Medial–lateral balance during stance phase of straight and circular walking of human subjects

Kiriyama, Kiichi; Warabi, Tateo; Κato, Masamichi; Yoshida, Takehiko; Kokayashi, Nobuyoshi

doi:10.1016/j.neulet.2005.06.041

Cited by 19 publications

(6 citation statements)

References 9 publications

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“…The observed asymmetry between each lower limb during walking in the presence of chronic right-hemisphere lesion may stem in part from the inability to control the center of pressure over the affected lower limb. 21 This notion is supported by previous research indicating that compared to lesions within the left MCA territory, those within the right MCA territory-and particularly to regions such as the insula and temporoparietal junction-often result in more severe distortion of spatial postural representation, as well as the visual and nonvisual subjective perception of the body's verticality. [22][23][24] Previous work by our group has also suggested that right hemisphere infarcts are more disruptive to the ability to regulate postural sway when standing, but only in the frontal plane.…”

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confidence: 74%

Infarct hemisphere and noninfarcted brain volumes affect locomotor performance following stroke

Chen

Novak

Manor³

2014

Neurology

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Objective: Brain damage within the right middle cerebral artery (MCA) territory is particularly disruptive to mediolateral postural stabilization. The objective of this cross-sectional study was to test the hypothesis that chronic right MCA infarcts (as compared to left) are associated with slower and more bilaterally asymmetrical gait. We further hypothesized that in those with chronic right MCA infarct, locomotor performance is more dependent on gray matter (GM) volumes within noninfarcted regions of the brain that are involved in motor control yet lie outside of the MCA territory.Methods: Gait speed was assessed in 19 subjects with right MCA infarct, 20 with left MCA infarct, and 108 controls. Bilateral plantar pressure and temporal symmetry ratios were calculated in a subset of the cohort. GM volumes within 5 regions outside of the MCA territory (superior parietal lobe, precuneus, caudate, putamen, and cerebellum) were quantified from anatomic MRIs.Results: Right and left infarct groups had similar poststroke duration (7.6 6 6.0 years), infarct size, and functional independence. The right infarct group demonstrated slower gait speed and greater asymmetry compared to the left infarct group and controls (p , 0.05). In the right infarct group only, those with larger GM volumes within the cerebellum (r 2 5 0.32, p 5 0.02) and caudate (r 2 5 0.56, p , 0.001) exhibited faster gait speed.Conclusion: Individuals with chronic lesions within the right MCA territory, as compared to the left MCA territory, exhibit slower, more asymmetrical gait. For these individuals, larger GM volumes within regions outside of the infarcted vascular territory may help preserve locomotor control. Although approximately two-thirds of stroke survivors regain the ability to walk, 1 many present with diminished locomotor performance characterized by slow walking speed and bilaterally asymmetrical walking patterns. 2,3 Lesions within the right hemisphere of the brain, as compared to the left, appear to be more disruptive to both gait and postural control.4-9 More specifically, lesions within the right middle cerebral artery (MCA) territory are particularly disturbing to both the sense of postural verticality and the ability to stabilize the body in the frontal plane. 8,[10][11][12][13] Recent studies, however, have also indicated that the complex motor control system can compensate for impairment to one or more elements of the system by placing increased reliance on remaining intact elements.14 As such, the extent of residual gait abnormality following an infarct may be dependent on not only infarct hemisphere but also on the integrity of noninfarcted brain regions.The objectives of the study were to investigate the effects of infarct hemisphere, as well as gray matter (GM) volumes within regions outside of the infarcted vascular territory, on locomotor performance in individuals with chronic MCA infarcts. We hypothesized that individuals with

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confidence: 74%

Infarct hemisphere and noninfarcted brain volumes affect locomotor performance following stroke

Chen

Novak

Manor³

2014

Neurology

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“…During human walking, foot placement is used to balance the body. It would be interesting to use the proposed measurement method to characterize foot placement in more challenging environments such as circular walking (Kiriyama et al, 2005) or walking on uneven terrain. In principle, the methods proposed in this study are appropriate for such applications.…”

Section: Discussionmentioning

confidence: 99%

Ambulatory estimation of foot placement during walking using inertial sensors

Schepers

Asseldonk

Baten

et al. 2010

Journal of Biomechanics

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“…72-74 The combined activation of the hip abductors of one limb with the adductor muscles of the opposite limb is facilitated by a curved path goal for walking. 63, 75-77 …”

Section: Alternative Approach – Task-oriented Motor Learning (Table)mentioning

confidence: 99%

Interventions to Improve Walking in Older Adults

Brach

VanSwearingen

2013

Curr Transl Geriatr and Exp Gerontol Rep

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Interventions to improve walking in older adults have historically been multifactorial (i.e. strengthening, endurance and flexibility programs) focusing on improving the underlying impairments. These impairment-based programs have resulted in only modest improvements in walking. In older adults, walking is slow, less stable, inefficient, and the timing and coordination of stepping with postures and phases of gait is poor. We argue the timing and coordination problems are evidence of the loss of motor skill in walking. Taking a lesson from the sports world and from neurorehabilitation, task-oriented motor learning exercise is an essential component of training to improve motor skill and may be a beneficial approach to improving walking in older adults. In this article we: 1) briefly review the current literature regarding impairment-based interventions for improving mobility, 2) discuss why the results have been only modest, and 3) suggest an alternative approach to intervention (i.e. task oriented motor learning).

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Medial–lateral balance during stance phase of straight and circular walking of human subjects

Cited by 19 publications

References 9 publications

Infarct hemisphere and noninfarcted brain volumes affect locomotor performance following stroke

Infarct hemisphere and noninfarcted brain volumes affect locomotor performance following stroke

Ambulatory estimation of foot placement during walking using inertial sensors

Interventions to Improve Walking in Older Adults

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