Neuromuscular control of curved walking in people with stroke: Case report

Abstract

Abstract-People are required to adapt their basic walking pattern to turn and change directions safely for activities of daily living. This case study describes the changes in neuromuscular control among individuals with stroke on walking paths of different curvatures. Two men with hemiparetic stroke and one control subject walked along a straight, wide curved, and tight curved pathway while muscle activation of the medial and lateral gastrocnemius was recorded, along with the trajectory of the center of pressure (COP) during the single support phase. Balance, sensorimotor control, and functional ambulation were also evaluated. The subject with greater lower-limb sensorimotor impairment displayed a larger difference in the anterior-posterior COP displacement between limbs, which exacerbated as the path curvature increased. In addition, while the control subject demonstrated a lateral shift in the mediallateral COP position, this person was unable to adapt the COP position on the nonparetic side. The second participant with a stroke demonstrated better balance and lateral shifting of the COP position. Modulation of the COP trajectory is required to safely perform curved walking. Further study is required to confirm the role of stroke-related gait deficits in the ability to adapt to curved walking.

Robot controlled, continuous passive movement of the ankle reduces spinal cord excitability in participants with spasticity: a pilot study

“…The Timed Up and Go test (Podsiadlo and Richardson 1991) and timed 10 m Walk test were used to assess over-ground walking mobility, speed, and endurance. The Timed Up and Go test, in addition to the extra demand of standing from a seated position, also required unique demands on neural processes involved in the control of medial–lateral stability for the purpose of turning around which are not required for the 10 m Walk test (Chisholm et al 2015). The same individual, to limit inter-rater variability, performed all clinical walking tests.…”

Identification of Disease-Specific Turning Movement Hallmarks: A Systematic Review towards Establishment of Disease Screening Algorithm

“…Nine studies measured turning on the spot[10, 20, 37, 41, 46, 48, 52, 66, 67], three studies were radius circle or semicircle[33, 36, 57]. The maximum and average length of approach path was 7 m and 3.33 m, respectively.…”

“…The maximum and average length of approach path was 7 m and 3.33 m, respectively. Turn direction was set for both sides in 26 studies[9, 10, 27, 33, 34, 36, 37, 39-41, 45-49, 51, 52, 54, 56, 57, 62, 64-66, 68, 69], and 16 studies limited either side[11, 19, 20, 29, 32, 35, 38, 42-44, 59-61, 67, 70, 71]. The formalized task was only TUG with 7 studies[11, 28, 30, 40, 58, 62, 63], 11 studies including instrumented TUG[50, 55, 59, 68].…”

Walking behaviors for stroke survivors: comparison between straight line and curved path

“…However, a previous study reported that walking along a curved path implies a different spatiotemporal parameter of muscle activation compared with straight walking in humans [16][17][18][19]. After the studies, several researchers have reported on curved walking in hemiparetic individuals [20][21][22].…”

“…Godi et al [20] reported the velocity of curved walking was not significantly smaller in hemiparetic patients compared with linear walking. Two other studies examined the neuromuscular strategies in the paretic leg during curved walking for persons with stroke [21,22]. Indeed, there is a lack of studies comparing linear walking and curved path walking in stroke surivors.…”