Impaired Verticality Perception and Postural Balance at 1 Month After Hemispheric Stroke

Abstract

Introduction. In some patients with hemispheric strokes the internal model of verticality is shifted to the opposite side, so patients actively tilt the body axis in the opposite direction from the affected hemisphere. Disturbances of verticality perception are associated with worse functional conditions and slower dynamics of their recovery, with the need for longer rehabilitation treatment, etc. Objective: to investigate the relationships between impaired perception of verticality and indicators of postural balance during the 1st month after hemispheric strokes. Material and methods. There were examined 205 patients with hemispheric strokes that occurred during the last month. The Scale for Contraversive Pushing was used to assess the orientation of the body axis in relation to the force of gravity in the frontal plane. For evaluating of static and dynamic balance we used Berg Balance Scale, Postural Assessment Scale for Stroke, Trunk Impairment Scale, Test Timed Up and Go. Results. Depending on the presence (absence) of verticality perception disorders it had been revealed significant differences in postural balance scales and tests. Severity of verticality perception impairment was associated with significant changes in postural balance: patients with pushing syndrome had reliably worse indicators of postural balance compared to patients with lateropulsion. Moreover, even minimal lateropulsion was associated with significant deterioration of postural balance indicators, compared to normal perception of verticality. In addition, increasing severity of lateropulsion was associated with significant deterioration of postural balance indicators, regardless of spatial hemineglect and hemiparesis severity. Conclusions. 1. Impaired verticality perception in the recovery period of hemispheric strokes was associated with reliable negative changes in postural balance status. 2. Increasing severity of verticality perception disorders corresponded to a reliable deterioration of postural balance indicators.