Asymmetrical trunk posture,unilateral neglect and motor performance following stroke

Abstract

It has been observed that some patients, often with unilateral neglect, have difficulty sitting with their trunk symmetrically and tend to lean towards their affected side. The aim of the study was to see whether this inability to achieve midline sitting existed, and if it did whether there was any relationship with motor function and unilateral neglect.

The sample consisted of 38 stroke patients assessed at one, three and six weeks post stroke. Of these 17 had a right hemiplegia and 21 a left hemiplegia. Data were collected using the Rivermead Motor Assessment (RMA), star cancellation tests and a measure of midline position.

By six weeks most (28) of the subjects sat with their trunk in the midline or towards their unaffected side (group A). Nine subjects sat with their trunk leaning to their affected side (group B). Most of this group (eight) showed signs of unilateral neglect. Chi-square statistics showed that there were more subjects with unilateral neglect in group B than group A (p <0.001).

In the gross function section of the RMA Mann-Whitney statistics showed that group B scored significantly worse than group A at three and six weeks post stroke (p = 0.029, p = 0.008). There were no differences in the groups in terms of leg/trunk or arm scores.

The findings suggest that there is a group of stroke patients who tend to sit with their trunk leaning towards their affected side and that these patients tend to have unilateral neglect and a poorer functional outcome.

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