Best of poster
Le 15/10/2021 de 09:00 à 10:30
Dans les 3 premiers mois après AVC, la récupération de l'équilibre est liée à une meilleure orientation par rapport à la gravité
Shenhao Dai (Echirolles, France), Camille Lemaire (Echirolles, France), Céline Piscicelli (Echirolles, France), Marie Jaeger (Echirolles, France), Anne Chrispin (Echirolles, France), Davoine Patrice (Echirolles, France), Dominic Pérennou (Echirolles, France)
Objective : Mobility is one of the top priorities after stroke. Recent literature showed that mobility disability is mainly due to balance disorders, overall at the subacute stage to an impaired body orientation with respect to gravity in the frontal plan (lateropulsion). Here we test the hypothesis that a satisfactory lateropulsion recovery magnifies balance recovery.
Material / Patients and Methods : Data from DOBRAS cohort study of 106 individuals consecutively admitted to a neurorehabilitation ward after a first hemisphere stroke (ClinicalTrials.gov: NCT03203109), were systematically collected on day30, day60 and day90 after stroke. Primary outcomes were lateropulsion quantified by the Scale for Contraversive Pushing (SCP) and balance disorders assessed with the Postural Assessment Scale for Stroke (PASS).
Results : The correlation between changes in SCP and PASS scores was moderate from D30 to D60 (r= 0.63, 95%CI [0.47-0.76], p<0.001) meaning that between D30 and D60 lateropulsion recovery explains 40% (95%CI [22-58]) of balance recovery. This relationship was smaller however substantial from D60 to D90 (r= 0.44, 95%CI [0.15-0.63], p<0.001). Within the 46 individuals with a satisfactory lateropulsion recovery between D30 and D60 (SCP ≥0.75), 43/46 (93%) had a satisfactory balance improvement (PASS MDC95 >2) and only 3/46 (7%, v=0.44, p<0.001) had a poor balance improvement. Conversely within the 60 individuals with a poor lateropulsion recovery, only half (32, 53%) had a satisfactory balance improvement, with a mean change lower than that observed with a good lateropulsion recovery (5.4 [3.1] vs 8.1 [3.8]; η2=0.14, p=0.002).
Discussion - Conclusion : Balance improvement is amplified when lateropulsion recovers. After stroke, rehabilitation programs should better consider body orientation with respect to gravity.
Keywords : Lateropulsion; Balance disorder; Stroke recovery
Disclosure of interest : None.