Reliance on visual information after stroke. Part I: balance on dynamic posturography

• Published in: Archives of physical medicine and rehabilitation Vol. 85; no. 2; pp. 268 - 273
• Main Authors: Bonan, Isabelle V, Colle, Florence M, Guichard, Jean P, Vicaut, Eric, Eisenfisz, Martine, Tran Ba Huy, P, Yelnik, Alain P
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.02.2004; Elsevier
• Subjects: Biological and medical sciences; Cerebral Cortex - physiopathology; Diseases of the osteoarticular system; Female; Hemiplegia; Hemiplegia - physiopathology; Humans; Male; Medical sciences; Middle Aged; Motor Activity - physiology; Neurology; Postural Balance - physiology; Posture; Posture - physiology; Rehabilitation; Sensory Deprivation - physiology; Sensory disorders; Stroke; Stroke - physiopathology; Traumas. Diseases due to physical agents; Vascular diseases and vascular malformations of the nervous system; Vestibule, Labyrinth - physiopathology; Visual Perception - physiology; Hemiplegia; Stroke; Rehabilitation; Posture; Sensory disorders; Nervous system diseases; Cardiovascular disease; Posturography; Information; Traumatology; Equilibrium; Cerebral disorder; Vascular disease; Dynamics; Orthopedics; Central nervous system disease; Cerebrovascular disease
• ISSN: 0003-9993; 1532-821X
• DOI: 10.1016/j.apmr.2003.06.017

Bonan IV, Colle FM, Guichard JP, Vicaut E, Eisenfisz M, Tran Ba Huy P, Yelnik AP. Reliance on visual information after stroke. Part I: Balance on dynamic posturography. Arch Phys Med Rehabil 2004;85:268–73. To test the hypothesis that postural imbalance after stroke may be caused by inability to use pertinent somatosensory, vestibular, or visual information. Description of the sensory organization of patients with hemiplegia. Public rehabilitation center in France. Forty patients with hemiplegia after a single hemisphere stroke who were at least 12 months poststroke. Not applicable. The patients performed computerized dynamic posturography (EquiTest), which is designed to assess a patient’s ability use sensory inputs separately and to effectively suppress inaccurate inputs in case of sensory conflict. Body stability under each of 6 sensory conditions was assessed by an equilibrium score (ES). In conditions of altered somatosensory information, with visual deprivation (ES5) or visuovestibular conflict (ES6), the median scores for patients with hemiplegia (ES5–43; ES6–20) were significantly lower than those for normal subjects (ES5–69; ES6–67). Many patients with hemiplegia seem to rely on visual input. The mechanism of this excessive visual reliance is discussed. Rehabilitation programs of postural control for the patients with hemiplegia should take into account the possible impairment of sensory organization and should include exercises to be performed under conditions of sensory input deprivation and sensory conflict.