Applying a pelvic corrective force induces forced use of the paretic leg and improves paretic leg EMG activities of individuals post-stroke during treadmill walking

Hsu, Chao Jung; Kim, Janis; Tang, Rongnian; Roth, Elliot J.; Rymer, William Z.; Wu, Ming

doi:10.1016/j.clinph.2017.07.409

Cited by 31 publications

(30 citation statements)

References 54 publications

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“…Pelvis and ankle position data were measured using 4 custom‐designed 3D position sensors. The position sensors were attached to the legs and pelvis through straps and a waist belt (Hsu et al., ). The ankle and pelvis position signals were recorded through an A/D board using a custom LabVIEW program (National Instruments).…”

Section: Methodsmentioning

confidence: 99%

Error variability affects the after effects following motor learning of lateral balance control during walking in people with spinal cord injury

Lin

Hsu

Dee

et al. 2019

Eur J of Neuroscience

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People with incomplete spinal cord injury (iSCI) usually show impairments in lateral balance control during walking. Effective interventions for improving balance control are still lacking, probably due to limited understanding of motor learning mechanisms. The objective of this study was to determine how error size and error variability impact the motor learning of lateral balance control during walking in people with iSCI. Fifteen people with iSCI were recruited. A controlled assistance force was applied to the pelvis in the medial‐lateral direction using a customized cable‐driven robotic system. Participants were tested using 3 conditions, including abrupt, gradual, and varied forces. In each condition, participants walked on a treadmill with no force for 1 min (baseline), with force for 9 min (adaptation), and then with no force for additional 2 min (post‐adaptation). The margin of stability at heel contact (MoS_HC) and minimum value moment (MoS_Min) were calculated to compare the learning effect across different conditions. Electromyogram signals from the weaker leg were also collected. Participants showed an increase in MoS_Min (after effect) following force release during the post‐adaptation period for all three conditions. Participants showed a faster adaptation and a shorter lasting of after effect in MoS_Min for the varied condition in comparison with the gradual and abrupt force conditions. Increased error variability may facilitate motor learning in lateral balance control during walking in people with iSCI, although a faster learning may induce a shorter lasting of after effect. Error size did not show an impact on the lasting of after effect.

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Section: Methodsmentioning

confidence: 99%

Error variability affects the after effects following motor learning of lateral balance control during walking in people with spinal cord injury

Lin

Hsu

Dee

et al. 2019

Eur J of Neuroscience

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“…An alternative approach applies mediolateral forces to the trunk during walking. While these forces can assist symmetric weight shift by pushing the pelvis toward the paretic leg, 21,[52][53] other work has sought to either augment pelvis motion errors by pushing the pelvis farther toward the non-paretic leg, 52 or apply unpredictable mediolateral forces. 42 In the longer-term, it would be valuable to compare the effects of these various perturbation paradigms.…”

Section: Manipulating Post-stroke Step Widthmentioning

confidence: 99%

Effects of targeted assistance and perturbations on the relationship between pelvis motion and step width in people with chronic stroke

Reimold

Knapp

Chesnutt

et al. 2020

Preprint

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Background. People with chronic stroke (PwCS) often exhibit a weakened relationship between pelvis motion and paretic step width, a behavior important for gait stabilization.We have developed a force-field able to manipulate this relationship on a step-by-step basis.Objective. The objective of this study was to investigate the effects of a single exposure to our novel force-field on the step-by-step modulation of paretic step width among PwCS, quantified by the partial correlation between mediolateral pelvis displacement at the start of a step and paretic step width (step start paretic ρdisp).Methods. Following a 3-minute period of normal walking, participants were exposed to 5-minutes of either force-field assistance (n=10; pushing the swing leg toward a mechanically-appropriate step width) or perturbations (n=10; pushing the swing leg away from a mechanically-appropriate step width). This period of assistance or perturbations was followed by a 1-minute catch period to identify any after-effects, a sign of sensorimotor adaptation.Results. We found that assistance did not have a significant direct effect or after-effect on step start paretic ρdisp. In contrast, perturbations directly reduced step start paretic ρdisp (p=0.004), but were followed by an after-effect in which this metric was increased above the baseline level (p=0.02).Conclusions. These initial results suggest that PwCS have the ability to strengthen the link between pelvis motion and paretic foot placement if exposed to a novel mechanical Manipulating post-stroke step width environment, which may benefit gait stability. Future work is needed to determine whether this effect can be extended with repeated exposure to force-field perturbations.

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“…This may indicate that weight transfer de cits negatively affect forward progression. Indeed, forceful weight shift towards the paretic limb enhanced paretic lower extremity kinetics and muscle activities that contribute to forward progression (15). Moreover, de cits in paretic limb weight-bearing contribute to lateral and vertical balance instability and are associated with risk of falling in individuals with chronic stroke (16).…”

Section: Introductionmentioning

confidence: 99%

Biomechanical Control of Paretic Lower Limb During Imposed Weight Transfer in Individuals Post-Stroke

Hsiao

Gray

Borrelli

et al. 2020

Preprint

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Background: stroke is a leading cause of disability with associated hemiparesis resulting in difficulty bearing and transferring weight on to the paretic limb. Difficulties in weight bearing and weight transfer may result in impaired mobility and balance, increased fall risk, and decreased community engagement. Despite considerable efforts aimed at improving weight transfer after stroke, impairments in its neuromotor and biomechanical control remain poorly understood. In the present study, a novel experimental paradigm was used to characterize differences in weight transfer biomechanics in individuals with chronic stroke versus able-bodied controls. Methods: fifteen participants with stroke and fifteen age-matched able-bodied controls participated in the study. Participants stood with one foot on each of two custom built platforms. One of the platforms dropped 4.3 cm vertically to induce lateral weight transfer and weight bearing. Trials involving a drop of the platform beneath the paretic lower extremity (non-dominant limb for control) were included in the analyses. Paretic lower extremity joint kinematics, vertical ground reaction forces, and center of pressure velocity were measured. All participants completed the clinical Step Test and Four-Square Step Test. Results: reduced paretic ankle, knee, and hip joint angular displacement and velocity, delayed ankle and knee inter-joint timing, increased downward displacement of center of mass, and increased center of pressure (COP) velocity stabilization time were exhibited in the stroke group compared to the control group. In addition, paretic COP velocity stabilization time during induced weight transfer predicted Four-Square Step Test scores in individuals post-stroke. Conclusions: the induced weight transfer approach identified stroke-related abnormalities in the control of weight transfer towards the paretic limb side compared to controls. Decreased joint flexion of the paretic ankle and knee, altered inter-joint timing, and increased COP stabilization times may reflect difficulties in neuromuscular control during weight transfer following stroke. Future work will investigate the potential of improving functional weight transfer through induced weight transfer training exercise.

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Applying a pelvic corrective force induces forced use of the paretic leg and improves paretic leg EMG activities of individuals post-stroke during treadmill walking

Cited by 31 publications

References 54 publications

Error variability affects the after effects following motor learning of lateral balance control during walking in people with spinal cord injury

Error variability affects the after effects following motor learning of lateral balance control during walking in people with spinal cord injury

Effects of targeted assistance and perturbations on the relationship between pelvis motion and step width in people with chronic stroke

Biomechanical Control of Paretic Lower Limb During Imposed Weight Transfer in Individuals Post-Stroke

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