhshi
- Department of Biostatistics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Hojjat Allah Haghgoo
- Department of Occupational Therapy. University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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14
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Fonseca BHDS, de Andrade PHS, Henrique MESA, Baggio JADO, Bazan R, de Souza LAPS, Luvizutto GJ. Perception of verticality in the post-COVID-19 condition correlates to infection severity. J Cent Nerv Syst Dis 2023; 15:11795735231195693. [PMID: 38025401 PMCID: PMC10655649 DOI: 10.1177/11795735231195693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 08/02/2023] [Indexed: 12/01/2023] Open
Abstract
Background SARS-CoV-2 infection affects multiple systems, including musculoskeletal, neurological, and respiratory systems. Changes associated with physical inactivity due to prolonged hospitalization can affect the functional capacity of individuals with long coronavirus disease 2019 (COVID-19) or post-COVID-19 condition and may cause changes in some postural control functions, such as verticality. Objectives This study aimed to evaluate the perception of verticality in individuals with long COVID. Design Cross-sectional study. Methods This study included 60 participants with post-COVID-19 condition divided into 2 groups: hospitalized group (n = 24), those hospitalized owing to SARS-CoV-2 infection; and non-hospitalized group (n = 36), those infected with SARS-CoV-2 but not hospitalized. All participants were examined using a post-COVID-19 functional status (PCFS), sit-to-stand test, grip strength assessment, painful and tactile sensory assessments, visual acuity assessment, and vestibular assessment. Verticality perception was evaluated using the subjective visual vertical (SVV) and subjective haptic vertical (SHV) tests. In both tests, the absolute values (positive values only) and true values (positive and negative values) were considered. To verify potential confounders that could influence the verticality of the results, logistic regression models were used for categorical variables and multiple linear regressions were used for continuous variables. For analysis between groups, the independent samples test (Mann-Whitney U test) was used. Results There were no confounders between clinical variables and verticality in either group. There was a significant increase in absolute SVV (mean deviation [MD]: 2.83; P < .0001) and true SVV (MD: -4.18; P = .005) in the hospitalized group compared to the non-hospitalized group. Furthermore, there was a significant increase in the true SHV (MD: -3.6; P = .026) in the hospitalized group compared to that in the non-hospitalized group. Conclusion Less accurate visual and haptic verticality perception task performance was observed in hospitalized patients with post-COVID-19 condition.
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Affiliation(s)
| | | | | | | | - Rodrigo Bazan
- Department of Neurology, Psychology, and Psychiatry, Botucatu Medical School, Botucatu, Brazil
| | | | - Gustavo José Luvizutto
- Department of Applied Physical Therapy, Federal University of Triângulo Mineiro, Uberaba, Brazil
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15
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Akremi H, Higgins J, Guediri A, Aissaoui R, Nadeau S. Seated postural organization during bilateral upper limb symmetric and asymmetric pushing tasks in individuals after stroke compared to healthy controls. Gait Posture 2023; 104:83-89. [PMID: 37343399 DOI: 10.1016/j.gaitpost.2023.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 06/12/2023] [Accepted: 06/16/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND Asymmetric weight distribution in sitting has been reported in people after stroke. However, postural strategies used during bilateral symmetric and asymmetric movements performed while seated require more evidence to inform rehabilitation strategies. RESEARCH QUESTIONS How do symmetric and asymmetric effort levels exerted during upper limb (UL) pushing movements affect seated postural organization parameters (weight bearing (WB) between hands and hemibody sides, and forward trunk displacement) of stroke compared to healthy individuals? How are these parameters associated? METHODS Using an instrumented exerciser, 19 post-stroke individuals were compared to 17 healthy individuals when executing four bilateral UL pushing movements in a seated position: symmetrical pushing at 30 % and 15 % of their maximal force (MF) and asymmetrical pushing with 15 % of their MF for one UL vs. 30 % of the MF for the other UL and vice versa. Anterior and vertical forces of the push, as well as vertical forces under each foot and thigh were compared between groups, sides and conditions. Forward trunk displacement was compared between groups and conditions. Correlations were used to determine the association between trunk displacement, hands and hemibody vertical forces. RESULTS Increasing pushing effort caused increased WB on thighs and decreased on WB on feet during the 30 % MF symmetric condition compared to the 15 % MF and asymmetric conditions (p < 0.05). Individuals post-stroke showed WB asymmetry and greater forward trunk displacement when compared to healthy persons (p < 0.05). For both groups, hemibody WB and trunk displacement showed moderate association (r > - 0.5) in the asymmetric condition executed with more resistance on the paretic or non-dominant hand. SIGNIFICANCE Individuals post-stroke presented a similar WB pattern to that of healthy persons during symmetric and asymmetric bilateral UL movements with greater forward trunk displacement and asymmetry. Increased effort and asymmetric force between both UL had effects on seated postural organization strategy.
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Affiliation(s)
- Haifa Akremi
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Canada; Laboratoire de pathokinésiologie, Institut universitaire sur la réadaptation en déficience physique de Montréal-Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Canada
| | - Johanne Higgins
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Canada; Laboratoire de pathokinésiologie, Institut universitaire sur la réadaptation en déficience physique de Montréal-Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Canada
| | - Amine Guediri
- Laboratoire de pathokinésiologie, Institut universitaire sur la réadaptation en déficience physique de Montréal-Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Canada
| | - Rachid Aissaoui
- Laboratoire de pathokinésiologie, Institut universitaire sur la réadaptation en déficience physique de Montréal-Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Canada; École de Technologie Supérieure (ETS) and Imaging and Orthopaedics Research Laboratory, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Canada
| | - Sylvie Nadeau
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Canada; Laboratoire de pathokinésiologie, Institut universitaire sur la réadaptation en déficience physique de Montréal-Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR), Canada.
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16
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Lafitte R, Diaine F, Dai S, Carré O, Dupierrix E, Jolly C, Piscicelli C, Pérennou D. Clinimetric properties of relevant criteria for assessing writing and drawing orientation after right hemisphere stroke. J Neurosci Methods 2023:109900. [PMID: 37295749 DOI: 10.1016/j.jneumeth.2023.109900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 05/25/2023] [Accepted: 06/05/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND Writing and drawing orientation is rarely assessed in clinical routine, although it might have a potential value in detecting impaired verticality perception after right hemispheric stroke (RHS). Assessment tools and criteria must be conceived and validated. We therefore explored the clinimetric properties of a set of quantitative writing and drawing orientation criteria, their ranges of normality, and their tilt prevalence in RHS individuals. NEW METHODS We asked 69 individuals with subacute RHS and 64 matched healthy controls to write three lines and to copy the Gainotti Figure (house and trees). We determined six criteria referring to the orientation of writing and drawing main axes: for writing, the line and margin orientations, and for drawing, the tree, groundline, wall, and roofline orientations. Orientations were measured by using an electronic protractor from specific landmarks positioned by independent evaluators. RESULTS The set of criteria fulfilling all clinimetric properties (feasibility, measurability, reliability) comprised the line orientation of the writing and the wall and roofline orientations of the drawing. Writing and drawing tilts were frequent after RHS (about 30% by criterion). COMPARISON WITH EXISTING METHODS So far, graphomotor orientation was mostly tested qualitatively and could not be objectively appreciated in absence of validated tools and criteria, and without ranges of normality. Writing and drawing tilts may now be assessed both in routine clinical practice and research. CONCLUSIONS Our study paves the way for investigating the clinical determinants of graphomotor tilts, including impaired verticality perception, to better understand their underlying mechanisms.
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Affiliation(s)
- R Lafitte
- Univ. Grenoble Alpes, UMR CNRS 5105 Neuropsychology and NeuroCognition; CHU Grenoble Alpes, Dept of NeuroRehabilitation South Hospital, Grenoble, France.
| | - F Diaine
- Univ. Grenoble Alpes, UMR CNRS 5105 Neuropsychology and NeuroCognition; CHU Grenoble Alpes, Dept of NeuroRehabilitation South Hospital, Grenoble, France.
| | - S Dai
- Univ. Grenoble Alpes, UMR CNRS 5105 Neuropsychology and NeuroCognition; CHU Grenoble Alpes, Dept of NeuroRehabilitation South Hospital, Grenoble, France.
| | - O Carré
- Univ. Grenoble Alpes, UMR CNRS 5105 Neuropsychology and NeuroCognition; CHU Grenoble Alpes, Dept of NeuroRehabilitation South Hospital, Grenoble, France.
| | - E Dupierrix
- Univ. Grenoble Alpes, UMR CNRS 5105 Neuropsychology and NeuroCognition; CHU Grenoble Alpes, Dept of NeuroRehabilitation South Hospital, Grenoble, France.
| | - C Jolly
- Univ. Grenoble Alpes, UMR CNRS 5105 Neuropsychology and NeuroCognition; CHU Grenoble Alpes, Dept of NeuroRehabilitation South Hospital, Grenoble, France.
| | - C Piscicelli
- Univ. Grenoble Alpes, UMR CNRS 5105 Neuropsychology and NeuroCognition; CHU Grenoble Alpes, Dept of NeuroRehabilitation South Hospital, Grenoble, France.
| | - D Pérennou
- Univ. Grenoble Alpes, UMR CNRS 5105 Neuropsychology and NeuroCognition; CHU Grenoble Alpes, Dept of NeuroRehabilitation South Hospital, Grenoble, France.
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17
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van der Waal C, Embrechts E, Loureiro-Chaves R, Gebruers N, Truijen S, Saeys W. Lateropulsion with active pushing in stroke patients: its link with lesion location and the perception of verticality. A systematic review. Top Stroke Rehabil 2023; 30:281-297. [PMID: 35102816 DOI: 10.1080/10749357.2022.2026563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Lateropulsion with active Pushing (LwP) is characterized by impairments in postural control. Previous research suggests an association between LwP, lesion location and verticality misperception. This first-ever systematic review evaluates the association between LwP, lesion location and the perception of verticality (PROSPERO: CRD42020159248). METHODS PubMed, Web of Science, REHABDATA, Embase, Cochrane Library and PEDro were systematically searched on December 16, 2021. Studies were included when examining lesion location or perception of verticality (Subjective Haptic, Visual or Postural Vertical) in supratentorial stroke patients showing LwP. Two reviewers independently screened and assessed risk of bias using the Newcastle Ottawa Scale. Data were qualitatively analyzed and extracted. RESULTS Nineteen studies were included, examining a total of 340 LwP patients. Lesions in: the thalamus, internal capsule, inferior parietal lobule at the junction of the postcentral gyrus, the posterior insula and the superior temporal gyrus, were associated with LwP. Whereas all studies examining the Subjective Postural and Haptic Vertical (haptic only examined once) reported a significant increased deviation in LwP patients, inconsistent results were found for the Subjective Visual Vertical. Furthermore, the Subjective Visual and Postural Vertical showed inconsistent results for magnitude, direction and variability of this deviation. DISCUSSION A complex brain network, rather than only one brain region, seems responsible for body control with respect to gravity. A disruption within this network might lead to a bias in the construction of a correct internal reference frame, crucial for perceiving verticality. There was an association of LwP with verticality misperception in all three modalities.
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Affiliation(s)
- Charlotte van der Waal
- Research Group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Elissa Embrechts
- Research Group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Renata Loureiro-Chaves
- Research Group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Nick Gebruers
- Research Group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Steven Truijen
- Research Group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Wim Saeys
- Research Group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium.,Department of Neurorehabilitation, RevArte Rehabilitation Hospital, Edegem, Belgium
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18
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Paci M, Macchioni G, Ferrarello F. Treatment approaches for pusher behaviour: a scoping review. Top Stroke Rehabil 2023; 30:119-136. [PMID: 35156566 DOI: 10.1080/10749357.2021.2016098] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Some individuals with hemiplegia show a postural disorder called pusher behavior. Various underlying theoretical mechanisms have been proposed, thus leading to various treatment approaches. OBJECTIVES The aim of this scoping review is to identify and analyze the available evidence on the treatment approaches for pusher behavior. METHODS Two independent reviewers conducted a literature search for original studies reporting on treatments for pusher behavior. Studies were searched in PubMed, Scopus, Web of Science, CINAHL and PEDro from their inception to December 2020. Treatment approaches were grouped in homogeneous areas based on the supposed underlying mechanism. To assess the reporting of the interventions, the Template for Intervention Description and Replication (TIDieR) was used. RESULTS Thirty-one papers describing 45 interventions were included in the review. Most of the studies were case reports (i.e. including 1 person) (n = 16), followed by randomized controlled trials (n = 5), single subject design trials (n = 5), non-randomized controlled trials (n = 3), and case series (i.e. including more than 1 person) (n = 2). Treatment approaches were grouped into five categories: visual feedback, somatosensory cues, visual-somatosensory integration, brain stimulation, and other nonspecific treatments. The median number of TIDIeR items reported was 7 (range 4 to 10). CONCLUSION Pusher behavior is still little-known. Five main categories of treatment approaches based on the alleged etiological underlying mechanisms have been identified. Most of studies are case reports; controlled trials should be further conducted. Intervention reporting should be improved to allow treatment replication in larger trials.
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Affiliation(s)
- Matteo Paci
- Department of Allied Health Professions, Unit of Functional Rehabilitation, Azienda Usl Toscana Centro, Florence, Italy
| | | | - Francesco Ferrarello
- Department of Allied Health Professions, Unit of Functional Rehabilitation, Azienda Usl Toscana Centro, Prato, Italy
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Lafitte R, Jeager M, Piscicelli C, Dai S, Lemaire C, Chrispin A, Davoine P, Dupierrix E, Pérennou D. Spatial neglect encompasses impaired verticality representation after right hemisphere stroke. Ann N Y Acad Sci 2023; 1520:140-152. [PMID: 36478572 DOI: 10.1111/nyas.14938] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Spatial neglect after right hemisphere stroke (RHS) was recently found to encompass lateropulsion, a deficit in body orientation with respect to gravity caused by altered brain processing of graviception. By analogy, we hypothesized that spatial neglect after RHS might encompass an altered representation of verticality. We also assumed a strong relation between body neglect and impaired postural vertical, both referring to the body. To tackle these issues, we performed contingency and correlation analyses between two domains of spatial neglect (body, extra-body) and two modalities of verticality perception (postural, visual) in 77 individuals (median age = 67) with a first-ever subacute RHS (1-3 months). All individuals with a transmodal (postural and visual) tilt in verticality perception (n = 26) had spatial neglect, but the reverse was not found. Correlation and multivariate analyses revealed that spatial neglect (and notably body neglect) was associated more with postural than visual vertical tilts. These findings indicate that after RHS, an impaired verticality representation results from a kind of graviceptive neglect, bearing first on somaesthetic graviception and second on vestibular graviception. They also suggest that the human brain uses not only a mosaic of 2D representations but also 3D maps involving a transmodal representation of verticality.
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Affiliation(s)
- Rémi Lafitte
- Department of Neurorehabilitation, Univ. Grenoble Alpes, UMR CNRS 5105 Neuropsychology and Neurocognition, CHU Grenoble Alpes, South Hospital, Grenoble, France
| | - Marie Jeager
- Department of Neurorehabilitation, Univ. Grenoble Alpes, UMR CNRS 5105 Neuropsychology and Neurocognition, CHU Grenoble Alpes, South Hospital, Grenoble, France
| | - Céline Piscicelli
- Department of Neurorehabilitation, Univ. Grenoble Alpes, UMR CNRS 5105 Neuropsychology and Neurocognition, CHU Grenoble Alpes, South Hospital, Grenoble, France
| | - Shenhao Dai
- Department of Neurorehabilitation, Univ. Grenoble Alpes, UMR CNRS 5105 Neuropsychology and Neurocognition, CHU Grenoble Alpes, South Hospital, Grenoble, France
| | - Camille Lemaire
- Department of Neurorehabilitation, Univ. Grenoble Alpes, UMR CNRS 5105 Neuropsychology and Neurocognition, CHU Grenoble Alpes, South Hospital, Grenoble, France
| | - Anne Chrispin
- Department of Neurorehabilitation, Univ. Grenoble Alpes, UMR CNRS 5105 Neuropsychology and Neurocognition, CHU Grenoble Alpes, South Hospital, Grenoble, France
| | - Patrice Davoine
- Department of Neurorehabilitation, Univ. Grenoble Alpes, UMR CNRS 5105 Neuropsychology and Neurocognition, CHU Grenoble Alpes, South Hospital, Grenoble, France
| | - Eve Dupierrix
- Department of Neurorehabilitation, Univ. Grenoble Alpes, UMR CNRS 5105 Neuropsychology and Neurocognition, CHU Grenoble Alpes, South Hospital, Grenoble, France
| | - Dominic Pérennou
- Department of Neurorehabilitation, Univ. Grenoble Alpes, UMR CNRS 5105 Neuropsychology and Neurocognition, CHU Grenoble Alpes, South Hospital, Grenoble, France
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20
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Nolan J, Godecke E, Singer B. Authors' response to commentary on the article entitled, "Post-stroke lateropulsion rehabilitation outcomes: a retrospective analysis". Disabil Rehabil 2023; 45:1752-1754. [PMID: 36722342 DOI: 10.1080/09638288.2023.2172221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Jessica Nolan
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia.,School of Physiotherapy and Health Sciences, University of Notre Dame Australia, Fremantle, Australia.,Sir Charles Gairdner Osborne Park Health Care Group, Nedlands, Australia
| | - Erin Godecke
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia.,Sir Charles Gairdner Osborne Park Health Care Group, Nedlands, Australia.,Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Australia
| | - Barbara Singer
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
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Ben-Shabat E, Morgan P. Assessing lesion location, visual midline perception and proprioception may assist outcome predictions for people affected by lateropulsion. Disabil Rehabil 2022; 45:1750-1751. [PMID: 36541185 DOI: 10.1080/09638288.2022.2156627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
| | - Prue Morgan
- School of Primary Health Care, Monash University, Frankston, Australia
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22
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Embrechts E, van der Waal C, Anseeuw D, van Buijnderen J, Leroij A, Lafosse C, Nijboer TC, Truijen S, Saeys W. Association between spatial neglect and impaired verticality perception after stroke: A systematic review. Ann Phys Rehabil Med 2022; 66:101700. [PMID: 35963568 DOI: 10.1016/j.rehab.2022.101700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 07/01/2022] [Accepted: 07/02/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Although most research on spatial neglect (SN) has focused on spatial perception deficits with regard to the lateral (left-right) axis, deficits of spatial perception with regard to the vertical (up-down) axis, such as disturbances in the perception of verticality (e.g., judgement of vertical orientations), have also been suggested. OBJECTIVE We aimed to systematically analyse reported associations between SN and characteristics of verticality perception while considering the time post-stroke. METHODS PubMed, Web of Science, Scopus, PubPsych and PsycArticles databases were searched on May 24, 2022 for articles written in English that evaluated the association between SN and verticality perception (i.e., the subjective visual vertical [SVV], subjective postural vertical [SPV] and subjective haptic vertical [SHV]) in adults after stroke. Left and right SN were considered and had to be assessed using standardized methods. Data were manually extracted, and risk of bias was assessed with the Newcastle-Ottawa Scale. The tilt of the line/chair relative to the gravitational vector and its direction, together with uncertainty (i.e., variability across measurements), were evaluated. RESULTS Thirteen studies were included (431 participants after stroke); at least 191 participants exhibited SN. Mainly the first 3 to 6 months post-stroke were evaluated. SN was associated with SVV misperception, which resulted in larger SVV tilts (mostly in the contralesional direction) and uncertainty in participants with than without SN. SVV tilt magnitudes ranged from a mean/median of -8.9° to -2.3° in SN participants and from -1.6° to 0.6° in non-SN participants, the latter falling within normative ranges. For SPV and SHV measurements, the magnitude of tilt and the uncertainty were insufficiently assessed or results were inconclusive. CONCLUSIONS SN was associated with larger SVV tilts and uncertainty, which suggests that SVV misperception is a key feature of SN. This observation highlights the importance of regular SVV assessment in people with SN in clinical practice. PROSPERO CRD42019127616.
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Affiliation(s)
- Elissa Embrechts
- Research group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium; Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, the Netherlands.
| | - Charlotte van der Waal
- Research group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Dorine Anseeuw
- Research group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Jessica van Buijnderen
- Research group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Améline Leroij
- Research group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Christophe Lafosse
- Department of Neurorehabilitation, RevArte Rehabilitation Hospital, Edegem, Belgium
| | - Tanja Cw Nijboer
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, the Netherlands; Center of Excellence for Rehabilitation Medicine, UMC Brain Center, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | - Steven Truijen
- Research group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium
| | - Wim Saeys
- Research group MOVANT, Department of Rehabilitation Sciences & Physiotherapy, University of Antwerp, Wilrijk, Belgium; Department of Neurorehabilitation, RevArte Rehabilitation Hospital, Edegem, Belgium
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Fukata K, Fujino Y, Inoue M, Inoue M, Sekine D, Miki H, Sato H, Kobayashi Y, Hasegawa K, Amimoto K, Makita S, Takahashi H. Early incidence and factors affecting recovery from lateropulsion after acute hemispheric stroke. Ann Phys Rehabil Med 2022; 66:101706. [PMID: 36182061 DOI: 10.1016/j.rehab.2022.101706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 08/24/2022] [Accepted: 08/26/2022] [Indexed: 12/02/2022]
Affiliation(s)
- Kazuhiro Fukata
- Department of Rehabilitation, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan.
| | - Yuji Fujino
- Department of Physical Therapy, Faculty of Health Sciences, Juntendo University, 3-2-12, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Masahide Inoue
- Department of Rehabilitation, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan
| | - Mamiko Inoue
- Department of Rehabilitation, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan
| | - Daisuke Sekine
- Department of Rehabilitation, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan
| | - Hiroshi Miki
- Department of Rehabilitation, Tokyo Saiseikai Central Hospital, 1-4-17 Mita, Minato-ku, Tokyo, 108-0073, Japan
| | - Hirofumi Sato
- Department of Rehabilitation, Saitama Citizens Medical Center, 299-1, Shimane, Nishi-ku, Saitama, Saitama, 331-0054, Japan
| | - Yohei Kobayashi
- Department of Rehabilitation, Saitama Sekishinkai Hospital, 2-37-20, Irumagawa, Sayamashi, Saitama, 350-1305, Japan
| | - Koki Hasegawa
- Department of Rehabilitation, Sainokuni Higashiomiya Medical Center, 1522, Torocyo, kita-ku, Saitama, Saitama, 331-8577, Japan
| | - Kazu Amimoto
- Department of Physical Therapy, Faculty of Human Health Sciences, Tokyo Metropolitan University, 7-2-10, Higashi-Ogu, Arakawa-ku, Tokyo 116-8551, Japan
| | - Shigeru Makita
- Department of Rehabilitation, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan
| | - Hidetoshi Takahashi
- Department of Rehabilitation, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan
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24
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Deb-Chatterji M, Flottmann F, Meyer L, Brekenfeld C, Fiehler J, Gerloff C, Thomalla G, Fiehler J, Thomalla G, Alegiani A, Boeckh-Behrens, Wunderlich S, Ernemann U, Poli S, Siebert E, Nolte CH, Zweynert S, Bohner G, Ludolph A, Henn KH, Schäfer JH, Keil F, Röther J, Eckert B, Berrouschot J, Bormann A, Dorn F, Petzold G, Kraemer C, Leischner H, Trumm C, Tiedt S, Kellert L, Petersen M, Stögbauer F, Braun M, Hamann GF, Gröschel K, Uphaus T, Reich A, Nikoubashman O, Schellinger P, Borggrefe J, Hattingen J, Liman J, Ernst M. Side matters: differences in functional outcome and quality of life after thrombectomy in left and right hemispheric stroke. Neurol Res Pract 2022; 4:58. [PMID: 36411484 PMCID: PMC9677692 DOI: 10.1186/s42466-022-00223-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 10/12/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Patients with a left (LHS) or right hemispheric stroke (RHS) differ in terms of clinical symptoms due to lateralization of specific cortical functions. Studies on functional outcome after stroke and endovascular thrombectomy (EVT) comparing both hemispheres showed conflicting results so far. The impact of stroke laterality on patient-reported health-related quality of life (HRQoL) after EVT has not yet been adequately addressed and still remains unclear. METHODS Consecutive stroke thrombectomy patients, derived from a multi-center, prospective registry (German Stroke Registry) between June 2015 and December 2019, were included in this study. At 90 days, outcome after EVT was assessed by the modified Rankin scale (mRS) and HRQoL using the European QoL-five dimensions questionnaire utility-index (EQ-5D-I; higher values indicate better HRQoL) in patients with LHS and RHS. Adjusted regression analysis was applied to evaluate the influence of stroke laterality on outcome after EVT. RESULTS In total, 5683 patients were analyzed. Of these, 2953 patients (52.8%) had LHS and 2637 (47.2%) RHS. LHS patients had a higher baseline NIHSS (16 vs. 13, p < 0.001) and a higher ASPECTS (9 vs. 8, p < 0.001) compared to RHS patients. Among survivors, patients with LHS less frequently had a self-reported affected mobility (p = 0.037), suffered less often from pain (p = 0.04) and anxiety/depression (p = 0.032) three months after EVT. After adjusting for confounders (age, sex, baseline NIHSS), LHS was associated with a better HRQoL (ß coefficient 0.04, CI 95% 0.017-0.063; p = 0.001), and better functional outcome assessed by lower values on the mRS (ß coefficient - 0.109, CI 95% - 0.217-0.000; p = 0.049). CONCLUSIONS Ninety days after EVT, LHS patients have a better functional outcome and HRQoL. Patients with RHS should be actively assessed and treated for pain, anxiety and depression to improve their HRQoL after EVT.
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Affiliation(s)
- Milani Deb-Chatterji
- grid.13648.380000 0001 2180 3484Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Fabian Flottmann
- grid.13648.380000 0001 2180 3484Department of Neuroradiological Diagnostics and Intervention, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Lukas Meyer
- grid.13648.380000 0001 2180 3484Department of Neuroradiological Diagnostics and Intervention, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Caspar Brekenfeld
- grid.13648.380000 0001 2180 3484Department of Neuroradiological Diagnostics and Intervention, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Jens Fiehler
- grid.13648.380000 0001 2180 3484Department of Neuroradiological Diagnostics and Intervention, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Christian Gerloff
- grid.13648.380000 0001 2180 3484Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Götz Thomalla
- grid.13648.380000 0001 2180 3484Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
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25
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Bakalkin G. The left-right side-specific endocrine signaling in the effects of brain lesions: questioning of the neurological dogma. Cell Mol Life Sci 2022; 79:545. [PMID: 36219330 PMCID: PMC9553812 DOI: 10.1007/s00018-022-04576-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 09/26/2022] [Accepted: 09/27/2022] [Indexed: 11/25/2022]
Abstract
Each cerebral hemisphere is functionally connected to the contralateral side of the body through the decussating neural tracts. The crossed neural pathways set a basis for contralateral effects of brain injury such hemiparesis and hemiplegia as it has been already noted by Hippocrates. Recent studies demonstrated that, in addition to neural mechanisms, the contralateral effects of brain lesions are mediated through the humoral pathway by neurohormones that produce either the left or right side-specific effects. The side-specific humoral signaling defines whether the left or right limbs are affected after a unilateral brain injury. The hormonal signals are released by the pituitary gland and may operate through their receptors that are lateralized in the spinal cord and involved in the side-specific control of symmetric neurocircuits innervating the left and right limbs. Identification of features and a proportion of neurological deficits transmitted by neurohormonal signals vs. those mediated by neural pathways is essential for better understanding of mechanisms of brain trauma and stroke and development of new therapies. In a biological context, the left–right side-specific neuroendocrine signaling may be fundamental for the control of the left- and right-sided processes in bilaterally symmetric animals.
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Affiliation(s)
- Georgy Bakalkin
- Department of Pharmaceutical Biosciences, Uppsala University, Box 591, SE-751 24, Uppsala, Sweden.
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26
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Négyesi J, Petró B, Salman DN, Khandoker A, Katona P, Wang Z, Almaazmi AISQ, Hortobágyi T, Váczi M, Rácz K, Pálya Z, Grand L, Kiss RM, Nagatomi R. Biosignal processing methods to explore the effects of side-dominance on patterns of bi- and unilateral standing stability in healthy young adults. Front Physiol 2022; 13:965702. [PMID: 36187771 PMCID: PMC9523607 DOI: 10.3389/fphys.2022.965702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 08/09/2022] [Indexed: 11/13/2022] Open
Abstract
We examined the effects of side-dominance on the laterality of standing stability using ground reaction force, motion capture (MoCap), and EMG data in healthy young adults. We recruited participants with strong right (n = 15) and left (n = 9) hand and leg dominance (side-dominance). They stood on one or two legs on a pair of synchronized force platforms for 50 s with 60 s rest between three randomized stance trials. In addition to 23 CoP-related variables, we also computed six MoCap variables representing each lower-limb joint motion time series. Moreover, 39 time- and frequency-domain features of EMG data from five muscles in three muscle groups were analyzed. Data from the multitude of biosignals converged and revealed concordant patterns: no differences occurred between left- and right-side dominant participants in kinetic, kinematic, or EMG outcomes during bipedal stance. Regarding single leg stance, larger knee but lower ankle joint kinematic values appeared in left vs right-sided participants during non-dominant stance. Left-vs right-sided participants also had lower medial gastrocnemius EMG activation during non-dominant stance. While right-side dominant participants always produced larger values for kinematic data of ankle joint and medial gastrocnemius EMG activation during non-dominant vs dominant unilateral stance, this pattern was the opposite for left-sided participants, showing larger values when standing on their dominant vs non-dominant leg, i.e., participants had a more stable balance when standing on their right leg. Our results suggest that side-dominance affects biomechanical and neuromuscular control strategies during unilateral standing.
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Affiliation(s)
- János Négyesi
- Division of Biomedical Engineering for Health and Welfare, Tohoku University Graduate School of Biomedical Engineering, Sendai, Japan
- *Correspondence: János Négyesi,
| | - Bálint Petró
- Faculty of Mechanical Engineering, Department of Mechatronics, Optics and Mechanical Engineering Informatics, Budapest University of Technology and Economics, Budapest, Hungary
| | - Diane Nabil Salman
- Biomedical Engineering Department, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Ahsan Khandoker
- Biomedical Engineering Department, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Péter Katona
- Department of Kinesiology, Hungarian University of Sports Science, Budapest, Hungary
| | - Ziheng Wang
- Division of Biomedical Engineering for Health and Welfare, Tohoku University Graduate School of Biomedical Engineering, Sendai, Japan
| | | | - Tibor Hortobágyi
- Department of Kinesiology, Hungarian University of Sports Science, Budapest, Hungary
- Center for Human Movement Sciences, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
- Somogy County Kaposi Mór Teaching Hospital, Kaposvár, Hungary
- Department of Sport Biology, Institute of Sport Sciences and Physical Education, University of Pécs, Pécs, Hungary
| | - Márk Váczi
- Department of Sport Biology, Institute of Sport Sciences and Physical Education, University of Pécs, Pécs, Hungary
| | - Kristóf Rácz
- Faculty of Mechanical Engineering, Department of Mechatronics, Optics and Mechanical Engineering Informatics, Budapest University of Technology and Economics, Budapest, Hungary
| | - Zsófia Pálya
- Faculty of Mechanical Engineering, Department of Mechatronics, Optics and Mechanical Engineering Informatics, Budapest University of Technology and Economics, Budapest, Hungary
| | - László Grand
- Faculty of Information Technology, Pázmány Péter Catholic University, Budapest, Hungary
| | - Rita M. Kiss
- Faculty of Mechanical Engineering, Department of Mechatronics, Optics and Mechanical Engineering Informatics, Budapest University of Technology and Economics, Budapest, Hungary
| | - Ryoichi Nagatomi
- Division of Biomedical Engineering for Health and Welfare, Tohoku University Graduate School of Biomedical Engineering, Sendai, Japan
- Department of Medicine and Science in Sports and Exercise, Tohoku University Graduate School of Medicine, Sendai, Japan
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27
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Nestmann S, Röhrig L, Müller B, Ilg W, Karnath HO. Tilted 3D visual scenes influence lateropulsion: A single case study of pusher syndrome. J Clin Exp Neuropsychol 2022; 44:478-486. [DOI: 10.1080/13803395.2022.2121382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Sophia Nestmann
- Division of Neuropsychology, Center of Neurology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Lisa Röhrig
- Division of Neuropsychology, Center of Neurology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Björn Müller
- Section for Computational Sensomotorics, Hertie-Institute for Clinical Brain Research & Centre for Integrative Neuroscience, University of Tübingen, Tübingen, Germany
| | - Winfried Ilg
- Section for Computational Sensomotorics, Hertie-Institute for Clinical Brain Research & Centre for Integrative Neuroscience, University of Tübingen, Tübingen, Germany
| | - Hans-Otto Karnath
- Division of Neuropsychology, Center of Neurology, Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- Department of Psychology, University of South Carolina, Columbia, SC, USA
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28
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Pantera E, Froment P, Vernay D. Does Hippotherapy Improve the Functions in Children with Cerebral Palsy? Systematic Review Based on the International Classification of Functioning. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2022; 28:705-720. [PMID: 35671520 DOI: 10.1089/jicm.2021.0417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To perform a systematic review of the literature regarding scientific reality of hippotherapy in children with cerebral palsy graded according to France HAS (Haute Autorité de Santé) recommendations and applied to the International Classification of Functioning. Methods: The research in MEDLINE and Cochrane Library databases was performed using the keywords: "Equestrian therapy," "Riding for the disabled," "Hippotherapy," "Equine-movement therapy," and "Therapeutic horse (back) riding." The methodological quality of the articles was assessed using four levels of proof and three guideline grades (A: strong; B: moderate; C: poor). Results: Seven prospective, randomized controlled studies and one systematic review confirm the level of proof of hippotherapy in children with cerebral palsy with grade B. Hippotherapy in children with cerebral palsy contributes to improve motor function, symmetry of muscle contraction, spasticity, posture, and walking. Fifty prospective no randomized studies confirm the level with grade C for balance, motor coordination, lumbopelvic mobility, walking speed, functional development, and social behavior. Conclusions: Hippotherapy in children with cerebral palsy can be recommended. Regarding the literature data, the level of proof of hippotherapy in children with cerebral palsy is moderate (grade B).
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Affiliation(s)
- Eric Pantera
- Department of Physical Medicine and Rehabilitation, University Rehabilitation Hospital Nimes University Hospital, Le Grau-du-Roi, France
- Department of Hippotherapy (Equine Mediator Module), French Riding Federation, Lamotte-Beuvron, France
| | - Priscilla Froment
- Department of Physical Medicine and Rehabilitation, Valdegour Elsan Functional Rehabilitation Center, Nimes, France
| | - Didier Vernay
- Department of Public Health, Clermont Ferrand University Hospital, Clermont Ferrand, France
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29
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Sawa K, Amimoto K, Ishigami K, Miyamoto T, Setoyama C, Suzuki R, Nozomi K, Tamura M, Miyagami M. Efficacy of lateral truncal tilt training with a wedge on postural vertical and activities of daily living in recovery phase after stroke: A randomized crossover trial. NeuroRehabilitation 2022; 51:33-40. [DOI: 10.3233/nre-210255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: The subjective postural vertical (SPV) is affected by training that requires participants to maintain balance; training to achieve sitting balance may also help SPV recovery and activities of daily living (ADLs). OBJECTIVE: This study aimed to assess the medium-term effects of balance training on the postural vertical (PV) and ADLs in patients with stroke. METHODS: Thirty-three patients with stroke were enrolled in this randomized crossover trial. The outcomes were SPV, SPV with eyes opened (SPV-EO), and the Functional Independent Measure (FIM) after the 14-day intervention of experimental or control training. Experimental training consisted of a maximum lateral truncal tilt to the paretic side at 0.25 Hz with or without a 10° wedge, repeated 60 times. Repeated-measures two-way analysis of variance was performed with two factors: intervention and the intervention period. RESULTS: There was no interaction between the control condition and the PV, but there was interaction between the intervention period and using a wedge for SPV variability errors. FIM showed an interaction between the intervention period and the use of a wedge. CONCLUSIONS: Balance training while sitting with a wedge significantly improved the SPV and FIM. This improved cognition and perception, which facilitate difficult dynamic tasks in ADLs.
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Affiliation(s)
- Kota Sawa
- Department of Rehabilitation, Takenotsuka Noshinkei Rehabilitation Hospital, Tokyo, Japan
- Department of Physiotherapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
| | - Kazu Amimoto
- Department of Physiotherapy, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
| | - Keisuke Ishigami
- Department of Rehabilitation, Takenotsuka Noshinkei Rehabilitation Hospital, Tokyo, Japan
| | - Takuya Miyamoto
- Department of Rehabilitation, Takenotsuka Noshinkei Rehabilitation Hospital, Tokyo, Japan
| | - Chika Setoyama
- Department of Rehabilitation, Takenotsuka Noshinkei Rehabilitation Hospital, Tokyo, Japan
| | - Rikuya Suzuki
- Department of Rehabilitation, Takenotsuka Noshinkei Rehabilitation Hospital, Tokyo, Japan
| | - Kuwabara Nozomi
- Department of Rehabilitation, Takenotsuka Noshinkei Rehabilitation Hospital, Tokyo, Japan
| | - Miko Tamura
- Department of Rehabilitation, Takenotsuka Noshinkei Rehabilitation Hospital, Tokyo, Japan
| | - Mitsusuke Miyagami
- Department of Rehabilitation, Takenotsuka Noshinkei Rehabilitation Hospital, Tokyo, Japan
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Meng L, Tsang RCC, Ge Y, Guo Q, Gao Q. rTMS for poststroke pusher syndrome: study protocol for a randomised, patient-blinded controlled clinical trial. BMJ Open 2022; 12:e064905. [PMID: 35948377 PMCID: PMC9379536 DOI: 10.1136/bmjopen-2022-064905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Poststroke pusher syndrome (PS) prevalence is high. Patients with PS require longer rehabilitation with prolonged length of stay. Effective treatment of PS remains a challenge for rehabilitation professionals. Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive neuromodulation technique that is effective and recommended in the clinical guidelines of stroke rehabilitation. However, the role of rTMS for PS has not been examined. The study is to assess the efficacy of a specific rTMS programme for patients with PS in reducing pushing behaviour, enhancing motor recovery and improving mobility, as well as testing the safety of rTMS for patients with PS. METHODS AND ANALYSIS A randomised, patient and assessor blinded sham-controlled trial with two parallel groups will be conducted. Thirty-four eligible patients with PS will be randomly allocated to receive either rTMS or sham rTMS for 3 weeks. The primary assessment outcome is the pushing behaviour measured by the Burke Lateropulsion Scale and Scale for Contraversive Pushing. The secondary outcomes are the motor functions and mobility measured by the Fugl-Meyer Assessment Scale (motor domain) and Modified Rivermead Mobility Index, and any adverse events. Assessment will be performed at baseline and 1 week, 2 weeks and 3 weeks after intervention. Repeated-measures analysis of variance will be used for data analysis with the level of significance level set at 0.05. ETHICS AND DISSEMINATION The protocol has been approved by the Biomedical Ethics Committee of West China Hospital, Sichuan University on 23 March 2022 (2022-133). The trial findings will be published in peer-reviewed journals. TRIAL REGISTRATION NUMBER Chinese Clinical Trial Registry (ChiCTR2200058015).
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Affiliation(s)
- Lijiao Meng
- Rehabilitation Medicine Center, Sichuan University West China Hospital, Chengdu, Sichuan, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Sichuan University West China Hospital, Chengdu, Sichuan, China
| | - Raymond C C Tsang
- Physiotherapy Department, MacLehose Medical Rehabilitation Centre, Hong Kong, China
| | - Yanlei Ge
- Rehabilitation Medicine Center, Sichuan University West China Hospital, Chengdu, Sichuan, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Sichuan University West China Hospital, Chengdu, Sichuan, China
| | - Qifan Guo
- Department of Rehabilitation Sciences, West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Qiang Gao
- Rehabilitation Medicine Center, Sichuan University West China Hospital, Chengdu, Sichuan, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Sichuan University West China Hospital, Chengdu, Sichuan, China
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31
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Stefano LHS, Favoretto DB, Nascimento DC, Santos LRA, Louzada F, Bikson M, Leite JP, Pontes-Neto OM, Edwards DJ, Edwards TGS. Middle cerebral artery blood flow stability in response to high-definition transcranial electrical stimulation: a randomized sham-controlled clinical trial. Clin Neurol Neurosurg 2022; 220:107345. [DOI: 10.1016/j.clineuro.2022.107345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/11/2022] [Accepted: 06/16/2022] [Indexed: 11/28/2022]
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32
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Agostini LS, Rodrigues PSM, Bazan R, de Oliveira Baggio JA, de Souza LAPS, Luvizutto GJ. Analysis of Verticality Perception in Older Adults With and Without Acute Stroke in Half-Lying Versus Sitting Positions. Percept Mot Skills 2022; 129:591-605. [PMID: 35511924 DOI: 10.1177/00315125221091344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Currently, there is no research consensus regarding the influence of body position on verticality perception in acute stroke. In this study, we aimed to compare the influence of half-lying and sitting positions on measurements of the subjective visual vertical (SVV) and the subjective haptic vertical (SHV) of individuals in the acute stroke phase. In this cross-sectional study, we compared these positional experiences in two groups of participants: adults in the acute stroke phase and elderly individuals without stroke. Independent variables were stroke versus no-stroke groups, in half-lying versus sitting positions. Analyzed variables of related interest were cognition (Mini-Mental State Examination or MMSE), stroke severity (National Institutes of Health Stroke Scale or NIHSS), and trunk control (Trunk Impairment Scale or TIS). Dependent variables were visual and haptic verticality, as evaluated by SVV and SHV. There were observed differences in absolute SVV in sitting position between groups (p = 0.021), absolute SVV in half-lying position between groups (p = 0.033), absolute SHV in sitting position between groups (p = 0.003), absolute SHV in half-lying position between groups (p = 0.002), and constant SVV in half-lying position between groups (p = 0.007). In the stroke group there was a higher coefficient of variation of SVV and SHV in the half-lying position compared to sitting position. In the sitting position, we observed a very strong correlation between the TIS and absolute SHV (p = 0.008). We concluded that individuals in the acute phase of stroke had greater misperceptions of visual and haptic verticality than older adults without strokes and that individuals in the acute phase of stroke showed less variability in visual and haptic vertical perception in the sitting position than in the half-lying position. By implication, we should encourage the sitting position in the acute stroke phase and develop early strategies to increase the verticality perception.
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Affiliation(s)
- Lívia S Agostini
- Department of Physical Therapy, 74348Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Priscila S M Rodrigues
- Department of Physical Therapy, 74348Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Rodrigo Bazan
- Department of Neurology Psychology and Psychiatry, Botucatu Medical School (UNESP), Botucatu, São Paulo, Brazil
| | | | - Luciane A P S de Souza
- Department of Physical Therapy, 74348Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Gustavo J Luvizutto
- Department of Physical Therapy, 74348Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
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Argiuolo A, Somma F, Bartolomeo P, Gigliotta O, Ponticorvo M. Indexes for the E-Baking Tray Task: A Look on Laterality, Verticality and Quality of Exploration. Brain Sci 2022; 12:brainsci12030401. [PMID: 35326356 PMCID: PMC8946214 DOI: 10.3390/brainsci12030401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/14/2022] [Accepted: 03/15/2022] [Indexed: 12/01/2022] Open
Abstract
The Baking Tray Task is an ecological task developed for the assessment of unilateral neglect that can also be used for research on neurotypical participants. In this task, participants are asked to place 16 objects inside a board as evenly as possible. In the case of impaired spatial exploration, consequent to right attentional networks damage, asymmetrical object disposition is observed as more objects are placed on the ipsilesional side (typically the right side). The E-BTT is a technology-enhanced version of the Baking Tray Task, implemented with a software platform, E-TAN, which detects the objects and automatically computes their spatial coordinates. This allows a complement to the traditional scoring methods with new measures to extract richer information from the data. In this study, we focus on neurotypical participants to explore if some new indexes, derived from the literature review on similar tasks, can be applied to BTT and E-BTT for research aims. A principal component analysis (PCA) was then performed to verify if these new indexes reflect some common dimensions. Results indicate the emergence of two principal dimensions: spatiality, which summarizes both laterality and verticality, and quality, which regards the explored space and (dis)organization in placing the items.
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Affiliation(s)
- Antonietta Argiuolo
- Natural and Artificial Cognition Laboratory, Department of Humanistic Studies, University of Naples Federico II, 80133 Naples, Italy; (F.S.); (O.G.); (M.P.)
- Correspondence:
| | - Federica Somma
- Natural and Artificial Cognition Laboratory, Department of Humanistic Studies, University of Naples Federico II, 80133 Naples, Italy; (F.S.); (O.G.); (M.P.)
| | - Paolo Bartolomeo
- Institut du Cerveau—Paris Brain Institute—ICM, Inserm, Hôpital de la Pitié Salpêtrière, Sorbonne Université, 75013 Paris, France;
| | - Onofrio Gigliotta
- Natural and Artificial Cognition Laboratory, Department of Humanistic Studies, University of Naples Federico II, 80133 Naples, Italy; (F.S.); (O.G.); (M.P.)
| | - Michela Ponticorvo
- Natural and Artificial Cognition Laboratory, Department of Humanistic Studies, University of Naples Federico II, 80133 Naples, Italy; (F.S.); (O.G.); (M.P.)
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Tomioka Y, Tohyama T, Honaga K, Kawakami M, Kondo K, Tsuji T. Effects of Galvanic Vestibular Stimulation on Subjective Visual Vertical and Sitting Balance in Patients with Stroke. J Stroke Cerebrovasc Dis 2022; 31:106430. [PMID: 35279006 DOI: 10.1016/j.jstrokecerebrovasdis.2022.106430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 02/19/2022] [Accepted: 02/20/2022] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE This study aimed to examine the effects of galvanic vestibular stimulation (GVS) on visual vertical cognition and sitting balance in stroke patients. MATERIALS AND METHODS Patients with unilateral supratentorial infarction and hemorrhagic lesions and healthy controls were recruited. Bipolar GVS was performed through the bilateral mastoid processes with an 1.5-mA electric current. Each participant received three stimulation patterns: right anode-left cathode, left anode-right cathode, and sham. The subjective visual vertical (SVV) and center of gravity positions in the sitting posture were measured in three groups of participants: patients with right hemisphere lesions, patients with left hemisphere lesions, and in healthy controls. Changes in the SVV and center of gravity positions before and during galvanic vestibular stimulation were assessed. RESULTS In each group, eight individuals were recruited for SVV measurements and nine individuals for center of gravity measurements. We found changes due to polarity of stimulation on the SVV and mediolateral changes in the center of gravity in the sitting position of patients with stroke, while there was no significant difference between groups or interaction of the two factors (polarity vs. group). CONCLUSION Changes in the visual vertical cognition and sitting balance occur during GVS in patients with stroke. GVS is a potential tool for ameliorating balance dysfunction in patients with stroke.
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Affiliation(s)
- Yohei Tomioka
- Department of Rehabilitation Medicine, National Hospital Organization Murayama Medical Center, Musashimurayama, Tokyo, Japan
| | - Takamichi Tohyama
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Kaoru Honaga
- Department of Rehabilitation Medicine, Juntendo University Graduate School of Medicine, Bunkyo, Tokyo, Japan
| | - Michiyuki Kawakami
- Department of Rehabilitation Medicine, Keio University School of Medicine, Shinjuku, Tokyo, Japan.
| | - Kunitsugu Kondo
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Narashino, Chiba, Japan
| | - Tetsuya Tsuji
- Department of Rehabilitation Medicine, Keio University School of Medicine, Shinjuku, Tokyo, Japan
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Dai S, Lemaire C, Piscicelli C, Pérennou D. Lateropulsion Prevalence after Stroke: A Systematic Review and Meta-analysis. Neurology 2022; 98:e1574-e1584. [PMID: 35190465 DOI: 10.1212/wnl.0000000000200010] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 01/03/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Lateropulsion is a deficit of active body orientation with respect to gravity in the frontal plane, mostly observed after a stroke. It magnifies mobility limitations and so represents an emerging target in rehabilitation. Efforts to design specific interventional studies require some basic knowledge of epidemiology, which is insufficient today because many studies focused on a few severe forms in individuals called pushers. The objectives of this study were to bridge this gap. METHODS We systematically searched MEDLINE, EMBASE, CINAHL, and Cochrane Clinical Trials up to 31 May 2021 for original research reporting a prevalence or incidence of post-stroke lateropulsion. We followed MOOSE and PRISMA guidelines. Eligibility for inclusion, data extraction, and study quality (Joanna Briggs Institute guidelines) were evaluated by two reviewers who used a standardized protocol: PROSPERO (CRD42020175037). A random-effects meta-analysis was used to obtain the pooled prevalence, whose heterogeneity was investigated by subgroup analysis (stroke locations and post-stroke phases) and meta-regression. RESULTS We identified 22 studies (5125 individuals; mean age 68.5 years; 42.6% female; assessed 24 days, on average, after stroke), most published after 2000. The studies' quality was adequate, with only 8 (36.4%) showing risk of bias. The pooled lateropulsion prevalence was 55.1% (95% confidence interval [CI] [35.9-74.2]) and was consistent across assessment tools. After supratentorial stroke, lateropulsion prevalence was 41% (95%CI [33.5-48.5]), and only 12.5% (95%CI [9.2-15.9]) in individuals with severe lateropulsion, called pushers. Meta-regression did not reveal any effect of age, sex, geographic region, publication year, or study quality. Lateropulsion prevalence progressively decreased from 52.8% (95%CI [40.7-65]) in the acute phase to 37% (95%CI [26.3-47.7]) in the early subacute phase and 22.8% (95%CI [0-46.3]) in the late subacute phase. The ratio of right- to left-hemispheric stroke with lateropulsion increased as a function of time: 1.7 in the acute phase to 7.7 in the late subacute phase. After infratentorial stroke, lateropulsion prevalence was very high, reaching 83.2% (95%CI [63.9-100.3]). CONCLUSIONS Post-stroke lateropulsion prevalence is high, which appeals for its systematic detection to guide early interventions. Uprightness is predominantly controlled from the right hemisphere.
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Affiliation(s)
- Shenhao Dai
- Univ. Grenoble Alpes, UMR CNRS 5105 Neuropsychology and NeuroCognition, CHU Grenoble Alpes, Dept of NeuroRehabilitation South Hospital, Cs 10217 - 38043 Grenoble cedex 9, France
| | - Camille Lemaire
- Univ. Grenoble Alpes, UMR CNRS 5105 Neuropsychology and NeuroCognition, CHU Grenoble Alpes, Dept of NeuroRehabilitation South Hospital, Cs 10217 - 38043 Grenoble cedex 9, France
| | - Celine Piscicelli
- Univ. Grenoble Alpes, UMR CNRS 5105 Neuropsychology and NeuroCognition, CHU Grenoble Alpes, Dept of NeuroRehabilitation South Hospital, Cs 10217 - 38043 Grenoble cedex 9, France
| | - Dominic Pérennou
- Univ. Grenoble Alpes, UMR CNRS 5105 Neuropsychology and NeuroCognition, CHU Grenoble Alpes, Dept of NeuroRehabilitation South Hospital, Cs 10217 - 38043 Grenoble cedex 9, France
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Huh YE, Seo DW, Kim K, Chung WH, Kim S, Cho JW. Factors Contributing to the Severity and Laterality of Pisa Syndrome in Parkinson's Disease. Front Aging Neurosci 2022; 13:716990. [PMID: 35046790 PMCID: PMC8761952 DOI: 10.3389/fnagi.2021.716990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 11/18/2021] [Indexed: 11/21/2022] Open
Abstract
Objective: Pisa syndrome (PS) is a disabling postural deformity in Parkinson’s disease (PD). We aimed to elucidate clinical factors determining the severity and laterality of PS in PD. Methods: In 54 PD patients with PS, we measured the clinical factors that are previously known to contribute to the occurrence of PS as follows: asymmetry of motor symptoms for the evaluation of asymmetric basal ganglia dysfunction, the degree and direction of subjective visual vertical (SVV) tilt for the misperception of body verticality, the canal paresis for unilateral peripheral vestibulopathy, and the tonic electromyographic (EMG) hyperactivity of paraspinal muscles for dystonia. Multivariable linear and logistic regression analyses were conducted to identify the clinical factors associated with the degree of truncal tilt, for the quantification of the severity of PS, and PS tilting to the less affected side, respectively. Results: The multivariable linear regression analyses revealed that the larger degree of SVV tilt (β = 0.29, SE = 0.10, p = 0.005), right-sided SVV tilt (β = 2.32, SE = 0.82, p = 0.007), and higher Hoehn and Yahr (HY) stage (β = 4.01, SE = 1.29, p = 0.003) significantly increased the severity of PS. In the multivariable logistic regression analyses, greater asymmetry of motor symptoms [odds ratio (OR) = 2.01, 95% CI = 1.34–3.49] was significantly associated with PS tilting to the less affected side, while right-sided SVV tilt (OR = 0.02, 95% CI = 0.001–0.21), unilateral canal paresis (OR = 0.06, 95% CI = 0.003–0.79), and higher HY stage (OR = 0.04, 95% CI = 0.002–0.46) were associated with PS tilting to the more affected side. Conclusion: Misperception of verticality, asymmetric basal ganglia dysfunction, unilateral peripheral vestibulopathy, and motor disability are the clinical factors associated with the severity and laterality of PS in patients with PD.
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Affiliation(s)
- Young Eun Huh
- Department of Neurology, CHA Bundang Medical Center, CHA University, Seongnam, South Korea
| | - Dae-Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Kunhyun Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Won-Ho Chung
- Department of Otolaryngology, Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Seonwoo Kim
- Statistics and Data Center, Samsung Medical Center, Research Institute for Future Medicine, Seoul, South Korea
| | - Jin Whan Cho
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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Catanzariti JF, Coget M, Brouillard A. A perception bias of the gravitational vertical is confirmed in Adolescent Idiopathic Scoliosis. Spine Deform 2022; 10:69-78. [PMID: 34319559 DOI: 10.1007/s43390-021-00390-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 07/15/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE Adolescent Idiopathic Scoliosis (AIS) is the most frequent spine deformity in adolescence. The cause of AIS remains unknown. Several studies show that AIS can be associated with a perception bias of gravitational vertical. In particularly, AIS patients with a right thoracic convexity exhibit deviation of the Subjective Postural Vertical. The origin of this disturbance could be located in trunk proprioceptive graciveptors. We wanted to verify this result with a population of lumbar and thoracolumbar AIS with left convexity. METHODS It was a multicenter, cross-sectional case-control study. Thirty adolescents with left lumbar or thoraco-lumbar AIS (age 14.3 ± 1.7 years; Cobb angle 27.6° ± 6.1°) and 30 controls matched for age (14.0 ± 1.5 years), were compared for Subjective Visual Vertical (SVV) measured in static and dynamic (optokinetic stimulation) conditions, and Subjective Postural Vertical (SPV). RESULTS For SVV, there was no difference in the two groups, for static and dynamic conditions. The SPV was significantly different between the two groups (p < 0.0001). The SPV was shifted to the left for most of the AIS patients (med - 2.4°[- 3.6; - 1.7]) compared with controls (med 0°[- 0.5; 1.7]). Adolescents with AIS perceived verticality with significant greater uncertainty in postural modality than controls (p = 0.017). CONCLUSION Our study confirms a significant directional bias in the orientation of SPV in left lumbar or thoraco-lumbar AIS. This confirmation paves the way to a new physiopathological model focused on trunk proprioception. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Jean-François Catanzariti
- Spine Department, SSR Pediatric Center Marc Sautelet, Villeneuve-d'Ascq, France. .,La Maison de la Scoliose, Villeneuve-d'Ascq, France.
| | - Monique Coget
- Spine Department, SSR Pediatric Center Marc Sautelet, Villeneuve-d'Ascq, France
| | - Anthony Brouillard
- Spine Department, SSR Pediatric Center Marc Sautelet, Villeneuve-d'Ascq, France.,La Maison de la Scoliose, Villeneuve-d'Ascq, France
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Tohyama T, Kondo K, Otaka Y. Effects of Galvanic Vestibular Stimulation on Visual Verticality and Standing Posture Differ Based on the Polarity of the Stimulation and Hemispheric Lesion Side in Patients With Stroke. Front Neurol 2021; 12:768663. [PMID: 34858316 PMCID: PMC8631773 DOI: 10.3389/fneur.2021.768663] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 10/08/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction: There is growing evidence supporting the relationship of vertical misperception and poor balance control with asymmetrical standing posture in patients with stroke. Although the vestibular system has been shown to be responsible for vertical misperception and balance disorders, the effect of galvanic vestibular stimulation (GVS) on both vertical misperception and postural asymmetry after stroke remains elusive. The aim of this study was to investigate the effects of GVS on visual verticality and postural asymmetry after stroke and to clarify whether the effects differ depending on the polarity of the stimulation and hemispheric lesion side. Methods: We measured the subjective visual vertical (SVV) and body weight distribution on each foot in an upright stance in 24 patients with a hemispheric stroke (10 with a left hemisphere lesion and 14 with a right hemisphere lesion) and nine age-matched healthy controls. During the measurements, bipolar GVS (1.5 mA) was applied over the bilateral mastoid processes in three stimulation conditions: contralesional-anodal and ipsilesional-cathodal vestibular stimulation, ipsilesional-anodal and contralesional-cathodal vestibular stimulation, and no stimulation. To examine whether GVS modulates visual verticality and standing posture, SVV and weight-bearing in the three conditions were analyzed. Results: During no stimulation, the SVV deviated to the contralesional side in patients with a right hemisphere lesion, while more weight-bearing was observed on the ipsilesional limb than on the contralesional limb in both patient groups than in the controls. The SVV was modulated by reversing the polarity of GVS in all the groups when the cathodal stimulus side was either ipsilateral or contralateral to the lesion while the ipsilesional-cathodal vestibular stimulation reduced weight-bearing asymmetry in only the patients with a right hemisphere lesion. Conclusions: These findings demonstrate that the effects of GVS on the SVV and standing posture differ depending on the polarity of GVS and the hemispheric lesion side. Patients with a right hemisphere lesion have difficulty maintaining their preferred standing posture under visual verticality modulation evoked by GVS. The application of GVS may clarify whether the vestibular system has neural redundancy after stroke to suppress any effects of the stimulation, including modulation of the visual verticality, on balance.
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Affiliation(s)
- Takamichi Tohyama
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Narashino, Japan.,Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Kunitsugu Kondo
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Narashino, Japan
| | - Yohei Otaka
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Narashino, Japan.,Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
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Delle Monache S, Indovina I, Zago M, Daprati E, Lacquaniti F, Bosco G. Watching the Effects of Gravity. Vestibular Cortex and the Neural Representation of "Visual" Gravity. Front Integr Neurosci 2021; 15:793634. [PMID: 34924968 PMCID: PMC8671301 DOI: 10.3389/fnint.2021.793634] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 11/08/2021] [Indexed: 11/13/2022] Open
Abstract
Gravity is a physical constraint all terrestrial species have adapted to through evolution. Indeed, gravity effects are taken into account in many forms of interaction with the environment, from the seemingly simple task of maintaining balance to the complex motor skills performed by athletes and dancers. Graviceptors, primarily located in the vestibular otolith organs, feed the Central Nervous System with information related to the gravity acceleration vector. This information is integrated with signals from semicircular canals, vision, and proprioception in an ensemble of interconnected brain areas, including the vestibular nuclei, cerebellum, thalamus, insula, retroinsula, parietal operculum, and temporo-parietal junction, in the so-called vestibular network. Classical views consider this stage of multisensory integration as instrumental to sort out conflicting and/or ambiguous information from the incoming sensory signals. However, there is compelling evidence that it also contributes to an internal representation of gravity effects based on prior experience with the environment. This a priori knowledge could be engaged by various types of information, including sensory signals like the visual ones, which lack a direct correspondence with physical gravity. Indeed, the retinal accelerations elicited by gravitational motion in a visual scene are not invariant, but scale with viewing distance. Moreover, the "visual" gravity vector may not be aligned with physical gravity, as when we watch a scene on a tilted monitor or in weightlessness. This review will discuss experimental evidence from behavioral, neuroimaging (connectomics, fMRI, TMS), and patients' studies, supporting the idea that the internal model estimating the effects of gravity on visual objects is constructed by transforming the vestibular estimates of physical gravity, which are computed in the brainstem and cerebellum, into internalized estimates of virtual gravity, stored in the vestibular cortex. The integration of the internal model of gravity with visual and non-visual signals would take place at multiple levels in the cortex and might involve recurrent connections between early visual areas engaged in the analysis of spatio-temporal features of the visual stimuli and higher visual areas in temporo-parietal-insular regions.
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Affiliation(s)
- Sergio Delle Monache
- UniCamillus—Saint Camillus International University of Health Sciences, Rome, Italy
- Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Iole Indovina
- Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, Rome, Italy
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Myrka Zago
- Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, Rome, Italy
- Center for Space Biomedicine, University of Rome “Tor Vergata”, Rome, Italy
- Department of Civil and Computer Engineering, University of Rome “Tor Vergata”, Rome, Italy
| | - Elena Daprati
- Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, Rome, Italy
- Center for Space Biomedicine, University of Rome “Tor Vergata”, Rome, Italy
- Department of Systems Medicine, University of Rome “Tor Vergata”, Rome, Italy
| | - Francesco Lacquaniti
- Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, Rome, Italy
- Center for Space Biomedicine, University of Rome “Tor Vergata”, Rome, Italy
- Department of Systems Medicine, University of Rome “Tor Vergata”, Rome, Italy
| | - Gianfranco Bosco
- Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, Rome, Italy
- Center for Space Biomedicine, University of Rome “Tor Vergata”, Rome, Italy
- Department of Systems Medicine, University of Rome “Tor Vergata”, Rome, Italy
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Ferreira LR, Ferreira FJPDA, Campos FA, Luvizutto GJ, Souza LAPSD. Evaluation of subjective vertical perception among stroke patients: a systematic review. ARQUIVOS DE NEURO-PSIQUIATRIA 2021; 79:1026-1034. [PMID: 34816993 DOI: 10.1590/0004-282x-anp-2020-0584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 03/25/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Verticality misperception is relatively common among patients after stroke, and it may be evaluated in terms of (a) subjective visual vertical (SVV), (b) subjective haptic vertical (SHV) and (c) subjective postural vertical (SPV). To better understand these assessment methods, we conducted a systematic review of the methodological characteristics of different protocols for evaluating SVV, SHV and SPV among individuals after stroke. OBJECTIVE To standardize the methodological characteristics of protocols for evaluating verticality perception after stroke. METHODS We searched the following databases: PUBMED, regional BVS portal (MEDLINE, LILACS, IBECS, CUBMED, Psychology Index and LIS), CINAHL, SCOPUS, Web of Science, Science Direct, Cochrane Library and PEDro. Two review authors independently used the QUADAS method (Quality Assessment of Diagnostic Accuracy Studies) and extracted data. RESULTS We included 21 studies in the review: most (80.9%) used SVV, eight (38.1%) used SPV and four (19.0%) used SHV. We observed high variability in assessments of verticality perception, due to patient positions, devices used, numbers of repetitions and angle of inclination for starting the tests. CONCLUSION This systematic review was one of the first to explore all the methods of assessing verticality perception after stroke, and it provides crucial information on how to perform the tests, in order to guide future researchers/clinicians.
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Affiliation(s)
| | | | | | - Gustavo José Luvizutto
- Universidade Federal do Triângulo Mineiro, Departamento de Fisioterapia Aplicada, Uberaba MG, Brazil
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Hugues A, Guinet-Lacoste A, Bin S, Villeneuve L, Lunven M, Pérennou D, Giraux P, Foncelle A, Rossetti Y, Jacquin-Courtois S, Luauté J, Rode G. Effects of prismatic adaptation on balance and postural disorders in patients with chronic right stroke: protocol for a multicentre double-blind randomised sham-controlled trial. BMJ Open 2021; 11:e052086. [PMID: 34819284 PMCID: PMC8614142 DOI: 10.1136/bmjopen-2021-052086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 10/21/2021] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Patients with right stroke lesion have postural and balance disorders, including weight-bearing asymmetry, more pronounced than patients with left stroke lesion. Spatial cognition disorders post-stroke, such as misperceptions of subjective straight-ahead and subjective longitudinal body axis, are suspected to be involved in these postural and balance disorders. Prismatic adaptation has showed beneficial effects to reduce visuomotor disorders but also an expansion of effects on cognitive functions, including spatial cognition. Preliminary studies with a low level of evidence have suggested positive effects of prismatic adaptation on weight-bearing asymmetry and balance after stroke. The objective is to investigate the effects of this intervention on balance but also on postural disorders, subjective straight-ahead, longitudinal body axis and autonomy in patients with chronic right stroke lesion. METHODS AND ANALYSIS In this multicentre randomised double-blind sham-controlled trial, we will include 28 patients aged from 18 to 80 years, with a first right supratentorial stroke lesion at chronic stage (≥12 months) and having a bearing ≥60% of body weight on the right lower limb. Participants will be randomly assigned to the experimental group (performing pointing tasks while wearing glasses shifting optical axis of 10 degrees towards the right side) or to the control group (performing the same procedure while wearing neutral glasses without optical deviation). All participants will receive a 20 min daily session for 2 weeks in addition to conventional rehabilitation. The primary outcome will be the balance measured using the Berg Balance Scale. Secondary outcomes will include weight-bearing asymmetry and parameters of body sway during static posturographic assessments, as well as lateropulsion (measured using the Scale for Contraversive Pushing), subjective straight-ahead, longitudinal body axis and autonomy (measured using the Barthel Index). ETHICS AND DISSEMINATION The study has been approved by the ethical review board in France. Findings will be submitted to peer-reviewed journals relative to rehabilitation or stroke. TRIAL REGISTRATION NUMBER NCT03154138.
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Affiliation(s)
- Aurélien Hugues
- Service de médecine physique et réadaptation, hôpital Henry Gabrielle, Hospices Civils de Lyon, Saint-Genis Laval, France
- Equipe 'Trajectoires', Centre de Recherche en Neurosciences de Lyon, Inserm UMR-S 1028, CNRS UMR 5292, Université de Lyon, Université Lyon 1, Bron, France
- Plate-forme 'Mouvement et Handicap', hôpital Henry Gabrielle, Hospices Civils de Lyon, Saint-Genis-Laval, France
| | - Amandine Guinet-Lacoste
- Service de médecine physique et réadaptation, hôpital Henry Gabrielle, Hospices Civils de Lyon, Saint-Genis Laval, France
- Equipe 'Trajectoires', Centre de Recherche en Neurosciences de Lyon, Inserm UMR-S 1028, CNRS UMR 5292, Université de Lyon, Université Lyon 1, Bron, France
- Plate-forme 'Mouvement et Handicap', hôpital Henry Gabrielle, Hospices Civils de Lyon, Saint-Genis-Laval, France
| | - Sylvie Bin
- Service de Recherche Clinique et Epidémiologique, Pôle de Santé Publique, Hospices Civils de Lyon, Lyon, France
| | - Laurent Villeneuve
- Service de Recherche Clinique et Epidémiologique, Pôle de Santé Publique, Hospices Civils de Lyon, Lyon, France
- EMR 3738, Université Lyon 1, Villeurbanne, France
| | - Marine Lunven
- Département d'Etudes Cognitives, École normale supérieure, PSL University, Paris, France
- Hôpital Henri Mondor-Albert Chenevier, Centre de référence Maladie de Huntington, Service de Neurologie, AP-HP, Créteil, France
- INSERM U955, Institut Mondor de Recherche Biomédicale, Equipe NeuroPsychologie Interventionnelle, Université Paris Est Créteil, Créteil, France
| | - Dominic Pérennou
- Département de médecine physique et de réadaptation, Institut de rééducation, Hôpital sud, Centre Hospitalier Universitaire Grenoble-Alpes, Grenoble, France
- Laboratoire Neurosciences Cognitives, CNRS UMR5105, Université Grenoble Alpes, Grenoble, France
| | - Pascal Giraux
- Service de médecine physique et réadaptation, Hôpital Bellevue, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
- Laboratoire Inter-universitaire de Biologie de la Motricité (LIBM, EA 7424), Université Jean Monnet Saint-Etienne, Université de Lyon, Saint-Etienne, France
| | - Alexandre Foncelle
- Equipe 'Trajectoires', Centre de Recherche en Neurosciences de Lyon, Inserm UMR-S 1028, CNRS UMR 5292, Université de Lyon, Université Lyon 1, Bron, France
| | - Yves Rossetti
- Service de médecine physique et réadaptation, hôpital Henry Gabrielle, Hospices Civils de Lyon, Saint-Genis Laval, France
- Equipe 'Trajectoires', Centre de Recherche en Neurosciences de Lyon, Inserm UMR-S 1028, CNRS UMR 5292, Université de Lyon, Université Lyon 1, Bron, France
- Plate-forme 'Mouvement et Handicap', hôpital Henry Gabrielle, Hospices Civils de Lyon, Saint-Genis-Laval, France
| | - Sophie Jacquin-Courtois
- Service de médecine physique et réadaptation, hôpital Henry Gabrielle, Hospices Civils de Lyon, Saint-Genis Laval, France
- Equipe 'Trajectoires', Centre de Recherche en Neurosciences de Lyon, Inserm UMR-S 1028, CNRS UMR 5292, Université de Lyon, Université Lyon 1, Bron, France
- Plate-forme 'Mouvement et Handicap', hôpital Henry Gabrielle, Hospices Civils de Lyon, Saint-Genis-Laval, France
| | - Jacques Luauté
- Service de médecine physique et réadaptation, hôpital Henry Gabrielle, Hospices Civils de Lyon, Saint-Genis Laval, France
- Equipe 'Trajectoires', Centre de Recherche en Neurosciences de Lyon, Inserm UMR-S 1028, CNRS UMR 5292, Université de Lyon, Université Lyon 1, Bron, France
- Plate-forme 'Mouvement et Handicap', hôpital Henry Gabrielle, Hospices Civils de Lyon, Saint-Genis-Laval, France
| | - Gilles Rode
- Service de médecine physique et réadaptation, hôpital Henry Gabrielle, Hospices Civils de Lyon, Saint-Genis Laval, France
- Equipe 'Trajectoires', Centre de Recherche en Neurosciences de Lyon, Inserm UMR-S 1028, CNRS UMR 5292, Université de Lyon, Université Lyon 1, Bron, France
- Plate-forme 'Mouvement et Handicap', hôpital Henry Gabrielle, Hospices Civils de Lyon, Saint-Genis-Laval, France
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Renaissance of "lateropulsion". Ann Phys Rehabil Med 2021; 64:101595. [PMID: 34687959 DOI: 10.1016/j.rehab.2021.101595] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 10/14/2021] [Accepted: 10/16/2021] [Indexed: 10/19/2022]
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Matsuo H, Kubota M, Matsumura M, Takayama M, Mae Y, Kitazaki Y, Enomoto S, Ueno A, Ikawa M, Hamano T, Takahashi A, Tsubokawa M, Shimada S. Center of pressure velocities in patients with body lateropulsion: three case report series of Wallenberg's syndrome. Physiother Theory Pract 2021; 38:3264-3272. [PMID: 34661499 DOI: 10.1080/09593985.2021.1990448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE In patients with Wallenberg's syndrome who present with body lateropulsion (BL), whether the center of pressure (COP) position and velocity characterize postural dysregulation is unknown. We measured time-course changes in COP parameters in three BL patients. METHODS Three patients with acute Wallenberg's syndrome presented with BL. COP was measured for time-course changes during first standing and every week thereafter. COP positions, which indicate the deviation in the center of gravity, were calculated. COP velocities associated with dynamic movements of the center of gravity were analyzed separately for the BL and non-BL sides. RESULTS All patients showed that COP position shifted to the BL side in first standing and changed to the center over time. COP velocities to the BL side were fast in first standing. Two of the three patients had significantly faster COP velocities to the BL side than to the non-BL side (p < .05), and one did not. In all three cases, the faster COP velocities to the BL side decreased significantly after 2 weeks compared to the initial standing position (p < .001). The change seemed to be related to the time when independent walking became possible. CONCLUSIONS Fast COP velocity to the BL side might reflect postural dysregulation in patients with BL. These findings might be useful information for devising effective rehabilitation in patients with BL.
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Affiliation(s)
- Hideaki Matsuo
- Division of Physical Therapy and Rehabilitation Medicine, University of Fukui Hospital, Fukui, Japan
| | - Masafumi Kubota
- Division of Physical Therapy and Rehabilitation Medicine, University of Fukui Hospital, Fukui, Japan
| | - Mayumi Matsumura
- Division of Physical Therapy and Rehabilitation Medicine, University of Fukui Hospital, Fukui, Japan
| | - Mami Takayama
- Division of Physical Therapy and Rehabilitation Medicine, University of Fukui Hospital, Fukui, Japan
| | - Yuri Mae
- Division of Physical Therapy and Rehabilitation Medicine, University of Fukui Hospital, Fukui, Japan
| | - Yuki Kitazaki
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Soichi Enomoto
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Asako Ueno
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Masamichi Ikawa
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Tadanori Hamano
- Second Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Ai Takahashi
- Division of Physical Therapy and Rehabilitation Medicine, University of Fukui Hospital, Fukui, Japan.,Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Misao Tsubokawa
- Division of Physical Therapy and Rehabilitation Medicine, University of Fukui Hospital, Fukui, Japan.,Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Seiichiro Shimada
- Division of Physical Therapy and Rehabilitation Medicine, University of Fukui Hospital, Fukui, Japan
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Birnbaum M, Brock K, Clark R, Muir S, Burton E, Hill KD. Standing weight-bearing asymmetry in adults with lateropulsion following stroke. Gait Posture 2021; 90:427-433. [PMID: 34597984 DOI: 10.1016/j.gaitpost.2021.09.172] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 09/08/2021] [Accepted: 09/09/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Weight-bearing asymmetry biasing the non-paretic leg is common following stroke. However, little is known as to how lateropulsion impacts on the weight-bearing patterns adopted in standing by individuals following stroke. RESEARCH QUESTIONS (1) Are there differences in weight-bearing asymmetry patterns observed in standing in people with lateropulsion relative to healthy controls; (2) What is the relationship between weight-bearing asymmetry and clinical measures of lateropulsion and postural function; and (3) Are measures of weight-bearing asymmetry reliable between test occasions. METHODS Thirty-three individuals with lateropulsion and 35 healthy controls participated in this study. For the participants with lateropulsion, weight-bearing asymmetry during standing tasks (measured using two Wii Balance Boards) and clinical measures of lateropulsion (Burke Lateropulsion Scale) and postural function (Postural Assessment Scale for Stroke) were assessed initially and fortnightly over eight weeks. RESULTS Individuals with lateropulsion displayed marked weight-bearing asymmetry in standing compared to healthy controls. This asymmetry was predominantly towards their non-paretic leg when standing unsupported, and mixed presentation of weight-bearing asymmetry directions when standing with arm support. No significant correlations were observed between directional weight-bearing asymmetry and the Burke Lateropulsion Scale. A moderate correlation was found between absolute weight-bearing asymmetry for the stand with arm support task and the Postural Assessment Scale for Stroke (r = -0.608). The weight-bearing asymmetry variables for the standing with arm support task were found to be highly reliable between test occasions (ICC 0.915-0.972) and the standard error of measurement was 8.2%-9.3% body weight. SIGNIFICANCE Individuals with lateropulsion following stroke demonstrate marked and varied patterns of asymmetry in standing. Weight-bearing asymmetry when standing with arm support may be an appropriate outcome measure for use with patients with lower functional abilities, including those with lateropulsion.
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Affiliation(s)
- Melissa Birnbaum
- St. Vincent's Hospital Melbourne, Physiotherapy Department, PO Box 2900, Fitzroy, Victoria, 3065, Australia; School of Allied Health, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, Western Australia, 6845, Australia.
| | - Kim Brock
- St. Vincent's Hospital Melbourne, Physiotherapy Department, PO Box 2900, Fitzroy, Victoria, 3065, Australia.
| | - Ross Clark
- School of Health and Behavioural Science, T3.29, University of the Sunshine Coast, Sippy Downs, Queensland, 4556, Australia.
| | - Sophie Muir
- St. Vincent's Hospital Melbourne, Physiotherapy Department, PO Box 2900, Fitzroy, Victoria, 3065, Australia.
| | - Elissa Burton
- School of Allied Health, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, Western Australia, 6845, Australia.
| | - Keith D Hill
- School of Allied Health, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, Western Australia, 6845, Australia; Rehabilitation Ageing and Independent Living (RAIL) Research Centre, School of Primary and Allied Health Care, Monash University (Peninsula Campus), McMahons Road, Frankston, Victoria, 3199, Australia.
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Chronic Central Vestibulopathies for the Otolaryngologist. Otolaryngol Clin North Am 2021; 54:939-948. [PMID: 34538359 DOI: 10.1016/j.otc.2021.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Central vestibulopathies involve disorders of the central nervous system that lead to problems with balance, often manifested as dizziness, vertigo, and gait difficulty. Central vestibulopathies can be distinguished from peripheral vestibulopathies with the use of certain tests, including nystagmography and posturography. The neuroanatomy of individuals with central vestibulopathies can reveal structural abnormalities in the posterior cerebrum or cerebellum. Various medications can be used to manage central vestibulopathies, including vestibular migraine.
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Dai S, Lemaire C, Piscicelli C, Jaeger M, Chrispin A, Davoine P, Pérennou D. White matter hyperintensities do not represent a critical lateropulsion determinant after stroke. Ann Phys Rehabil Med 2021; 64:101569. [PMID: 34530152 DOI: 10.1016/j.rehab.2021.101569] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 06/29/2021] [Accepted: 07/23/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Shenhao Dai
- Neurorehabilitation Department, Institute of Rehabilitation, Hôpital sud CHU Grenoble-Alpes Cs 10217, 38043 Grenoble cedex 9, France; Laboratoire de Psychologie et NeuroCognition, UMR CNRS 5105, Univ. Grenoble Alpes, Grenoble, France
| | - Camille Lemaire
- Neurorehabilitation Department, Institute of Rehabilitation, Hôpital sud CHU Grenoble-Alpes Cs 10217, 38043 Grenoble cedex 9, France; Laboratoire de Psychologie et NeuroCognition, UMR CNRS 5105, Univ. Grenoble Alpes, Grenoble, France
| | - Céline Piscicelli
- Neurorehabilitation Department, Institute of Rehabilitation, Hôpital sud CHU Grenoble-Alpes Cs 10217, 38043 Grenoble cedex 9, France; Laboratoire de Psychologie et NeuroCognition, UMR CNRS 5105, Univ. Grenoble Alpes, Grenoble, France
| | - Marie Jaeger
- Neurorehabilitation Department, Institute of Rehabilitation, Hôpital sud CHU Grenoble-Alpes Cs 10217, 38043 Grenoble cedex 9, France
| | - Anne Chrispin
- Neurorehabilitation Department, Institute of Rehabilitation, Hôpital sud CHU Grenoble-Alpes Cs 10217, 38043 Grenoble cedex 9, France
| | - Patrice Davoine
- Neurorehabilitation Department, Institute of Rehabilitation, Hôpital sud CHU Grenoble-Alpes Cs 10217, 38043 Grenoble cedex 9, France
| | - Dominic Pérennou
- Neurorehabilitation Department, Institute of Rehabilitation, Hôpital sud CHU Grenoble-Alpes Cs 10217, 38043 Grenoble cedex 9, France; Laboratoire de Psychologie et NeuroCognition, UMR CNRS 5105, Univ. Grenoble Alpes, Grenoble, France.
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Inoue M, Fujino Y, Sugimoto S, Amimoto K, Fukata K, Miura K, Matsuda T, Makita S, Takahashi H. Effects of dynamic supported standing training in a patient with pusher behavior: a case report. Physiother Theory Pract 2021; 38:3241-3247. [PMID: 34498984 DOI: 10.1080/09593985.2021.1978119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND The effects of task-specific and voluntary exercise in upright positions for pusher behavior remain unclear. In this report, we aimed to describe the effects of dynamic supported standing training using a modified standing frame to correct the alignment in a patient with severe pusher behavior. CASE DESCRIPTION A 76-year-old man with cardioembolic ischemic stroke demonstrated pusher behavior. The patient underwent 3 days of dynamic supported standing training using a modified standing frame. The Scale for Contraversive Pushing, the Burke Lateropulsion Scale, and the Trunk Control Test were used to assess changes. OUTCOMES Immediate improvements in sitting balance were observed after the intervention, and the effects persisted to 8 days later. CONCLUSION Dynamic supported standing training using a modified standing frame may improve pusher behavior with short-term training. The collapsed posture of the patient in the present case was corrected using the modified standing frame. This neutral standing position could have a positive effect on motor learning with respect to holding one's posture.
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Affiliation(s)
- Masahide Inoue
- Department of Rehabilitation, Saitama Medical University International Medical Center, Saitama, Japan.,Department of Physical Therapy, Tokyo Metropolitan University, Tokyo, Japan
| | - Yuji Fujino
- Department of Physical Therapy, Juntendo University, Tokyo, Japan
| | - Satoshi Sugimoto
- Department of Physical Therapy, Tokyo International University, Saitama, Japan
| | - Kazu Amimoto
- Department of Physical Therapy, Tokyo Metropolitan University, Tokyo, Japan
| | - Kazuhiro Fukata
- Department of Rehabilitation, Saitama Medical University International Medical Center, Saitama, Japan
| | - Kohei Miura
- Department of Rehabilitation, Saitama Medical University International Medical Center, Saitama, Japan
| | | | - Shigeru Makita
- Department of Rehabilitation, Saitama Medical University International Medical Center, Saitama, Japan
| | - Hidetoshi Takahashi
- Department of Rehabilitation, Saitama Medical University International Medical Center, Saitama, Japan
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Kuramatsu Y, Suzukamo Y, Izumi SI. Two types of sensorimotor strategies for whole-body movement in individuals with stroke: a pilot study. Physiother Theory Pract 2021; 38:2580-2591. [PMID: 34402735 DOI: 10.1080/09593985.2021.1962461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE This study compared the sensory-motor interactions and strategies for whole-body movement in individuals with stroke who had damaged motor system area or sensory system area in the brain. METHODS Participants with hemiparesis were asked to perform sit-to-stand movements while their vision was restricted, which can affect completion of the task. The participants were divided into two groups. The first group had no history of lesions in the sensory system area but did have a history of lesions in the motor system area (no damaged sensory-system: NDS). The second group had a history of lesions in the sensory system area of the brain (damaged sensory-system: DS). Center-of-pressure (COP) trajectories were measured to evaluate balance control in participants with and without vision, and numbers of sub-movements (i.e. numbers of segmented movements which reflect the degree of use of the feedback loops) were measured to evaluate feedforward and feedback control. Movement times were also measured. RESULTS When vision was restricted, NDS participants showed increased variability in mediolateral COP trajectories during movement and utilized mainly feedforward control. In contrast, DS participants showed reduced variability in mediolateral COP trajectories during movement and utilized additional feedback control. CONCLUSIONS These results demonstrate two types of strategies for whole-body movements in individuals with stroke. These differences may be attributed to whether the individual can compensate for vision with somatic senses and whether appropriate processing of somatosensory information has been lost. Individuals with hemiparesis created dexterous and flexible strategies to execute tasks successfully, depending on the characteristics of their sensorimotor disorders.
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Affiliation(s)
- Yuko Kuramatsu
- Department of Physical Medicine and Rehabilitation, Graduate School of Medicine, Tohoku University, Aoba-ku, Japan
| | - Yoshimi Suzukamo
- Department of Physical Medicine and Rehabilitation, Graduate School of Medicine, Tohoku University, Aoba-ku, Japan
| | - Shin-Ichi Izumi
- Department of Physical Medicine and Rehabilitation, Graduate School of Medicine, Tohoku University, Aoba-ku, Japan.,Graduate School of Biomedical Engineering, Tohoku University, Aoba-ku, Japan
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Piscicelli C, Castrioto A, Jaeger M, Fraix V, Chabardes S, Moro E, Krack P, Debû B, Pérennou D. Contribution of Basal Ganglia to the Sense of Upright: A Double-Blind Within-Person Randomized Trial of Subthalamic Stimulation in Parkinson's Disease with Pisa Syndrome. JOURNAL OF PARKINSONS DISEASE 2021; 11:1393-1408. [PMID: 33896847 DOI: 10.3233/jpd-202388] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Verticality perception is frequently altered in Parkinson's disease (PD) with Pisa syndrome (PS). Is it the cause or the consequence of the PS? OBJECTIVE We tested the hypothesis that both scenarios coexist. METHODS We performed a double-blind within-person randomized trial (NCT02704910) in 18 individuals (median age 63.5 years) with PD evolving for a median of 17.5 years and PS for 2.5 years and treated with bilateral stimulation of the subthalamus nuclei (STN-DBS) for 6.5 years. We analyzed whether head and trunk orientations were congruent with the visual (VV) and postural (PV) vertical, and whether switching on one or both sides of the STN-DBS could modulate trunk orientation via verticality representation. RESULTS The tilted verticality perception could explain the PS in 6/18 (33%) patients, overall in three right-handers (17%) who showed net and congruent leftward trunk and PV tilts. Two of the 18 (11%) had an outstanding clinical picture associating leftward: predominant parkinsonian symptoms, whole-body tilt (head -11°, trunk -8°) and transmodal tilt in verticality perception (PV -10°, VV -8.9°). Trunk orientation or VV were not modulated by STN-DBS, whereas PV tilts were attenuated by unilateral or bilateral stimulations if it was applied on the opposite STN. CONCLUSION In most cases of PS, verticality perception is altered by the body deformity. In some cases, PS seems secondary to a biased internal model of verticality, and DBS on the side of the most denervated STN attenuated PV tilts with a quasi-immediate effect. This is an interesting track for further clinical studies.
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Affiliation(s)
- Céline Piscicelli
- Department of NeuroRehabilitation, Grenoble-Alpes University Hospital, Grenoble, France.,Lab Cognitive Neurosciences CNRS-UMR5105 (LPNC), University Grenoble-Alpes, Grenoble, France
| | - Anna Castrioto
- Grenoble Institute Neurosciences (GIN), Grenoble-Alpes University Hospital, University Grenoble-Alpes, Inserm, U1216, Grenoble, France
| | - Marie Jaeger
- Department of NeuroRehabilitation, Grenoble-Alpes University Hospital, Grenoble, France
| | - Valerie Fraix
- Grenoble Institute Neurosciences (GIN), Grenoble-Alpes University Hospital, University Grenoble-Alpes, Inserm, U1216, Grenoble, France
| | - Stephan Chabardes
- Department of Neurosurgery, Grenoble-Alpes University Hospital, Grenoble, France
| | - Elena Moro
- Grenoble Institute Neurosciences (GIN), Grenoble-Alpes University Hospital, University Grenoble-Alpes, Inserm, U1216, Grenoble, France
| | - Paul Krack
- Movement Disorders Center, Department of Neurology, University Hospital (Inselspital) and University of Bern, Bern, Switzerland
| | - Bettina Debû
- Grenoble Institute Neurosciences (GIN), Grenoble-Alpes University Hospital, University Grenoble-Alpes, Inserm, U1216, Grenoble, France
| | - Dominic Pérennou
- Department of NeuroRehabilitation, Grenoble-Alpes University Hospital, Grenoble, France.,Lab Cognitive Neurosciences CNRS-UMR5105 (LPNC), University Grenoble-Alpes, Grenoble, France
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50
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Bakalkin G, Kahle A, Sarkisyan D, Watanabe H, Lukoyanov N, Carvalho LS, Galatenko V, Hallberg M, Nosova O. Coordinated expression of the renin-angiotensin genes in the lumbar spinal cord: Lateralization and effects of unilateral brain injury. Eur J Neurosci 2021; 54:5560-5573. [PMID: 34145943 DOI: 10.1111/ejn.15360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 05/29/2021] [Accepted: 06/17/2021] [Indexed: 12/19/2022]
Abstract
In spite of its apparent symmetry, the spinal cord is asymmetric in its reflexes and gene expression patterns including leftward expression bias of the opioid and glutamate genes. To examine whether this is a general phenomenon for neurotransmitter and neurohormonal genes, we here characterized expression and co-expression (transcriptionally coordinated) patterns of genes of the renin-angiotensin system (RAS) that is involved in neuroprotection and pathological neuroplasticity in the left and right lumbar spinal cord. We also tested whether the RAS expression patterns were affected by unilateral brain injury (UBI) that rewired lumbar spinal neurocircuits. The left and right halves of the lumbar spinal cord were analysed in intact rats, and rats with left- or right-sided unilateral cortical injury, and left- or right-sided sham surgery. The findings were (i) lateralized expression of the RAS genes Ace, Agtr2 and Ren with higher levels on the left side; (ii) the asymmetry in coordination of the RAS gene expression that was stronger on the right side; (iii) the decay in coordination of co-expression of the RAS and neuroplasticity-related genes induced by the right-side but not left-side sham surgery and UBI; and (iv) the UBI-induced shift to negative regulatory interactions between RAS and neuroplasticity-related genes on the contralesional spinal side. Thus, the RAS genes may be a part of lateralized gene co-expression networks and have a role in a side-specific regulation of spinal neurocircuits.
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Affiliation(s)
- Georgy Bakalkin
- Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
| | - Anika Kahle
- Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
| | - Daniil Sarkisyan
- Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
| | - Hiroyuki Watanabe
- Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
| | - Nikolay Lukoyanov
- Departamento de Biomedicina, Faculdade de Medicina; Instituto de Investigação e Inovação em Saúde; Instituto de Biologia Molecular e Celular, Universidade do Porto, Porto, Portugal
| | - Liliana S Carvalho
- Departamento de Biomedicina, Faculdade de Medicina; Instituto de Investigação e Inovação em Saúde; Instituto de Biologia Molecular e Celular, Universidade do Porto, Porto, Portugal
| | - Vladimir Galatenko
- Faculty of Mechanics and Mathematics, Lomonosov Moscow State University, Moscow, Russia.,Evotec International GmbH, Göttingen, Germany
| | - Mathias Hallberg
- Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
| | - Olga Nosova
- Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
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