Lower limb coordination patterns in hemiparetic gait: Factors of knee flexion impairment

Walking velocity and lower limb coordination in hemiparesis

“…We re-sampled angle positions ðu N i Þ and velocities ðv N i Þ over 10 data points for the early stance, 40 data points for the middle stance, 10 data points for the late stance and 40 data points for the swing phase. We quantified inter-segmental coordination in the sagittal plane using CRP measurements as previously described in Hutin et al [9,22]. For the three segments, a graph plotting angle velocity ðv N i ; Y axisÞ vs. angle displacement ðu N i ; X axisÞ represented the phase plot of the segment.…”

“…For the three segments, a graph plotting angle velocity ðv N i ; Y axisÞ vs. angle displacement ðu N i ; X axisÞ represented the phase plot of the segment. The phase angle (w i ) at any given point is defined on the phase plot as the angle between the X axis and the line from the origin to the data point [9,22,24].…”

“…The low CRP Thigh-Shank represented lesser lead of the thigh over the shank in early swing. In the paretic limb, the loss of thigh lead during swing could involve impairment in active hip flexion, passive knee flexion, or a combination of both, impairments that could all be due to bursts of rectus femoris overactivity in particular [22]. That phase difference between thigh and shank during swing, low at baseline compared with healthy subjects, remained unchanged in either the non-paretic or the paretic limbs.…”

“…We analyzed inter-segmental coordination in the sagittal plane, using the continuous relative phase (CRP) [9,[20][21][22], which correlates temporal-spatial parameters in lower limb segments. We measured thigh-shank and shank-foot coordination at preferred and maximal gait velocity in healthy subjects and in the paretic and non-paretic limbs of subjects with hemiparesis.…”

Apport de l’analyse quantifiée de la marche (AQM) dans la compréhension des mécanismes responsables des troubles de la marche des patients hémiplégiques et dans l’évaluation des effets des différents traitements classiquement utilisés

“…Elles ont également permis de diminuer la résis-tance au mouvement passif lors d'étirements du droit anté-rieur et du semi-tendineux et ont entraîné une augmentation significative du pic de flexion de genou pendant la phase oscillante (cinq degrés). Hutin et al [12] ont, quant à eux, montré au moyen de la phase relative continue qu'une injection de toxine botulique dans le RF permettait d'améliorer la coordination intersegmentaire entre le segment cuisse et le segment jambe et de diminuer les compensations du côté non parétique. Cette étude démontre à elle seule l'intérêt de l'analyse 3D du mouvement, car aucun autre outil d'analyse du mouvement disponible à ce jour ne permet d'explorer la coordination d'un mouvement.…”