Lower limb co-contraction during walking in subjects with stroke: A systematic review

Rosa, Marlene Cristina Neves; Marques, Alda; Demain, Sara; Metcalf, Cheryl

doi:10.1016/j.jelekin.2013.10.016

Cited by 50 publications

(32 citation statements)

References 43 publications

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“…Walking speed can be improved if gait pattern is corrected. Rosa et al 44 noted in their study of lower limb co-contraction in stroke subjects during walking that long co-contraction of agonist and antagonist muscles, e.g. quadriceps and hamstrings or gastrocnemius and tibialis anterior, could improve the walking ability and gait patterns of stroke survivors.…”

Section: Walking Speedmentioning

confidence: 99%

The effects of rehabilitation education for village health volunteers on walking speed and upper extremity function in stroke survivors in Thailand

Chinchai¹,

Khamwong²

2017

S. Afr. j. occup. ther

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INTRODUCTION: Stroke can cause long-term disabilities to survivors. Rehabilitation is an on-going process and should, ideally, be provided to these people in their homes. This study aimed to investigate the effect that rehabilitation education provided to village health volunteers (VHVs) would have on walking speed and upper extremity (UE) function in stroke survivors who stay at home in Thailand. METHODS: Participants were recruited by purposive sampling, which included 27 stroke survivors from four municipalities in Chiang Mai and Lamphun provinces. The measuring instruments used were the Ten-Meter Walk Test and the UE motor domain of the Fugl-Meyer Assessment. Researchers presented a 7-hour rehabilitation education programme to VHVs, who then made weekly1-hour visits to the homes of stroke survivors to implement the rehabilitation programme over eight weeks. Data were collected within seven days before and again after the 8-week programme. RESULTS: Descriptive statistics and the paired t-test were applied to analyse the data. Results showed that the participants used significantly less walking time from pre-test ( X =34.73 ±8.48) to post-test ( X =32.18±9.32) (p<0.05). However, the score of UE function at pre-test (X=36.81±9.59) was not significantly different from that at post-test (X =37.26±9.67). CONCLUSION: The findings suggest that trained VHVs can be part of the rehabilitation team and contribute to improved functional performance for disabled stroke survivors, particularly in developing countries. Key words: Hand function, gait speed, Home visit, motor function after stroke, community rehabilitation, home-based rehabilitation

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Section: Walking Speedmentioning

confidence: 99%

The effects of rehabilitation education for village health volunteers on walking speed and upper extremity function in stroke survivors in Thailand

Chinchai¹,

Khamwong²

2017

S. Afr. j. occup. ther

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“…However, few studies analysed the ipsilesional limb performance (Peterson et al 2010;Rosa et al 2014). This recent hypothesis justifies the possibility of bilateral involvement in stroke subjects.…”

Section: Introductionmentioning

confidence: 99%

Ankle antagonist coactivation in the double-support phase of walking: Stroke vs. healthy subjects

Silva

Sousa

Silva

et al. 2015

Somatosensory & Motor Research

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Introduction: Lesions at ipsilateral systems related to postural control at ipsilesional side, may justify the lower performance of stroke subjects during walking. Purpose: To analyse bilateral ankle antagonist coactivation during double-support in stroke subjects. Methods: Sixteen (8 females; 8 males) subjects with a first isquemic stroke, and twenty two controls (12 females; 10 males) participated in this study. The double support phase was assessed through ground reaction forces and electromyography of ankle muscles was assessed in both limbs. Results: Ipsilesional limb presented statistical significant differences from control when assuming specific roles during double support, being the tibialis anterior and soleus pair the one in which this atypical behavior was more pronounced. Conclusion: The ipsilesional limb presents a dysfunctional behavior when a higher postural control activity was demanded.

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“…Destaca-se ainda, o elevado gasto de energia, devido a mecanismos compensatórios que interferem na deambulação com máxima eficiência dos pacientes hemiparéticos [15,16]. Estudos anteriores já mostraram que a marcha de indivíduos hemiparéticos, quando comparada com indivíduos saudáveis, demonstra muitas diferenças [5], destacando-se a diminuição da velocidade, da cadência e do comprimento do passo, como observado na presente pesquisa, onde ambas as variáveis demonstraram diferença significativa quando comparadas com a normalidade [15]. Em relação à velocidade da marcha, os hemiplégicos em geral demonstram valores reduzidos em ambos os membros inferiores, com maior acometimento no membro espástico, indo ao encontro com o observado no presente estudo, que também identificou significativa diminuição da velocidade da marcha quando comparada com a normalidade.…”

Section: Discussionunclassified

“…Após o AVC ocorrem diversas alterações biomecânicas, especialmente no membro hemiparético, como redução da amplitude dos movimentos das articulações e anormalidades no controle e ativação muscular [5,14]. A literatura destaca diversas alterações angulares, como a redução da flexão de quadril no contato inicial e a diminuição da flexão de joelho e aumento no quadril durante a retirada do pé do solo.…”

Section: Discussionunclassified

“…A alteração funcional resultante, inclusive na motricidade, pode ser temporária ou permanente e parcial ou total, e a localização das sequelas depende da área do cérebro afetada [3,4]. Na marcha hemiparética, também chamada de ceifante, observam-se diversas alterações biomecânicas e neuromusculares [5], devido à espasticidade no hemicorpo afetado [2,6]. Nesses indivíduos observamse também alterações na propriocepção, ausência de seletividade na ação de alguns grupos musculares e incapacidade para gerar dissociação entre a cintura escapular e a cintura pélvica.…”

Section: Introductionunclassified

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Análise cinemática da marcha em indivíduos com hemiparesia espástica após acidente vascular cerebral

Jacobsen¹,

Ferreira²,

Schmitt³

et al. 2016

Sci Med

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Este artigo está licenciado sob forma de uma licença Creative Commons Atribuição 4.0 Internacional, que permite uso irrestrito, distribuição e reprodução em qualquer meio, desde que a publicação original seja corretamente citada. RESUMOObjetivos: Avaliar a cinemática linear e angular da marcha em pacientes hemiparéticos espásticos após acidente vascular cerebral, considerando os valores da normalidade e o membro não afetado. Métodos: Estudo transversal, no qual participaram indivíduos adultos com hemiparesia espástica após acidente vascular cerebral, selecionados na Clínica de Fisioterapia da Universidade de Caxias do Sul. A análise cinemática da marcha foi realizada no Laboratório de Análises Biomecânicas do Movimento Humano da mesma instituição, seguindo o protocolo de Laroche. Para análise de dados foi utilizada estatística descritiva, teste t para média de uma amostra e teste t pareado. O nível de significância adotado foi p<0,05. Resultados: Foram estudados oito indivíduos adultos, com idade entre 43 a 59 anos, de ambos os sexos. Foi identificada diferença significativa na cinemática linear da marcha do membro afetado para todas as variáveis estudadas. Considerando a comparação entre os membros inferiores, o comprimento do passo e o tempo do passo foram significativamente maiores no hemicorpo acometido. Com relação às variáveis angulares, os indivíduos demonstraram diferença significativa da normalidade em todas as variáveis, exceto flexão de quadril. Observou-se ainda, menor variação angular (flexão/extensão) no joelho do membro afetado quando comparado com o sadio. Conclusões: O estudo indicou alterações na cinemática da marcha do membro acometido de indivíduos hemiparéticos após acidente vascular cerebral, comparando com a normalidade e com o membro contralateral, caracterizando a presença de um padrão flexor incomum. Essas alterações podem estar relacionadas com diminuição do equilíbrio e do controle motor, fraqueza muscular, déficit proprioceptivo, aumento do tônus, contraturas e deformidades.DESCRITORES: acidente vascular cerebral; cinemática; fenômenos biomecânicos; marcha. ABSTRACT Aims:To evaluate linear and angular kinematics of gait in patients with spastic hemiparesis secondary to stroke considering reference values and the unaffected limb. Methods: Cross-sectional study of adult patients with spastic hemiparesis secondary to stroke selected from the Physical Therapy Clinic of Universidade de Caxias do Sul (UCS). The kinematic gait analysis was performed at the Human Motion Biomechanical Analysis Laboratory at UCS according to Larouche's protocol. Descriptive statistics, one-sample t test, and paired t test were used for the data analysis. Statistical significance was set as p<0.05. Results: Eight adult male and female individuals aged 43 to 59 years were assessed. All variables indicated a significant difference in the linear kinematics of the gait of the affected limb. By comparing the lower limbs, stride length and rate were significantly higher in the affected hemibody. Angular kinematics w...

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Lower limb co-contraction during walking in subjects with stroke: A systematic review

Abstract: Subjects with stroke commonly present longer MCo during walking, probably in an attempt to improve walking ability. However, to ensure recommendations for clinical practice, further research with standardized methodologies is needed.

Cited by 50 publications

References 43 publications

The effects of rehabilitation education for village health volunteers on walking speed and upper extremity function in stroke survivors in Thailand

The effects of rehabilitation education for village health volunteers on walking speed and upper extremity function in stroke survivors in Thailand

Ankle antagonist coactivation in the double-support phase of walking: Stroke vs. healthy subjects

Análise cinemática da marcha em indivíduos com hemiparesia espástica após acidente vascular cerebral

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