Gait Asymmetry in Community-Ambulating Stroke Survivors

Patterson, Kara K.; Parafianowicz, Iwona; Danells, Cynthia; Closson, Valerie; Verrier, Mary C.; Staines, Richard; Black, Sandra E.; McIlroy, William E.

doi:10.1016/j.apmr.2007.08.142

Cited by 528 publications

(461 citation statements)

References 21 publications

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“…28 This delay may also translate to slowed steadystate walking. Hesitation when loading the paretic leg may partially explain slow walking speeds 29 and temporal asymmetry 30,31 among those with post-stroke motor impairment. However, it is important to acknowledge that only the ML COP was used in the identification of APAs and associated characteristics in the present study.…”

Section: Multiple Apasmentioning

confidence: 99%

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%

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

et al. 2017

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“…It adversely affects the acquisition of function because it interferes with the processing of spatial stimuli, responses, and spatial orientation 5) . Somatosensory deficit and unilateral spatial neglect in stroke patients increase posture asymmetry, difficulties with transfer of weight, difficulties with postural control as well as inhibiting upper limb function, and causing gait disturbance 6) . In particular, poor upper limb function in stroke patients not only causes physical and psychological suffering, but also provokes increased dependence in activities of daily living (ADL), which eventually leading to a decrease in patient's motivation 7) .…”

Section: Introductionmentioning

confidence: 99%

The Effects of Somatosensory Training Focused on the Hand on Hand Function, Postural Control and ADL of Stroke Patients with Unlateral Spatial Neglect and Sensorimotor Deficits

2013

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Abstract. [Purpose] We investigated the effect of somatosensory training, e.g. facilitation of reaching and somatosensory stimulus of upper limb (UL) on hand function and postural control.[Subjects] The subjects were 20 stroke patients in the Bobath Memorial Hospital, who has problems with unilateral neglect, and somatosensory deficits.[Methods] The patients were divided into two groups: a unilateral neglect group (NG), and a sensrimotor deficit group (SMG). Somatosensory training for the hand was carried out eighteen times, three times a week for six weeks, together with 40 minutes preservative treatment. To compare the groups, we used several assessment tools: the manual function test (MFT), the postural assessment scale for stroke (PASS) and the functional reach test (FRT).[Results] In NG, somatosensory training for the hand significantly improved MFT, and PASS (p<0.05). In the SMG, somatosensory training for the hand significantly improved MFT, PASS and FRT (p<0.05). Also, there were significantly differences in MFT, and PASS between the groups. [Conclusion] Somatosensory training for the hand influenced hand function and postural control. Therefore, we consider that somatosensory function plays a major role in hand and postural control.

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“…Such an overall conclusion is not new, but the results add considerable detail in characterising the nature and extent of the problem [13] [28].…”

Section: Discussionmentioning

confidence: 96%

“…Individual Stance and Swing time ratios, with and without cueing. Stance time ratio with value less than 1.0 means that more time is spent on the non-paretic leg [28]. Swing time ratio with value greater than 1.0 means that the paretic leg takes longer to swing (leaving the body supported on only the non-paretic leg for longer).…”

Section: Resultsmentioning

confidence: 99%

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Questioning Classic Patient Classification Techniques in Gait Rehabilitation: Insights from Wearable Haptic Technology

Georgiou

Holland

Linden

et al. 2016

Lecture Notes of the Institute for Computer Sciences, Social Informatics and Telecommunications Engineering

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Abstract. Classifying stroke survivors based on their walking abilities is an important part of the gait rehabilitation process. It can act as powerful indicator of function and prognosis in both the early days after a stroke and long after a survivor receives rehabilitation. This classification often relies solely on walking speed; a quick and easy measure, with only a stopwatch needed. However, walking speed may not be the most accurate way of judging individual's walking ability. Advances in technology mean we are now in a position where ubiquitous and wearable technologies can be used to elicit much richer measures to characterise gait. In this paper we present a case study from one of our studies, where within a homogenous group of stroke survivors (based on walking speed classification) important differences in individual results and the way they responded to rhythmic haptic cueing were identified during the piloting of a novel gait rehabilitation technique.

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Gait Asymmetry in Community-Ambulating Stroke Survivors

Cited by 528 publications

References 21 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 Effects of Somatosensory Training Focused on the Hand on Hand Function, Postural Control and ADL of Stroke Patients with Unlateral Spatial Neglect and Sensorimotor Deficits

Questioning Classic Patient Classification Techniques in Gait Rehabilitation: Insights from Wearable Haptic Technology

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