Evaluation of subjective vertical perception among stroke patients: a systematic review.

Luana Ribeiro Ferreira,Gustavo José Luvizutto,Flávio José Pereira De Almeida Ferreira,Luciane Aparecida Pascucci Sande De Souza,Fernanda Aparecida Campos

doi:10.1590/0004-282x-anp-2020-0584

Luana Ribeiro Ferreira, Gustavo José Luvizutto + Show 3 more

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https://doi.org/10.1590/0004-282x-anp-2020-0584

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Abstract

Verticality misperception is relatively common among patients after stroke, and it may be evaluated in terms of (a) subjective visual vertical (SVV), (b) subjective haptic vertical (SHV) and (c) subjective postural vertical (SPV). To better understand these assessment methods, we conducted a systematic review of the methodological characteristics of different protocols for evaluating SVV, SHV and SPV among individuals after stroke. To standardize the methodological characteristics of protocols for evaluating verticality perception after stroke. We searched the following databases: PUBMED, regional BVS portal (MEDLINE, LILACS, IBECS, CUBMED, Psychology Index and LIS), CINAHL, SCOPUS, Web of Science, Science Direct, Cochrane Library and PEDro. Two review authors independently used the QUADAS method (Quality Assessment of Diagnostic Accuracy Studies) and extracted data. We included 21 studies in the review: most (80.9%) used SVV, eight (38.1%) used SPV and four (19.0%) used SHV. We observed high variability in assessments of verticality perception, due to patient positions, devices used, numbers of repetitions and angle of inclination for starting the tests. This systematic review was one of the first to explore all the methods of assessing verticality perception after stroke, and it provides crucial information on how to perform the tests, in order to guide future researchers/clinicians.

Highlights

Stroke can lead to multiple systemic impairments, including sensory, perceptual and cognitive disabilities
Verticality can be perceived in different manners: 1) visual perception of the vertical, evaluated by means of a subjective visual vertical (SVV) test that relies on visuo-vestibular information; 2) postural perception of the vertical, measured through a subjective postural vertical (SPV) test derived from
Some questions still need to be clarified: 1) Are there any validated methods for evaluating verticality perception after stroke? 2) How are these tests performed? To better understand these assessment methods, we conducted a systematic review of the methodological characteristics of different protocols for evaluating SVV, subjective haptic vertical (SHV), and SPV among individuals who had suffered stroke

Summary

Introduction

Stroke can lead to multiple systemic impairments, including sensory, perceptual and cognitive disabilities All of these can affect balance and interfere with perceptions of verticality[1]. The SVV is responsible for an individual’s ability to determine whether objects are aligned vertically without a visual reference point for verticality It depends on the interaction of sensory information in the visual and vestibular systems. Verticality misperception is relatively common among patients after stroke, and it may be evaluated in terms of (a) subjective visual vertical (SVV), (b) subjective haptic vertical (SHV) and (c) subjective postural vertical (SPV). To better understand these assessment methods, we conducted a systematic review of the methodological characteristics of different protocols for evaluating SVV, SHV and SPV among individuals after stroke. Conclusion: This systematic review was one of the first to explore all the methods of assessing verticality perception after stroke, and it provides crucial information on how to perform the tests, in order to guide future researchers/clinicians

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