Deans' stroke musings: Step length asymmetry is representative of compensatory mechanisms used in post-stroke hemiparetic walking

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Sunday, November 17, 2019

Step length asymmetry is representative of compensatory mechanisms used in post-stroke hemiparetic walking

Useless, described a problem but offered NO SOLUTION.

Step length asymmetry is representative of compensatory mechanisms used in post-stroke hemiparetic walking

Jessica L. Allen1, Steven A. Kautz2,3, and Richard R. Neptune1 1 Department of Mechanical Engineering, The University of Texas at Austin, TX 2 Brain Rehabilitation Research Center, Malcolm Randall VA Medical Center, Gainesville FL 3 Department of Health Sciences and Research, Medical University of South Carolina, Charleston, SC

Abstract

Post-stroke hemiparetic subjects walk with asymmetrical step lengths that are highly variable between subjects and may be indicative of the underlying impairments and compensatory mechanisms used. The goal of this study was to determine if post-stroke hemiparetic subjects grouped by step length asymmetry have similar abnormal walking biomechanics compared to nonimpaired walkers. Kinematic and ground reaction force data were recorded from 55 hemiparetic subjects walking at their self-selected speed and 21 age and speed-matched non-impaired control subjects. Hemiparetic subjects were grouped by paretic step ratio, which was calculated as the paretic step-length divided by the sum of paretic and nonparetic step-lengths, into high (>0.535), symmetric (0.535–0.465) and low (<0.465) groups. Non-parametric Wilcoxin signed-rank tests were used to test for differences in joint kinetic measures between hemiparetic groups and speedmatched control subjects during late single-leg stance and pre-swing. The paretic leg ankle moment impulse was reduced in all hemiparetic subjects regardless of their paretic step ratio. The high group had increased nonparetic leg ankle plantarflexor and knee extensor moment impulses, the symmetric group had increased hip flexor moment impulses on both the paretic and nonparetic leg and the low group had no additional significant differences in joint moment impulses. These results suggest that the direction of asymmetry can be used to identify both the degree of paretic plantarflexor impairment and the compensatory mechanisms used by post-stroke hemiparetic subjects.