Is Visuospatial Hemineglect Longitudinally Associated with Postural Imbalance in the Postacute Phase of Stroke?

Nes, Ilse J. W. van; Kessel, Marlies E. van; Schils, F.; Fasotti, Luciano; Geurts, Alexander C. H.; Kwakkel, Gert

doi:10.1177/1545968309336148

Cited by 25 publications

(21 citation statements)

References 42 publications

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“…Neglect is primarily associated with the right hemisphere and there is a wealth of evidence also demonstrating the dominance of the right hemisphere for control of balance and posture (Bohannon, Smith, & Larkin, 1986;Malhotra, Coulthard, & Husain, 2006;Perennou, 2006;Punt & Riddoch, 2002;Spinazzola, Cubelli, & Della, 2003;Taylor, Ashburn, & Ward, 1994). A longitudinal association between neglect and poor postural control during the first three months after stroke has also recently been established, highlighting the apparent importance of the deficit in regaining balance (van Nes et al, 2009).…”

Section: Introductionmentioning

confidence: 95%

Caloric vestibular stimulation and postural control in patients with spatial neglect following stroke

Sturt

Punt

2013

Neuropsychological Rehabilitation

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The impact of spatial neglect remains a substantial challenge to patients undergoing rehabilitation following stroke. Beyond the relatively well-described implications for visuospatial function, neglect is increasingly shown to have a negative impact on the wider aspects of sensori-motor performance with corresponding implications for activities including gait and balance. Caloric vestibular stimulation (CVS) administered to the contralesional ear has previously been shown to improve performance in patients with spatial neglect. Here, in Experiment One, we investigated the effect of CVS on clinical measures of spatial neglect and postural control in three groups of patients following stroke; left brain damaged patients (LBD, n = 6), right brain damaged patients without neglect (RBD-, n = 6), and right brain damaged patients with neglect (RBD+ , n = 6). While post-stimulation scores demonstrated an improvement for participants with spatial neglect, further analysis of postural scores indicated that improvement was selective for asymmetrical activities, with symmetrical activities remaining unchanged. We interpret these results with reference to the related problem of extinction which predicts that activities demanding synchronous bilateral activity (symmetrical activities) would cause greater difficulties for patients with neglect. In Experiment Two, we tested a further six RBD+ patients on the same measures following CVS to the ipsilesional (right) ear. There was no significant improvement in perceptual or postural scores. Our findings are supportive of previous studies that demonstrate improvement in perception and movement for patients with spatial neglect following contralesional CVS and suggest that these improvements may have clinical benefits.

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Section: Introductionmentioning

confidence: 95%

Caloric vestibular stimulation and postural control in patients with spatial neglect following stroke

Sturt

Punt

2013

Neuropsychological Rehabilitation

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“…Previous studies have found that unilateral spatial neglect independently affected trunk balance in stroke patients 6. Other studies also found that unilateral spatial neglect affected trunk balance six to twelve weeks after stroke occurrence 7. In addition, unilateral spatial neglect hampers effects of rehabilitation treatments and slows down functional recovery.…”

Section: Introductionmentioning

confidence: 97%

The Effect of Virtual Reality Training on Unilateral Spatial Neglect in Stroke Patients

et al. 2011

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ObjectiveTo investigate the effect of virtual reality training on unilateral spatial neglect in stroke patients.MethodTwenty-four stroke patients (14 males and 10 females, mean age=64.7) who had unilateral spatial neglect as a result of right hemisphere stroke were recruited. All patients were randomly assigned to either the virtual reality (VR) group (n=12) or the control group (n=12). The VR group received VR training, which stimulated the left side of their bodies. The control group received conventional neglect therapy such as visual scanning training. Both groups received therapy for 30 minutes a day, five days per week for three weeks. Outcome measurements included star cancellation test, line bisection test, Catherine Bergego scale (CBS), and the Korean version of modified Barthel index (K-MBI). These measurements were taken before and after treatment.ResultsThere were no significant differences in the baseline characteristics and initial values between the two groups. The changes in star cancellation test results and CBS in the VR group were significantly higher than those of the control group after treatment. The changes in line bisection test score and the K-MBI in the VR group were not statistically significant.ConclusionThis study suggests that virtual reality training may be a beneficial therapeutic technique on unilateral spatial neglect in stroke patients.

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“…The presence of hemineglect is associated with postural control after stroke [15]. Kerhoff et al [1] pointed out that trunk rotation toward the neglect side reduces neglect manifestation, and head-trunk compensation may improve the patient’s performance in the line bisection test.…”

Section: Discussionmentioning

confidence: 99%

“…Severe impairment of functional activities of daily living (ADLs) has been found in patients with large right hemisphere lesions [3,4]. Patients with hemineglect have been reported to show lower recovery of ADLs [5,6,7,8,9,10], poorer posture control [11,12,13,14,15], greater hemiparesis [16], increased risk of falling [17,18], and worse functional outcome [19] than those without hemineglect. Therefore, it is important for clinicians to identify and analyze the severity of hemineglect in stroke patients and alter the rehabilitation program accordingly to reduce the severity of hemineglect [1,20,21,22] and improve the functional outcome [19,23].…”

Section: Introductionmentioning

confidence: 99%

Relationship between the Head Deviation Angle and Hemineglect in Patients with Right Hemisphere Stroke

Yang

Hsin²,

Liaw³

et al. 2012

Eur Neurol

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Background: Patients with hemineglect have been reported to have abnormal head posture. We attempted to determine the extent to which the angles are correlated with the severity of hemineglect. Methods: In a prospective, single-center, cross-sectional study on 40 patients with single right hemisphere stroke, we evaluated left hemineglect severity using the line bisection and line cancellation tests. Head deviation angles were measured at admission and discharge using a head device containing 3 graduated discs that determined the angles of head deviation in the sagittal, coronal and transverse planes. Results: Head angles in the transverse and coronal planes differed significantly between the left hemineglect and non-hemineglect groups. Scores obtained from the line bisection and line cancellation tests correlated with these angles. Furthermore, improvement in left hemineglect after rehabilitation training corresponded to a reduction in the angles. Conclusion: Stroke patients with hemineglect exhibited significant head deviations in the transverse and coronal planes. Deviation angles correlated with hemineglect test scores.

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Is Visuospatial Hemineglect Longitudinally Associated with Postural Imbalance in the Postacute Phase of Stroke?

Abstract: 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.

Cited by 25 publications

References 42 publications

Caloric vestibular stimulation and postural control in patients with spatial neglect following stroke

Caloric vestibular stimulation and postural control in patients with spatial neglect following stroke

The Effect of Virtual Reality Training on Unilateral Spatial Neglect in Stroke Patients

Relationship between the Head Deviation Angle and Hemineglect in Patients with Right Hemisphere Stroke

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