Article

Hemiparetic stroke patients commonly bear more weight on the non-paretic side
which seems intuitively linked to unilateral control deficits. However, there is
evidence that some post-stroke favour weighting the paretic side, which may be
problematic given altered capacity of the paretic limb to contribute to the
control of upright posture. This study explores the prevalence and clinical
determinants of stance asymmetry, and the relationship between stance asymmetry
and postural control among chronic stroke patients. Subjects (n=147; >6 months
post-stroke) stood on two force plates in eyes-open and eyes-closed conditions;
59 were symmetric, 18 had paretic asymmetry (PA), and 70 had non-paretic
asymmetry (NPA). Root mean square (RMS) of antero-posterior and medio-lateral
centre-of-pressure under each limb and both limbs combined were compared. RMS of
total medio-lateral centre-of-pressure was greater for both asymmetric groups
compared with the symmetric group. PA subjects relied less on the loaded limb for
control than NPA subjects and relied more on visual information for postural
control than those who were symmetric. There were no differences in the
characteristics of individuals between the PA and NPA groups. The loading of the
paretic limb was not related to impaired postural control during stationary
standing which was attributable, in part, to individuals relying on control from
the non-paretic limb, in spite of lower vertical load, and a greater dependence
on visual contributions. There was no evidence that greater loading on the
paretic limb was related to persisting dyscontrol but may rather reflect a
learned strategy.
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Langue : ANGLAIS