Different Types of Disturbed Motor Control in Gait of Hemiparetic Patients

Abstract

The pattern of muscle activation in walking was studied in a group of 26 hemiparetic patients. Electromyograms were taken with surface electrodes from 6 muscle groups of the paretic leg and analysed after rectification and time averaging. The sagittal rotations in hip, knee and ankle joint were determined with intermittent light photography. The muscle activation pattern of each patient was compared to that in healthy subjects as well as to the movements performed by the patient and to the normal movement pattern. The normal patterns of movement and muscle activation were assessed from compiled data from 10 healthy female volunteers and average values of angular displacements and amplitude of intergrated EMG were determined at each 5 per cent of the gait cycle. Change of muscle length was determined with a length recording transducer. Gait capacity varied highly in the group of patients studied and the movement pattern also varied markedly. Three types of abnormal muscle activation pattern were disclosed in the patients. In 9 patients, the calf muscles were prematurely activated in the stance phase, probably due to enhanced stretch reflexes (Type I). In another 9 patients, EMG activity was abolished or extremely low in 2 or more of the muscles examined (Type II). In 4 patients, there was a pathological coactivation of several or all of the muscles during part of the gait-cycle, thus disrupting the normal sequential shift of activity in antagonistic muscles (Type III). In the remaining 4 patients, the muscle activation pattern was more complex and no common pattern was discerned.

Effects of isokinetic strength training on walking in persons with stroke: A double-blind controlled pilot study

“…Despite this effort to regain optimal walking function, only a small percentage (18%-25%) attain a walking speed that is required for community activities. [2][3][4] Possible factors contributing to their difficulties with gait include muscle weakness, [5][6][7] abnormal muscle activation patterns, 8 disturbed sensation, impaired postural control, disturbed cognition, and neglect.…”

Functional recovery of gait and joint kinematics after right hemispheric stroke

“…Several studies have suggested classification of different types of hemiplegic gait patterns in stroke patients. [11][12][13][14] However, much is still unknown about the relation between the changes in gait patterns over time and functional recovery of walking ability in stroke patients. Our purpose in this study, therefore, was to gain more insight into this relation.…”

Artificial Neural Networks (ANN) Applied for Gait Classification and Physiotherapy Monitoring in Post Stroke Patients

“…Burdett et al (1988) found certain leg joint angle values at certain gait phases to be most important qualitative traits distinguishing gait in post stroke patients from that of ablebodied subjects. Other authors concluded that the greatest differences between pathological and normal gait involve the maximal and minimal angles in the knee and ankle joints during the toe-off stage and at first foot contact with the ground (Knutsson & Richards 1979, Intiso et al, 1996. With respect to post stroke patients, in particular, impressive classification results (98%) were obtained by Mulroy et al (2003), utilizing the maximal and minimal values of only three kinematic parameters.…”

“…In terms of post stroke dysfunction, numerous authors (Mulroy et al, 2003;Knutsson & Richards, 1979;Perry et al, 1995;Kramers de Quervain et al, 1996;Kinsella & Moran, 2008) have attempted to identify homogeneous subgroups of post stroke walking patterns. Knutsson & Richards (1979) used EMG signals to distinguish three types of pathological gait. Kramers de Quervain et al (1995) used the Mahalanobis distance statistical technique on five temporal distance parameters to distinguish four gait patterns.…”