Control of lateral weight transfer is associated with walking speed in individuals post-stroke

Hsiao, Hao-Yuan; Gray, Vicki L.; Creath, Robert A.; Binder‐Macleod, Stuart A.; Rogers, Mark W.

doi:10.1016/j.jbiomech.2017.06.021

Cited by 57 publications

(49 citation statements)

References 40 publications

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“…Menz et al (2004) have shown people with peripheral neuropathy reduced walking speed and cadence. Hsiao et al (2017) suggested that a lateral weight shift mechanism is impaired in chronic stroke, leading to reduced gait speed.…”

Section: Introductionmentioning

confidence: 99%

Walking Cadence Affects the Recruitment of the Medial-Lateral Balance Mechanisms

Fettrow

Reimann

Grenet

et al. 2019

Front. Sports Act. Living

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We have previously identified three balance mechanisms that young healthy adults use to maintain balance while walking. The three mechanisms are: (1) The lateral ankle mechanism, an active modulation of ankle inversion/eversion in stance; (2) The foot placement mechanism, an active shift of the swing foot placement; and (3) The push-off mechanism, an active modulation of the ankle plantarflexion angle during double stance. Here we seek to determine whether there are changes in neural control of balance when walking at different cadences and speeds. Twenty-one healthy young adults walked on a self-paced treadmill while immersed in a 3D virtual reality cave, and periodically received balance perturbations (bipolar galvanic vestibular stimulation) eliciting a perceived fall to the side. Subjects were instructed to match two cadences specified by a metronome, 110 bpm (High) and 80 bpm (Low), which in this experiment, led to faster and slower gait speeds, respectively. The results indicate that subjects altered the use of the balance mechanisms at different cadences. The lateral ankle mechanism was used more in the Low condition, while the foot placement mechanism was used more in the High condition. There was no difference in the use of the push-off mechanism between cadence conditions. These results suggest that neural control of balance is altered when gait characteristics, such as cadence change, suggesting a flexible balance response that is sensitive to the constraints of the gait cycle. We speculate that the use of the balance mechanisms may be a factor resulting in well-known characteristics of gait in populations with compromised balance control, such as slower gait speed in older adults or higher cadence in people with Parkinson's disease.

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Section: Introductionmentioning

confidence: 99%

Walking Cadence Affects the Recruitment of the Medial-Lateral Balance Mechanisms

Fettrow

Reimann

Grenet

et al. 2019

Front. Sports Act. Living

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“…For able-bodied individuals, the hip loading/unloading mechanism and control of ankle joint motion are primary mechanisms for COP movement control (29). After stroke, de cits in hip (14,63,64) and ankle (65) frontal plane movement control have been observed. This is consistent with our ndings that hip abduction angular displacement and velocity were reduced and COP medial-lateral stabilization was delayed in participants with stroke.…”

Section: Discussionmentioning

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. 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, and altered center of pressure (COP) and center of mass control 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 altered COP and center of mass control appear to limit rapid lower limb loading ability. Future work will investigate the potential of improving functional weight transfer through induced weight transfer training exercise.

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“…In patient populations where reduced gait stability is present (e.g. stroke), the transfer of weight is typically difficult as strength deficits among extensor muscles make this transfer less efficient (Hsiao et al, 2017). Within healthy populations however, where muscle strength should be sufficient to support normal gait, more subtle differences may still be present that become relevant when compared across healthy participants.…”

Section: Aimmentioning

confidence: 99%

Identifying differences in gait adaptability across various speeds using movement synergy analysis

Reilly

Federolf

2020

Preprint

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IntroductionThe aim of this study was to identify movement synergies during normal-walking that can differentiate healthy adults in terms of gait adaptability at various speeds. To this end, the association between movement synergies and lower-limb coordination variability or Deviation Phase (DP) was investigated. A secondary aim of this study included an investigation into the moderating effect of these movement synergies on the relationship between DP and the smoothness of arm-swing motion quantified as the normalised jerk index (NJI).MethodA principal component analysis of whole-body marker trajectories from normal-walking treadmill trials at 0.8m/s, 1.2m/s and 1.6m/s was undertaken. Both DP and NJI were derived from approx. 8 minutes of perturbed-walking treadmill trials. Principal movement components, PMk, were derived and the RMS of the 2nd-order differentiation of these PMk (PAkRMS) were included as independent variables representing the magnitude of neuromuscular control in each PMk. The PAkRMS were input into separate maximal linear mixed-effects regression models to explain the variance in DP and (DP × NJI). A stepwise elimination of terms and comparison of models using Anova identified optimal models for both aims.ResultsAmong the first 7 validated PMk, PA4RMS (double-support phase) was identified as an optimal model and demonstrated a significant negative effect on DP however this effect may differ considerably across walking-speeds. An optimal model for describing the variance in (DP × NJI) included a fixed-effect of PA6RMS (Left – Right side weight transfer). Within-participant clustering was prevalent within both optimal models.InterpretationThe hypotheses that individuals who exhibited greater control on specific kinematic synergies would exhibit variations during perturbed walking was substantiated. Supporting evidence for the role of movement synergies during the double-support phase of gait in proactively correcting balance was presented. The potential influence of leg dominance on gait adaptability was also discussed. Future studies should investigate further the role of walking-speed and leg dominance on movement synergies and look to generalize these findings to patient populations.HighlightsBaseline movement synergies representing terminal-swing and double-support phases of gait were found to have significant negative effects on lower-limb coordination variability during perturbed-walking trials at various speeds.Movement synergies related to the double-support phase and weight transfer events of gait were determined to have a negative moderating effect on the translation of lower-limb coordination variability into upper-limb postural corrections.Evidence was presented for the important role of the double-stance phase of gait in gait adaptability while leg dominance was shown to play a potential role in differentiating healthy adults in this study.

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Control of lateral weight transfer is associated with walking speed in individuals post-stroke

Cited by 57 publications

References 40 publications

Walking Cadence Affects the Recruitment of the Medial-Lateral Balance Mechanisms

Walking Cadence Affects the Recruitment of the Medial-Lateral Balance Mechanisms

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

Identifying differences in gait adaptability across various speeds using movement synergy analysis

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