Reliance on visual information after stroke. Part II: effectiveness of a balance rehabilitation program with visual cue deprivation after stroke: a randomized controlled trial

Yelnik, A.; Colle, F.; Michaud, Carole; Normand, Emanuelle; Panigot, Benedicte; Roth, P.; Guichard, J.-P.; Vicaut, Éric

doi:10.1016/j.apmr.2003.06.016

Cited by 144 publications

(81 citation statements)

References 36 publications

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“…As a result, patients with remote consequences of an SCCI stand better with the eyes closed than with them open and an additional visual afferent stream, in particular, during optokinetic stimulation, disturbs their balance because of the formation of so-called sensory conflict. The results of this study are in agreement with data obtained by other researchers that the formation of upright posture during rehabilitation of patients with remote consequences of stroke is more successful under conditions of visual deprivation as compared to visual control [24,25].…”

Section: Discussionsupporting

confidence: 93%

“…A complex approach combining the posturographic (PG) indices and EEG coherence with dynamic scaling of functional possibilities makes it possible to fully assess various aspects of changes in the state of a patient during rehabilitation [8,9,[14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]. The use of various functional loads extends the possibilities of the complex approach and demonstrates the involvement of different analyzers in the recovery process in different periods after the SCCI [6,7].…”

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confidence: 99%

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Role of the Visual Afferent Stream in Recovery of the Postural Control in Different Periods after Craniocerebral Injury

2005

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A comprehensive posturographic (PG), electroencephalographic, and clinical examination was performed during rehabilitation in 17 patients (mean age 27.5 ± 7.4 years) who had suffered a severe craniocerebral injury (SCCI). Of these, nine were examined soon after the SCCI and eight, in the period of remote consequences of the SCCI. The patients were compared to a control group of 18 healthy subjects (mean age 27.8 ± 12.2). The PG studies showed that, in the healthy subjects, the amplitude of sway of the common center of pressure (A CCP ) in the absence of the visual control was higher than with the eyes open. The A CCP was higher in the sagittal than in the frontal plane and decreased during optokinetic stimulation. In the control group, rhythmic photostimulation produced a local increase in interhemispheric EEG coherence in symmetrical occipital and parietal cortical areas. In the patients examined early after the SCCI with the eyes open, the A CCP was higher than in the healthy subjects, especially in the frontal plane. The A CCP did not decrease in the Romberg posture and increased during optokinetic stimulation. In these patients, rhythmic photostimulation was accompanied by a generalized increase in mean interhemispheric EEG coherence as compared to the resting level. In the remote period after the SCCI, the PG and EEG responses to a decrease or an increase in the visual afferent stream proved to be inverted: the patients stood better with the eyes closed than with them open and photostimulation produced a decrease in EEG coherence in the occipitoparietal areas of the cortex. The results confirmed a greater efficiency of rehabilitation in the early period after the SCCI. Thus, specific PG and EEG reactions were observed in the SCCI patients at different stages of recovery. The generalized reactivity and "infantile" features of the EEG and PG rearrangements characteristic of the early period after the SCCI were considered to be a favorable prognostic sign for the recovery of the integrative brain activity and postural control of a patient. The inversion of the reactions in the remote period after the SCCI testified to limited possibilities of the recovery of the impaired functions and was indicative of a pathological type of compensatory rearrangements.

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Section: Discussionsupporting

confidence: 93%

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confidence: 99%

Role of the Visual Afferent Stream in Recovery of the Postural Control in Different Periods after Craniocerebral Injury

2005

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“…Customized gait training programs that incorporate altered sensory input have produced signiWcant gains in the elderly (van Hedel and Dietz 2004;Buccello-Stout et al 2007;Bugnariu and Fung 2007), in stroke patients (Bonan et al 2004b;Bayouk et al 2006) and in children with spastic cerebral palsy (Cherng et al 2007). By extension, we believe that accurately identifying astronauts' unique sensory biases and developing customized preXight and inXight gait training programs for them will oVer enhanced performance beneWts during missions involving planetary ambulation and following their return to Earth.…”

Section: Introductionmentioning

confidence: 96%

Gait adaptability training is affected by visual dependency

et al. 2012

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As part of a larger gait adaptability training study, we designed a program that presented combinations of visual flow and support-surface manipulations to investigate the response of healthy adults to walking on a treadmill in novel discordant sensorimotor conditions. A visual dependence score was determined for each subject, and this score was used to explore how visual dependency was linked to locomotor performance (1) during three training sessions and (2) in a new discordant environment presented at the conclusion of training. Performance measures included reaction time (RT), stride frequency (SF), and heart rate (HR), which respectively served as indicators of cognitive load, postural stability, and anxiety. We hypothesized that training would affect performance measures differently for highly visually dependent individuals than for their less visually dependent counterparts. A seemingly unrelated estimation analysis of RT, SF, and HR revealed a significant omnibus interaction of visual dependency by session (p < 0.001), suggesting that the magnitude of differences in these measures across training day 1 (TD1), training day 3 (TD3), and exposure to a novel test is dependent on subjects' levels of visual dependency. The RT result, in particular, suggested that highly visually dependent subjects successfully trained to one set of sensory discordant conditions but were unable to apply their adapted skills when introduced to a new sensory discordant environment. This finding augments rationale for developing customized gait training programs that are tailored to an individual. It highlights one factor--personal level of visual dependency--to consider when designing training conditions for a subject or patient. Finally, the link between visual dependency and locomotor performance may offer predictive insight regarding which subjects in a normal population will require more training when preparing for specific novel locomotor conditions.

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“…The subjects of the experimental group received task-oriented training with manipulations of sensory inputs and provision of sensory conflict for the trunk and lower limb[Appendix 2].The materials used in TOT training were a Chair,Stopwatch,SwissBall, Exercise Stepper,Cardboard for obstacles, Foams (50cm x 62cm x 8cm),Blindfold Panel made by Cardboard and Visual Conflict Dome. [14][15][16] The total approximate duration of training for both control and experimental groups was approximately 45 -60 minutes. Adequate rest periods were provided for the participants during the session.…”

Section: Methodsmentioning

confidence: 99%

“…The decreased ability to maintain static and dynamic balance in stroke has also been related to the inability in selecting reliable visual, vestibular and somatosensory information in order to produce proper motor action necessary to maintain postural stability and balance.Post stroke patients are known to exhibit excessive reliance on visual input for balance and walking and are unable to use somatosensory and vestibular input correctly. [14][15][16] Hence to address this deficits of sensorimotor integration adaptation of regular physical therapy exercises with the use of vision and surface input manipulations along with sensory conflict conditions to challenge balance has shown to have positive effects on balance recovery. 17 Recent studies have shown that exercise interventions in the form of task oriented exercises which are intended to reinforce the relationship between training and functional performance, such as exercises in sitting, standing, walking and stair climbing as a strategy to improve balance and functional mobility in stroke patients.…”

Section: Introductionmentioning

confidence: 99%

Effects of Task Oriented Exercises with Altered Sensory Input on Balance and Functional Mobility in Chronic Stroke: A Pilot Randomized Controlled Trial

Kuberan

Joshua

et al. 2017

Bangladesh J Med Sci

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Background: Stroke subjects presented with greater postural instability which lead to challenge their balance control in sensory conflict conditions. Studies have shown that deficits of sensorimotor integration and an inability to select the appropriate sensory input are associated with balance measures following stroke.However, limited studies have been focused to sensorimotor integration in balance rehabilitation. Objective: Our study aimed to evaluate the Task Oriented Training (TOT) with sensory manipulation to enhance balance and functional mobility in chronic stroke subjects. Design: Randomized controlled pilot study. Setting: Department of Physiotherapy in a Tertiary care Hospital. Subjects: A convenience sample consisting of 26 hemi paretic subjects at least 6 months post stroke duration with Brunnstrom's recovery stage ≥5 for the lower limb and Berg Balance Score of 40 or above were randomly assigned control group (n=13) and in experimental group (n=13). Interventions: Control group received the conventional physical therapy and in the Experimental group received TOT with manipulations of sensory inputs and provision of sensory conflict for the trunk and lower limb focusing on balance and mobility were implemented for 15 sessions, 5 days a week for 3 weeks with each session of 45-60 mints duration. Outcome measures: Dynamic Gait Index (DGI), Timed Up and Go Test (TUGT) and Fall Efficacy Scale (FES) were analyzed before and after the training. Results: Post training there was a significant improvement in all the outcome measurements for both the groups. However components 3, 4 and 5 of DGI, TUGT and FES of experimental group had a highly significant statistical difference between-group analysis with p<.05. Conclusion:Task oriented exercises with altered sensory input was found to be effective in improving functional mobility in terms of dynamic balance and reduction in their fear of fall levels after a 3 week training program.

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Reliance on visual information after stroke. Part II: effectiveness of a balance rehabilitation program with visual cue deprivation after stroke: a randomized controlled trial

Cited by 144 publications

References 36 publications

Role of the Visual Afferent Stream in Recovery of the Postural Control in Different Periods after Craniocerebral Injury

Role of the Visual Afferent Stream in Recovery of the Postural Control in Different Periods after Craniocerebral Injury

Gait adaptability training is affected by visual dependency

Effects of Task Oriented Exercises with Altered Sensory Input on Balance and Functional Mobility in Chronic Stroke: A Pilot Randomized Controlled Trial

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