Effects of hip abduction and adduction accuracy on post-stroke gait

Abstract

Background Gait instability often limits post-stroke function, although the mechanisms underlying this instability are not entirely clear. Our recent work has suggested that one possible factor contributing to post-stroke gait instability is a reduced ability to accurately control foot placement. The purpose of the present experiments was to investigate whether post-stroke gait function is related to the ability to accurately abduct and adduct the hip, as required for accurate foot placement. Methods 35 chronic stroke survivors and 12 age-matched controls participated in this experiment. Participants performed hip oscillation trials designed to quantify hip abduction/adduction accuracy, in which they lay supine and moved their leg through a prescribed range of motion in time with a metronome. Stroke survivors also performed overground walking trials at their self-selected speed. Findings 28 of the 35 stroke survivors had sufficient active range of motion to perform the prescribed hip oscillation task. In comparison to controls, these 28 stroke survivors were significantly less accurate at matching the abduction target, matching the adduction target, and moving in time with the metronome. Across these stroke survivors, a multiple regression revealed that only paretic hip abduction accuracy made a unique contribution to predicting paretic step width and paretic step period, metrics of gait performance. Interpretation The present results demonstrate that the ability to accurately abduct the hip is related to post-stroke gait performance, as predicted from a model-based gait stabilization strategy. Therefore, interventions designed to improve lower limb movement accuracy may hold promise for restoring post-stroke gait stability.

Control of human gait stability through foot placement

“…In line with a loss of coordination with ageing, Arvin et al [ 17 , 104 ] found not only a more variable step width, but also a more variable MoS in older adults. In stroke patients, impaired precision in performing a hip abduction tracking task was associated with wider steps of the paretic leg [ 108 ]. This suggests that precision of control over the swing leg may limit coordination between CoM movement and foot placement.…”

Compliant lower limb exoskeletons: a comprehensive review on mechanical design principles

“…Users’ balance may be compromised when using ambulatory unilateral or bilateral exoskeletons, due to the weight of the device and its behaviour. In addition, the loss of walking functions in most patients is frequently associated with balance disorders [105]. As a result, ambulatory exoskeletons are normally used in combination with crutches [25, 40, 70, 82].…”

Single Sessions of High-Definition Transcranial Direct Current Stimulation Do Not Alter Lower Extremity Biomechanical or Corticomotor Response Variables Post-stroke

“…Gait kinetics and kinematics were measured using an active LED marker set applied in a modified Helen Hayes setup while participants walked on an instrumented split-belt treadmill with bilateral force plates (Bertec, Corp., Worthington, OH, United States) (Dean et al, 2017). Participants performed two 30 s trials at their preferred self-selected comfortable speed with motion capture.…”