I see nothing here that tells survivors EXACTLY how to recover walking. So more useless research. Damn, a lot of people supposedly working in stroke need to be fired.
Spatio-temporal parameters and intralimb coordination patterns describing hemiparetic locomotion at controlled speed
RESEARCH Open Access
Lucio A Rinaldi 1
and Vito Monaco 2*
Abstract
Background:Comparison between healthy and hemiparetic gait is usually carried out while subjects walk overground at preferred speed. This generates bias due to the lack of uniformity across selected speeds because they reflect the great variability of the functional level of post-stroke patients. This study aimed at examining coordinative adaptations during walking in response to unilateral brain damage, while homologous participants walked at two fixed speeds.
Methods:
Methods:
Five patients with left and five with right chronic hemiparesis, characterized by similar level of motor functioning, were enrolled. Ten non-disabled volunteers were recruited as matched control group. Spatio-temporal parameters, and intralimb thigh-leg and leg-foot coordination patterns were used to compare groups while walking on a treadmill at 0.4 and 0.6 m/s. The likelihood of Continuous Relative Phase patterns between healthy and hemiparetic subjects was evaluated by means of the root mean square of the difference and the cross correlation coefficient. The effects of the group (i.e., healthy vs. hemiparetics), side (i.e., affected vs.unaffected), and speed(e.g., slow vs. fast) were analyzed on all metrics using the Analysis of Variance.
Results:
Results:
Spatio-temporal parameters of all hemiparetic subjects did not significantly differ from those of healthy subjects nor showed any asymmetry between affected and unaffected limbs. Conversely, both thigh-leg and foot-leg coordination patterns appeared to account for pathology related modifications.
Conclusion:
Conclusion:
Comparisons between hemiparetic and healthy gait should be carried out when all participants are asked to seek the same suitable dynamic equilibrium led by the same external (i.e., the speed) and internal(i.e., severity of the pathology) conditions. In this respect, biomechanical adaptations reflecting the pathology can be better highlighted by coordinative patterns of coupled segments within each limb than by the spatio-temporal parameters. Accordingly, a deep analysis of the intralimb coordination may be helpful for clinicians while designing therapeutic treatments.
Keywords:
Hemiparetic gait, Fixed speeds, Spatio-temporal parameters, Intralimb coordination, Stroke
Background
Compensatory strategies adopted by post-stroke patients to increase stability and efficiency of locomotion have been widely described in literature by spatio-temporal parameters, kinematic, and kinetic measures referring to walking both overground [1-3] and on treadmill [4,5]. On the whole, the gait of post-stroke patients is mainly characterized by reduced speed, stride length, and cadence,decreased angular excursions at leg joints, increased energetic cost, and asymmetry in kinematic and kinetic variables [3]. Furthermore, a recent study highlighted that post-stroke patients walk with different patterns between treadmill and overground and, in particular, the treadmill enhances the asymmetry between affected and unaffected limbs, decreases the self-selected speed and the step length,and increases stance and double support percentages [6]. A cerebrovascular accident has been also shown to significantly modify the coordinative relationship of segments
* Correspondence: v.monaco@sssup.it
2
Istituto di BioRobotica, Scuola Superiore Sant
’
Anna, P.za Martiri della Libertà,33, 56127, Pisa, I, ItalyFull list of author information is available at the end of the article
JNER
JOURNAL OF NEUROENGINEERINGAND REHABILITATION
© 2013 Rinaldi and Monaco; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of theCreative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use,distribution, and reproduction in any medium, provided the original work is properly cited.
Rinaldi and Monaco
Journal of NeuroEngineering and Rehabilitation
2013,
10
:53http://www.jneuroengrehab.com/content/10/1/53
Keywords:
Hemiparetic gait, Fixed speeds, Spatio-temporal parameters, Intralimb coordination, Stroke
Background
Compensatory strategies adopted by post-stroke patients to increase stability and efficiency of locomotion have been widely described in literature by spatio-temporal parameters, kinematic, and kinetic measures referring to walking both overground [1-3] and on treadmill [4,5]. On the whole, the gait of post-stroke patients is mainly characterized by reduced speed, stride length, and cadence,decreased angular excursions at leg joints, increased energetic cost, and asymmetry in kinematic and kinetic variables [3]. Furthermore, a recent study highlighted that post-stroke patients walk with different patterns between treadmill and overground and, in particular, the treadmill enhances the asymmetry between affected and unaffected limbs, decreases the self-selected speed and the step length,and increases stance and double support percentages [6]. A cerebrovascular accident has been also shown to significantly modify the coordinative relationship of segments
* Correspondence: v.monaco@sssup.it
2
Istituto di BioRobotica, Scuola Superiore Sant
’
Anna, P.za Martiri della Libertà,33, 56127, Pisa, I, ItalyFull list of author information is available at the end of the article
JNER
JOURNAL OF NEUROENGINEERINGAND REHABILITATION
© 2013 Rinaldi and Monaco; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of theCreative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use,distribution, and reproduction in any medium, provided the original work is properly cited.
Rinaldi and Monaco
Journal of NeuroEngineering and Rehabilitation
2013,
10
:53http://www.jneuroengrehab.com/content/10/1/53
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