Sensory System Characteristics of Posture Control in Patients with Stroke
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    Abstract:

    Objective To study the sensory system characteristics of posture control in stroke patients, and to analyze the contribution rate and utilization rate of each receptor to postural control ability of stroke patients. Methods Sensory organization tests (SOT) were conducted on 30 elderly stroke patients (patient group) and 30 healthy elderly patients (control group) with computer dynamic posture tracing system. The balance scores and balance comprehensive score were recorded under 6 conditions, and the contribution rate and overall utilization rate of vision, proprioception, and vestibular sense under different standing conditions were calculated and analyzed. Results The balance score of patient group was significantly lower than that of control group under the conditions of closed eyes / stable support surface ( Z = - 3. 248, P = 0. 001), visual disturbance/ stable support surface (Z = - 2. 829, P = 0. 005), closed eyes / unstable support surface ( Z = - 4. 283, P = 0), and visual disturbance/ unstable support surface (Z = - 4. 074, P = 0). The balance comprehensive score was significantly lower than that of the control group ( Z = - 4. 133, P = 0). In eyes-open/ stable-support and eyes-closed/ stablesupport tests, the proportion of proprioception in patient group was 16. 351% and 34. 942% , and 14. 307% and 18. 390% in control group. The proportion of proprioception in patient group was always greater than that in control group, indicating that proprioception had a greater effect in patient group than that in control group. Similarly, the effect of vision on patient group was greater than that on control group. The lowest contribution rate of vestibular sense under different standing conditions was 64. 648% , indicating that the main factor to maintain balance of human body is vestibular sense. The utilization rates of proprioception, vision and vestibular sense in patient group were 95. 092% , 72. 382% , and 32. 879% , respectively. The utilization rate of proprioception ( Z = -1. 984, P= 0. 047) and vestibular sense ( Z = - 4. 283, P = 0) was significantly lower than that of the control group. Conclusions The decline in contribution and utilization of sensory system in stroke patients is one of the important factors for stroke patients with postural control disorders. Posture control contributes the most to vestibular sense, followed by proprioception and vision. The largest utilization rate of posture control is proprioception, followed by vision and vestibular sense. One of the reasons that affect the decline in posture control ability of stroke patients is the decline in the efficiency of proprioception and visual sensory information input of stroke patients, as well as the partial decrease in proprioception and vestibular sense participating in motor output. It is suggested that stroke patients should pay attention to the training of proprioception and vestibular sense to improve their posture control ability.

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DUAN Linru, ZHENG Jiejiao. Sensory System Characteristics of Posture Control in Patients with Stroke[J]. Journal of medical biomechanics,2023,38(4):770-776

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History
  • Received:September 26,2022
  • Revised:November 09,2022
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  • Online: August 25,2023
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