The aim of this study was to analyze the alterations of arm and leg movements of patients during stroke gait. Joint angles of upper and lower limbs and spatiotemporal variables were evaluated in two groups: hemiparetic group (HG, 14 hemiparetic men, 53 ± 10 years) and control group (CG, 7 able-bodied men, 50 ± 4 years). The statistical analysis was based on the following comparisons (P ≤ 0.05): 1) right versus left sides of CG; 2) affected (AF) versus unaffected (UF) sides of HG; 3) CG versus both the affected and unaffected sides of HG, and 4) an intracycle comparison of the kinematic continuous angular variables between HG and CG. This study showed that the affected upper limb motion in stroke gait was characterized by a decreased range of motion of the glenohumeral (HG: 6.3 ± 4.5, CG: 20.1 ± 8.2) and elbow joints (AF: 8.4 ± 4.4, UF: 15.6 ± 7.6) on the sagittal plane and elbow joint flexion throughout the cycle (AF: 68.2 ± 0.4, CG: 46.8 ± 2.7). The glenohumeral joint presented a higher abduction angle (AF: 14.2 ± 1.6, CG: 11.5 ± 4.0) and a lower external rotation throughout the cycle (AF: 4.6 ± 1.2, CG: 22.0 ± 3.0). The lower limbs showed typical alterations of the stroke gait patterns. Thus, the changes in upper and lower limb motion of stroke gait were identified. The description of upper limb motion in stroke gait is new and complements gait analysis.
Restrições impostas pela pandemia de COVID-19 limitaram o acesso de pessoas com Doença de Parkinson(DP) à realização de exercícios. A telerreabilitação é uma estratégia que pode restaurar esse acesso. O objetivo do estudo foi avaliar os efeitos de um programa de exercícios, baseado em telerreabilitação, sobre a qualidade de vida de pessoas com DP e sua aderência e motivação ao programa, durante um período do isolamento social. Dezessete pessoas com DP participaram do programa por três semanas. Foram avaliados a qualidade de vida (PDQ-8) e aderência e motivação (MPAM-R) à participação, antes e ao final do programa. Foram encontradas diferenças significativas no PDQ-8, ao final de cada semana (p=0,02). Não foram verificadas diferenças nos níveis de motivação quanto aos exercícios durante todo o período de intervenção. A taxa de aderência aos exercícios permaneceu acima de 70%, durante todo o programa. Concluiu-se que pessoas com DP podem aderir e se manter motivadas a participar de um programa de telerreabilitação obtendo melhora da qualidade de vida, mesmo em um período de isolamento social.
Introduction: Postural abnormalities are common in patients with Parkinson’s disease (PD) and lead to gait abnormalities. Relationships between changes in the trunk posture of PD patients and gait profile score (GPS) and gait spatiotemporal parameters are poorly investigated. The aim of the current study was to investigate the relationships between trunk posture, GPS, and gait spatiotemporal parameters, in patients with PD. Materials and Methods: Twenty-three people with PD and nineteen age-matched healthy people participated in this study. A 3D gait kinematical analysis was applied to all participants using the Plug-In Gait Full BodyTM tool. Trunk and limb kinematics patterns and gait spatio-temporal parameters of patients with PD and the control group were compared. Additionally, correlations between trunk kinematics patterns, gait spatio-temporal parameters, and GPS of the PD group were tested. Results: Cadence, opposite foot off, step time, single support, double support, foot off, gait speed, trunk kinematics, and GPS showed significant differences between the two groups (p ≤ 0.05). Posture of the trunk during gait was not related to the spatio-temporal parameters and gait profile score in the PD group. The trunk flexor pattern influenced GPS domains, mainly of the ankle and the knee. Discussion and Conclusions: Flexed posture of the trunk in patients with PD seems to influence both ankle and knee movement patterns during the gait. The GPS analysis provided direct and simplified kinematic information for the PD group. These results may have implications for understanding the importance of considering the positioning of the trunk during gait.
The foot forms the base of propulsion and balance during the gait. It is well known that excessive or prolonged pronation and supination changes the gait's mechanical movement. Hence, the use of corrective insoles is recommended when calcaneus alterations (valgus and varun) are present. Objetive: The main purpose of this article was to analyze the effects of a calcaneus insole on normal individuals on the Ground Reaction Force variables. Method: The experiment used ten adults (31.9 ± 6,7 years, 65.9 ± 15.4 kg and 1.7 ± 0.1 m) and registered no apparent changes in gait or pathologies that have an effect on the locomotor system. The following gait conditions were analyzed and compared: barefoot, using a sport shoe, and using the sport shoe with insole. The variables analyzed were vertical, medial lateral, and anterior-posterior dynamic ground reaction forces. An ANOVA one-way was used in order to compare the three different conditions. Statistically significant differences were revealed between the conditions of barefoot and sport shoe with insole for the vertical GRF during initial contact Fz 1 (F 2,59 = 3.4; p < 0.0406) and for the GRF anterior-posterior in the terminal stance phase Fy 2 (F 2,59 = 3.63; p < 0.0332). Results: These results indicated that the use of an insole increased the vertical impact on the locomotor system during the response to load phase, probably because of its greater stiffness compared to the barefoot or sport shoe trials. The insole also changed the GRF anterior-posterior during the terminal stance that corresponded with the acceleration/propulsion gait phase. Conclusion: Just based on the analysis of the dynamic variables, it was concluded that the use of insoles did not induce any significant increase in lateral forces that would indicate the reduction of excessive pronation or supination during the response load phase. The use of an insole produced a significant dynamic effect on the pronation/supination only in the propulsive gait phase.
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