Influence of visual symptoms on posturographic performance after stroke.
Bianca Nunes Pimentel, Valdete Alves Valentins Dos Santos Filha
PMID 36629550WHAT IT FOUND
Stroke survivors with visual symptoms showed significantly worse balance when relying on vision, unlike those without such symptoms.
This suggests these patients struggle to use visual cues for stability. Assessing visual complaints is crucial before prescribing balance exercises that rely on sight.
Key findings
01Twenty-eight of the fifty participants reported post-stroke visual impairments such as blurred vision, reduced acuity, oscillopsia, diplopia, or visual field loss.
02Participants with visual symptoms had significantly worse scores on SOT position VI, which tests balance when visual cues are unreliable or conflicting.
03Those with visual symptoms performed better on SOT position II, which evaluates proprioceptive input with eyes closed.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The sample size was small (n=50), which limits the generalizability of the findings. Participants had to be able to stand unaided for 20 seconds, excluding those with more severe motor impairments or hemiplegia who cannot maintain this position, potentially biasing the sample toward higher-functioning patients. The study was cross-sectional, so it cannot establish causality or track changes over time. Visual symptoms were self-reported via questionnaire rather than objectively measured by an ophthalmologist, which may introduce reporting bias. The participants were generally older (average age 63), and age-related decline in balance may have confounded the results, although the study attempted to control for this.
Declared interests
The study was funded by CAPES (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior), a Brazilian government agency. No other conflicts of interest were declared.
The easy way to misread this
Do not assume that all stroke survivors with dizziness have the same balance deficits. This study shows that those with visual symptoms have a specific profile: they struggle with visual reliance but are relatively better at using proprioception. Applying a generic 'visual fixation' strategy to these patients might not help and could ignore their potential to use other sensory inputs.