Article

Visual vertical (VV) measurements are being increasingly used for
routine clinical assessment of spatial cognition, to investigate otolithic
vestibular function and identify altered verticality perception as a possible
cause of postural disorders after stroke. The objective of this paper was to
synthesize knowledge of assessment methods for testing VV after stroke. METHODS:
This systematic review, following the PRISMA statement, involved a search for
articles in MEDLINE via PubMED published up to November 2015 by using the search
terms "visual vertical," "verticality perception" and "stroke". We included only
case or group studies on VV perception after hemispheric, brainstem or cerebellar
strokes. Two authors independently assessed data on patients' and VV assessment
characteristics, outcome measures, ranges of normality and psychometric
properties. RESULTS: We assessed reports for 61 studies (1982 patients) of VV for
hemispheric (n=43), brainstem (n=18) or cerebellar (n=8) stroke. VV assessment
procedures varied widely in paradigm, type of stimulus, patient posture, number
of trials and outcome measures. However, on the basis of recent studies it is
recommended assessing VV in absolute darkness, with an even number of trials,
from 6 to 10, with the body maintained upright. Under these conditions, normal VV
orientation (mean of VV estimates) can be considered from -2.5 degrees to 2.5
degrees and is highly reliable for use in clinical practice and research. A
difference >/= 2 degrees between repeated measures for a given patient can be
interpreted as a real change in VV perception. Myriad of protocols have been
proposed, for which psychometric properties must be better analyzed. CONCLUSIONS:
This first review of VV assessment methods after stroke shows a great
heterogeneity of procedures, settings and parameters,
among which only some are
eligible for standardization to limit measurement errors and better interpret the results.
CI - Copyright (c) 2016. Published by Elsevier Masson SAS.

Langue : ANGLAIS