Examining the Process of Visual Cues during Dressing Movements in Patients with Hemiplegia: A Cross-Sectional Pilot Study

Background: Reportedly, in patients with hemiplegia, higher brain dysfunction is associated with difficulty in dressing. Nevertheless, it is not clear how patients with hemiplegia take in clothing information (visual information). Objective: This study aimed to compare the process of taking in visual cues during dressing in patients with hemiplegia. Methods: A cross-sectional observational study was conducted on 11 patients with hemiplegia and 11 age- and gender- matched healthy adults. The two groups wore eye mark recorders between 2009 and 2015, and their eye movements were observed as they wore the shirts. Results: The number of fixations per second in patients with hemiplegia was negatively correlated with paralyzed upper limb function (rs = 0.90, p = 0.001). In comparison with the control group, patients with hemiplegia had a higher number of fixations per second (p = 0.020), and the ratio of fixation time to movement execution times was also higher (p = 0.008). Additionally, whereas the control group more often demonstrated fixation at tags (p = 0.001), patients with hemiplegia fixated more often at the body of the clothes (p = 0.001) and sleeves (p = 0.001), especially fixation on their own nonparalyzed hands (p = 0.001). Conclusions: In hemiplegic patients, the more severe the paralysis, the more the patients' movements tended to rely on visual cues. Nevertheless, their perception of visual cues was very inefficient when compared with the control group, suggesting that they disrupted the execution of movements.