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Reliance on visual information after stroke. Part II: effectiveness of a balance rehabilitation program with visual cue deprivation after stroke: a randomized controlled trial1

      Abstract

      Bonan IV, Yelnik AP, Colle FM, Michaud C, Normand E, Panigot B, Roth P, Guichard JP, Vicaut E. Reliance on visual information after stroke. Part II: Effectiveness of a balance rehabilitation program with visual cue deprivation after stroke: a randomized controlled trial. Arch Phys Med Rehabil 2004;85:274–8.

      Objective

      To test the hypothesis that balance rehabilitation with visual cue deprivation improves balance more effectively than rehabilitation with free vision.

      Design

      Single-blind, randomized controlled trial.

      Setting

      Public rehabilitation center in France.

      Participants

      Twenty patients with hemiplegia after a single-hemisphere stroke that occurred at least 12 months before the study.

      Intervention

      Patients were randomly assigned to 1 of 2 balance rehabilitation programs—with and without visual cue deprivation. In all other respects, the programs were identical. Each lasted for 1 hour and was implemented 5 days a week for 4 weeks. All patients completed the program.

      Mean outcome measures

      Balance under 6 sensory conditions was assessed by computerized dynamic posturography (EquiTest), gait velocity, timed stair climbing, and self-assessment of ease of gait before and after program completion.

      Results

      After completing the program, balance, gait velocity, and self-assessment of gait improved significantly in all patients. The improvements in gait velocity (P=.03) and timed stair climbing (P=.01) correlated significantly with improved balance. Balance improved more in the vision-deprived group than in the free-vision group.

      Conclusions

      Balance improved more after rehabilitation with visual deprivation than with free vision. Visual overuse may be a compensatory strategy for coping with initial imbalance exacerbated by traditional rehabilitation.

      Keywords

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