title: Motor strategies of postural control after hemispheric stroke.
abstract: After stroke, the causes of balance disorders include motor disorders, sensory loss, perceptual deficits and altered spatial cognition. This review focuses on motor strategies for postural control after stroke. Weight-bearing asymmetry, smaller surface of stability, increased sway, body tilting and sometimes pushing syndrome are observed. Weakness and sensory impairments account only for some of these disturbances; altered postural reactions and anticipated postural adjustments as well as abnormal synergistic muscular activation play an important part. These disorders are often linked to cognitive impairments (visuospatial analysis, perception of verticality, use of sensory information, attention, etc.), which explain the preeminent disorders of postural control seen with right rather than left-hemisphere lesions. Most of the motor changes are due to an impaired central nervous system but some could be considered adaptive behaviors. These changes have consequences for rehabilitation and need further studies for building customized programs based on the motor comportment of a given patient.
authors.affiliation: Service de médecine physique et de réadaptation, université Picardie-Jules-Verne, CHU d'Amiens, avenue René-Laënnec, Salouel, 80054 Amiens cedex 1, France. Electronic address: stasseel@gmail.com.
authors.forename: S
authors.initials: S
authors.lastname: Tasseel-Ponche
authors.affiliation: Service de médecine physique et de réadaptation, université Paris-Diderot, groupe hospitalier Saint-Louis-Lariboisière-F. Widal, AP-HP, 200, rue du Faubourg-Saint-Denis, 75010 Paris, France; COGNAC G (COGNition and Action Group), université Paris-Descartes, CNRS, UMR 8257, 45, rue des Saints-Pères, 75270 Paris cedex 06, France.
authors.forename: A P
authors.initials: AP
authors.lastname: Yelnik
authors.affiliation: Service de médecine physique et de réadaptation, université de Rennes 1, 2, rue Henri-Le-Guilloux, 35000 Rennes, France.
authors.forename: I V
authors.initials: IV
authors.lastname: Bonan
mesh_terms: D006429:Hemiplegia / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D004856:Postural Balance; D011187:Posture; D012678:Sensation Disorders / Q000209:etiology / Q000503:physiopathology*; D020521:Stroke / Q000150:complications* / Q000503:physiopathology*; D016474:Weight-Bearing
keywords: AVC; Adaptation; Balance; Debout; Posture; Rehabilitation; Rééducation; Standing; Strategies; Stratégies; Stroke; Équilibre