Efficacy of lateral truncal tilt training with a wedge on postural vertical and activities of daily living in recovery phase after stroke: A randomized crossover trial

Amimoto

Ishigami³

et al. 2023

Brain and Behavior

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Introduction: Clarifications regarding the recovery process of the subjective postural vertical (SPV) and activities of daily living in stroke patients are required to help clinicians determine treatment plans. Therefore, we aimed to investigate the characteristics of the longitudinal recovery process of SPV and activities of daily living after stroke.Methods: Overall, 109 patients with stroke were enrolled. Clinical assessments included the SPV and total functional independence measure (FIM), initially and after 1 month. The mean and standard deviation of SPV indicated the directional and variability errors, respectively. Participants were categorized as follows: nondeviation group comprised directional and variability errors within the standard values, deviation of variability errors group comprised directional errors within the standard value and variability errors greater than the standard value, and deviation of both directional and variability errors group comprised directional and variability errors greater than the standard values. In addition, a two-way analysis of variance was performed for initial pre-and post-SPV, and pre-and posttotal FIM scores (p < .05). Results:The deviation of variability errors group, and deviation of both directional and variability errors group, had larger SPV variability errors than did the nondeviation group. Furthermore, the deviation of variability errors group showed a significant improvement in variability errors after 1 month. There was a correlation between the initial SPV with eyes opened variability error and total FIM after 1 month in Pusher patients with unilateral spatial neglect in the deviation of both directional and variability errors group.Conclusions: SPV with eyes opened variability errors and initial FIM score may influence the independence of activities of daily living after 1 month in the recovery of patients with stroke with Pusher and unilateral spatial neglect.

Section: Discussionmentioning

confidence: 99%

“…The starting direction of the tilt measurements was left or right, based on the ABBABAAB or BAABABBA sequences. The standard deviation of eight measurements was used as the PV tilt variability (Fukata et al, 2020;Sawa et al, 2022).…”

Section: Measurement Of Subjective Postural Vertical Valuesmentioning

confidence: 99%

Recovery process of vertical perception and activities of daily living in stroke patients: A retrospective cohort study

Amimoto

Ishigami³

et al. 2023

Brain and Behavior

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“…2B). [4,21] The SPV-EO and SPV measurements were performed on the left and right sides in a counterbalanced order, using ABBABAAB or BAABABBA sequences. Participants indicated when they perceived themselves as being in a true vertical position, and the tilt of the VB was recorded using a digital inclinometer.…”

Section: Methodsmentioning

confidence: 99%

“…Our results showed that sitting balance training improved variability by enhancing verticality cognition and the ability to perform activities of daily living, as supported by longitudinal studies. [4,5] However, the mechanism by which sitting balance training affects sitting pressure has not yet been clarified. On the other hand, recent reviews have revealed that various sensory and higher brain functions contribute to the vertical perception in balance components.…”

Section: Introductionmentioning

confidence: 99%

Effects of sitting balance training with a wedge on sitting pressure and verticality in young adults: A randomized crossover trial

Ishigami²,

Miyamoto³

et al. 2023

Medicine

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Background: In sensory-motor rehabilitation, sitting-balance training using a wedge may enable optimal postural control. The efficacy and mechanism of achieving lateral adaptation to the sitting pressure and postural vertical are unclear. Methods: We included 20 healthy participants in a single-blind, randomized crossover trial conducted over 1 day. Sitting pressure was measured while the postural vertical was assessed. The initial training required maximally and laterally inclining the trunk to the left or right, with or without a wedge, 60 times in 2 minutes (0.25 Hz). A repeated-measures 2-way analysis of variance with Bonferroni post hoc analysis was used, and a P value < .05 considered statistically significant. Results: After wedge-adaptation training, the pressure on the weight-bearing surface in the postural vertical position increased only on the left side (P < .05). The directional and variability errors of the subjective postural vertical with eyes open and subjective postural vertical were within the range of normative values on verticality. Conclusion: Wedge-adaptation during sitting training affected sitting pressure and verticality. Therefore, there is potential for future rehabilitation interventions using sitting training with a wedge in individuals with balance disorders.

Section: Measurement Of Spvmentioning

confidence: 99%

Recovery process of vertical perception and activities of daily living in stroke: A retrospective cohort study

Amimoto

Ishigami³

et al. 2022

Preprint

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It is important to clarify the recovery process of the subjective postural vertical (SPV) and activities of daily living (ADL) in stroke to help clinicians determine treatment plans. This study aimed to investigate the characteristics of the longitudinal recovery process of SPV and ADL after stroke. In total, 109 patients with stroke were enrolled in the study. Clinical assessments included the SPV and total functional independence measure (FIM), both initially and after 1 month. The SPV mean and standard deviation values indicated the directional and variability errors, respectively. The participants were categorized as follows: group A had directional and variability errors within the standard values, group B had directional errors within the standard value range and variability errors greater than the standard values, and group C had directional and variability errors greater than the standard values. A two-way analysis of variance was performed for SPV and FIM scores (p < 0.05). Groups B and C had larger SPV variability errors than group A. Furthermore, group B showed a significant improvement in variability errors after 1 month. We found that the recovery of SPV variability might be an important predictor of ADL recovery.