Effect of Leg Extension Angle on Knee Flexion Angle during Swing Phase in Post-Stroke Gait

Matsuzawa, Yuta; Miyazaki, Takasuke; Takeshita, Yasufumi; Higashi, Naoto; Hayashi, Hiroyuki; Araki, Sota; Nakatsuji, Shintaro; Fukunaga, Seiji; Kawada, Masayuki; Kiyama, Ryoji

doi:10.3390/medicina57111222

Cited by 9 publications

(6 citation statements)

References 36 publications

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“…Previous studies also support that gait asymmetry ratios are more sensitive 2 of 11 outcome measures [9][10][11]. Furthermore, the inadequate propulsion force is correlated to an alteration of the leg extension angle, knee flexion angle and foot dorsiflexion in the paretic side [12].…”

Section: Introductionmentioning

confidence: 72%

The Relationship between Gait Velocity and Walking Pattern in Hemiplegic Patients

Nesi¹,

Taviani²,

D’Auria

et al. 2023

Applied Sciences

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Background Gait speed represents a functional predictor and an impairment severity index in stroke survivors; gait analysis parameters are descriptors of walking strategies used to compensate for the muscle impairment such as vaulting, circumduction and hip hiking. The aim of this study was to assess if there is a relationship between the gait compensatory strategy and gait speed of progression. Methods A sample of 30 patients with post-stroke hemiparesis was assessed for gait compensatory patterns through gait analysis and videorecording. BMI, pain-VAS, Barthel Index, Nottingham Extended ADL Scale, Motricity Index, lower limb muscles strength and aROMs were also included in the assessment. Results In 19 patients it was possible to identify one or more compensatory strategies; in 11 patients no specific gait pattern was found. The vaulting and hip hiking combined gait strategy had an effect on gait speed. Gait speed was directly related to Barthel Index, Nottingham Extended ADL Scale, Motricity Index of the paretic side and in particular with quadriceps and iliopsoas strength and hip extension aROM. Gender, age and paretic side did not influence gait speed. Conclusion Compensatory gait strategies influence gait speed but studies with larger sample size are needed to better highlight their impact.

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Section: Introductionmentioning

confidence: 72%

The Relationship between Gait Velocity and Walking Pattern in Hemiplegic Patients

Nesi¹,

Taviani²,

D’Auria

et al. 2023

Applied Sciences

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“…Previous studies report a significant relationship between walking speed and the muscle strength of an affected lower limb [48][49][50] and the severity of motor paralysis in stroke patients [51]. In addition, the motor function of the affected lower limb can be correlated with the leg extension angle [17] and spatiotemporal parameters, including cadence, step length, and stride length [52]. In contrast, other studies report that muscle strength is not significantly associated with gait parameters, including step length and gait ability (speed and distance) in stroke patients [53,54].…”

Section: Discussionmentioning

confidence: 98%

“…IMUs were comprised of a 3D gyroscope, an accelerometer, and a magnetometer and could calculate the 3-axis acceleration and Euler angles in a laboratory coordinate system with a sampling frequency of 100 Hz. IMUs are widely used tools in healthcare [17,[37][38][39], with high reliability [40], and are fixed along the frontal plane where possible. Software (MT manager 4.7.2, Xsens, Enschede, The Netherlands) was used to adjust the vertical axis of the IMU to align with gravity during static stance.…”

Section: Gait Measurementmentioning

confidence: 99%

“…An increase in the propulsion force on the affected side after gait training results in an increased gait speed in stroke patients [15]. Furthermore, the leg extension angle is associated with the 6-minute walk distance [16] and knee flexion angle during the swing phase [17]. Therefore, the leg extension angle on the affected side is a beneficial indicator of gait quality and the main target for gait training during stroke rehabilitation.…”

Section: Introductionmentioning

confidence: 99%

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For Patients with Stroke, Balance Ability Affects the Leg Extension Angle on the Affected Side

et al. 2022

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In stroke patients, the impact of lower limb physical functions on the leg extension angle remains unclear. We set out to reveal the physical impairments of the affected side in such patients that were associated with leg extension angle during gait. Twenty-six stroke patients walked for 16 m at a spontaneous speed. During walking, the leg extension angle and the increment of velocity during late stance, as an indicator of propulsion, were measured by inertial measurement units. The Berg balance scale (BBS), Fugl-Meyer assessment-lower limb, and motricity index-lower limb (MI-LL) were also evaluated. Stepwise multiple regression analysis was employed to reveal functions associated with the leg extension angle on the affected side. A path analysis was also used to confirm the relationship between the extracted factors, leg extension angle, and gait speed. Multiple regression analysis showed that the BBS was significantly related to the leg extension angle on the affected side (p < 0.001). Path analysis revealed that the leg extension angle was also indirectly affected by the MI-LL and that it affected gait speed via propulsion on the affected side. These findings could guide the prescription of effective gait training for improving gait performance during stroke rehabilitation.

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“…Since the magnitude of TLA is directly related to PF 20 – 22 , this suggests that stroke patients with smaller PF have larger LBF, as reported in a previous study 15 . Moreover, TLA is related to the knee joint flexion angle during the pre-swing phase 40 . Hence, a decrease in TLA might have delayed the de-loading of the paretic limb during the pre-swing phase and contributed to the development of LBF.…”

Section: Discussionmentioning

confidence: 99%

Kinetic and kinematic parameters associated with late braking force and effects on gait performance of stroke patients

Ohta

Tanabe²,

Katsuhira

et al. 2023

Sci Rep

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Late braking force (LBF) is often observed in the late stance phase of the paretic lower limb of stroke patients. Nevertheless, the effects and association of LBF remain unclear. We examined the kinetic and kinematic parameters associated with LBF and its effect on walking. Herein, 157 stroke patients were enrolled. Participants walked at a comfortable speed selected by them, and their movements were measured using a 3D motion analysis system. The effect of LBF was analyzed as a linear relationship with spatiotemporal parameters. Multiple linear regression analyses were performed with LBF as the dependent variable and kinetic and kinematic parameters as independent variables. LBF was observed in 110 patients. LBF was associated with decreased knee joint flexion angles during the pre-swing and swing phases. In the multivariate analysis, trailing limb angle, cooperativity between the paretic shank and foot, and cooperativity between the paretic and non-paretic thighs were related to LBF (p < 0.01; adjusted R2 = 0.64). LBF in the late stance phase of the paretic lower limb reduced gait performance in the pre-swing and swing phases. LBF was associated with trailing limb angle in the late stance, coordination between the paretic shank and foot in the pre-swing phase, and coordination between both thighs.

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Effect of Leg Extension Angle on Knee Flexion Angle during Swing Phase in Post-Stroke Gait

Cited by 9 publications

References 36 publications

The Relationship between Gait Velocity and Walking Pattern in Hemiplegic Patients

The Relationship between Gait Velocity and Walking Pattern in Hemiplegic Patients

For Patients with Stroke, Balance Ability Affects the Leg Extension Angle on the Affected Side

Kinetic and kinematic parameters associated with late braking force and effects on gait performance of stroke patients

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