Comparison of the lower limb inter-segmental coordination during walking between healthy controls and people with multiple sclerosis with and without fall history

Salehi, Reza; Mofateh, Razieh; Mehravar, Mohammad; Negahban, Hossein; Tajali, Shirin; Monjezi, Saeideh

doi:10.1016/j.msard.2020.102053

Cited by 10 publications

(9 citation statements)

References 42 publications

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“…However, current gait evaluation mainly focuses on isolated individual joint kinematics and kinematics at specific events or on summary metrics, such as maximum and minimum, which may be insufficient for fully describing the coordination involved in the completion of a movement task ( Chiu and Chou, 2013 ; Chiu et al, 2013 ). Walking is a complex task that imposes a high demand on the motor control system to generate coordinated limb movements to achieve a smooth and accurate gait pattern ( Ogaya et al, 2016 ; Salehi et al, 2020 ). The deficit in one joint can affect the coordination of the entire lower limb chain ( Milner, 2009 ).…”

Section: Introductionmentioning

confidence: 99%

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Intersegmental Coordination in Patients With Total Knee Arthroplasty During Walking

Wang

Qie

et al. 2022

Front. Bioeng. Biotechnol.

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Precise identification of deficient intersegmental coordination patterns and functional limitations is conducive to the evaluation of surgical outcomes after total knee arthroplasty (TKA) and the design of optimal personalized rehabilitation protocols. However, it is still not clear how and when intersegmental coordination patterns change during walking, and what functional limitations are in patients with TKA. This study was designed to investigate lower limb intersegmental coordination patterns in patients with knee osteoarthritis before and after TKA and identify how intersegmental coordination of patients is altered during walking before and after TKA. It was hypothesized that 6-month after TKA, intersegmental coordination patterns of patients are improved compared with that before TKA, but still do not recover to the level of healthy subjects. Gait analysis was performed on 36 patients before and 6-month after TKA and on 34 healthy subjects. Continuous relative phase (CRP) derived from the angle-velocity phase portrait was used to measure the coordination between interacting segments throughout the gait cycle. Thigh-shank CRP and shank-foot CRP were calculated for each subject. Statistical parametric mapping (SPM), a one-dimensional analysis of the entire gait cycle curve, was performed directly to determine which periods of the gait cycle were different in patients and healthy subjects. Six-month after TKA, thigh-shank CRP was significantly higher during 5–12% of the gait cycle (p = 0.041) and lower during 44–95% of the gait cycle (p < 0.001) compared with healthy subjects, and was significantly higher during 62–91% of the gait cycle (p = 0.002) compared with pre-operation. Shank-foot CRP was significantly lower during 0–28% of the gait cycle (p < 0.001) and higher during 58–94% of the gait cycle (p < 0.001) compared with healthy subjects, and was significantly lower during 3–18% of the gait cycle (p = 0.005) compared with pre-operation. This study found that patients exhibited altered intersegmental coordination during the loading response and swing phase both before and after TKA. Six-month after TKA, the thigh-shank coordination was partially improved compared with pre-operation, but still did not recover to the level of healthy subjects, while there was no improvement in the shank-foot coordination pattern after TKA compared with pre-operation. CRP combined with SPM methods can provide insights into the evaluation of surgical outcomes and the design of rehabilitation strategy.

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Section: Introductionmentioning

confidence: 99%

“…The deficit in one joint can affect the coordination of the entire lower limb chain ( Milner, 2009 ). Lower limb intersegmental coordination can be a good indicator of motor control mechanisms during walking ( Ogaya et al, 2016 ; Salehi et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Intersegmental Coordination in Patients With Total Knee Arthroplasty During Walking

Wang

Qie

et al. 2022

Front. Bioeng. Biotechnol.

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“…Stroke often results in spasticity and associated motor impairments in the lower limbs, including muscle weakness ( Li et al, 2014 ), proprioceptive deficit ( Gorst et al, 2019 ), abnormal agonist-antagonist coactivation ( Trumbower et al, 2010 ), and altered inter-joint and inter-segmental coordination ( Subramanian et al, 2018 ; Salehi et al, 2020 ). In clinical rehabilitation, the spasticity and movement deficits disorders have been traditionally been considered as separate phenomena ( Levin, 2016 ).…”

Section: Introductionmentioning

confidence: 99%

Short-Step Adjustment and Proximal Compensatory Strategies Adopted by Stroke Survivors With Knee Extensor Spasticity for Obstacle Crossing

Huang

Wang

et al. 2020

Front. Bioeng. Biotechnol.

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Stroke survivors adopt cautious or compensatory strategies for safe and successful obstacle crossing. Although knee extensor spasticity is a common independent secondary sensorimotor disorder post-stroke, few studies have examined the step adjustment and compensatory strategies used by stroke survivors with knee extensor spasticity during obstacle crossing. This study aimed to compare the differences in the kinematics and kinetics during obstacle crossing between stroke survivors with and without knee extensor spasticity, and to identify knee extensor spasticity-related differences in step adjustment and compensatory strategies. Twenty stroke subjects were divided into a spasticity group [ n = 11, modified Ashworth scale (MAS) ≥ 1] and a non-spasticity group ( n = 9, MAS = 0), based on the MAS score of the knee extensor. Subjects were instructed to walk at a self-selected speed on a 10-m walkway and step over a 15 cm obstacle. A ten-camera 3D motion analysis system and two force plates were used to collect the kinematic and kinetic data. During the pre-obstacle phase, stroke survivors with knee extensor spasticity adopted a short-step strategy to approach the obstacle, while the subjects without spasticity used long-step strategy. During the affected limb swing phase, the spasticity group exhibited increased values that were significantly higher than those seen in the non-spasticity group for the following measurements: pelvic lateral tilt angle, trunk lateral tilt angle, medio-lateral distance between the ankle and ipsilateral hip joint, hip work contributions, the inclination angles between center of mass and center of pressure in anterior–posterior and medio-lateral directions. These results indicate that the combined movement of the pelvic, trunk lateral tilt, and hip abduction is an important compensatory strategy for successful obstacle crossing, but it sacrifices some balance in the sideways direction. During the post-obstacle phase, short-step and increase step width strategy were adopted to reestablish the walking pattern and balance control. These results reveal the step adjustment and compensatory strategies for obstacle crossing and also provide insight into the design of rehabilitation interventions for fall prevention in stroke survivors with knee extensor spasticity.

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“…The greater the asymmetry, the more it affects balance and coordination [19,20]. Therefore, patients with MS often have a greater risk of falling [18,21,22], and use various support measures [23,24]. Thus, coordination assessment is a key component of the neurological examination.…”

Section: Introductionmentioning

confidence: 99%

“…A number of studies have been performed on balance and movement coordination of impaired locomotion involving qualitative and quantitative methods. Examining MS in particular, it is observed that the most common parameters are slowing down of movements, decreased repeatability of repetitive movements, trajectory accuracy when targeting, differences in joint amplitudes, increased variation and asymmetry between damaged and undamaged sides of the body [22,[25][26][27][28]. Movement variability is considered as a clinical measure to assess the locomotor coordination in various motor dysfunctions.…”

Section: Introductionmentioning

confidence: 99%

Quantitative body symmetry assessment during neurological examination

Daunoravičienė

Žižienė

Ovcinikova

et al. 2020

THC

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BACKGROUND: A lack of movement coordination characterized by the undershoot or overshoot of the intended location with the hand, arm, or leg is often found in individuals with multiple sclerosis (MS). Standardized as Finger-to-Nose (FNT) and The Heel-to-Shin (HST) tests are the most frequently used tests for qualitative examination of upper and lower body coordination. Inertial sensors facilitate in performing quantitative motion analysis and by estimating body symmetry more accurately assess coordination lesion and imbalance. OBJECTIVES: To assess the body symmetry of upper and lower limbs quantitatively, and to find the best body symmetry indices to discriminate MS from healthy individuals (CO). METHODS: 28 MS patients and 23 CO participated in the study. Spatiotemporal parameters obtained from six Inertial Measurement Units (IMUs) were placed on the upper and lower extremities during FNT and HST tests. All data were analyzed using statistical methods in MATLAB. RESULTS: Asymmetry indices of temporal parameters showed a significant increase in upper body and lower body asymmetry of MS compared to CO. However, CO have a greater kinematic asymmetry compared to MS. CONCLUSION: Temporal parameters are the most sensitive to body asymmetry evaluation. However, range of motion is completely inappropriate if it is calculated for one movement cycle.

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Comparison of the lower limb inter-segmental coordination during walking between healthy controls and people with multiple sclerosis with and without fall history

Cited by 10 publications

References 42 publications

Intersegmental Coordination in Patients With Total Knee Arthroplasty During Walking

Intersegmental Coordination in Patients With Total Knee Arthroplasty During Walking

Short-Step Adjustment and Proximal Compensatory Strategies Adopted by Stroke Survivors With Knee Extensor Spasticity for Obstacle Crossing

Quantitative body symmetry assessment during neurological examination

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