Effect of Eye Movement Training on Balance in Post Stroke Patients with Unilateral Spatial Neglect. First Preliminary report

Document Type : Original Article

Authors

1 National Institute for Longevity Elderly Sciences (NILES), Beni Suef University

2 Ophthalmology department , Faculty of Medicine , Beni-Suef University

3 Faculty of Physical Therapy, Beni Suef University

Abstract

Background: Unilateral Spatial Neglect (USN) is a complex disorder associated with stroke and is more severe and persistent following right hemisphere damage. Stroke patients have mobility limitations, muscle weakness, and behaviors disorders. The problem with USN is lack of orientation and information from affected side that may cause balance problems specially in elderly survivors. Training eye movements are aimed at improving visual function by training patients to navigate the blind hemifield and increase their overall sensitivity. Accurate reliable knowledge of balance in stroke survivors is important for prognosis and to predict falls. Aim of the study: This study was designed to find out the effect of training eye movements on balance in elderly post stroke survivors with USN. Subjects and Methods: The study included 15 of both sexes with post stroke USN (11 males and 4 females) their mean age was 69.1 ± 1.9 years. Patients received sequentially in same session training for eye movement program and a traditional gait training program 4 days/week for 6 weeks. Balance assessment was measured by Berg Balance Scale (BBS), Time Up and go test (TUG), 10 meters Talking Test (10mWT), and 6 Minutes Walking Test (6MWT). Results: there were significant changes in between pre and post-study as the analysis of mean values of BBS, TUG, 10mW, and 6MWT.Conclusion: eye movement training had a significant effect on improving balance in post stroke survivors with USN. Eye movement training improved patients with USN ability to explorer the blind hemispace and to improve balance.

Keywords

References

  1. A.G. Thrift, Cadilhac D.A., Thayabaranathan T., Howard G.: Global stroke statistics, International Journal of Stroke, Vol. 9, 6-18, 2014 .
  2. World Health Organization (WHO) 2017: Stroke and cerebrovascular accident.http://www.who.int/topics/cerebrovascular_accident/en. A
  3. Meschia JF, Bushnell C, Boden-Albala B, Braun LT, Bravata DM., et al.: Guidelines for the primary prevention of stroke: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke ;45:3754–3832, 2014.
  4. Abd-Allah F., Moustafa R.R. (2014): Burden of stroke in Egypt: current status and opportunities. Int J Stroke.Dec;9(8):1105-8. doi: 10.1111/ijs.12313. Epub 2014 Jul 7.
  5. Sand K.M., Midelfart A., Thomassen L., Melms A., Wilhelm H., et al. : Visual impairment in stroke patients – a review Acta Neurol Scand: 127 (Suppl. 196): 52–56 DOI: 10.1111/ane.12050, 2013.
  6. Chen P, Hreha K, Kong Y, Barrett AM:  Impact of spatial neglect on stroke rehabilitation: evidence from the setting of an inpatient rehabilitation facility. Arch Phys Med Rehabil. 2015 Aug. 96 (8):1458-66.
  7. Kas A, de Souza LC, Samri D, Bartolomeo P, Lacomblez L, Kalafat M, et al. Neural correlates of cognitive impairment in posterior cortical atrophy. Brain. 2011 May. 134 (Pt 5):1464-78.
  8. Oh-Park M, Hung C, Chen P, Barrett AM. Severity of spatial neglect during acute inpatient rehabilitation predicts community mobility after stroke. PM R. 2014 Aug. 6 (8):716-22.
  9. Boukrina O, Barrett AM. Disruption of the ascending arousal system and cortical attention networks in post-stroke delirium and spatial neglect. Neurosci Biobehav Rev. 2017 Dec. 83:1-10.
  10. Song JW, Kim JM, Cheong YS, Lee YS, Chun SM, Min YS, Jung TD: Balance Assessment in Subacute Stroke Patients Using the Balance Control Trainer (BalPro). Ann Rehabil Med. 2017 Apr;41(2):188-196. doi: 10.5535/arm.2017.41.2.188. Epub 2017 Apr 27.
  11. Joseph Demer: Current concepts of mechanical and neural factors in ocular motility. Current Opinion in Neurology. 19(1):4–13, FEBRUARY 2006.
  12. Rowe FJ., et al.: Visual impairment following stroke. Do stroke patients require vision assessment? Age and Ageing. 38: 188-193, 2009.
  13. Pollock A., Hazelton C., Henderson C. A., Angilley J. (2012): Interventions for visual field defects in patients with stroke. American Heart Association/American Stroke Association. Stroke, 43, 37–38.
  14. Barbara M., Barbara V., Cesare G. (2016): Visual field restorative rehabilitation after brain injury. Journal of Vision 16(9):11, 1–18.
  15. M. D. Lezak, D. B. Howieson, D. W. Loring, H. J. Hannay, J. S. Fischer. Neuropsychological assessment (4th ed.). Oxford University Press, New York, 2012.
  16. Wilson B, Cockburn J, Halligan P. Development of a behavioral test of visuospatial neglect. Arch Phys Med Rehabil. 1987;68:98–102.
  17. Basagni B, De Tanti A, Damora Aet al. The assessment of hemineglect syndrome with cancellation tasks: a comparison between the Bells test and the Apples test. Neurol Sci. 2017 Dec;38(12):2171-2176. doi: 10.1007/s10072-017-3139-7. Epub 2017 Oct 4.
  18. World Health Organization (WHO 2012): Global data base on body mass index, osteoporo.2012.
  19. Flansbjer UB, Holmback AM, Downham D, Patten C, Lexell J. Reliability of gait performance tests in men and women with hemiparesis after stroke. J Rehabil Med. 2005; 37:75–82.
  20. Wood-Dauphinee S, Berg K, Bravo G, Williams JI. The Balance Scale: responding clinically meaningful changes. Can J Rehabil. 1997; 10:35–50.
  21. Yelnik A, Bonan I. Clinical tools for assessing balance disorders. Neurophysiol Clin. 2008; 38:439–445.
  22. Perssonet al.: Timed Up & Go as a measure for longitudinal change in mobility after stroke–Postural Stroke Study in Gothenburg (POSTGOT) Journal of Neuro Engineering and Rehabilitation. 2014, 11:83 Page 2 of 7http://www.jneuroengrehab.com/content/11/1/83
  23. Wade DT. Measurement in neurological rehabilitation. Oxford: Oxford University Press; 1992
  24.  Richards CL, Malouin F, Dean C. Gait in stroke: assessment and rehabilitation. Clin Geriatr Med. 1999;15:833–855.
  25. Michele P, West and  Jaime C. Paz (2013): Acute care handbook for physical therapists 3rded
  26. Bisson E, Contant B, Sveistrup H, et al.(2007): Functional balance and dual-task reaction times in older adults are improved by virtual reality and biofeedback training. Cyber psychol Behav, 10: 16–23.
  27. De Weerdt W, Crossley SM, Lincoln NB, et al. : Restoration of balance in stroke patients: a single case design study. Clin Rehabil, 1989, 3: 139–147
  28. Park CS, Kang KY: The effects of additional action observational training for functional electrical stimulation treatment on weight bearing, stability and gait velocity of hemiplegic patients. J Phys Ther Sci, 2013, 25: 1173–1175.
  29. Saif M, Saif A, Saif P, El Saftawy H, Dabbous O, Salem M. Evaluation of large cupping in children with anemia. Journal of the Egyptian Ophthalmological Society. 2015;108(4):167. doi:10.4103/2090-0686.174651.
  30. Mohamed Yasser Sayed Saif, Mohamed Othman Abdel Khalek, Ahmed Tamer Sayed Saif, Passant Sayed Saif, Sherif Kamel Safina. Predictability and Accuracy of IOL formulas in high myopia. J Emmetropia 2016; 1: 17-21
  31. Saif MYS, Sayed MA, Saif ATS. Effect of hormonal contraception on lacrimal gland function. Guoji Yanke Zazhi(Int Eye Sci) 2016;16(7):1207-1211
  32. Sayed S E H Saif, Moh Yasser S Saif, Ahmed T S Saif ; The Glaucoma suspect, the dilemma. What is new? Bull Ophthalmol Soc Egypt, 2008; Vol 101,
  33. Amer S, Saif M, Saif A, Saif P. Variations of Cup-to-Disc Ratio in Children. Open Journal of Ophthalmology. 2014;04(01):12-17.
  34. Elsaftawy, H., Ahmed, M., Saif, M. and Mousa, R. (2015). Sequential Intracorneal Ring Segment Implantation and Corneal Transepithelial Collagen Cross-Linking in Keratoconus. Cornea, 34(11), pp.1420-1426.
  35. Nassar M, Saif M, Saif A, Saif P. Sensitivity and specificity of nassar color test in early detection of diabetic macular edema. Journal of Retina-Vitreous. 2016;24:109-113.
  36. Saif M, Saif A, Saif P, El Saftawy H, Dabbous O, Salem M. Evaluation of large cupping in children with anemia. Journal of the Egyptian Ophthalmological Society. 2015;108(4):167.
  37. Saif M, Saif A, Saif P, Abdel Khalek M, Mahran W. Dry Eye Changes After Phacoemulsification And Manual Small Incision Cataract Surgery (MSICS). . Int J Ophthalmol Eye Res.2016; 4(2), 184-191
  38. Saif A, Saif P, Dabous O. Fundus changes in thalassemia in Egyptian patients. Delta Journal of Ophthalmology. 2017;18(1):20.
  39. Saif ATS, Saif PS , El Deeb A. Role of amniotic membrane transplantation in symblepharon. Guoji Yanke Zazhi(Int Eye Sci) 2017;17(5):819-824
NILES journal for Geriatric and Gerontology
Volume 2, Issue 1
January 2019
Pages 71-76

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