@article{ref1,
title="Effect of visuospatial neglect on spatial navigation and heading after stroke",
journal="Annals of physical and rehabilitation medicine",
year="2018",
author="Aravind, Gayatri and Lamontagne, Anouk",
volume="61",
number="4",
pages="197-206",
abstract="BACKGROUND: Visuospatial neglect (VSN) impairs the control of locomotor heading in post-stroke individuals, which may affect their ability to safely avoid moving objects while walking. <br><br>OBJECTIVE: We aimed to compare VSN+ and VSN- stroke individuals in terms of changes in heading and head orientation in space while avoiding obstacles approaching from different directions and reorienting toward the final target. <br><br>METHODS: Stroke participants with VSN (VSN+) and without VSN (VSN-) walked in a virtual environment avoiding obstacles that approached contralesionally, head-on or ipsilesionally. Measures of obstacle avoidance (onset-of-heading change, maximum mediolateral deviation) and target alignment (heading and head-rotation errors with respect to target) were compared across groups and obstacle directions. <br><br>RESULTS: In total, 26 participants with right-hemisphere stroke participated (13 VSN+ and 13 VSN-; 24 males; mean age 60.3 years, range 48 to 72 years). A larger proportion of VSN+ (75%) than VSN- (38%) participants collided with contralesional and head-on obstacles. For VSN- participants, deviating to the same-side, as the obstacle was a safe strategy to avoid diagonal obstacles and deviating to the opposite-side led to occasional collisions. VSN+ participants deviated ipsilesionally, displaying same-side and opposite-side strategies for ipsilesional and contralesional obstacles, respectively. Overall, VSN+ participants showed greater distances at onset-of-heading change, smaller maximum mediolateral deviation and larger errors in target alignment as compared with VSN- participants. <br><br>CONCLUSION: The ipsilesional bias arising from VSN influences the modulation of heading in response to obstacles and, along with the adoption of the &quot;riskier&quot; strategies, contribute to the higher number colliders and poor goal-directed walking abilities in stroke survivors with VSN. Future research should focus on developing assessment and training tools for complex locomotor tasks such as obstacle avoidance in this population.<br><br>Copyright © 2017 Elsevier Masson SAS. All rights reserved.<p /> <p>Language: en</p>",
language="en",
issn="1877-0657",
doi="10.1016/j.rehab.2017.05.002",
url="http://dx.doi.org/10.1016/j.rehab.2017.05.002"
}