Deans' stroke musings: Maintaining Trunk and Head Upright Optimizes Visual Vertical Measurement After Stroke

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Monday, December 14, 2015

Maintaining Trunk and Head Upright Optimizes Visual Vertical Measurement After Stroke

If spasticity is cranking your head down or to the side this is going to be impossible. And since your doctor has NOTHING to cure spasticity, once again you are screwed. No clue on what knowing this helps your recovery
http://nnr.sagepub.com/content/30/1/9?etoc

¹Grenoble University Hospital, Grenoble, France
²Grenoble-Alpes University, Grenoble, France
³Paris Descartes University, Paris, France
⁴Savoie University, Chambéry, France

Dominic Alan Pérennou, Clinique MPR-CHU, Laboratoire de Psychologie et Neurocognition CNRS UMR 5105, Grenoble Université, Avenue de Kimberley, Grenoble 38000, France. Email: DPerennou@chu-grenoble.fr

Abstract

Background. Visual vertical (VV) measurement provides information about spatial cognition and is now part of postural disorders assessment. Guidelines for clinical VV measurement after stroke remain to be established, especially regarding the orientation settings for patients who do not sit upright.

Objectives. We analyzed the need to control body orientation while patients estimate the VV. Methods. VV orientation and variability were assessed in 20 controls and 36 subacute patients undergoing rehabilitation after a first hemisphere stroke, in 3 settings: body not maintained (trunk and head free), partially maintained (trunk maintained, head free), or maintained (trunk and head). VV was analyzed as a function of trunk and head tilt, also quantified. Results. Trunk and head orientations were independent. The ability to sit independently was affected by a tilted trunk. The setting had a strong effect on VV orientation and variability in patients with contralesional trunk tilt (n = 11; trunk orientation −18.4 ± 11.7°). The contralesional VV bias was severe and consistent under partially maintained (−8.4 ± 5.2°) and maintained (−7.8 ± 3.5°) settings, whereas various individual behaviors reduced the mean bias under the nonmaintained setting (−3.6 ± 9.3°, P < .05). VV variability was lower under the maintained (1.5 ± 0.2°) than nonmaintained (3.7 ± 0.4°, P < .001) and partially maintained (3.6 ± 0.2°, P < .001) settings. In contrast, setting had no effect in patients with satisfactory postural control in sitting.

Conclusion. Subject setting improves VV measurement in stroke patients with postural disorders. Maintaining the trunk upright enhances the validity of VV orientation, and maintaining the head upright enhances the validity of within-subject variability. Measuring VV without any body maintaining is valid in patients with satisfactory balance abilities.