The effect of visual perception on standing reach in individuals with hemiparesis

Cunningham, K.; Ustinova, K.

Авторы: Cunningham K., Ustinova K.
Журнал: Physiotherapy
Том: 97
Номер: S1
Год издания: 2011
Издательство: Chartered Society of Physiotherapists
Местоположение издательства: United Kingdom
Первая страница: eS249
Последняя страница: eS249
DOI: 10.1016/j.physio.2011.04.002
Аннотация: Purpose: Functional reaching activities involve complex processing and are executed according to our perception of body position in space and are relative to environmental objects. One identified component in the creating of such perception is the viewing angle, under which the environment is observed. A previous study suggested that manipulation of viewing angle in a virtual environment may modulate reaching in healthy subjects. We examined whether manipulating the visual presentation of a virtual reality simulation would alter reaching performance in patients with hemiparesis after stroke. Relevance: Increasingly therapists are incorporating virtual reality games in rehabilitation. Finding an optimal visual presentation of virtual environment is important for designing therapeutic virtual games and environments for functional re-training of individuals with post-stroke hemiparesis. Participants: Adults with hemiparesis following unilateral cerebral vascular accident (CVA) with an average age of 56.7 years (ranging from 49 to 64 years) participated in the study. Participants had mild to moderate hemiparesis according to the Arm and Hand section of Fugl-Meyer stroke assessment scale, with the scores ranging from 48 to 63 points. All participants were able to maintain balance well with Berg Balance Scores from 48 points and higher. Methods: Participants performed forward arm reaching in a virtual environment, presented on a flat screen in third-person perspective. On the screen, they saw a computer-generated model or avatar standing in a courtyard facing a hedge topped with flowers. This scene was presented in three viewing angles: 0º above horizon (directly behind the avatar), 45º above horizon, and 90º above horizon (directly overhead). Participants were instructed to touch the furthest flower possible without losing balance or stepping, and then return to quiet standing. Virtual reaches were compared with reaches forward and pointing at a target in actual environment.
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