Article

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 degrees ). The contralesional VV bias was
severe and consistent under partially maintained (-8.4 +/- 5.2 degrees ) and
maintained (-7.8 +/- 3.5 degrees ) settings, whereas various individual behaviors
reduced the mean bias under the nonmaintained setting (-3.6 +/- 9.3 degrees , P <
.05). VV variability was lower under the maintained (1.5 +/- 0.2 degrees ) than
nonmaintained (3.7 +/- 0.4 degrees , P < .001) and partially maintained (3.6 +/-
0.2 degrees , 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.
CI - (c) The Author(s) 2015.

Langue : ANGLAIS