Factors affecting premature plantarflexor muscle activity during hemiparetic gait

Fujita, Kazuki; Miaki, Hiroichi; Fujimoto, Akira; Hori, Hideaki; Fujimoto, Hitomi; Kobayashi, Yasutaka

doi:10.1016/j.jelekin.2018.02.006

Cited by 7 publications

(4 citation statements)

References 21 publications

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“…In patients with RHD, the loading of knee joint moment for the first PC on the paretic (left) side was a negative value, representing flexion moment, which is unlike the patients with LHD. A previous study showed excessive cocontraction of ankle plantar flexors and knee flexors in the stance phase during gait in patients with stroke ( Fujita et al, 2018 ). In addition, patients with RHD had larger knee flexion moments in the stance phase on the paretic (left) side than those with LHD and in healthy controls.…”

Section: Discussionmentioning

confidence: 97%

Differences in kinetic factors affecting gait speed between lesion sides in patients with stroke

Sekiguchi,

Owaki,

Honda

et al. 2024

Front. Bioeng. Biotechnol.

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The differences in kinetic mechanisms of decreased gait speed across brain lesion sides have not been elucidated, including the arrangement of motor modules reflected by kinetic interjoint coordination. The purpose of this study was to elucidate the differences in the kinetic factors of slow gait speed in patients with stroke on the lesion sides. A three-dimensional motion analysis system was employed to assess joint moment in the lower limb and representative gait parameters in 32 patients with right hemisphere brain damage (RHD) and 38 patients with left hemisphere brain damage (LHD) following stroke as well as 20 healthy controls. Motor module composition and timing were determined using principal component analysis based on the three joint moments in the lower limb in the stance phase, which were the variances accounted for principal components (PCs) and the peak timing in the time series of PCs. A stepwise multiple linear regression analysis was performed to identify the most significant joint moment and PC-associated parameter in explaining gait speed. A negligible difference was observed in age, weight, height, and gait speed among patients with RHD and LHD and controls. The following factors contributed to gait speed: in patients with RHD, larger ankle plantarflexion moment on the paretic (p = 0.001) and nonparetic (p = 0.002) sides and ankle dorsiflexion moment on the nonparetic side (p = 0.004); in patients with LHD, larger ankle plantarflexion moment (p < 0.001) and delayed peak timing of the first PC (p = 0.012) on the paretic side as well as ankle dorsiflexion moment on the nonparetic side (p < 0.001); in the controls, delayed peak timing of the first PC (p = 0.002) on the right side and larger ankle dorsiflexion moment (p = 0.001) as well as larger hip flexion moment on the left side (p = 0.023). The findings suggest that the kinetic mechanisms of gait speed may differ among patients with RHD following patients with stroke with LHD, and controls.

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Section: Discussionmentioning

confidence: 97%

Differences in kinetic factors affecting gait speed between lesion sides in patients with stroke

Sekiguchi,

Owaki,

Honda

et al. 2024

Front. Bioeng. Biotechnol.

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“…Skin impedance was reduced to ≤20 kΩ using alcohol-soaked cotton swabs and an abrasive cream (skinPure, Nihon Kohden Co., Ltd., Tokyo, Japan). A Dual EMG Electrode (EM-272, Noraxon) with an interelectrode distance of 2 cm between Ag-AgCl electrodes was applied to the treated skin area [23]. To identify the gait phase, foot switches (Noraxon Inc.) were placed on both feet [18].…”

Section: Assessmentsmentioning

confidence: 99%

“…In addition, skeletal muscle atrophy and muscle fiber type II shifts are induced after stroke [21], and peripheral fatigue may also affect extended walking. Furthermore, the mechanism of muscle fatigue that differs between paretic and nonparetic sides [8], differences in fiber type ratios in different muscles [22], and walking muscle activity patterns that differ from those of an unaffected person [23] are also considered to impact the performance of extended walking. Therefore, it is important to investigate changes in muscle activity in various parts during extended walking by surface electromyography to adjust the walking training time in consideration of neuromuscular fatigue and determine the target parts of muscle endurance training.…”

Section: Introductionmentioning

confidence: 99%

Temporal Changes in Electromyographic Activity and Gait Ability during Extended Walking in Individuals Post-Stroke: A Pilot Study

Fujita¹,

Kobayashi²,

Hitosugi

2021

Healthcare

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Abnormal gait, particularly in patients with stroke, causes neuromuscular fatigue. We aimed to clarify temporal changes in gait performance and lower limb muscle activity during extended walking in people with stroke hemiplegia. Twelve adults with stroke and eleven healthy controls performed an extended trial involving 20-min continuous walk at a comfortable speed. The primary outcome was electromyography amplitude during the trial and secondary outcomes were walking performance and the instantaneous mean frequency of electromyography during the trial. Data at 1, 6, 12, and 18 min after initiating walking were compared. Performance during extended walking in people with stroke was maintained over time. The electromyography amplitude decreased in the tibialis anterior during the pre-swing phase and increased in the rectus femoris during the single-support phase over time; these changes were similar on the paretic and nonparetic sides. Instantaneous mean frequency decreased over time on the nonparetic side in the tibialis anterior and on the paretic side in the rectus femoris. Healthy subjects did not show any changes over time. The changes in muscle activity in patients with stroke differed between the paretic and nonparetic sides, muscle type, and gait phase; walking performance was maintained despite being affected by neuromuscular fatigue.

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“…However, the temporal order of muscle activity during walking can often be disrupted following cerebral stroke 11 ) . For example, in case of hemiparetic patients, premature plantarflexor muscle activity on the paretic side occurs to supplement lower extremity extension force 12 ) . Over time, stroke patients develop various compensatory strategies to try to achieve an efficient method of walking 13 ) .…”

Section: Introductionmentioning

confidence: 99%

Contribution of muscle activity at different gait phases for improving walking performance in chronic stroke patients with hemiparesis

Fujita¹,

Hori²,

Kobayashi

2018

J Phys Ther Sci

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[Purpose] The aim of this study was to clarify the optimal timing for increasing muscle activity in the paralyzed lower limb of stroke survivors by evaluating the relationship between gait muscle activity patterns and gait parameters. [Participants and Methods] Electromyography of the tibialis anterior, soleus, rectus femoris, and biceps femoris on the paralyzed side and spatiotemporal gait parameters were evaluated in 40 chronic post-stroke patients as they walked at a comfortable speed. The normalized average amplitude and asymmetry indexes of each gait phase were calculated. The correlations between gait velocity or asymmetry indexes and the activity amplitudes of various muscles during each gait phase were analyzed. Multiple regression analysis was performed with gait velocity or asymmetry indexes as the response variable and the muscle activity amplitudes in the various gait phases as explanatory variables. [Results] The major determinants of gait velocity were the tibialis anterior activity (β=−0.35) and biceps femoris activity (β=0.45) during the swing phase. In addition, the biceps femoris activity during the swing phase was the major determinant of the asymmetry index for the swing phase duration (β=−0.41). [Conclusion] For patients with hemiparesis, increasing the biceps femoris activity during the swing phase is considered optimal, which may lead to improvement in walking performance.

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Factors affecting premature plantarflexor muscle activity during hemiparetic gait

Cited by 7 publications

References 21 publications

Differences in kinetic factors affecting gait speed between lesion sides in patients with stroke

Differences in kinetic factors affecting gait speed between lesion sides in patients with stroke

Temporal Changes in Electromyographic Activity and Gait Ability during Extended Walking in Individuals Post-Stroke: A Pilot Study

Contribution of muscle activity at different gait phases for improving walking performance in chronic stroke patients with hemiparesis

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