Rhythm Perturbations in Acoustically Paced Treadmill Walking After Stroke

Roerdink, Melvyn; Lamoth, Claudine J. C.; Kordelaar, Joost van; Elich, Peter; Konijnenbelt, Manin; Kwakkel, Gert; Beek, Peter J.

doi:10.1177/1545968309332879

Cited by 104 publications

(110 citation statements)

References 38 publications

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“…[1][2][3][6][7][8][9][10]12,18 First, we found that asymmetry in neither component was significantly correlated with mean step-length asymmetry, indicating that variations in step-length asymmetry cannot be fully explained by the components of trunk progression (TP) and forward foot placement relative to the trunk (FFP) in isolation. Second, Figure 2 clearly shows that step-length asymmetry is, by and large, the sum of asymmetries in TP and FFP.…”

Section: Discussionmentioning

confidence: 99%

Understanding Inconsistent Step-Length Asymmetries Across Hemiplegic Stroke Patients

Roerdink¹,

Beek²

2010

Neurorehabil Neural Repair

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Background. In hemiplegic gait, step length typically differs in magnitude between paretic and nonparetic sides. However, the direction of step-length asymmetry varies across stroke patients. Objective. The study sought to understand directional variations in step-length asymmetry in terms of asymmetries in forward foot placement relative to the trunk and trunk progression. Methods. A total of 10 hemiplegic stroke patients and 9 healthy elderly controls walked at a self-selected comfortable speed while pelvic and heel marker positions were recorded.Step length, forward foot placement relative to the trunk, and trunk progression of paretic and nonparetic steps were quantified, as well as the asymmetries therein. Results. The 3 asymmetry indices in question varied within individual patients and occasionally fell within control reference ranges, whereas directional variations across stroke patients were observed for asymmetries in step length and forward foot placement only. Despite heterogeneity in asymmetry across patients, step-length asymmetry was determined by the sum of asymmetries in forward foot placement and trunk progression. Asymmetries in trunk progression and forward foot placement were negatively correlated. No significant association was observed between step-length asymmetry and any other asymmetry index. Conclusions.Step-length asymmetry was accounted for by asymmetries in forward foot placement and trunk progression, whereas their relative contribution accounted for directional variations in step-length asymmetry. Partitioning of step-length asymmetry further helped to identify individual impairments and compensatory gait strategies. An encompassing hemiplegic gait evaluation should therefore include an assessment of foot positioning relative to the trunk.

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Section: Discussionmentioning

confidence: 99%

Understanding Inconsistent Step-Length Asymmetries Across Hemiplegic Stroke Patients

Roerdink¹,

Beek²

2010

Neurorehabil Neural Repair

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“…Healthy persons are able to initiate such adjustments in response to new visual information at remarkably short latency (~120 ms) and to alter their foot placement successfully according to the environmental demands. [7][8][9] After a stroke, studies have shown that the ability to make step adjustments is often impaired, [10][11][12][13][14][15] but the exact underlying deficits and their interplay remain poorly understood. In general, step adjustments could fail either because the stepping leg is adjusted too late or because the movement itself is inadequate in some way.…”

Section: Introductionmentioning

confidence: 99%

Deficits Underlying Impaired Visually Triggered Step Adjustments in Mildly Affected Stroke Patients

Nonnekes

Talelli²,

Niet

et al. 2009

Neurorehabil Neural Repair

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Background. The ability to make step adjustments while walking is often impaired following a stroke, but the basic sensorimotor control deficits responsible have not been established. Objective. To identify these deficits in Patients who have recovered from stroke leaving only mild lower limb impairment. Methods. Ten stroke and 10 age-matched control patients stepped onto an illuminated rectangle. In 40% of trials it jumped 140 mm either medially or laterally when the stepping foot left the ground, thus provoking a mid-step adjustment. In a separate block, patients performed the same task but with the body supported by a frame to eliminate balance responses. Results. Irrespective of support condition stroke patients produced short-latency foot trajectory adjustments compatible with a fast-acting, possibly subcortical, visuomotor process. However, the latency was slightly but significantly longer for the contralesional leg (148 ms) than the ipsilesional leg (141 ms) and longer than for controls (129 ms). Stroke patients' foot adjustments were executed slower and undershot the target more than controls. These deficits were most pronounced in the medial direction when the body was unsupported. The pattern of undershooting was the same for ipsilesional and contralesional legs. Conclusions. Mildly impaired stroke patients have deficits in initiating and executing visually triggered step adjustments but more profound difficulties with balance control during the adjustment, which caused them to suppress mid-step adjustments of foot placement in the medial direction where balance demands were greatest. Paradoxically, such suppression outside the laboratory may also threaten balance if it leads to unsafe foot placement or obstacle collision.

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“…It has been generally known that rhythmic auditory stimulation training and treadmill training are both effective to promote normal gait pattern through providing the repetitive and intensive stimulus for motor areas in the brain [Hesse S, 2008,Thaut MH et al, 2007.Studies on RAS training have shown that when different tempos of rhythmic stimuli were given, the faster tempo led to increase in cadence and step and decrease in GA, resulting in the positive effects on recovery of gait ability [Plotnik M et al, 2007, Arias P et al, 2008,Willems AM et al, 2006.The stability of inter limb coordination was more improved when RAS was provided on both paretic and non-paretic side, compare with non-paretic side only [Roerdink M et al, 2009].…”

Section: Discussionmentioning

confidence: 96%

Effects of Real-time Auditory Stimulation Feedback on Balance and Gait after Stroke: a Randomized Controlled Trial

Yang¹,

Kim²,

Lee³

2017

J Exp Stroke Transl Med

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Rhythm Perturbations in Acoustically Paced Treadmill Walking After Stroke

Cited by 104 publications

References 38 publications

Understanding Inconsistent Step-Length Asymmetries Across Hemiplegic Stroke Patients

Understanding Inconsistent Step-Length Asymmetries Across Hemiplegic Stroke Patients

Deficits Underlying Impaired Visually Triggered Step Adjustments in Mildly Affected Stroke Patients

Effects of Real-time Auditory Stimulation Feedback on Balance and Gait after Stroke: a Randomized Controlled Trial

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