Motor dysfunction of the “non-affected” lower limb: a kinematic comparative study between hemiparetic stroke and total knee prosthesized patients

Abstract

In patients with hemispheric stroke, abnormal motor performances are described also in the ipsilateral limbs. They may be due to a cortical reorganization in the unaffected hemisphere; moreover, also peripheral mechanisms may play a role. To explore this hypothesis, we studied motor performances in 15 patients with hemispheric stroke and in 14 patients with total knee arthroplasty, which have a reduced motility in the prosthesized leg. Using the unaffected leg, they performed five superimposed circular trajectories in a prefixed pathway on a computerized footboard, while looking at a marker on the computer screen. The average trace error was significantly different between the groups of patients and healthy subjects [F (2,25) = 7.9; p = 0.003]; on the contrary, the test time execution did not vary significantly. In conclusion, both groups of patients showed abnormal motor performances of the unaffected leg; this result suggests a likely contribution of peripheral mechanisms.

Force control of quadriceps muscle is bilaterally impaired in subacute stroke

“…Several factors may contribute to impaired motor function of the less-affected limbs, including hemispheric lateralization for the executed tasks and hemispheric asymmetry (36) or evolving maladaptive changes in the intact hemisphere (38). Some peripheral mechanisms may also play a role (1), and the potential contribution of prolonged inactivity early in recovery should be considered (51).…”

The Effects of Baduanjin Qigong on Postural Stability, Proprioception, and Symptoms of Patients With Knee Osteoarthritis: A Randomized Controlled Trial

“…For right limb affected participants, clockwise movements were performed whereas anticlockwise movements were performed for left limb affected. Participants were instructed to perform five circular laps for each limb as fast as possible and to the best of their ability within a maximum allotted time of 60 s. Variables of interest were average trace error (ATE) in percentage (%) and test time execution (TTE) in seconds (s) (44).…”

A Systematic Review Establishing the Current State-of-the-Art, the Limitations, and the DESIRED Checklist in Studies of Direct Neural Interfacing With Robotic Gait Devices in Stroke Rehabilitation

“…A minimum set of agonist and antagonist muscles in the distal and the proximal compartment of the leg needs to be defined to provide comprehensive muscle recruitment patterns and muscle synergies during the gait cycle after a stroke, which could be helpful for future HMI. Additionally, for individuals after a stroke, sEMG data from both legs (stroke affected and non-affected sides) should be collected as motor deficits are not only associated with the stroke-affected side but also of the non-affected side during spontaneous walking (Parvataneni et al, 2007 ; Bagnato et al, 2009 ; Tseng and Morton, 2010 ; Raja et al, 2012 ). Recent reviews of muscle synergies in post-stroke gait and robotic gait devices support the need for better standardization of muscles chosen for EMG data capture (Molteni et al, 2018 ; Van Criekinge et al, 2019 ).…”