title: Is perception of vertical impaired in individuals with chronic stroke with a history of 'pushing'?
abstract: Post-stroke 'pushing' behaviour appears to be caused by impaired perception of vertical in the roll plane. While pushing behaviour typically resolves with stroke recovery, it is not known if misperception of vertical persists. The purpose of this study was to determine if perception of vertical is impaired amongst stroke survivors with a history of pushing behaviour. Fourteen individuals with chronic stroke (7 with history of pushing) and 10 age-matched healthy controls participated. Participants sat upright on a chair surrounded by a curved projection screen in a laboratory mounted on a motion base. Subjective visual vertical (SVV) was assessed using a 30 trial, forced-choice protocol. For each trial participants viewed a line projected on the screen and indicated if the line was tilted to the right or the left. For the subjective postural vertical (SPV), participants wore a blindfold and the motion base was tilted to the left or right by 10-20°. Participants were asked to adjust the angular movements of the motion base until they felt upright. SPV was not different between groups. SVV was significantly more biased towards the contralesional side for participants with history of pushing (-3.6 ± 4.1°) than those without (-0.1 ± 1.4°). Two individuals with history of pushing had SVV or SPV outside the maximum for healthy controls. Impaired vertical perception may persist in some individuals with prior post-stroke pushing, despite resolution of pushing behaviours, which could have consequences for functional mobility and falls.
authors: Toronto Rehabilitation Institute - University Health Network, Toronto, ON, Canada; Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Sunnybrook Health Science Centre, Toronto, ON, Canada. Electronic address: avril.mansfield@uhn.ca.
authors: Avril
authors: A
authors: Mansfield
authors: Toronto Rehabilitation Institute - University Health Network, Toronto, ON, Canada; Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Toronto, ON, Canada; York University, Toronto, ON, Canada.
authors: Lindsey
authors: L
authors: Fraser
authors: Toronto Rehabilitation Institute - University Health Network, Toronto, ON, Canada; Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Toronto, ON, Canada; University of Waterloo, Waterloo, ON, Canada.
authors: Roshanth
authors: R
authors: Rajachandrakumar
authors: Toronto Rehabilitation Institute - University Health Network, Toronto, ON, Canada; Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; Sunnybrook Health Science Centre, Toronto, ON, Canada.
authors: Cynthia J
authors: CJ
authors: Danells
authors: Toronto Rehabilitation Institute - University Health Network, Toronto, ON, Canada.
authors: Svetlana
authors: S
authors: Knorr
authors: Toronto Rehabilitation Institute - University Health Network, Toronto, ON, Canada; Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Toronto, ON, Canada; University of Toronto, Toronto, ON, Canada; York University, Toronto, ON, Canada.
authors: Jennifer
authors: J
authors: Campos
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010468:Perceptual Disorders / Q000523:psychology*; D011434:Proprioception; D020521:Stroke / Q000523:psychology*; D014796:Visual Perception
keywords: BBS; Berg Balance Scale; HP; NIH-SS; National Institutes of Health Stroke Scale; Perception; Posture; Rehabilitation; SCP; SNAP; SPV; SVV; Scale for Contraversive Pushing; Stroke; Sunnybrook Neglect Assessment Procedure; Vision; history of pushing (group); no history of pushing (group); subjective postural vertical; subjective visual vertical