Asymmetric standing posture after stroke is related to a biased egocentric coordinate system
Asymmetric standing posture after stroke is related to a biased egocentric coordinate system
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DOI：
10.1212/wnl.0b013e3181a4123a
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发表时间：
2009-05-05
期刊：
影响因子：
9.9
通讯作者：
Perennou, D.
中科院分区：
文献类型：
--
作者：
Barra, J.;Oujamaa, L.;Perennou, D.
背景：虚弱和躯体感觉缺陷早已被认为与中风患者的姿势不稳定有关。最近，研究表明，身体纵轴方向(LBA，自我中心参考)和垂直性(局部中心参考)的表征受损也可能起作用。本研究的目的是确定这两个参考文献是否独立地与站立中风患者的姿势不对称有关。方法：22名受试者在第一次大脑半球中风(13+/-7.5周)后进行测试。通过调整发光棒在前额平面上的方向以与主观LBA相对应来研究仰卧状态下的LBA知觉。通过调整发光线在额面上的方向以与直立患者的主观视觉垂直(SVV)相对应来评估SVV。结果：LBA与SVV之间存在较强的相关性(r=0.7p&t；0.001)。在调整了运动无力和感觉减退因素后，LBA比SVV更能预测负重不对称(r=-0.52：p<；0.02)(r=-0.41；p=0.074)。这种对负重不对称的新解释强调了中风后直立姿势控制的复杂性，并为康复计划带来了新的视角。神经病学(R)2009；72：1582-1587
Background: Weakness and somatosensory deficits have long been known to be involved in the postural instability of subjects with stroke. Recently, it has been shown that impaired representations of the orientation of the longitudinal axis of the body (LBA, egocentric reference) and of verticality (allocentric reference) may also play a role. The objective of the present study was to determine whether these two references were independently linked to postural asymmetry in standing stroke patients.Methods: Twenty-two subjects were tested after a first hemispheric stroke (13 +/- 7.5 weeks). The LBA perception was investigated in the supine position by adjusting the orientation of a luminous rod in the frontal plane to correspond to the subjective LBA. The subjective visual vertical (SVV) was assessed by adjusting the orientation of a luminous line in the frontal plane to correspond to the SVV in upright patients. Weight distribution was measured in the standing position for about 2 minutes and 45 seconds by two separate force platforms under the feet.Results: LBA and SVV were strongly associated (r = 0.7; p < 0.001). The estimate of the LBA was a better predictor (r = -0.52: p < 0.02) of weight bearing asymmetry than was SVV (r = -0.41; p = 0.074) when adjusted for motor weakness and hypoesthesia.Conclusion: Contralesional rotation of the longitudinal axis of the body could lead to unequal distribution of loading on the feet. This novel interpretation of weight bearing asymmetry underlines the complexity of control of the erect stance following stroke and brings new perspectives for rehabilitation programs. Neurology (R) 2009;72:1582-1587