Tasseel-Ponche Sophie, Le Liepvre Hélène, Colle Florence, Andriantsifanetra Cédric, Vidal Pierre-Paul, Bonan Isabelle Véronique, Yelnik Alain-Pierre
PRM Department, GH St-Louis Lariboisière F. Widal AP-HP, Paris Diderot University, 200 Rue Fbg Saint Denis, 75010 Paris Cedex 10, France; PRM Departement, CHU Amiens-Picardie, UPJV CURS LNFP EA 4559, avennue Laennec 80000 Amiens Cedex 1, France.
PRM Department, GH St-Louis Lariboisière F. Widal AP-HP, Paris Diderot University, 200 Rue Fbg Saint Denis, 75010 Paris Cedex 10, France.
Gait Posture. 2017 Oct;58:171-175. doi: 10.1016/j.gaitpost.2017.07.036. Epub 2017 Jul 22.
Balance rehabilitation should consider individual comportments according to visual input (VI). Indeed, visual dependence (VD), defined as the predominance given to the VI whatever the circumstances, frequent after stroke it could disturb balance. Because the term VD is a bit restrictive and cannot be deduced from clinical tests, the term visual sensitivity (VS) is preferred here.
VI could have different influence depending on the task for a given individual.
We retrospectively compared 2 VS tests routinely used: the rod and frame test (RFT) and optokinetic stimulation (OKS). In RFT, VS was defined by a misperception of the visual verticality induced by a tilted frame (VS RFT) and in OKS by tilted sitting posture induced by rotational OKS (VS OKS). We studied the relations between VS RFT and VS OKS.
We analysed data for 84 patients, mean age 55±10years, 45±30days after stroke. Scores for both tests were correlated with autonomy measured by the functional independence measure (r=-0.3, p=0.01 and r=-0.2, p=0.02). VS OKS score was also correlated with balance measured by the postural assessment scale for stroke (r=-0.3, p=0.03). VS RFT score was not correlated with VS OKS score (p=0.4, r=0.04).
DISCUSSION - CONCLUSION: A patient may display VS for one test without sensitivity for the other because these tests investigate different neural organisation - perception for RFT or action for OKS. Their relation to balance disorders should be further investigated to build individualized rehabilitation programs.
平衡康复应根据视觉输入（VI）考虑个体行为。事实上，视觉依赖（VD）被定义为无论何种情况都优先给予视觉输入，中风后常见，它可能会干扰平衡。由于术语VD有点局限且无法从临床测试中推断出来，这里更倾向使用术语视觉敏感性（VS）。
对于给定个体，视觉输入可能因任务不同而产生不同影响。
我们回顾性比较了两种常规使用的视觉敏感性测试：杆框测试（RFT）和视动刺激（OKS）。在RFT中，视觉敏感性由倾斜框架引起的视觉垂直方向误判来定义（VS RFT），在OKS中由旋转视动刺激引起的倾斜坐姿来定义（VS OKS）。我们研究了VS RFT和VS OKS之间的关系。
我们分析了84例患者的数据，平均年龄55±10岁，中风后45±30天。两种测试的分数均与功能独立性测量所衡量的自主性相关（r = -0.3，p = 0.01和r = -0.2, p =
0.02）。VS OKS分数也与中风姿势评估量表所衡量的平衡相关（r = -0.3，p = 0.03）。VS RFT分数与VS OKS分数不相关（p = 0.4，r = 0.04）。
讨论 - 结论：患者可能对一种测试表现出视觉敏感性而对另一种测试不敏感，因为这些测试研究不同神经网络组织——RFT的感知或OKS的行动。它们与平衡障碍的关系应进一步研究，以制定个性化康复方案。
