Alterations in Weight-Transfer Capabilities in Adults With Hemiparesis

Pai, Yi–Chung; Rogers, Mark W.; Hedman, Lois Deming; Hanke, Timothy

doi:10.1093/ptj/74.7.647

Cited by 96 publications

(63 citation statements)

References 16 publications

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“…Using these novel objective analytical methods to evaluate weight transfer will help to provide the needed clinical evidence to incorporate new assessment techniques when selecting the most effective orthotic interventions to efficiently maximize functional recovery and create an improved standard of care for individuals with hemiplegia secondary to stroke. 36 A potential limitation of the current study is that the inclusion and exclusion criteria of the study may have created a sample of stroke patients that were higher functioning, especially because they were able to walk twenty-five feet without their AFO. 37,38 However, research has found that patients who receive an AFO on entry to or discharge from rehabilitation are more functionally impaired than patients who do not receive an AFO.…”

Section: Discussionmentioning

confidence: 98%

Weight transfer analysis in adults with hemiplegia using ankle foot orthosis

Nolan

Yarossi²

2011

Prosthetics &Amp; Orthotics International

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Background: Identifying and understanding the changes in transfer of momentum that are directly affected by orthotic intervention are significant factors related to the improvement of mobility in individuals with hemiplegia. Objectives: The purpose of this investigation was to use a novel analysis technique to objectively measure weight transfer during double support (DS) in healthy individuals and individuals with hemiplegia secondary to stroke with and without an ankle foot orthosis. Study design: Prospective, Repeated measures, case-controlled trial. Methods: Participants included 25 adults with stroke-related hemiplegia >6 months using a prescribed ankle foot orthosis and 12 age-matched healthy controls. Main outcome measures included the weight transfer point timing (WTP, %DS), maximum total force timing (MTF, %DS), timing difference between WTP and MTF (MTF-WTP, %DS) and the linearity of loading (LOL, R 2 ) during the DS phase of the gait cycle. Results: The WTP and LOL were significantly different between conditions with and without the ankle foot orthosis for the affected and unaffected limb in post-stroke individuals, p 0.01. The MTF and difference in timing between MTF-WTP were significantly different during affected limb loading with and without the ankle foot orthosis in the stroke group, p 0.0001 and p ¼ 0.03, respectively. MTF, MTF-WTP and LOL were significantly different between individuals with stroke (during affected limb loading) and healthy controls (during right limb loading). Conclusions: This research established a systematic method for analysing weight transfer during walking to evaluate the effect of an ankle foot orthosis on loading during double support in hemiplegic gait. This novel method can be used to elucidate biomechanical mechanisms behind orthosis-mediated changes in gait patterns and quantify functional mobility outcomes in rehabilitation. Clinical relevanceThis novel approach to orthotic assessment will provide the clinician with needed objective evidence to select the most effective orthotic intervention to maximize functional recovery for individuals with hemiplegia secondary to stroke.

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Section: Discussionmentioning

confidence: 98%

Weight transfer analysis in adults with hemiplegia using ankle foot orthosis

Nolan

Yarossi²

2011

Prosthetics &Amp; Orthotics International

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“…Studies have reported high within session reliability (consecutive trials) for forward and lateral weight-shifting in persons with stroke, 13 good within session reliability (consecutive trials) for the body centre of mass displacement when transferring weight laterally into a single leg posture in persons with stroke, 27 and good test-retest reliability measured over two separate days for the vertical ground reaction force for healthy adults when rising from a chair. 8 Our study is the first to assess the reliability of weight-bearing abilities over different days in persons with chronic stroke.…”

Section: Reliability Of the Weight-bearing Abilitymentioning

confidence: 99%

Reliability and comparison of weight-bearing ability during standing tasks for individuals with chronic stroke

Eng

Chu

2002

Archives of Physical Medicine and Rehabilitation

234

157

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Objectives-To determine the test-retest reliability over 2 separate days for weight-bearing ability during standing tasks in individuals with chronic stroke and to compare the weight-bearing ability among five standing tasks for the paretic and non-paretic limbs.Design-Prospective study using a convenient sample. Setting-Free-standing tertiary rehabilitation center.Participants-15 community-dwelling stroke individuals with moderate motor deficits; volunteer sample. Interventions-Not applicable.Main Outcome Measures-Weight-bearing ability as measured by the vertical ground reaction force during 5 standing tasks (rising from a chair, quiet standing, weight-shifting forward, backward, laterally).Results-The weight-bearing ability was less for the paretic limb compared with the nonparetic limb, but the intraclass correlation coefficients were high (0.95-0.99) for both limbs between the 2 sessions for all 5 tasks. The forward weight-shifting ability was particularly low in magnitude on the paretic side compared with the other weight-shifting tasks. In addition, the forward weightshift ability of the nonparetic limb was also impaired but to a lesser extent. Large asymmetry was evident when rising from a chair, with the paretic limb bearing a mean 296N and the nonparetic side bearing a mean 458N. The weight-bearing ability during all 5 tasks correlated with one another (r range, 0.56-0.94).Conclusions-Weight-bearing ability can be reliably measured and may serve as a useful outcome measure in individuals with stroke. We suggest that impairments of the hemiparetic side during forward weight shifting and sit-to-stand tasks presents a challenge to the motor systems of individuals with stroke, which may account for the poor balance that is often observed in these individuals.

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“…Among the lower-extremity problems that most hemiplegia patients experience, decrease of proprioceptive sense and muscle strength in the damaged joints lead to asymmetry of the lower extremity [1,2]. Decreased sensory makes it difficult to support weight on the affected side and causes asymmetric weight bearing on both lower extremity [3]. Also, in quiet standing, postural sway occurs more severely because of decreased stability of the affected leg compared with the unaffected leg [4].…”

Section: Introductionmentioning

confidence: 99%

Immediate effects of single-leg stance exercise on dynamic balance, weight bearing and gait cycle in stroke patients

Jung¹,

Lee

2014

PTRS

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Objective: This study aimed to identify how various applications of weight bearing on the affected side of hemiplegia patients affect the ability of balance keeping of the affected leg and the gait parameters. Design: Cross-sectional study. Methods: Eighteen patients with hemiplegia participated in this study. There were twelve males and six females. This study investigated the effects of the single-leg stance exercise on dynamic balance, weight bearing, and gait ability compared with four conditions. Dynamic balance and weight bearing were measured using the step test (ST) of the affected side in stroke patients. In addition, gait parameters were measured using the optogait system for analysis of the spatial and temporal parameters of walking in stroke patients. Results: This study investigated the effect of the single leg stance exercise on the paralysis side. The ST showed significant findings for all conditions (p<0.05). Therefore, knee extension and flexion exercise on the affected side single-leg stance (condition 4) significantly improved dynamic balance and weight bearing on the affected side (p<0.05). In the condition of moving the knee joint in a single-leg stance was discovered that the stance phase time significantly increased more than in the condition of supporting the maximal voluntary weight on the affected side (p<0.05). Conclusions: Single-leg stance on the paralysis side with knee flexion and extension increased symmetry in weight bearing during stance phase time. This study suggests that single-leg stance exercises augments improved gait function through sufficient weight bearing in the stance phase of the affected side.

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Alterations in Weight-Transfer Capabilities in Adults With Hemiparesis

Cited by 96 publications

References 16 publications

Weight transfer analysis in adults with hemiplegia using ankle foot orthosis

Weight transfer analysis in adults with hemiplegia using ankle foot orthosis

Reliability and comparison of weight-bearing ability during standing tasks for individuals with chronic stroke

Immediate effects of single-leg stance exercise on dynamic balance, weight bearing and gait cycle in stroke patients

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