Bonan Isabelle V, Guettard Emilie, Leman Marie C, Colle Florence M, Yelnik Alain P
Department of Physical Medicine and Rehabilitation, Groupe Hospitalier Lariboisiere-F. Widal, Paris, France.
Arch Phys Med Rehabil. 2006 May;87(5):642-6. doi: 10.1016/j.apmr.2006.01.019.
To determine whether misperception of the subjective visual vertical (SVV) underlies balance difficulties in hemiplegic patients.
Descriptive study, using a convenience sample.
Department of physical medicine of a university hospital.
Thirty inpatients with hemiplegia after a hemispheric stroke during the 3 previous months.
Not applicable.
The SVV was tested while subjects sat in a dark room and were asked to adjust a luminous line to the vertical position. Mean SVV deviation and uncertainty, defined as the standard deviation, were calculated for 8 trials. Balance was assessed by the Postural Assessment Scale for Stroke (PASS) and while patients sat on a laterally rocking platform placed on a Satel force platform. The mean body position and the instability score (Lx), calculated as the length of the course of the center of pressure, were recorded. Functional outcome was also evaluated by the FIM instrument.
An abnormal SVV was recorded for 20 of 30 patients. Balance (ie, PASS, Lx) and FIM correlated significantly with SVV tilt (P<.001, P=.01, and P<.001, respectively) and with uncertainty (PASS, P=.006; FIM, P=.003).
Verticality misperception was related to poor balance and might be an important element in the assessment of contributing factors to balance disorders after stroke. It should probably be taken into account when establishing balance rehabilitation programs for patients with hemiplegia.
确定主观视觉垂直（SVV）的感知错误是否是偏瘫患者平衡障碍的潜在原因。
描述性研究，采用便利抽样。
大学医院物理医学科。
前3个月内发生半球性卒中后偏瘫的30名住院患者。
不适用。
让受试者坐在暗室中，要求他们将一条发光线调整到垂直位置，测试SVV。计算8次试验的平均SVV偏差和不确定性（定义为标准差）。通过卒中姿势评估量表（PASS）评估平衡，同时让患者坐在置于Satel力平台上的侧向摇摆平台上。记录平均身体位置和不稳定评分（Lx），Lx通过压力中心轨迹长度计算得出。还通过FIM工具评估功能结局。
30例患者中有20例记录到SVV异常。平衡（即PASS、Lx）和FIM与SVV倾斜度（分别为P<0.001、P=0.01和P<0.001）以及不确定性显著相关（PASS，P=0.006；FIM，P=0.003）。
垂直感知错误与平衡能力差有关，可能是评估卒中后平衡障碍影响因素的一个重要因素。在为偏瘫患者制定平衡康复计划时可能应予以考虑。
