Desordens visuomotoras em indivíduos com AVC: uma revisão narrativa
DOI:
https://doi.org/10.34024/rnc.2025.v33.20371Palavras-chave:
acidente vascular cerebral, movimento ocular, ortóptica, transtornos da motilidade ocularResumo
Introdução. A prevalência das desordens visuomotoras na população com acidente vascular cerebral (AVC) está em torno de 68% e sua etiologia ainda não está bem definida, apresentando hipóteses multifatoriais. Objetivo. Analisar, por meio de uma revisão narrativa, as desordens visuomotoras e os benefícios da fisioterapia oftálmica em indivíduos com AVC. Método. Foi realizada uma revisão da literatura do tipo narrativa, com busca em diferentes bases de dados. Resultados. Foram encontrados 46 estudos, sendo incluídos no total 18 artigos pertinentes ao tema. Das referências pesquisadas, foi encontrada 1 revisão sistemática, 7 estudos de revisão e 10 estudos experimentais. Conclusão. No contexto geral, os exercícios visuomotores parecem beneficiar esses pacientes, otimizando diferentes funções como a coordenação visuo-manual, a síndrome de negligência visuoespacial, o equilíbrio postural, as características da marcha e a qualidade de vida. Assim, mais estudos são necessários para investigar melhor esses efeitos.
Métricas
Referências
1.Hankey GJ. Stroke. Lancet 2017;389:641-54. https://doi.org/10.1016/S0140-6736(16)30962-X
2.Bolognini N, Russo C, Edwards DJ. The sensory side of post-stroke motor rehabilitation. Rest Neurol Neurosci 2016;34:571-86. https://doi.org/10.3233/RNN-150606
3.Mehrholz J, Thomas S, Werner C, Kugler J, Pohl M, Elsner B. Electromechanical-assisted training for walking after stroke. Cochr Database Syst Rev 2017;48:188-9. https://doi.org/10.1002/14651858.CD006185.pub4
4.Adia S, Shinde C, Desai R, Mahajan AG, Sharma S, Singh B, et al. Ocular manifestations in patients with cerebrovascular accidents in India: a cross-sectional observational study. Inter Ophthalmol 2019;39:2843-9. https://doi.org/10.1007/s10792-019-01131-7
5.Büttner-Ennever JA. Progress in brain research: Neuroanatomy of the oculomotor system. New York: Science Direct; 2006.
6.Alvarez TL, Vicci VR, Alkan Y, Kim EH, Gohel S, Barrett AM, et al. Vision Therapy in Adults with Convergence Insufficiency: Clinical and Functional Magnetic Resonance Imaging Measures. Optometr Vis Sci 2010;87:E985-1002. https://doi.org/10.1097/OPX.0b013e3181fef1aa
7.Alvarez TL, Jaswal R, Gohel S, Biswal BB. Functional activity within the frontal eye fields, posterior parietal cortex, and cerebellar vermis significantly correlates to symmetrical vergence peak velocity: an ROI-based, fMRI study of vergence training. Front Integr Neurosci 2014;8:50. https://doi.org/10.3389/fnint.2014.00050
8.Scheiman MM, Talasan H, Mitchell GL, Alvarez TL. Objective Assessment of Vergence after Treatment of Concussion-Related CI. Optometr Vis Sci 2017;94:74-88. https://doi.org/10.1097/OPX.0000000000000936
9.Menigite NC, Taglietti M. Visual symptoms and convergence insufficiency in university teachers. Rev Bras Oftalmol 2017;76:242-6. https://doi.org/10.5935/0034-7280.20170050
10.Bicas HEA. Fisiologia da visão binocular. Arq Bras Oftalmol 2004;67:172-80. https://doi.org/10.1590/S0004-27492004000100032
11.Bicas HEA. Oculomotricidade e seus fundamentos. Arq Bras Oftalmol 2003;66:687-700. https://doi.org/10.1590/S0004-27492003000500026
12.Racette BA, Gokden MS, Tychsen LS, Perlmutter JS. Convergence insufficiency in idiopathic Parkinson's disease responsive to levodopa. Strabismus 1999;7:169-74. https://doi.org/10.1076/stra.7.3.169.636
13.Lepore FE. Parkinson’s disease and diplopia. Neuro Ophthalmol 2006;30:37-40. https://doi.org/10.1080/01658100600742838
14.Zeng Y, Oechslin TS, Widmer DE, Kulp MT, Fogt N, Toole A, et al. Neural consequences of symptomatic convergence insufficiency: A small sample study. Ophthalm Physiol Opt 2024;44:537-45. https://doi.org/10.1111/opo.13303
15.Bogousslavsky J, Meienberg O. Eye-Movement Disorders in Brain-Stem and Cerebellar Stroke. Arc Neurol 1987;44:141-8. https://doi.org/10.1001/archneur.1987.00520140013011
16.Kawata K, Rubin LH, Lee JH, Sim T, Takahagi M, Szwanki V, et al. Association of Football Subconcussive Head Impacts With Ocular Near Point of Convergence. JAMA Ophthalmol 2016;134:763. https://doi.org/10.1001/jamaophthalmol.2016.1085
17.Kim SH, Kim JS. Eye movement abnormalities in middle cerebellar peduncle strokes. Acta Neurol Belg 2017;119:37-45. https://doi.org/10.1007/s13760-017-0860-1
18.Batool S, Zafar H, Syed Amir Gilani, Ahmad A, Hanif A. Intrarater and interrater reliability of the dynamic gait index in post stroke patients with eye movement disorders. J Bodywork Movem Ther 2023;35:38-42. https://doi.org/10.1016/j.jbmt.2023.04.015
19.Pollock A, Hazelton C, Brady M. Visual Problems After Stroke: A Survey of Current Practice by Occupational Therapists Working in UK Stroke Inpatient Settings. Top Stroke Rehab 2011;18(sup1):643-51. https://doi.org/10.1310/tsr18s01-643
20.Rowe FJ, Hepworth LR, Coco-Martin MB, Gillebert CR, Leal-Vega L, Palmowski-Wolfe A, et al. European Stroke Organisation (ESO) guideline on visual impairment in stroke. Eur Stroke J 2025:23969873251314693. https://doi.org/10.1177/23969873251314693
21.Beheshti M, Hudson TE, Rizzo JR. What’s the Deal With Eye-Hand Coordination Post-stroke? Am J Phys Med Rehab 2020;99:968. https://doi.org/10.1097/PHM.0000000000001497
22.Rizzo JA, Fung J, Hosseini M, Shafieesabet A, Ahdoot E, Pasculli RM, et al. Eye Control Deficits Coupled to Hand Control Deficits: Eye–Hand Incoordination in Chronic Cerebral Injury. Fornt Neurol 2017;8:330. https://doi.org/10.3389/fneur.2017.00330
23.Singh T, Perry CM, Fritz SL, Fridriksson J, Herter TM. Eye Movements Interfere With Limb Motor Control in Stroke Survivors. Neurorehab Neural Repair 2018;32:724-34. https://doi.org/10.1177/1545968318790016
24.Meadmore KL, Exell TA, Burridge JH, Hughes AM, Freeman CT, Benson V. Upper limb and eye movement coordination during reaching tasks in people with stroke. Disab Rehab 2017;40:2424-32. https://doi.org/10.1080/09638288.2017.1336649
25.Riggs RV, Andrews K, Roberts P, Gilewski M. Visual Deficit Interventions in Adult Stroke and Brain Injury. Am J Phys Med Rehab 2007;86:853-60. https://doi.org/10.1097/PHM.0b013e318151f907
26.Elhamrawy M, SAIF MY, Mohamed S, Said M. Effect of Eye Movement Training on Balance in Post Stroke Patients with Unilateral Spatial Neglect. First Preliminary report. NILES J Geriatr Gerontol 2019;2:71-6. https://doi.org/10.21608/niles.2019.58080
27.Kang KY, Yu KH. The effects of eye movement training on gait function in patients with stroke. J Phys Ther Sci 2016;28:1816-8. https://doi.org/10.1589/jpts.28.1816
28.Pang MY. Smooth pursuit eye movement training improves recovery from functional neglect in individuals with postacute stroke. J Physiother 2015;61:45. https://doi.org/10.1016/j.jphys.2014.11.012
29.Kerkhoff G, Reinhart S, Ziegler W, Artinger F, Marquardt C, Keller I. Smooth Pursuit Eye Movement Training Promotes Recovery From Auditory and Visual Neglect. Neurorehab Neural Repair 2013;27:789-98. https://doi.org/10.1177/1545968313491012
30.Kerkhoff G. Neurovisual rehabilitation: recent developments and future directions. Am J Ophthalmol 2000;130:687-8. https://doi.org/10.1016/s0002-9394(00)00753-4
31.Park SE. Effects of eye movement with functional electrical stimulation on balance in stroke patients with neglect syndrome. J Phys Ther Sci 2016;28:1577-81. https://doi.org/10.1589/jpts.28.1577
32.Kapoor N, Ciuffreda KJ. Assessment of neuro-optometric rehabilitation using the Developmental Eye Movement (DEM) test in adults with acquired brain injury. J Optometr 2018;11:103-12. https://doi.org/10.1016/j.optom.2017.01.001
Downloads
Publicado
Edição
Seção
Licença
Copyright (c) 2025 Nélio Silva de Souza da Costa, Ana Carolina Gomes Martins, Danielle de Paula Aprígio Alves, Felipe Barros de Escobar, Silmar Silva Teixeira, Victor Hugo do Vale Bastos, Marco Antônio Araújo-Leite
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
