Maintaining Trunk and Head Upright Optimizes Visual Vertical Measurement After Stroke
Maintaining Trunk and Head Upright Optimizes Visual Vertical Measurement After Stroke
复制标题
保持躯干和头部直立可优化中风后的视觉垂直测量
DOI：
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发表时间：
2015
影响因子：
4.2
通讯作者：
D. Pérennou
中科院分区：
文献类型：
--
作者：
C. Piscicelli;J. Barra;B. Sibille;C. Bourdillon;M. Guerraz;D. Pérennou
背景。视觉垂直（VV）测量提供了空间认知的信息，现在是姿势障碍评估的一部分。脑卒中后VV测量的临床指南仍有待建立，特别是对于不坐直的患者的方向设置。目标。我们分析了在患者估计VV时控制身体方向的需要。方法。对20名对照组和36名第一半球卒中后接受康复治疗的亚急性患者进行VV定向和变异性评估，分为3种情况：身体不维持（躯干和头部自由）、部分维持（躯干维持，头部自由）或维持（躯干和头部）。VV作为躯干和头部倾斜的函数进行了分析，并进行了量化。结果。躯干和头部的方向是独立的。独立坐下的能力会受到躯干倾斜的影响。设置对对侧躯干倾斜患者的VV定向和变异性有很强的影响（n = 11；躯干定向−18.4±11.7°）。在部分维持（- 8.4±5.2°）和维持（- 7.8±3.5°）设置下，对侧VV偏倚严重且一致，而在非维持设置下，各种个体行为降低了平均偏倚（- 3.6±9.3°，P < 0.05）。维持（1.5±0.2°）的VV变异性低于未维持（3.7±0.4°，P < .001）和部分维持（3.6±0.2°，P < .001）设置。相比之下，环境对坐姿控制满意的患者没有影响。结论。受试者设置可改善卒中体位障碍患者的VV测量。躯干直立增强了VV方向的有效性，头部直立增强了主体内变异性的有效性。在平衡能力良好的患者中，测量VV无需任何身体维持是有效的。
Background. Visual vertical (VV) measurement provides information about spatial cognition and is now part of postural disorders assessment. Guidelines for clinical VV measurement after stroke remain to be established, especially regarding the orientation settings for patients who do not sit upright. Objectives. We analyzed the need to control body orientation while patients estimate the VV. Methods. VV orientation and variability were assessed in 20 controls and 36 subacute patients undergoing rehabilitation after a first hemisphere stroke, in 3 settings: body not maintained (trunk and head free), partially maintained (trunk maintained, head free), or maintained (trunk and head). VV was analyzed as a function of trunk and head tilt, also quantified. Results. Trunk and head orientations were independent. The ability to sit independently was affected by a tilted trunk. The setting had a strong effect on VV orientation and variability in patients with contralesional trunk tilt (n = 11; trunk orientation −18.4 ± 11.7°). The contralesional VV bias was severe and consistent under partially maintained (−8.4 ± 5.2°) and maintained (−7.8 ± 3.5°) settings, whereas various individual behaviors reduced the mean bias under the nonmaintained setting (−3.6 ± 9.3°, P < .05). VV variability was lower under the maintained (1.5 ± 0.2°) than nonmaintained (3.7 ± 0.4°, P < .001) and partially maintained (3.6 ± 0.2°, P < .001) settings. In contrast, setting had no effect in patients with satisfactory postural control in sitting. Conclusion. Subject setting improves VV measurement in stroke patients with postural disorders. Maintaining the trunk upright enhances the validity of VV orientation, and maintaining the head upright enhances the validity of within-subject variability. Measuring VV without any body maintaining is valid in patients with satisfactory balance abilities.
半侧空间忽视中垂直知觉的多模态和多空间缺陷
影响因子：
3.3
作者：
Keller;Artinger;Stumpf;Kerkhoff
通讯作者：
Kerkhoff
影响因子：
9.9
作者：
Baier, Bernhard;Suchan, Julia;Dieterich, Marianne
通讯作者：
Dieterich, Marianne