TY - JOUR
T1 - The association between visuospatial neglect and balance and mobility post-stroke onset
T2 - A systematic review
AU - Embrechts, Elissa
AU - Van Criekinge, Tamaya
AU - Schröder, Jonas
AU - Nijboer, Tanja
AU - Lafosse, Christophe
AU - Truijen, Steven
AU - Saeys, Wim
N1 - Copyright © 2020 Elsevier Masson SAS. All rights reserved.
PY - 2021/7
Y1 - 2021/7
N2 - BACKGROUND: Although previous narrative reviews have highlighted a potential association between visuospatial neglect (VSN) and balance disorders, to what extent different areas of balance and mobility could be affected is still unclear.OBJECTIVES: This systematic review updates previous literature findings and systematically reviews sitting balance, standing balance and mobility outcomes.METHODS: PubMed, Web of Science, ScienceDirect, Naric-Rehabdata, PEDro and the Cochrane Trials Library were systematically searched. Methodological quality was assessed by the National Heart, Lung, and Blood Institute Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. The association between VSN and sitting balance, standing balance and mobility (walking, stair climbing/descending and transfers) was investigated.RESULTS: In total, 48 studies were included (4595 stroke survivors): at least 1319 (29%) showed symptoms of VSN. VSN was associated with less independence during sitting, with an asymmetric posture toward the affected body side. For standing balance, we revealed a significant negative association between VSN and mediolateral stability and weight shifting, whereas only activities of daily living-related VSN was associated with weight-bearing asymmetry during static stance. While walking, patients with VSN laterally deviated from their path. Results were inconclusive regarding other aspects of mobility. The association between VSN and balance/mobility seemed to decrease over time.CONCLUSIONS: Despite great heterogeneity in results, this study suggests that stroke survivors with VSN show specific deviations in posture and movement in the mediolateral direction. Although the association between VSN and balance/mobility has been extensively investigated, explanatory studies evaluating underlying mechanisms of the frequently present association are lacking. Future studies should address this by combining clinical and instrumented assessment of balance and gait performance, preferably longitudinally to investigate the associations over time.
AB - BACKGROUND: Although previous narrative reviews have highlighted a potential association between visuospatial neglect (VSN) and balance disorders, to what extent different areas of balance and mobility could be affected is still unclear.OBJECTIVES: This systematic review updates previous literature findings and systematically reviews sitting balance, standing balance and mobility outcomes.METHODS: PubMed, Web of Science, ScienceDirect, Naric-Rehabdata, PEDro and the Cochrane Trials Library were systematically searched. Methodological quality was assessed by the National Heart, Lung, and Blood Institute Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. The association between VSN and sitting balance, standing balance and mobility (walking, stair climbing/descending and transfers) was investigated.RESULTS: In total, 48 studies were included (4595 stroke survivors): at least 1319 (29%) showed symptoms of VSN. VSN was associated with less independence during sitting, with an asymmetric posture toward the affected body side. For standing balance, we revealed a significant negative association between VSN and mediolateral stability and weight shifting, whereas only activities of daily living-related VSN was associated with weight-bearing asymmetry during static stance. While walking, patients with VSN laterally deviated from their path. Results were inconclusive regarding other aspects of mobility. The association between VSN and balance/mobility seemed to decrease over time.CONCLUSIONS: Despite great heterogeneity in results, this study suggests that stroke survivors with VSN show specific deviations in posture and movement in the mediolateral direction. Although the association between VSN and balance/mobility has been extensively investigated, explanatory studies evaluating underlying mechanisms of the frequently present association are lacking. Future studies should address this by combining clinical and instrumented assessment of balance and gait performance, preferably longitudinally to investigate the associations over time.
KW - Stroke
KW - Visuospatial neglect
KW - Balance
KW - Mobility
KW - Walking
U2 - 10.1016/j.rehab.2020.10.003
DO - 10.1016/j.rehab.2020.10.003
M3 - Review article
C2 - 33152521
SN - 1877-0657
VL - 64
SP - 1
EP - 16
JO - Annals of Physical and Rehabilitation Medicine
JF - Annals of Physical and Rehabilitation Medicine
IS - 4
M1 - 101449
ER -