Recovery of head and trunk coordination after stroke

Verheyden, G., Ashburn, A., Burnett, M., Lawrence, J., Shepard, N. and Taylor, D. (2007) Recovery of head and trunk coordination after stroke. International Society for Posture and Gait Research Conference, Vermont, USA. 13 - 17 Jul 2007.

Abstract

Introduction: Studies in healthy individuals have described a clear sequence of head and trunk coordination during horizontal gaze transfers that require whole body movements. For patients after stroke, there is evidence to suggest that sensorimotor integration of postural adjustments and voluntarily head movements may have been modified. The aim of our study was to examine head and trunk coordination, in particular movement initiation in people early after stroke.
Methods: We evaluated 6 people with stroke and 6 healthy controls. Subjects with stroke were assessed clinically and in a laboratory setting at three, six and 12 weeks after stroke. Control subjects were also examined at three consecutive time points with the same weekly interval as the stroke group. Participants were asked verbally to rotate their head to the side of preference and look at a visual signal placed at 90° left and right from centre. Markers were attached at standardised positions of the body and 3-D motion recordings were made using CODAmotion. Data analysis consisted of examining the sequence of head and trunk rotation in both groups separately using Wilcoxon signed rank test. Differences in degree of head rotation, shoulder rotation and delay in rotation were analysed between groups and over time by means ofWilcoxon ranked sum test and Friedman analysis respectively.
Results: The pattern of movement demonstrated by the healthy controls (2 females, 4 males, median (IQR) age 64 (62-70) years) at all three time points showed rotation of the head before rotation of the shoulders (p=0.028). In comparison, the mildly impaired stroke group (1 female, 5 males; median (IQR) age 70 (65-79) years) showed no significant difference between rotation of the head and shoulder at three weeks after stroke (p=0.075). This pattern changed over time, reflecting the sequence demonstrated by the healthy controls, with a significant start of rotating the head before the shoulders both at six weeks (p=0.046) and at 12 weeks (p=0.028) after stroke.When comparing both groups at the three time points, there was no significant difference in degree of head rotation, shoulder rotation or in delay in rotation. However the stroke group had a relatively smaller variability in degree of head rotation and a larger variability in degree of shoulder rotation in comparison to the healthy controls. The results of the Friedman test with post-hoc analysis showed a significant decrease in degree of head rotation for stroke patients between three and 12 weeks after stroke (p=0.028).
Conclusions: We believe this is the first study to evaluate recovery of the sequence of head and trunk coordination during the acute stages following stroke. Our results suggest that people with stroke show a modified coordination pattern early after stroke but recover over time towards the level of healthy subjects. Future research should include more impaired stroke patients as well as evaluate the relation with clinical measures and thus importance in everyday activities.

This record has no associated files available for download.

Contributors

Author: M. Burnett

Download statistics