1. Asymmetric standing posture after stroke is related to a biased egocentric coordinate system
- Author
-
V. Chauvineau, Dominic Pérennou, L. Oujamaa, Patrice Rougier, Julien Barra, Bases Génétiques, Moléculaires et Cellulaires du Développement (BGMCD), Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS), Santé, Plasticité, Motricité (TIMC-IMAG-SPM), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS), and VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)
- Subjects
Male ,030506 rehabilitation ,Supine position ,MESH: Proprioception ,Somatosensory system ,Weight-Bearing ,MESH: Postural Balance ,0302 clinical medicine ,MESH: Rotation ,MESH: Aged, 80 and over ,Orientation (geometry) ,MESH: Weight-Bearing ,Postural Balance ,Stroke ,Aged, 80 and over ,MESH: Aged ,MESH: Muscle, Skeletal ,Movement Disorders ,MESH: Middle Aged ,Brain ,[SDV.NEU.SC]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Cognitive Sciences ,Hypoesthesia ,Middle Aged ,MESH: Leg ,MESH: Vision Disorders ,Female ,MESH: Somatosensory Disorders ,medicine.symptom ,0305 other medical science ,Psychology ,Adult ,medicine.medical_specialty ,Weakness ,Rotation ,MESH: Space Perception ,Vision Disorders ,MESH: Orientation ,MESH: Stroke ,Perceptual Disorders ,03 medical and health sciences ,MESH: Brain ,Physical medicine and rehabilitation ,Orientation ,medicine ,Humans ,Force platform ,Muscle, Skeletal ,MESH: Perceptual Disorders ,Aged ,Leg ,MESH: Humans ,MESH: Adult ,Proprioception ,medicine.disease ,MESH: Male ,Space Perception ,Coronal plane ,Somatosensory Disorders ,Neurology (clinical) ,Neuroscience ,MESH: Female ,030217 neurology & neurosurgery ,MESH: Movement Disorders - Abstract
International audience; 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.
- Published
- 2009