Hemiparesis
Conditions
Keywords
Hemiparetic patients, Stability, Orientation, Postural control, Strategy, Motion
Brief summary
Among the repercussions of hemiparesis following stroke, disturbed stability is responsible for a high risk of falls. Picking up objects from the ground, frequently trained in rehabilitation due to its risk of falling and its frequency in daily life, is a task requiring balance. To date, however, it has been little studied. We suggest that stability conditions the asymmetry adopted by patients. We hypothesise that asymmetric support at the expense of the paretic lower limb provides better stability during an unstable functional task (picking up an object from the ground) compared with the symmetrical support traditionally imposed in rehabilitation. Postural control involves stability (maintaining balance despite constraints) and orientation (posture adopted, such as the distribution of supports). Hemiparetic patients show a lack of stability and, with regard to orientation, an asymmetry in the distribution of body weight to the detriment of the paretic limb. Symmetrisation of weight distribution has been one of the predominant concepts in rehabilitation.
Detailed description
To analyse the stability of hemiparetic stroke patients when picking up an object on the ground in a spontaneous condition compared with a condition of imposed support symmetry. To analyse and compare the stability, spontaneous symmetry and duration of picking up the object in a complex situation (distant target) compared with the near target in stroke patients and healthy subjects. To explore strategy and performance of picking up the object regarding clinical outcomes (falls, sensori-motor impairments, balance..) To compare strategy of patients with right and left stroke.
Interventions
None listed
Sponsors
Assistance Publique - Hôpitaux de Paris
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
All: Male or female ≥ 18 years For patients : * Haemiparesis after a single unilateral hemispheric Stroke. * Stroke ≥ 6 months * Asymmetry of support between the 2 lower limbs (distribution of body weight) in a standing position at the expense of the paretic lower limb \> 10%. * Able to stand alone, without technical aids or equipment, with feet the width of the pelvis * Able to pick up an object from the ground alone (minimum score 3/4 item 9 of the Berg Balance Scale). * Patient informed and having signed a consent form For healthy subjects: \- Similar characteristics (in terms of sex, age range and BMI class) to those of one of the patients already included.
Exclusion criteria
\-
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| stability parameter: the range of the medio-lateral centre of pressure during the object picking up task | at baseline | Two forceplate platforms. 3 trials for each condition |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Ellipse area of the centre of pressure | at baseline | With 95% confidence, in mm², obtained with forceplat plateforms under feet of participants during the object picking up task |
| Range of the centre of pressure | at baseline | Range in antero-posterior plane, in mm, obtained with forceplat plateforms during the object picking up task |
| Percentage of weight bearing | at baseline | Under each lower limb, in %, obtained with forceplat plateforms during the object picking up task |
| Kinematics parameters | at baseline | range of movements of trunk, pelvis and lower limbs (hip, knee, ankle), in degrees, obtained with the optoelectronic system during the object picking up task |
| Questionnaires : Confidence perception and stability perception during the object picking up task | at baseline | On a visual scale 0 (no confidence) to 10 (perfect confidence) |
| Clinical scales - Berg balance scale | at baseline | — |
| Velocity of the centre of pressure | at baseline | Mean velocity and in each place, in mm/s, obtained with forceplat plateforms under feet of participants during the object picking up task. |
| Clinical scales-Modified Ashworth | at baseline | — |
| Clinical scales-Nottingham Sensory Assessment | at baseline | — |
| Clinical scales -Neglect and lateropulsion scale | at baseline | — |
| Cognitive scale : Batterie Rapide d'Efficience Frontale | at baseline | — |
| Activities-Specific Balance Confidence | at baseline | — |
| Functional reach test | at baseline | In cm |
| Clinical scales-Medical Research Council | at baseline | — |
Countries
France
Contacts
Primary ContactCéline Bonnyaud, PhD
Outcome results
None listed