The relationship of asymmetric weight-bearing with postural sway and visual reliance in stroke

Abstract 

Due to motor and sensory deficits in individuals with stroke, we proposed that they must compensate for these impairments during standing with greater dependence on vision. In addition, we hypothesized that asymmetric weight-bearing, which occurs following stroke, is related to increased postural sway and those with greater asymmetry will have greater reliance on vision. Twenty-eight individuals with stroke and 28 healthy older adult controls stood quietly with eyes open (EO) or closed on a force platform while postural sway was quantified by centre of pressure measures and weight-bearing asymmetry was calculated from vertical ground reaction forces. To determine the influence of vision on postural sway, a visual ratio (eyes open/eyes closed (EC)) was calculated for the sway measures. The results demonstrated that individuals with stroke had greater visual dependence for the control of postural sway velocity in the medial–lateral (ML), but not anterior–posterior (AP) direction, compared to controls. Further, we found that greater asymmetry was moderately related to increased medial–lateral sway for the individuals with stroke. Contrary to predictions, those individuals with stroke with mild asymmetry had greater visual dependence than those with more severe asymmetry.

Keywords: Postural control, Cerebrovascular accident, Balance