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Relationships Between Affected-Leg Motor Impairment, Postural Asymmetry, and Impaired Body Sway Control After Unilateral Supratentorial Stroke

Background. The relationships between motor impairment of the affected leg, postural control asymmetry, and impaired body sway control after stroke are not well understood. Objective. To examine the relationship between motor impairment of the affected leg and reduced contribution of this leg to bod...

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Autores principales: Roelofs, Jolanda M. B., van Heugten, Kirsten, de Kam, Digna, Weerdesteyn, Vivian, Geurts, Alexander C. H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6238182/
https://www.ncbi.nlm.nih.gov/pubmed/30411675
http://dx.doi.org/10.1177/1545968318804405
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author Roelofs, Jolanda M. B.
van Heugten, Kirsten
de Kam, Digna
Weerdesteyn, Vivian
Geurts, Alexander C. H.
author_facet Roelofs, Jolanda M. B.
van Heugten, Kirsten
de Kam, Digna
Weerdesteyn, Vivian
Geurts, Alexander C. H.
author_sort Roelofs, Jolanda M. B.
collection PubMed
description Background. The relationships between motor impairment of the affected leg, postural control asymmetry, and impaired body sway control after stroke are not well understood. Objective. To examine the relationship between motor impairment of the affected leg and reduced contribution of this leg to body sway control (ie, dynamic control asymmetry [DCA]) and to determine the relationships between impaired body sway control, DCA, and weight-bearing asymmetry (WBA). Methods. We assessed quiet-standing balance with eyes open in 70 persons with a unilateral supratentorial chronic stroke using 2 force plates. Center-of-pressure (COP) velocity was calculated for both feet together in the anteroposterior (AP) and mediolateral (ML) directions as a measure of body sway control. Bilateral AP COP velocities were used to calculate an index for DCA and weight borne on each side to calculate WBA. Fugl-Meyer assessment of the lower extremity (FMA-LE; range: 0-28) served as a measure of affected-leg motor impairment. Results. All participants with FMA-LE <24 showed pronounced DCA, but this was also true for 21% of those with FMA ⩾24. Higher DCA values were related to more WBA (r(s) = 0.496; P < .001), and less ML sway control (r(s) = 0.268; P = .025). AP sway control was not significantly related to either DCA or WBA. Conclusions. Even clinically well-recovered stroke survivors with (near) maximal FMA-LE scores may show clear postural asymmetry in terms of the relative contribution of the affected leg to body sway control. WBA seems to be an effective compensatory mechanism to optimize the contribution of the less-affected leg to balance, particularly in the AP direction.
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spelling pubmed-62381822018-12-10 Relationships Between Affected-Leg Motor Impairment, Postural Asymmetry, and Impaired Body Sway Control After Unilateral Supratentorial Stroke Roelofs, Jolanda M. B. van Heugten, Kirsten de Kam, Digna Weerdesteyn, Vivian Geurts, Alexander C. H. Neurorehabil Neural Repair Original Research Articles Background. The relationships between motor impairment of the affected leg, postural control asymmetry, and impaired body sway control after stroke are not well understood. Objective. To examine the relationship between motor impairment of the affected leg and reduced contribution of this leg to body sway control (ie, dynamic control asymmetry [DCA]) and to determine the relationships between impaired body sway control, DCA, and weight-bearing asymmetry (WBA). Methods. We assessed quiet-standing balance with eyes open in 70 persons with a unilateral supratentorial chronic stroke using 2 force plates. Center-of-pressure (COP) velocity was calculated for both feet together in the anteroposterior (AP) and mediolateral (ML) directions as a measure of body sway control. Bilateral AP COP velocities were used to calculate an index for DCA and weight borne on each side to calculate WBA. Fugl-Meyer assessment of the lower extremity (FMA-LE; range: 0-28) served as a measure of affected-leg motor impairment. Results. All participants with FMA-LE <24 showed pronounced DCA, but this was also true for 21% of those with FMA ⩾24. Higher DCA values were related to more WBA (r(s) = 0.496; P < .001), and less ML sway control (r(s) = 0.268; P = .025). AP sway control was not significantly related to either DCA or WBA. Conclusions. Even clinically well-recovered stroke survivors with (near) maximal FMA-LE scores may show clear postural asymmetry in terms of the relative contribution of the affected leg to body sway control. WBA seems to be an effective compensatory mechanism to optimize the contribution of the less-affected leg to balance, particularly in the AP direction. SAGE Publications 2018-11-09 2018-11 /pmc/articles/PMC6238182/ /pubmed/30411675 http://dx.doi.org/10.1177/1545968318804405 Text en © The Author(s) 2018 http://www.creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Research Articles
Roelofs, Jolanda M. B.
van Heugten, Kirsten
de Kam, Digna
Weerdesteyn, Vivian
Geurts, Alexander C. H.
Relationships Between Affected-Leg Motor Impairment, Postural Asymmetry, and Impaired Body Sway Control After Unilateral Supratentorial Stroke
title Relationships Between Affected-Leg Motor Impairment, Postural Asymmetry, and Impaired Body Sway Control After Unilateral Supratentorial Stroke
title_full Relationships Between Affected-Leg Motor Impairment, Postural Asymmetry, and Impaired Body Sway Control After Unilateral Supratentorial Stroke
title_fullStr Relationships Between Affected-Leg Motor Impairment, Postural Asymmetry, and Impaired Body Sway Control After Unilateral Supratentorial Stroke
title_full_unstemmed Relationships Between Affected-Leg Motor Impairment, Postural Asymmetry, and Impaired Body Sway Control After Unilateral Supratentorial Stroke
title_short Relationships Between Affected-Leg Motor Impairment, Postural Asymmetry, and Impaired Body Sway Control After Unilateral Supratentorial Stroke
title_sort relationships between affected-leg motor impairment, postural asymmetry, and impaired body sway control after unilateral supratentorial stroke
topic Original Research Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6238182/
https://www.ncbi.nlm.nih.gov/pubmed/30411675
http://dx.doi.org/10.1177/1545968318804405
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