Starting position effects in the measurement of the postural vertical for pusher behavior
Starting position effects in the measurement of the postural vertical for pusher behavior
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DOI：
10.1007/s00221-020-05882-z
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发表时间：
2020-07-18
影响因子：
2
通讯作者：
Takahashi, Hidetoshi
中科院分区：
文献类型：
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作者：
Fukata, Kazuhiro;Amimoto, Kazu;Takahashi, Hidetoshi
推挤行为（PB）是一种严重的侧位姿势障碍，涉及额面的主观姿势垂直（SPV）紊乱。SPV是通过确定对侧和同侧倾斜位置开始的几次试验的平均值和标准差来测量的。然而，当被动倾斜到对侧与同侧位置时，PB患者与非PB患者的姿势表示是不同的。因此，我们假设SPV对起始位置的依赖性将受到PB的影响。对于53例半球卒中患者，使用非机动垂直板闭眼测量SPV。在4项试验中计算平均值（倾斜方向）和标准差（变异性），每项试验从两个位置开始，患者倾斜至对侧病灶位置（SPV-CL条件），然后倾斜至同侧病灶位置（SPV-IL条件）。患者分为非推送器组（n = 29）和推送器组（n = 24）。在SPV-CL试验中，与非推进器组（-2.2度+/-1.8度;p < 0.001）相比，推进器组（-6.3度+/-1.6度）的倾斜方向明显向病灶对侧倾斜，两组之间的变异性无显著差异。在SPV-IL试验中，两组之间的倾斜方向没有显著差异，但推送器组的变异性（4.8度± 2.0度）显著高于非推送器组（2.2度± 1.3度;p < 0.001）。PB患者的倾斜方向和SPV变异性对起始位置的依赖性与无PB患者不同。这些结果可能有助于解释这种异常的姿势，并优化PB的神经康复策略。
Pusher behavior (PB) is a severe lateral postural disorder that involves a disturbed subjective postural vertical (SPV) in the frontal plane. SPV is measured by determining the mean value and standard deviation of several trials beginning on both the contralesional- and ipsilesional-tilted positions. However, the postural representation, when passively tilted to the contralesional versus ipsilesional position, is different between patients with and without PB. Therefore, we hypothesized that SPV dependence on the starting position will be influenced by PB. For 53 patients with hemispheric stroke enrolled, SPV was measured using a non-motorized vertical board with eyes closed. The mean value (tilt direction) and standard deviation (variability) were calculated in four trials, each from two positions, with the patient tilted to the contralesional position (SPV-CL condition) and then to the ipsilesional position (SPV-IL condition). Patients were categorized into the non-pusher (n = 29) and pusher (n = 24) groups. In the SPV-CL trials, the tilt direction was significantly tilted contralesionally for the pusher group (- 6.3 degrees +/- 1.6 degrees) compared with that for the non-pusher group (- 2.2 degrees +/- 1.8 degrees;p < 0.001), with no significant difference in variability between the groups. In the SPV-IL trials, the tilt direction was not significantly different between the groups, but the variability was significantly higher in the pusher group (4.8 degrees +/- 2.0 degrees) than in the non-pusher group (2.2 degrees +/- 1.3 degrees;p < 0.001). The dependence of tilt direction and variability of SPV on the starting position in patients with PB differed from those noted in patients without PB. These results may help explain this abnormal posture and optimize neurological rehabilitation strategies for PB.