Determinants of Balance Recovery After Stroke - Retrospective Study

Study Overview
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Brief Summary
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Retrospective cohort study of consecutive patients investigated in a neurorehabilitation ward after a first hemispheric stroke. Postural and gait disorders in relation to referential of verticality have been analyzed in routine care.

Detailed Description
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300 consecutive patients, admitted in our department for neurorehabilitation after a first hemispherical stroke, have been enrolled retrospectively. During their hospitalisation, all patients have been routinely evaluated with clinical scales, evaluating motor and cognitive deficits. Postural and visual vertical (VV) assessments have been performed 1 to 4 times during in-patient-stay. The objective was to analyse the determinants of balance recovery after stroke, in particular the impact of wrong referential of verticality. Data collection was performed by means of medical records. Observation period covered from january 2012 to february 2018.

Official Title
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Determinants of Balance Recovery After Stroke

Conditions
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Stroke

Intervention / Treatment
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* Behavioral: Postural Assessment Scale for Stroke (PASS)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: first hemispheric stroke patient non-opposed to inclusion Exclusion Criteria: history of neurological disorders interfering with balance history of vestibularly disorders interfering with balance unstable medical conditions history of cognitive disorders

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Behavioral: Postural Assessment Scale for Stroke (PASS)|Postural Assessment Scale for Stroke (PASS)|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Posture | Change from Baseline Score of Postural Assessment Scale for Stroke (PASS) at discharge | admission and monthly, up to 3 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Balance | Assessment of Balance and Posture with SCP (Scale for Contraversive Pushing) | admission and monthly, up to 3 months | 
| Gait | Assessment of Gait with Lindmark test | admission and monthly, up to 3 months | 
| Postural disorders | Assessment of Postural control with CDP (Computerized posturography) | admission and monthly, up to 3 months | 
| Visual vertical perception | Assessment of the visual vertical (vv). Subject indicates which direction a visual line displayed on a computer screen (in darkness) is perceived as vertical in the roll plane. | admission and monthly, up to 3 months | 
| Postural vertical perception | Assessment of the postural vertical (pv). Subject is seated in a specific device (CE-marked) in darkness, and indicates which direction of her/his whole body is perceived as vertical in the roll plane. | admission and monthly, up to 3 months | 
| Walking distance | Assessment of walking distance with the 6-minute-walking-test (6-MWT) | admission and monthly, up to 3 months | 
| Gait velocity | Assessment of gait velocity at self-prefered-velocity on 10 meters | admission and monthly, up to 3 months | 
| Pressure sensitivity (Hand and foot) | Assessment of hypoesthesia with Semmes-Weinstein monofilaments test | admission and monthly, up to 3 months | 
| Spasticity | Assessment of Spasticity with Ashworth Scale | admission and monthly, up to 3 months | 
| Laterality | Assessment of Laterality with Edinburgh Handedness Inventory | admission and monthly, up to 3 months | 
| Disability | Assessment of Autonomy with FIM (Functional Independence Measure) | admission and monthly, up to 3 months | 
| Neuropsychological Assessment 1 | Assessment of Hemispatial Neglect with the Catherine Bergego Scale (CBS) | admission and monthly, up to 3 months | 
| Neuropsychological Assessment 2 | Assessment of Hemispatial Neglect with the fluff Test | admission and monthly, up to 3 months | 
| Neuropsychological Assessment 3 | Assessment of Hemispatial Neglect using 'thumb localizing test' (TLT) | admission and monthly, up to 3 months | 
| Neuropsychological Assessment 4 | Assessment of Hemispatial Neglect with the 'Comb and Razor Test' | admission and monthly, up to 3 months | 
| Neuropsychological Assessment 5 | Assessment of Hemispatial Neglect with the BEN ( Battery of tests for the quantitative assessment of unilateral neglect) | admission and monthly, up to 3 months | 
| Neuropsychological Assessment 6 | Assessment of Apraxia with ATS (Apraxia Screen of TULIA) | admission and monthly, up to 3 months | 
| Neuropsychological Assessment 7 | Assessment of Language with LAST (Language Screening Test) | admission and monthly, up to 3 months | 
| Neuropsychological Assessment 8 | Assessment of Aphasia with BDAE (Boston Diagnostic Aphasia Examination) | admission and monthly, up to 3 months | 
| Neuropsychological Assessment 10 | Assessment of depression with ADRS (Aphasia Depression Rating Scale) | admission and monthly, up to 3 months | 
| Falls | Monitoring of falls occuring during the hospitalization | at discharge, the number of falls is totalized | 
| Visual field defect (hemianopia/quadranopia) | standardized clinical examination | admission and monthly, up to 3 months | 
| Identification of brain structures involved in the stroke | anatomical MRI | once, at 2 month | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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lateropulsion, pusher syndrome, posture, balance, PASS, verticality perception, gait