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Evolution of sensory reweighting after stroke

Abstract : Objectives.– Continuous re-weighting of sensory information is required for a flexible control of upright stance. We recently showed that patients after recent stroke may be highly dependent on visual, proprioceptive and/or vestibular information [1]. The aim of this study was to describe the evolution of these sensory comportments. Methods.– Thirty subjects with a first and unique hemispheric stroke (age = 54.7 ± 10.6, 21 men, right lesion = 13) and 20 control subjects (age = 50.0 ± 17.1, 11 men) were studied. Postural control while standing at rest was probed with successively tendon vibration, visual optokinetic and vestibular galvanic stimulations. Patients were investigated mean 2 months after stroke, using a force platform (Technoconcept®). Patients as controls were retested 1 month later. Analysis was conducted from composite scores for each sensory stimulation as the mean of the absolute value of the displacement of the centre of pression in the different directions. Results.– Both control and stroke patients showed large inter-individual variations. Patients were globally more sensitive than controls (mean global score = 49.4, SD 18.9 versus 36.5, SD 12.8, P = 0.01). They were excessively reliant on visual information (P = 0.01) and to vestibular stimulation (P = 0.05). While the scores were reproducible at one month in controls, patients displayed different kinds of evolution, sensory dependence remaining in most of them, but decreasing for some even increasing for a few. Implication in rehabilitation: Post stroke comportment regarding sensory reweighting is a complex and evolutive behavior. Better knowledge is needed to build personalized rehabilitation programmes
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Submitted on : Wednesday, January 20, 2016 - 1:10:14 PM
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Isabelle Bonan. Evolution of sensory reweighting after stroke. Annals of Physical and Rehabilitation Medicine, Elsevier Masson, 2013, 28e Congrès de Médecine Physique et de Réadaptation, Reims, 17, 18 et 19 octobre 2013, 56, Supplement 1, pp.e44. ⟨10.1016/j.rehab.2013.07.013⟩. ⟨hal-01259399⟩

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