Asymmetry of gait initiation in hemiparetic stroke subjects

Hesse, Stefan; Reiter, Frank; Jahnke, M.T.; Dawson, Michael; Sarkodie-Gyan, Thompson; Mauritz, Karl Heinz

doi:10.1016/s0003-9993(97)90079-4

Cited by 105 publications

(106 citation statements)

References 15 publications

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“…Similar to our findings, previous research has observed large oscillations of ML COP prior to gait initiation (similar to our definition of multiple APAs) with the non-paretic limb among individuals with stroke, but did not specifically identify if these oscillations fit the criteria to be APAs (e.g., if the COP oscillations passed the ±10 mm threshold). 12 The authors concluded that these oscillations were due to weakness in the paretic limb and its inability to provide sufficient support to the body during its stance phase. 12 Gait initiation represents an internally-induced perturbation to an individual's upright standing balance.…”

Section: Multiple Apasmentioning

confidence: 99%

“…12 The authors concluded that these oscillations were due to weakness in the paretic limb and its inability to provide sufficient support to the body during its stance phase. 12 Gait initiation represents an internally-induced perturbation to an individual's upright standing balance. Therefore, the large ML COP oscillations observed during multiple APA trials may result from participants responding to this perturbation through excessive postural sway in the ML direction, which may be further influenced by functional differences between the limbs post-stroke.…”

Section: Multiple Apasmentioning

confidence: 99%

“…Furthermore, participants with hemiparesis tend to shift their body weight towards their non-paretic limb before stepping, as it is stronger and more capable of handling the increased weight. 12 This tendency may contribute to the ML COP being located closer to the participant's non-paretic limb during the stance phase, thereby requiring a smaller amplitude ML COP shift during gait initiation in the paretic limb compared to the non-paretic limb. 12 The occurrence of atypical APA patterns has been documented in other neurologicallyimpaired populations, such as individuals with Parkinson's disease.…”

Section: Introductionmentioning

confidence: 99%

“…12 This tendency may contribute to the ML COP being located closer to the participant's non-paretic limb during the stance phase, thereby requiring a smaller amplitude ML COP shift during gait initiation in the paretic limb compared to the non-paretic limb. 12 The occurrence of atypical APA patterns has been documented in other neurologicallyimpaired populations, such as individuals with Parkinson's disease. 4,6,13 Multiple APAs have been documented in people with Parkinson's disease during gait initiation and when stepping in response to an unexpected postural perturbation.…”

Section: Introductionmentioning

confidence: 99%

“…Previous research has observed large oscillations of ML COP prior to gait initiation with the non-paretic limb among individuals with stroke. 12 These oscillations may be due to weakness in the paretic limb and its inability to properly support the body during its stance phase. 12 However, this study did not characterize the identified oscillations into different categories of APAs, and we are unaware of any study to describe atypical APAs post-stroke.…”

Section: Introductionmentioning

confidence: 99%

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Atypical anticipatory postural adjustments during gait initiation among individuals with sub-acute stroke

et al. 2017

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Anticipatory postural adjustments, executed prior to gait initiation, help preserve lateral stability when stepping. Atypical patterns of anticipatory activity prior to gait initiation may occur in individuals with unilateral impairment (e.g., stroke). This study aimed to determine the prevalence, correlates, and consequences of atypical anticipatory postural adjustment patterns prior to gait initiation in a sub-acute stroke population. Forty independently-ambulatory individuals with subacute stroke stood on two force plates and initiated gait at a self-selected speed. Medio-lateral centre of pressure displacement was calculated and used to define anticipatory postural adjustments (shift in medio-lateral centre of pressure >10 mm from baseline). Stroke severity, motor recovery, and functional balance and mobility status were also obtained. Three patterns were identified: single (typical), absent (atypical), and multiple (atypical) anticipatory postural adjustments. Thirty-five percent of trials had atypical anticipatory postural adjustments (absent and multiple). Frequency of absent anticipatory postural adjustments was negatively correlated with walking speed. Multiple anticipatory postural adjustments were more prevalent when leading with the non-paretic than the paretic limb. Trials with multiple anticipatory postural adjustments had longer duration of anticipatory postural adjustment and time to foot-off, and shorter unloading time than trials with single anticipatory postural adjustments. A high prevalence of atypical anticipatory control prior to gait initiation was found in individuals with stroke. Temporal differences were identified with multiple anticipatory postural adjustments, indicating altered gait initiation. These findings provide insight into postural control during gait initiation in individuals with sub-acute stroke, and may inform interventions to improve ambulation in this population.

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Section: Multiple Apasmentioning

confidence: 99%

Section: Multiple Apasmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Atypical anticipatory postural adjustments during gait initiation among individuals with sub-acute stroke

et al. 2017

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The Control of Locomotion

Holland

Lynch‐Ellerington

2009

Bobath Concept

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Influence of foot positions on the spine and pelvis

Betsch

Schneppendahl

Dor

et al. 2011

Arthritis Care & Research

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Objective. The management of knee osteoarthritis includes the use of wedged shoe insoles to unload the affected knee compartment. Although the biomechanical effects of shoe insoles on the knee joint are known and described, only little is known about their influence on the pelvis and spine. Therefore, the purpose of this study was to evaluate the effects of different foot positions, such as how they could be achieved by shoe insoles, on pelvic position and spinal posture. Methods. A total of 51 test subjects were measured for this study. The different foot positions (inner and outer margin increase, positive and negative heel height) were simulated with a specially designed stand platform. A rasterstereographic device was used to measure the immediate effects of the simulated foot positions on the pelvic position and spinal posture. Results. Positive and negative heel heights as well as an increase of the outer margin of the platform led to significant changes of the pelvic tilt. The pelvic torsion also changed significantly during positive heel height changes of 10 and 15 mm and increases of the outer margin of the foot. No significant changes were found between foot position and spinal parameters. Conclusion. The results of our study support the existence of a kinematic chain, where changes of foot position also led to significant alterations of the pelvic position. Whether these changes could lead to long-term pathologic alterations still needs to be evaluated. However, in our setting, no correlation between foot position and spinal posture changes was found.

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Asymmetry of gait initiation in hemiparetic stroke subjects

Cited by 105 publications

References 15 publications

Atypical anticipatory postural adjustments during gait initiation among individuals with sub-acute stroke

Atypical anticipatory postural adjustments during gait initiation among individuals with sub-acute stroke

The Control of Locomotion

Influence of foot positions on the spine and pelvis

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