Article

The purpose of this study was to determine the longitudinal
association of visuospatial hemineglect with postural imbalance in postacute
stroke patients and to establish whether this relationship is confounded by other
determinants. METHODS:
A prospective cohort study of 53 postacute stroke patients
consecutively admitted for inpatient rehabilitation was conducted. Transfers and
standing balance were assessed with the Berg Balance Scale (BBS) and walking
balance with the Functional Ambulation Categories (FAC). Repeated measurements
took place at baseline (36.6 +/- 10.4 days after stroke) and after 6 and 12
weeks. Visuospatial hemineglect was assessed by an asymmetry index, derived from
the Letter and Star Cancellation Tests. Random coefficient analysis was used to
analyze the longitudinal impact of visuospatial hemineglect on the BBS and FAC.
The association between hemineglect and outcome was corrected for the following
potential confounders: age, severity of paresis of the lower leg, sensory
deficits, and presence of hypertonia. A covariate was considered to be a
confounder if the regression coefficient of hemineglect on outcome changed by
>15%. RESULTS: Visuospatial hemineglect was significantly associated with BBS and
FAC. The relation between hemineglect and both BBS and FAC was confounded by
severity of paresis of the lower limb. After controlling for severity of paresis,
hemineglect remained independently associated with BBS, whereas the association
with FAC lost significance. CONCLUSION: Visuospatial hemineglect is an
independent covariate that is longitudinally associated with postural imbalance
after stroke. These findings suggest that hemineglect is an important factor for
controlling static and dynamic standing balance during the first months poststroke.

Langue : ANGLAIS