Kinetic and kinematic parameters associated with late braking force and effects on gait performance of stroke patients

Abstract

Late braking force (LBF) is often observed in the late stance phase of the paretic lower limb of stroke patients. Nevertheless, the effects and association of LBF remain unclear. We examined the kinetic and kinematic parameters associated with LBF and its effect on walking. Herein, 157 stroke patients were enrolled. Participants walked at a comfortable speed selected by them, and their movements were measured using a 3D motion analysis system. The effect of LBF was analyzed as a linear relationship with spatiotemporal parameters. Multiple linear regression analyses were performed with LBF as the dependent variable and kinetic and kinematic parameters as independent variables. LBF was observed in 110 patients. LBF was associated with decreased knee joint flexion angles during the pre-swing and swing phases. In the multivariate analysis, trailing limb angle, cooperativity between the paretic shank and foot, and cooperativity between the paretic and non-paretic thighs were related to LBF (p < 0.01; adjusted R2 = 0.64). LBF in the late stance phase of the paretic lower limb reduced gait performance in the pre-swing and swing phases. LBF was associated with trailing limb angle in the late stance, coordination between the paretic shank and foot in the pre-swing phase, and coordination between both thighs.

Stroke walking and balance characteristics via principal component analysis

“…These compensatory adaptations typically affected the low maximum excursion of hip extension, ankle plantarflexion during the stance phase, low maximum excursion of hip and knee flexion and ankle dorsiflexion during the swing phase, and excessive pelvic tilts during the stance and swing phases 33 . According to a recent study, reduced knee flexion during the pre-swing and swing phase is associated with paretic ground reaction force in the late stance phase 34 . This relationship is related to the cooperation between the paretic and non-paretic thighs 34 .…”

“…According to a recent study, reduced knee flexion during the pre-swing and swing phase is associated with paretic ground reaction force in the late stance phase 34 . This relationship is related to the cooperation between the paretic and non-paretic thighs 34 . In this study, the BBS low group exhibited an increase in joint variability on the paretic side, particularly in the sagittal and horizontal planes, as well as an increase in ankle and knee variability on the nonparetic side in the sagittal plane.…”