Upright standing after stroke: How loading-unloading mechanism participates to the postural stabilization.
Identifieur interne : 000288 ( Main/Curation ); précédent : 000287; suivant : 000289Upright standing after stroke: How loading-unloading mechanism participates to the postural stabilization.
Auteurs : Patrice R. Rougier [France] ; Dominic Pérennou [France]Source :
- Human movement science [ 1872-7646 ] ; 2019.
Descripteurs français
- KwdFr :
- Accident vasculaire cérébral (physiopathologie), Adulte (MeSH), Adulte d'âge moyen (MeSH), Articulation talocrurale (physiopathologie), Femelle (MeSH), Humains (MeSH), Mouvement (physiologie), Mâle (MeSH), Poids (physiologie), Position debout (MeSH), Pression (MeSH), Réadaptation après un accident vasculaire cérébral (méthodes), Sujet âgé (MeSH), Équilibre postural (physiologie), Études cas-témoins (MeSH).
- MESH :
- méthodes : Réadaptation après un accident vasculaire cérébral.
- physiologie : Mouvement, Poids, Équilibre postural.
- physiopathologie : Accident vasculaire cérébral, Articulation talocrurale.
- Adulte, Adulte d'âge moyen, Femelle, Humains, Mâle, Position debout, Pression, Sujet âgé, Études cas-témoins.
English descriptors
- KwdEn :
- Adult (MeSH), Aged (MeSH), Ankle Joint (physiopathology), Body Weight (physiology), Case-Control Studies (MeSH), Female (MeSH), Humans (MeSH), Male (MeSH), Middle Aged (MeSH), Movement (physiology), Postural Balance (physiology), Pressure (MeSH), Standing Position (MeSH), Stroke (physiopathology), Stroke Rehabilitation (methods).
- MESH :
- methods : Stroke Rehabilitation.
- physiology : Body Weight, Movement, Postural Balance.
- physiopathology : Ankle Joint, Stroke.
- Adult, Aged, Case-Control Studies, Female, Humans, Male, Middle Aged, Pressure, Standing Position.
Abstract
Postural strategies employed by hemiparetic stroke patients need to be better understood to guide rehabilitation. Of the two complementary mechanisms used to stabilize the standing posture, loading-unloading (LU) and pressure distribution (PD), it is hypothesized that the former would be predominantly used. To this aim, posturographic assessments, through a dual force-platform, were performed in 30 Hemiparetics tested 3 months after a unilateral stroke, and 30 matched healthy Controls. Original indices (from 0 to 1) were calculated to assess LU and PD contributions. The results show that along the mediolateral axis, the LU contribution was very high and similar in Hemiparetics and in Controls (0.80 ± 0.07 vs 0.76 ± 0.09 a.u; p > 0.05), indicating a predominant hip involvement. Along the anteroposterior axis, the PD contribution was very close to 1 in controls (0.96 ± 0.03 a.u.) indicating an exclusive ankle involvement. Despite a lower contribution in Hemiparetics (0.88 ± 0.11 a.u.; p < 0.01), the indices were surprisingly always above 0.5, meaning that ankle movements remain predominant for controlling postural sways along the anteroposterior axis in all patients even those with severe clinical deficits. However the PD contribution appeared larger in patients with light or moderate deficits of the sensitivity (r = -0.532; p < 0.01) or the motor command (r = -0.513; p < 0.01). These results indicate that postural stabilization of hemiparetic persons remains controlled by a PD mechanism along the anteroposterior axis, even in those combining poor distal motor command and deep sensory loss. This ankle control, piloted by the more-loaded non-paretic limb, would therefore be preferred to a hip control through lateral trunk motion. This should be considered when defining the objectives of the postural rehabilitation after stroke.
DOI: 10.1016/j.humov.2019.01.004
PubMed: 30658239
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Rougier</name><affiliation wicri:level="1"><nlm:affiliation>Laboratoire Interuniversitaire de Biologie de la Motricité, EA 7424, Université de Savoie, Domaine Scientifique de Savoie-Technolac, 73 376 Le Bourget du Lac cedex, France. Electronic address: patrice.rougier@univ-savoie.fr.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Laboratoire Interuniversitaire de Biologie de la Motricité, EA 7424, Université de Savoie, Domaine Scientifique de Savoie-Technolac, 73 376 Le Bourget du Lac cedex</wicri:regionArea></affiliation></author><author><name sortKey="Perennou, Dominic" sort="Perennou, Dominic" uniqKey="Perennou D" first="Dominic" last="Pérennou">Dominic Pérennou</name><affiliation wicri:level="1"><nlm:affiliation>Clinique MPR CHU Grenoble, Laboratoire de Psychologie et NeuroCognition (CNRS UMR 5105) Université Pierre Mendes France, Grenoble, France. Electronic address: dperennou@chu-grenoble.fr.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Clinique MPR CHU Grenoble, Laboratoire de Psychologie et NeuroCognition (CNRS UMR 5105) Université Pierre Mendes France, Grenoble</wicri:regionArea></affiliation></author></analytic><series><title level="j">Human movement science</title><idno type="eISSN">1872-7646</idno><imprint><date when="2019" type="published">2019</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term><term>Aged (MeSH)</term><term>Ankle Joint (physiopathology)</term><term>Body Weight (physiology)</term><term>Case-Control Studies (MeSH)</term><term>Female (MeSH)</term><term>Humans (MeSH)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Movement (physiology)</term><term>Postural Balance (physiology)</term><term>Pressure (MeSH)</term><term>Standing Position (MeSH)</term><term>Stroke (physiopathology)</term><term>Stroke Rehabilitation (methods)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Accident vasculaire cérébral (physiopathologie)</term><term>Adulte (MeSH)</term><term>Adulte d'âge moyen (MeSH)</term><term>Articulation talocrurale (physiopathologie)</term><term>Femelle (MeSH)</term><term>Humains (MeSH)</term><term>Mouvement (physiologie)</term><term>Mâle (MeSH)</term><term>Poids (physiologie)</term><term>Position debout (MeSH)</term><term>Pression (MeSH)</term><term>Réadaptation après un accident vasculaire cérébral (méthodes)</term><term>Sujet âgé (MeSH)</term><term>Équilibre postural (physiologie)</term><term>Études cas-témoins (MeSH)</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Stroke Rehabilitation</term></keywords><keywords scheme="MESH" qualifier="méthodes" xml:lang="fr"><term>Réadaptation après un accident vasculaire cérébral</term></keywords><keywords scheme="MESH" qualifier="physiologie" xml:lang="fr"><term>Mouvement</term><term>Poids</term><term>Équilibre postural</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Body Weight</term><term>Movement</term><term>Postural Balance</term></keywords><keywords scheme="MESH" qualifier="physiopathologie" xml:lang="fr"><term>Accident vasculaire cérébral</term><term>Articulation talocrurale</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Ankle Joint</term><term>Stroke</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Case-Control Studies</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Pressure</term><term>Standing Position</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Femelle</term><term>Humains</term><term>Mâle</term><term>Position debout</term><term>Pression</term><term>Sujet âgé</term><term>Études cas-témoins</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Postural strategies employed by hemiparetic stroke patients need to be better understood to guide rehabilitation. Of the two complementary mechanisms used to stabilize the standing posture, loading-unloading (LU) and pressure distribution (PD), it is hypothesized that the former would be predominantly used. To this aim, posturographic assessments, through a dual force-platform, were performed in 30 Hemiparetics tested 3 months after a unilateral stroke, and 30 matched healthy Controls. Original indices (from 0 to 1) were calculated to assess LU and PD contributions. The results show that along the mediolateral axis, the LU contribution was very high and similar in Hemiparetics and in Controls (0.80 ± 0.07 vs 0.76 ± 0.09 a.u; p > 0.05), indicating a predominant hip involvement. Along the anteroposterior axis, the PD contribution was very close to 1 in controls (0.96 ± 0.03 a.u.) indicating an exclusive ankle involvement. Despite a lower contribution in Hemiparetics (0.88 ± 0.11 a.u.; p < 0.01), the indices were surprisingly always above 0.5, meaning that ankle movements remain predominant for controlling postural sways along the anteroposterior axis in all patients even those with severe clinical deficits. However the PD contribution appeared larger in patients with light or moderate deficits of the sensitivity (r = -0.532; p < 0.01) or the motor command (r = -0.513; p < 0.01). These results indicate that postural stabilization of hemiparetic persons remains controlled by a PD mechanism along the anteroposterior axis, even in those combining poor distal motor command and deep sensory loss. This ankle control, piloted by the more-loaded non-paretic limb, would therefore be preferred to a hip control through lateral trunk motion. This should be considered when defining the objectives of the postural rehabilitation after stroke.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" IndexingMethod="Curated" Owner="NLM"><PMID Version="1">30658239</PMID><DateCompleted><Year>2019</Year><Month>05</Month><Day>28</Day></DateCompleted><DateRevised><Year>2019</Year><Month>05</Month><Day>28</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1872-7646</ISSN><JournalIssue CitedMedium="Internet"><Volume>64</Volume><PubDate><Year>2019</Year><Month>Apr</Month></PubDate></JournalIssue><Title>Human movement science</Title><ISOAbbreviation>Hum Mov Sci</ISOAbbreviation></Journal><ArticleTitle>Upright standing after stroke: How loading-unloading mechanism participates to the postural stabilization.</ArticleTitle><Pagination><MedlinePgn>47-54</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">S0167-9457(18)30378-6</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.humov.2019.01.004</ELocationID><Abstract><AbstractText>Postural strategies employed by hemiparetic stroke patients need to be better understood to guide rehabilitation. Of the two complementary mechanisms used to stabilize the standing posture, loading-unloading (LU) and pressure distribution (PD), it is hypothesized that the former would be predominantly used. To this aim, posturographic assessments, through a dual force-platform, were performed in 30 Hemiparetics tested 3 months after a unilateral stroke, and 30 matched healthy Controls. Original indices (from 0 to 1) were calculated to assess LU and PD contributions. The results show that along the mediolateral axis, the LU contribution was very high and similar in Hemiparetics and in Controls (0.80 ± 0.07 vs 0.76 ± 0.09 a.u; p > 0.05), indicating a predominant hip involvement. Along the anteroposterior axis, the PD contribution was very close to 1 in controls (0.96 ± 0.03 a.u.) indicating an exclusive ankle involvement. Despite a lower contribution in Hemiparetics (0.88 ± 0.11 a.u.; p < 0.01), the indices were surprisingly always above 0.5, meaning that ankle movements remain predominant for controlling postural sways along the anteroposterior axis in all patients even those with severe clinical deficits. However the PD contribution appeared larger in patients with light or moderate deficits of the sensitivity (r = -0.532; p < 0.01) or the motor command (r = -0.513; p < 0.01). These results indicate that postural stabilization of hemiparetic persons remains controlled by a PD mechanism along the anteroposterior axis, even in those combining poor distal motor command and deep sensory loss. This ankle control, piloted by the more-loaded non-paretic limb, would therefore be preferred to a hip control through lateral trunk motion. This should be considered when defining the objectives of the postural rehabilitation after stroke.</AbstractText><CopyrightInformation>Copyright © 2019 Elsevier B.V. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Rougier</LastName><ForeName>Patrice R</ForeName><Initials>PR</Initials><AffiliationInfo><Affiliation>Laboratoire Interuniversitaire de Biologie de la Motricité, EA 7424, Université de Savoie, Domaine Scientifique de Savoie-Technolac, 73 376 Le Bourget du Lac cedex, France. Electronic address: patrice.rougier@univ-savoie.fr.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pérennou</LastName><ForeName>Dominic</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Clinique MPR CHU Grenoble, Laboratoire de Psychologie et NeuroCognition (CNRS UMR 5105) Université Pierre Mendes France, Grenoble, France. Electronic address: dperennou@chu-grenoble.fr.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2019</Year><Month>01</Month><Day>15</Day></ArticleDate></Article><MedlineJournalInfo><Country>Netherlands</Country><MedlineTA>Hum Mov Sci</MedlineTA><NlmUniqueID>8300127</NlmUniqueID><ISSNLinking>0167-9457</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000843" MajorTopicYN="N">Ankle Joint</DescriptorName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D001835" MajorTopicYN="N">Body Weight</DescriptorName><QualifierName UI="Q000502" MajorTopicYN="N">physiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016022" MajorTopicYN="N">Case-Control Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009068" MajorTopicYN="N">Movement</DescriptorName><QualifierName UI="Q000502" MajorTopicYN="N">physiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004856" MajorTopicYN="N">Postural Balance</DescriptorName><QualifierName UI="Q000502" MajorTopicYN="Y">physiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011312" MajorTopicYN="N">Pressure</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000078783" MajorTopicYN="N">Standing Position</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D020521" MajorTopicYN="N">Stroke</DescriptorName><QualifierName UI="Q000503" MajorTopicYN="Y">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000071939" MajorTopicYN="N">Stroke Rehabilitation</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Ankle</Keyword><Keyword MajorTopicYN="N">Force platform</Keyword><Keyword MajorTopicYN="N">Hemiparesis</Keyword><Keyword MajorTopicYN="N">Hip</Keyword><Keyword MajorTopicYN="N">Postural control</Keyword><Keyword MajorTopicYN="N">Stroke</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2018</Year><Month>05</Month><Day>25</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2018</Year><Month>12</Month><Day>22</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2019</Year><Month>01</Month><Day>09</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2019</Year><Month>1</Month><Day>19</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2019</Year><Month>5</Month><Day>29</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2019</Year><Month>1</Month><Day>19</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">30658239</ArticleId><ArticleId IdType="pii">S0167-9457(18)30378-6</ArticleId><ArticleId IdType="doi">10.1016/j.humov.2019.01.004</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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