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Master Thesis

Contributions and determinants of posturography indices to understand the standing posture after stroke

Abstract : Objective. (1) To determine the posturographic indices needed to explain the standing behavior after a subacute stroke. (2) To analyze their clinical determinants and (3) their role in balance and gait disorders in daily life. Methods. Cohort study of 95 patients consecutively admitted to rehabilitation after a first hemispheric stroke. Position and instability posturographic indices were measured in medio-lateral (ML) and antero-posterior (AP) axes. Functional abilities were also assessed. Deficits were quantified at Day 30 or Day 60 post-stroke. Statistics comprised factorial analysis of principal component and, uni-and multivariate analyses. Results. One instability index and both position indices on each axis, with or without vision, were required to describe the post-stroke postural control. Instability was the first component and contained nearly half of the posturographic information. The primary indices were independently determined by spatial neglect (p=0.002) and motor weakness (p=0.005). These deficits explained ML instability (p<0.001 and p=0.002, respectively) as well as AP instability (<10-4) and weight bearing asymmetry (WBA) (p<0.001), respectively. Balance and gait disorders were partly explained by ML instability (p<10-5 and p<10-7, respectively) and WBA (p<10-5 and p<10-4, respectively). Conclusion. Stroke rehabilitation care must not only target the WBA. Instability and WBA, determined by spatial neglect and motor weakness, are both independently involved in standing posture and in balance and gait disorders after stroke. Lateropulsion should also be considered.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03266184
Contributor : Jean-Hugues Morneau <>
Submitted on : Wednesday, June 30, 2021 - 2:09:46 PM
Last modification on : Friday, July 2, 2021 - 3:27:58 AM

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Adèle Chauvin. Contributions and determinants of posturography indices to understand the standing posture after stroke. Human health and pathology. 2020. ⟨dumas-03266184⟩

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