The association between visuospatial neglect and balance and mobility post-stroke onset: A systematic review

Embrechts, Elissa; Criekinge, Tamaya Van; Schröder, Jonas; Nijboer, Tanja C.W.; Lafosse, Christophe; Truijen, Steven; Saeys, Wim

doi:10.1016/j.rehab.2020.10.003

Cited by 19 publications

(20 citation statements)

References 71 publications

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“…Compared with the non‐VSN group, patients with VSN more frequently used a wheelchair and were more often dependent on the examiner for moving through the corridors. This is in line with previous research: stroke patients with lower levels of mobility are more severely affected, which is related to the presence and severity of VSN (Embrechts et al., 2021; Oh‐Park et al., 2014; Spreij et al., 2020). Since the MAC is a task in which participants are moving, a reduced level of mobility could potentially affect performance in two different ways.…”

Section: Discussionsupporting

confidence: 92%

“…Controlling for performance at conventional 6 impairments. Typically, patients with VSN are more severely affected in the motor domain compared to patients without VSN (Embrechts et al, 2020;Oh-Park, Hung, Chen, & Barrett, 2014;Spreij et al 2020). If we would find a relation between the level of mobility and performance on the MAC, this could simply reflect the known relation between motor impairments and VSN.…”

Section: Introductionmentioning

confidence: 99%

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The mobility assessment course: A ready‐to‐use dynamic measure of visuospatial neglect

Nelemans

Nijboer

Brink

2022

Journal of Neuropsychology

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The Mobility Assessment Course (MAC) is a tool to measure visuospatial neglect in a dynamic fashion. Although the MAC has been shown to dissociate between patients with and without neglect, it remains unclear whether it is applicable in clinical settings. We evaluated the MAC regarding its (1) feasibility as a diagnostic tool as part of standard care, (2) construct validity, and (3) underlying constructs and potential confounders. A consecutive sample of stroke patients admitted to inpatient rehabilitation completed the MAC, shape cancellation, line bisection, and/or Catherine Bergego Scale (CBS) as part of the standard assessment. To assess feasibility, we computed the percentage of patients who completed the MAC. Construct validity was tested by evaluating MAC performance between patients with and without neglect and controls. Finally, a regression analysis was conducted to assess underlying constructs and potential confounders of MAC performance (i.e., level of mobility and lesion side). The MAC was completed by 82% of patients (N = 182/223; of whom 145 completed all tasks). Patients with neglect performed worse on the MAC (indicating more severe neglect) compared to patients without neglect and controls. The MAC had a lower sensitivity and higher specificity than paper‐and‐pencil tasks and the CBS. Performance on shape cancellation, line bisection, and CBS were predictors of MAC performance. Level of mobility and lesion side did not predict MAC scores, indicating that these factors do not confound its reliability. To conclude, the MAC is an easy‐to‐implement tool to evaluate neglect in a dynamic manner, which can be administered in addition to conventional paper‐and‐pencil tasks.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

The mobility assessment course: A ready‐to‐use dynamic measure of visuospatial neglect

Nelemans

Nijboer

Brink

2022

Journal of Neuropsychology

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“…Control of balance in the mediolateral direction is critical ( 52 , 172 ) and is often impaired in older adults and when the asymmetry of stance is present, like for instance in stroke patients ( 173 , 174 ). There were considerable differences in the mean level of the spectrum of all the frequency windows between ML and AP directions, and the overall pattern of the effects of touch and vision were distinct along the frontal and sagittal planes and both on foam and solid BoS (compare Figures 8 , 12 ).…”

Section: Discussionmentioning

confidence: 99%

Specific Posture-Stabilising Effects of Vision and Touch Are Revealed by Distinct Changes of Body Oscillation Frequencies

2021

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We addressed postural instability during stance with eyes closed (EC) on a compliant surface in healthy young people. Spectral analysis of the centre of foot pressure oscillations was used to identify the effects of haptic information (light-touch, EC-LT), or vision (eyes open, EO), or both (EO-LT). Spectral median frequency was strongly reduced by EO and EO-LT, while spectral amplitude was reduced by all “stabilising” sensory conditions. Reduction in spectrum level by EO mainly appeared in the high-frequency range. Reduction by LT was much larger than that induced by the vision in the low-frequency range, less so in the high-frequency range. Touch and vision together produced a fall in spectral amplitude across all windows, more so in anteroposterior (AP) direction. Lowermost frequencies contributed poorly to geometric measures (sway path and area) for all sensory conditions. The same subjects participated in control experiments on a solid base of support. Median frequency and amplitude of the spectrum and geometric measures were largely smaller when standing on solid than on foam base but poorly affected by the sensory conditions. Frequency analysis but not geometric measures allowed to disclose unique tuning of the postural control mode by haptic and visual information. During standing on foam, the vision did not reduce low-frequency oscillations, while touch diminished the entire spectrum, except for the medium-high frequencies, as if sway reduction by touch would rely on rapid balance corrections. The combination of frequency analysis with sensory conditions is a promising approach to explore altered postural mechanisms and prospective interventions in subjects with central or peripheral nervous system disorders.

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“…Visuospatial neglect causes poor hemispatial awareness and midline orientation. 55 The influence of visuospatial neglect on postural control can affect a patient's ability to weight shift during gait, reducing the ability to step with the paretic leg, and increasing the load on the paretic leg during stance phase. 55 Visuospatial neglect also presents a safety issue when maneuvering around obstacles, likely leading to a longer period of supervision than a person without visuospatial neglect might need.…”

Section: Discussionmentioning

confidence: 99%

“…55 The influence of visuospatial neglect on postural control can affect a patient's ability to weight shift during gait, reducing the ability to step with the paretic leg, and increasing the load on the paretic leg during stance phase. 55 Visuospatial neglect also presents a safety issue when maneuvering around obstacles, likely leading to a longer period of supervision than a person without visuospatial neglect might need. Most patients recover fully from visuospatial neglect within 6 months 57 ; thus, visuospatial neglect is more likely to have an influence on earlier recovery timepoints than later.…”

Section: Discussionmentioning

confidence: 99%

The TWIST Tool Predicts When Patients Will Recover Independent Walking After Stroke: An Observational Study

Smith

Barber

Scrivener

et al. 2022

Neurorehabil Neural Repair

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Background The likelihood of regaining independent walking after stroke influences rehabilitation and hospital discharge planning. Objective This study aimed to develop and internally validate a tool to predict whether and when a patient will walk independently in the first 6 months post-stroke. Methods Adults with stroke were recruited if they had new lower limb weakness and were unable to walk independently. Clinical assessments were completed one week post-stroke. The primary outcome was time post-stroke by which independent walking (Functional Ambulation Category score ≥ 4) was achieved. Cox hazard regression identified predictors for achieving independent walking by 4, 6, 9, 16, or 26 weeks post-stroke. The cut-off and weighting for each predictor was determined using β-coefficients. Predictors were assigned a score and summed for a final TWIST score. The probability of achieving independent walking at each time point for each TWIST score was calculated. Results We included 93 participants (36 women, median age 71 years). Age < 80 years, knee extension strength Medical Research Council grade ≥ 3/5, and Berg Balance Test < 6, 6 to 15, or ≥ 16/56, predicted independent walking and were combined to form the TWIST prediction tool. The TWIST prediction tool was at least 83% accurate for all time points. Conclusions The TWIST tool combines routine bedside tests at one week post-stroke to accurately predict the probability of an individual patient achieving independent walking by 4, 6, 9, 16, or 26 weeks post-stroke. If externally validated, the TWIST prediction tool may benefit patients and clinicians by informing rehabilitation decisions and discharge planning.

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The association between visuospatial neglect and balance and mobility post-stroke onset: A systematic review

Cited by 19 publications

References 71 publications

The mobility assessment course: A ready‐to‐use dynamic measure of visuospatial neglect

The mobility assessment course: A ready‐to‐use dynamic measure of visuospatial neglect

Specific Posture-Stabilising Effects of Vision and Touch Are Revealed by Distinct Changes of Body Oscillation Frequencies

The TWIST Tool Predicts When Patients Will Recover Independent Walking After Stroke: An Observational Study

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