ArticlesRestoration of weight-shifting capacity in patients with postacute stroke: A rehabilitation cohort study
Section snippets
Participants
All patients with a first hemispheric intracerebral infarction or hematoma, who were admitted to our rehabilitation clinic for retraining motor skills and self-care abilities during a period of 2 years were eligible. Patients who, on admission, already walked safely and those with medication- or nonstroke-related sensory or motor impairments that could interfere with their postural regulation were excluded. Based on practical assessment, patients with concomitant cognitive or psychiatric
Cohort
Five follow-up assessments were completed in 36 stroke patients, whose main biologic and clinical characteristics are listed in table 1. As for their functional capacity, the median Brunnstrom stage was IV (range, II-VI) at the start of the balance training and improved to V (range, III-VI) after 12 weeks (P<.001). The median FAC score improved by 2 points from 2 (range, 1–4) at the start to 4 (range, 1–5) at the end of the 12-week period (P<.001). Eleven patients failed to make a minimum of 5
Discussion
The primary goal of this study was to provide insight into several characteristics of the restoration of weight-shifting control in first-ever postacute hemispheric stroke survivors during 12 weeks of inpatient rehabilitation, irrespective of the causal mechanisms. For this purpose, an instrumented dynamic balance task was used that required patients to make voluntary well-controlled weight shifts in the frontal plane while using real-time and real-size visual COP feedback. This task was
Conclusions
Even severe stroke patients who are selected for inpatient rehabilitation to retrain gross motor skills can substantially improve their weight-shifting capacity in the frontal plane during a 12-week training period, in terms of both speed and precision. Unlike the speed of weight shifting, precision may even reach the performance level of the healthy elderly. An advanced age (>65y) and the presence of visuospatial hemineglect primarily affect the absolute weight-shifting speed but not its
Acknowledgment
We thank the staff of the Department of Physical Therapy for their help during the posturographic assessments.
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2021, Annals of Physical and Rehabilitation MedicineCitation Excerpt :Paper-and-pencil tests were used most frequently, by 39 studies [18,19,21–25,27–35,37–41,43,45–47,49,50,52–62]. Ten studies used only a paper-and-pencil test to assess VSN [22,28,45,46,49,53,56,57,61,62], 26 studies used a paper-and-pencil test combined with other VSN tests [18,19,21,23–25,27,29–31,33–35,37–41,47,50,52,54,55,58–60], and 3 studies used paper-and-pencil tests within a complete test battery for VSN, namely the Behavioural Inattention test [32,36,43]. VSN was assessed 6 times by using observation, with a computerized visual reaction-time test [44], with the National Institute of Health Stroke Scale (NIHSS) neglect item [26], without reporting a scale [20], and by using the CBS (ADL-related VSN) [21,27,65].
Interaction between postural asymmetry and visual feedback effects in undisturbed upright stance control in healthy adults
2017, Neurophysiologie Clinique
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