Abstract: Hemiplegic stroke patients show asymmetric weight-bearing (WB) during functional movements, such as sit-to-stand (STS) tasks. This study aimed to investigate the effect of observation awareness on the WB distribution during STS tasks in these patients. A total of twenty-five hemiplegic stroke patients participated in this study and performed the STS task under three conditions based on awareness of evaluation and the presence of an observer. The first condition was to simulate a practice scenario without awareness of being evaluated and without an observer, the second condition was to perform the STS task while being aware of being evaluated without an observer, and the third condition was to perform the STS task while being aware of being evaluated with an observer present. The WB distribution between the affected (paretic) side and the unaffected (nonparetic) side during the STS was measured in the three conditions. As a result, there was a significant difference in WB distribution depending on the conditions. When patients were aware that they were being evaluated, the WB on the affected side was significantly higher than when they were unaware, and the greatest weight support was achieved in the condition of awareness of evaluation with an observer. This indicates that awareness of evaluation and the presence of an observer can significantly enhance WB symmetry in hemiplegic stroke patients during STS tasks. In conclusion, if patients are informed that an observer is assessing their movements or if a purposefully designed environment is applied to specific task training, such as sit-to-stand exercise or balance training so that patients feel as if they are being observed, it would be effective for stable movement performance.

Keywords: Awareness of evaluation, Observer presence, weight-bearing, stroke, hemiplegia, sit-to-stand

Pages: 359-367