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StrokeNCT05978596

Time Course of a Misperception of Verticality and Its Characteristics in Post-stroke Participants

An observational study of Stroke, run by Universiteit Antwerpen at 2 sites in Belgium.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Little is known about the time course of verticality perception after stroke. This study aims to assess: The time course of verticality perception (Subjective Visual, Haptic and Postural Vertical; resp., SVV, SHV, SPV); The longitudinal interaction of the recovery of spatial disorders (e.g., different types of… Read more about this study

Who is it for?
Ages 18 to 90 yearsHealthy volunteers can take part
Conditions the study is for
Stroke
How many people
40 participants
Where
2 sitesBelgium
Study dates
1 Oct 2021to Dec 2024
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 90 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Study population: Participants will be recruited from rehabiliation hospital RevArte (Edegem) and AZ Monica (Antwerp).

Who may be able to join

  • First-ever, MRI- or CT-confirmed, ischemic or hemorrhagic supratentorial stroke;
  • Able to give written informed consent.

Who cannot join

  • Bilateral lesions;
  • Vestibular dysfunction, symptomatic orthostatic hypotension or other pre-existing neurological conditions that could interfere with the assessments;
  • Inability to understand and follow basic verbal instructions;
  • Hemianopsia or other visual field deficits (glasses or corrective lenses are allowed)
  • And a group of healthy controls to obtain normative data. These participants are eligible for inclusion if they are between 18 and 90 years old and do not suffer from vestibular dysfunction, symptomatic orthostatic hypotension or other neurological conditions that could interfere with the assessment.

Trial locations and contacts

2 sites in 1 country.

Charlotte van der Waal, MSc contact

+3232659724

charlotte.vanderwaal@uantwerpen.be

Wim Saeys, Prof. Dr. contact

wim.saeys@uantwerpen.be

Belgium2 sites, 2 recruiting
  • AZ Monica

    Antwerp, 2018

    Charlotte van der Waal, charlotte.vanderwaal@uantwerpen.be

    Jelena Warmenbol

    Recruiting
  • RevArte

    Edegem, 2650

    Charlotte van der Waal, MSc, charlotte.vanderwaal@uantwerpen.be

    Wim Saeys, Dr

    Recruiting

Other trials in Belgium

About this study

Official title: Postural Alignment in Post-stroke Participants: Providing New Insights in the Time Course of a Misperception of Verticality and Its Characteristics

Little is known about the time course of verticality perception after stroke. This study aims to assess:

  • The time course of verticality perception (Subjective Visual, Haptic and Postural Vertical; resp., SVV, SHV, SPV);
  • The longitudinal interaction of the recovery of spatial disorders (e.g., different types of neglect, lateropulsion) with verticality perception;
  • The longitudinal interaction of motor function and outcomes (such as paresis, sitting balance and standing balance) and verticality perception.
Read more

The participants will be repetitively assessed during the subacute phase post-stroke, to evaluate the time course of:

  • The SVV, SHV and SPV;
  • Spatial disorders (visuospatial and personal neglect, lateropulsion)
  • Motor function (lower limb strength, sitting and standing balance, functionality in ADL, trunk performance)
Read the detailed description

For a correct vertical alignment of the body with the gravitational vector, the patient must be able to accurately perceive verticality. Estimation of verticality is a complex process, suggested to be based on internal references derived from the integration of multisensory input (e.g. visual, vestibular and somatosensory). Due to a brain lesion, this complex process can be hampered, resulting in a deviation of the subjective vertical.

Different modalities of verticality perception can be assessed, including the Subjective Visual (SVV), Haptic (SHV) and Postural (SPV) Vertical. Previous studies reported a deviation of the subjective vertical in post-stroke patients. These deviations are associated with poorer balance performance. However, some stroke participants have more difficulties with accurately estimating a vertical position as compared to others. This increased magnitude is often seen in participants with lateropulsion or spatial neglect.

Although previous studies showed an increased deviation of the subjective vertical in post-stroke patients, little is known about the recovery of this misperception of verticality. Especially in patients with spatial disorders (e.g., lateropulsion or (different subtypes of) neglect), there is clear lack of studies assessing the longitudinal recovery of a misperception of verticality. Knowledge about the spontaneous recovery of a deviated verticality perception and its association with spatial disorders, will give insights in the role of a misperception of verticality in these disorders.

Although disturbances in perceiving verticality and decreased balance performance seems to be related, it is unclear how these disturbances exactly impacts balance and functional outcome. A longitudinal interaction between verticality perception and motor function will be evaluated.

Participants will be recruited from rehabilitation hospital Revarte (Edegem) or AZ Monica (Antwerp). Participants will be included at 3 or 5 weeks post-stroke and evaluation will take place at 3, 5, 8 and 12 weeks post-stroke. Also, in healthy participants the SVV, SHV and SPV will be evaluated to obtain normative data.

The outcome measures contain:

  • Perception of verticality: SVV, SHV, SPV;
  • Combination of pen-and-paper tasks and computerized tests to asses visuospatial and personal neglect;
  • Clinical scales to evaluate lateropulsion;
  • Clinical scales to evaluate motor function (lower limb strength, sitting balance, standing balance, functionality in ADL, trunk performance);
  • Instrumented analysis to assess sitting and standing balance.

For the data-analysis Linear Mixed Models will be used, to evaluate study results and mean change over time.

Conditions
Stroke
Keywords
Perception of verticality, Spatial neglect, Lateropulsion, Postural control, Subjective Visual Vertical, Subjective Haptic Vertical, Subjective Postural Vertical
Medical subject headings
Stroke

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in Subjective Visual Vertical constant error

    Reflects the difference between the perceived visual vertical and the gravitational vector, with the direction (ipsi- vs contralesional) considered.

    Measured: Change from 3 to 5 weeks

  2. Change in Subjective Visual Vertical constant error

    Reflects the difference between the perceived visual vertical and the gravitational vector, with the direction (ipsi- vs contralesional) considered.

    Measured: Change from 5 to 8 weeks

  3. Change in Subjective Visual Vertical constant error

    Reflects the difference between the perceived visual vertical and the gravitational vector, with the direction (ipsi- vs contralesional) considered.

    Measured: Change from 8 to 12

  4. Change in Subjective Hapic Vertical constant error

    Reflects the difference between the perceived haptic vertical and the gravitational vector, with the direction (ipsi- vs contralesional) considered.

    Measured: Change from 3 to 5 weeks

  5. Change in Subjective Hapic Vertical constant error

    Reflects the difference between the perceived haptic vertical and the gravitational vector, with the direction (ipsi- vs contralesional) considered.

    Measured: Change from 5 to 8 weeks

  6. Change in Subjective Hapic Vertical constant error

    Reflects the difference between the perceived haptic vertical and the gravitational vector, with the direction (ipsi- vs contralesional) considered.

    Measured: Change from 8 to 12 weeks

  7. Change in Subjective Postural Vertical constant error

    Reflects the difference between the perceived postural vertical and the gravitational vector, with the direction (ipsi- vs contralesional) considered.

    Measured: Change from 3 to 5 weeks

  8. Change in Subjective Postural Vertical constant error

    Reflects the difference between the perceived postural vertical and the gravitational vector, with the direction (ipsi- vs contralesional) considered.

    Measured: Change from 5 to 8 weeks

  9. Change in Subjective Postural Vertical constant error

    Reflects the difference between the perceived postural vertical and the gravitational vector, with the direction (ipsi- vs contralesional) considered.

    Measured: Change from 8 to 12 weeks

  10. Change in Subjective Visual Vertical unsigned error

    Reflects the difference between the perceived visual vertical and the gravitational vector, irrespective of the direction.

    Measured: Change from 3 to 5 weeks

  11. Change in Subjective Visual Vertical unsigned error

    Reflects the difference between the perceived visual vertical and the gravitational vector, irrespective of the direction.

    Measured: Change from 5 to 8 weeks

  12. Change in Subjective Visual Vertical unsigned error

    Reflects the difference between the perceived visual vertical and the gravitational vector, irrespective of the direction.

    Measured: Change from 8 to 12 weeks

  13. Change in Subjective Haptic Vertical unsigned error

    Reflects the difference between the perceived haptic vertical and the gravitational vector, irrespective of the direction.

    Measured: Change from 3 to 5 weeks

  14. Change in Subjective Haptic Vertical unsigned error

    Reflects the difference between the perceived haptic vertical and the gravitational vector, irrespective of the direction.

    Measured: Change from 5 to 8 weeks

  15. Change in Subjective Haptic Vertical unsigned error

    Reflects the difference between the perceived haptic vertical and the gravitational vector, irrespective of the direction.

    Measured: Change from 8 to 12 weeks

  16. Change in Subjective Postural Vertical unsigned error

    Reflects the difference between the perceived postural vertical and the gravitational vector, irrespective of the direction.

    Measured: Change from 3 to 5 weeks

  17. Change in Subjective Postural Vertical unsigned error

    Reflects the difference between the perceived postural vertical and the gravitational vector, irrespective of the direction.

    Measured: Change from 5 to 8 weeks

  18. Change in Subjective Postural Vertical unsigned error

    Reflects the difference between the perceived postural vertical and the gravitational vector, irrespective of the direction.

    Measured: Change from 8 to 12 weeks

  19. Change in Subjective Visual Vertical variability

    Reflects the intra-individual variability (standard deviation of the trials)

    Measured: Change from 3 to 5 weeks

  20. Change in Subjective Visual Vertical variability

    Reflects the intra-individual variability (standard deviation of the trials)

    Measured: Change from 5 to 8 weeks

  21. Change in Subjective Visual Vertical variability

    Reflects the intra-individual variability (standard deviation of the trials)

    Measured: Change from 8 to 12 weeks

  22. Change in Subjective Haptic Vertical variability

    Reflects the intra-individual variability (standard deviation of the trials)

    Measured: Change from 3 to 5 weeks

  23. Change in Subjective Haptic Vertical variability

    Reflects the intra-individual variability (standard deviation of the trials)

    Measured: Change from 5 to 8 weeks

  24. Change in Subjective Haptic Vertical variability

    Reflects the intra-individual variability (standard deviation of the trials)

    Measured: Change from 8 to 12 weeks

  25. Change in Subjective Postural Vertical variability

    Reflects the intra-individual variability (standard deviation of the trials)

    Measured: Change from 3 to 5 weeks

  26. Change in Subjective Postural Vertical variability

    Reflects the intra-individual variability (standard deviation of the trials)

    Measured: Change from 5 to 8 weeks

  27. Change in Subjective Postural Vertical variability

    Reflects the intra-individual variability (standard deviation of the trials)

    Measured: Change from 8 to 12 weeks

Secondary outcomes (12)
  1. Trunk Control Test - item quiet siting for 30 seconds

    Sitting, hands on lap, feet of the ground. Score from 0 to 2. Higher score means better performance.

    Measured: 3, 5, 8, 12 weeks post-stroke

  2. Berg Balance Scale - item quiet standing for 2 minutes

    Ability to stand unsupported. Score from 0 to 4. Higher score means better performance.

    Measured: 3, 5, 8, 12 weeks post-stroke

  3. Motricity index - lower limbs

    Strength of the hip flexors, knee extensors and dorsiflexors (paretic vs non paretic limb)

    Measured: 3, 5, 8, 12 weeks post-stroke

  4. Line Bisection Test

    Visuospatial neglect test

    Measured: 3, 5, 8, 12 weeks post-stroke

  5. Visuospatial Search Time Test

    Visuospatial neglect test

    Measured: 3, 5, 8, 12 weeks post-stroke

  6. Fluff test

    Personal neglect test

    Measured: 3, 5, 8, 12 weeks post-stroke

  7. Tactile extinction test

    Personal neglect test

    Measured: 3, 5, 8, 12 weeks post-stroke

  8. Burke Lateropulsion Scale

    Lateropulsion test. Score from 0-17.

    Measured: 3, 5, 8, 12 weeks post-stroke

  9. Scale for Contraversive Pushing

    Lateropulsion test. Score 0-6.

    Measured: 3, 5, 8, 12 weeks post-stroke

  10. Trunk Impairment test (dynamic and coordination subscales)

    Test to evaluate the dynamic and coordinative performance of the trunk

    Measured: 3, 5, 8, 12 weeks post-stroke

  11. Weight bearing asymmetry (standing)

    Difference in weight bearing (paretic vs non-paretic) in percentage

    Measured: 3, 5, 8, 12 weeks post-stroke

  12. Broken Heart Test

    Change in cancellation task for visuospatial neglect

    Measured: 3, 5, 8, 12 weeks post-stroke

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted7 Aug 2023
  2. Study start1 Oct 2021
  3. Primary completionDec 2024 (estimated)
  4. Study completionDec 2024 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
40 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05978596
Sponsor's protocol ID
CvdW
Status last verified
Aug 2023
First submitted
20 Jun 2023
Last updated
7 Aug 2023
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • van der Waal C, Embrechts E, Loureiro-Chaves R, Gebruers N, Truijen S, Saeys W. Lateropulsion with active pushing in stroke patients: its link with lesion location and the perception of verticality. A systematic review. Top Stroke Rehabil. 2023 Apr;30(3):281-297. doi: 10.1080/10749357.2022.2026563. Epub 2022 Feb 1.

    PubMed 35102816
  • Embrechts E, van der Waal C, Anseeuw D, van Buijnderen J, Leroij A, Lafosse C, Nijboer TC, Truijen S, Saeys W. Association between spatial neglect and impaired verticality perception after stroke: A systematic review. Ann Phys Rehabil Med. 2023 Apr;66(3):101700. doi: 10.1016/j.rehab.2022.101700. Epub 2022 Dec 1.

    PubMed 35963568
  • Perennou DA, Mazibrada G, Chauvineau V, Greenwood R, Rothwell J, Gresty MA, Bronstein AM. Lateropulsion, pushing and verticality perception in hemisphere stroke: a causal relationship? Brain. 2008 Sep;131(Pt 9):2401-13. doi: 10.1093/brain/awn170. Epub 2008 Aug 4.

    PubMed 18678565
  • Bonan IV, Leman MC, Legargasson JF, Guichard JP, Yelnik AP. Evolution of subjective visual vertical perturbation after stroke. Neurorehabil Neural Repair. 2006 Dec;20(4):484-91. doi: 10.1177/1545968306289295.

    PubMed 17082504
  • van der Waal C, Saeys W, Truijen S, Embrechts E. Clinical Assessment of Subjective Visual and Haptic Vertical Norms in Healthy Adults. Arch Clin Neuropsychol. 2024 Nov 22;39(8):1408-1417. doi: 10.1093/arclin/acae049.

    PubMed 38940374

Questions about this trial

What is this clinical trial studying?

An observational study of Stroke, run by Universiteit Antwerpen at 2 sites in Belgium.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 7 Aug 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in Belgium. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Charlotte van der Waal, MSc (+3232659724, charlotte.vanderwaal@uantwerpen.be), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in Subjective Visual Vertical constant error (time frame: Change from 3 to 5 weeks). The study lists 27 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05978596, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 7 Aug 2023.

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