Among the repercussions of hemiparesis following stroke, disturbed stability is responsible for a high risk of falls. Picking up objects from the ground, frequently trained in rehabilitation due to its risk of falling and its frequency in daily life, is a task requiring balance. To date, however, it has been little studied. We suggest that stability conditions the asymmetry adopted by patients. We hypothesise that asymmetric support at the expense of the paretic lower limb provides better stability during an unstable functional task (picking up an object from the ground) compared with the symmetrical support traditionally imposed in rehabilitation. Postural control involves stability (maintaining balance despite constraints) and orientation (posture adopted, such as the distribution of supports). Hemiparetic patients show a lack of stability and, with regard to orientation, an asymmetry in the distribution of body weight to the detriment of the paretic limb. Symmetrisation of weight distribution has been one of the predominant concepts in rehabilitation.
To analyse the stability of hemiparetic stroke patients when picking up an object on the ground in a spontaneous condition compared with a condition of imposed support symmetry. To analyse and compare the stability, spontaneous symmetry and duration of picking up the object in a complex situation (distant target) compared with the near target in stroke patients and healthy subjects. To explore strategy and performance of picking up the object regarding clinical outcomes (falls, sensori-motor impairments, balance..) To compare strategy of patients with right and left stroke.
Study Type
OBSERVATIONAL
Enrollment
72
CHU Raymond Poincaré - APHP
Garches, France
RECRUITINGstability parameter: the range of the medio-lateral centre of pressure during the object picking up task
Two forceplate platforms. 3 trials for each condition
Time frame: at baseline
Velocity of the centre of pressure
Mean velocity and in each place, in mm/s, obtained with forceplat plateforms under feet of participants during the object picking up task.
Time frame: at baseline
Ellipse area of the centre of pressure
With 95% confidence, in mm², obtained with forceplat plateforms under feet of participants during the object picking up task
Time frame: at baseline
Range of the centre of pressure
Range in antero-posterior plane, in mm, obtained with forceplat plateforms during the object picking up task
Time frame: at baseline
Percentage of weight bearing
Under each lower limb, in %, obtained with forceplat plateforms during the object picking up task
Time frame: at baseline
Kinematics parameters
range of movements of trunk, pelvis and lower limbs (hip, knee, ankle), in degrees, obtained with the optoelectronic system during the object picking up task
Time frame: at baseline
Questionnaires : Confidence perception and stability perception during the object picking up task
On a visual scale 0 (no confidence) to 10 (perfect confidence)
Time frame: at baseline
Clinical scales - Berg balance scale
Time frame: at baseline
Clinical scales-Medical Research Council
Time frame: at baseline
Clinical scales-Modified Ashworth
Time frame: at baseline
Clinical scales-Nottingham Sensory Assessment
Time frame: at baseline
Clinical scales -Neglect and lateropulsion scale
Time frame: at baseline
Cognitive scale : Batterie Rapide d'Efficience Frontale
Time frame: at baseline
Activities-Specific Balance Confidence
Time frame: at baseline
Functional reach test
In cm
Time frame: at baseline
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