Reaction time analysis in patients with mild left unilateral spatial neglect employing the modified Posner task : vertical and horizontal dimensions

東京都立大学Tokyo Metropolitan University博士（理学療法学）doctoral thesi

Effects of visual-motor illusions with different visual stimuli on the sit-to-stand of people with hemiplegia following stroke : A randomized crossover controlled trial

東京都立大学Tokyo Metropolitan University博士（理学療法学）doctoral thesi

Effects and Adaptation of Visual-Motor Illusion Using Different Visual Stimuli on Improving Ankle Joint Paralysis of Stroke Survivors—A Randomized Crossover Controlled Trial

Visual-motor illusion (VMI) is an intervention to induce kinesthetic sensation from visual stimuli. We aimed to compare the effects of VMI of different visual stimuli on the paralyzed side ankle joint of stroke hemiplegic patients (hemiplegic patients) and to clarify their indication. We applied two types of VMI images of ankle dorsiflexion: ankle dorsiflexion without resistance (standard VMI (S-VMI)) and maximum effort dorsiflexion with resistance (power VMI (P-VMI)). Twenty-two hemiplegic patients were divided into two groups: Group A, which received S-VMI first and P-VMI one week later (n = 11), and Group B, which received P-VMI first and S-VMI one week later (n = 11). Immediate effects were evaluated. Outcomes were the dorsiflexion angle and angular velocity, degree of sense of agency (SoA), and sense of ownership. Patient’s characteristics of cognitive flexibility were assessed using the Trail making test-B (TMT-B). Fugl-Meyer assessment and the Composite-Spasticity-Scale were also assessed. P-VMI was significantly higher than S-VMI in SoA and dorsiflexion angular velocity. Additionally, the degree of improvement in dorsiflexion function with P-VMI was related to TMT-B and degree of muscle tone. Therefore, P-VMI improves ankle function in hemiplegic patients more than S-VMI but should be performed with cognitive flexibility and degree of muscle tone in mind

Investigating the Characteristics of Covert Unilateral Spatial Neglect Using the Modified Posner Task : A Single-subject Design Study

Objectives: Patients identified as asymptomatic for unilateral spatial neglect (USN) based on paper-and-pen tests nonetheless often collide with objects to their left while walking. This study aimed to investigate chronic USN in subjects who experienced collisions while walking. Methods: Two patients with chronic USN who experienced collisions while walking were evaluated using the Behavioral Inattention Test-conventional (BIT-c). Additionally, the modified Posner task (MPT) was used to evaluate the left and right reaction times. MPT targets randomly appeared either on the side indicated by the cue (valid condition) or on the opposite side (invalid condition). This study used an alternating treatments single-case design. The valid and invalid conditions of the MPT alternated rapidly and randomly to determine differences in reaction time. Statistical analysis compared left and right reaction times using a one-tailed randomization test to study valid and invalid conditions. Results: The total BIT-c score was in the normal range for both subjects, whereas MPT reaction times were higher on the left side than on the right side for the invalid condition. However, for the valid condition, only Case B had increased reaction times on the left side. Conclusions: The MPT valid condition evaluates voluntary attention, whereas the invalid condition evaluates the reorientation of attention. Consequently, for Case A, a left reorientation of attention deficit was observed, whereas, for Case B, left voluntary attention and left reorientation of attention deficits were observed. The MPT results revealed the characteristics of covert neglect signs. USN evaluation would benefit from additional research using MPT.東京都立大学学位論文甲第1251号　副論文journal articl

Effects of kinesthetic illusion induced by visual stimulation on the ankle joint for sit-to-stand in a hemiparesis stroke patient : ABA’ single-case design

[Purpose] The purpose of this study was to investigate the effect of kinesthetic illusion induced by visual stimulation to the paralyzed side ankle joint on the sit-to-stand of a hemiparesis stroke patient. [Participant and Methods] A 33-year-old male with left hemiparesis due to a right putamen hemorrhage participated. This study used the ABA’ single-case design. Phase A and A’ conducted only conventional physiotherapy. Phase B conducted kinesthetic illusion induced by visual stimulation and conventional physiotherapy. To create a kinesthetic illusion, a video image of the patient’s ankle joint dorsiflexion movement on the non-paralyzed side was inverted and placed on the patient’s paralyzed ankle. The patient observed this display for 5 min. We evaluated weight-bearing symmetry values during sit-to-stand, duration of sit-to-stand, trunk and ankle joint movement on the paralyzed side during sit-to-stand, active ankle dorsiflexion angle on the paralyzed side, and the composite spasticity score. [Results] The weight-bearing symmetry values, movement of the ankle dorsiflexion during sit-to-stand, active ankle dorsiflexion angle, and composite spasticity score were significantly improved in phase B as compared with phase A and the effect was sustained in phase A’. [Conclusion] Kinesthetic illusion induced by visual stimulation for a hemiparesis stroke patient affected the ankle dorsiflexion function, resulting in an improved asymmetry during sit-to-stand as assessed by weight-bearing symmetry values.東京都立大学学位論文甲第1253号　副論文journal articl

Effects and Adaptation of Visual-Motor Illusion Using Different Visual Stimuli on Improving Ankle Joint Paralysis of Stroke Survivors : A Randomized Crossover Controlled Trial

Visual-motor illusion (VMI) is an intervention to induce kinesthetic sensation from visual stimuli. We aimed to compare the effects of VMI of different visual stimuli on the paralyzed side ankle joint of stroke hemiplegic patients (hemiplegic patients) and to clarify their indication. We applied two types of VMI images of ankle dorsiflexion: ankle dorsiflexion without resistance (standard VMI (S-VMI)) and maximum effort dorsiflexion with resistance (power VMI (P-VMI)). Twenty-two hemiplegic patients were divided into two groups: Group A, which received S-VMI first and P-VMI one week later (n = 11), and Group B, which received P-VMI first and S-VMI one week later (n = 11). Immediate effects were evaluated. Outcomes were the dorsiflexion angle and angular velocity, degree of sense of agency (SoA), and sense of ownership. Patient’s characteristics of cognitive flexibility were assessed using the Trail making test-B (TMT-B). Fugl-Meyer assessment and the Composite-Spasticity-Scale were also assessed. P-VMI was significantly higher than S-VMI in SoA and dorsiflexion angular velocity. Additionally, the degree of improvement in dorsiflexion function with P-VMI was related to TMT-B and degree of muscle tone. Therefore, P-VMI improves ankle function in hemiplegic patients more than S-VMI but should be performed with cognitive flexibility and degree of muscle tone in mind.東京都立大学学位論文甲第1253号　副論文journal articl

Investigating the Characteristics of Covert Unilateral Spatial Neglect Using the Modified Posner Task : A Single-subject Design Study

Objectives: Patients identified as asymptomatic for unilateral spatial neglect (USN) based on paper-and-pen tests nonetheless often collide with objects to their left while walking. This study aimed to investigate chronic USN in subjects who experienced collisions while walking. Methods: Two patients with chronic USN who experienced collisions while walking were evaluated using the Behavioral Inattention Test-conventional (BIT-c). Additionally, the modified Posner task (MPT) was used to evaluate the left and right reaction times. MPT targets randomly appeared either on the side indicated by the cue (valid condition) or on the opposite side (invalid condition). This study used an alternating treatments single-case design. The valid and invalid conditions of the MPT alternated rapidly and randomly to determine differences in reaction time. Statistical analysis compared left and right reaction times using a one-tailed randomization test to study valid and invalid conditions. Results: The total BIT-c score was in the normal range for both subjects, whereas MPT reaction times were higher on the left side than on the right side for the invalid condition. However, for the valid condition, only Case B had increased reaction times on the left side. Conclusions: The MPT valid condition evaluates voluntary attention, whereas the invalid condition evaluates the reorientation of attention. Consequently, for Case A, a left reorientation of attention deficit was observed, whereas, for Case B, left voluntary attention and left reorientation of attention deficits were observed. The MPT results revealed the characteristics of covert neglect signs. USN evaluation would benefit from additional research using MPT.東京都立大学学位論文甲第1251号　副論

Effects of kinesthetic illusion induced by visual stimulation on the ankle joint for sit-to-stand in a hemiparesis stroke patient : ABA’ single-case design

[Purpose] The purpose of this study was to investigate the effect of kinesthetic illusion induced by visual stimulation to the paralyzed side ankle joint on the sit-to-stand of a hemiparesis stroke patient. [Participant and Methods] A 33-year-old male with left hemiparesis due to a right putamen hemorrhage participated. This study used the ABA’ single-case design. Phase A and A’ conducted only conventional physiotherapy. Phase B conducted kinesthetic illusion induced by visual stimulation and conventional physiotherapy. To create a kinesthetic illusion, a video image of the patient’s ankle joint dorsiflexion movement on the non-paralyzed side was inverted and placed on the patient’s paralyzed ankle. The patient observed this display for 5 min. We evaluated weight-bearing symmetry values during sit-to-stand, duration of sit-to-stand, trunk and ankle joint movement on the paralyzed side during sit-to-stand, active ankle dorsiflexion angle on the paralyzed side, and the composite spasticity score. [Results] The weight-bearing symmetry values, movement of the ankle dorsiflexion during sit-to-stand, active ankle dorsiflexion angle, and composite spasticity score were significantly improved in phase B as compared with phase A and the effect was sustained in phase A’. [Conclusion] Kinesthetic illusion induced by visual stimulation for a hemiparesis stroke patient affected the ankle dorsiflexion function, resulting in an improved asymmetry during sit-to-stand as assessed by weight-bearing symmetry values.東京都立大学学位論文甲第1253号　副論