VISUAL INFLUENCE ON CONTACT PRESSURE OF HEMIPLEGIC PATIENTS THROUGH PHOTOELASTIC SOLE IMAGE

Objectives: To assess the visual influence through photoelastic sole i mage on upright posture in hemiplegic patients. Design: Before-during trial. Setting: An academically based rehabilitation setting. Patients : Nineteen hemiplegic patients 3 to 8 months after the stroke were des ignated as severe (n = 5), moderate I (n = 4), moderate II (n = 5), an d mild groups (n = 5). The severe, moderate, and mild groups were in B runnstrom's motor recovery stage III, IV, and V, respectively. Vibrati on sense in the paretic leg was intact in the moderate II and mild gro ups, but impaired in the severe and moderate I groups. Intervention: V isual feedback therapy on standing before and while watching his or he r own photoelastic sole image on a television screen (before vs during ). Main Outcome Measure: The body-weight-bearing ratio on the paretic sole was analyzed. Results: The body-weight-bearing ratio on the paret ic sole increased during visual feedback (before vs during, percentage , severe, 21.8 +/- 11.4 vs 38.7 +/- 13.7, p < .02; moderate I, 30.4 +/ - 11.1 vs 39.3 +/- 6.4, not significant; moderate II, 32.8 +/- 10.3 vs 46.8 +/- 7.8, p < .05; mild, 29.7 +/- 7.0 vs 41.8 +/- 7.5, p < .005; mean +/- SD). Conclusion: As the only difference between the moderate I and II groups was impaired or intact vibration sense in the paretic limbs, vibration sense along with motor recovery is an important facto r to increase body weight loading on the paretic sole in hemiplegic pa tients. (C) 1996 by the American Congress of Rehabilitation Medicine a nd the American Academy of Physical Medicine and Rehabilitation