Standing weight-bearing asymmetry in adults with lateropulsion following stroke

Birnbaum, Melissa; Brock, Kim; Clark, Ross; Muir, Sophie; Burton, Elissa

doi:10.1016/j.gaitpost.2021.09.172

Cited by 7 publications

(4 citation statements)

References 30 publications

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“…In studies using these devices, belt speeds are altered asymmetrically, which elicits spatiotemporal adaptations over time [10]. However, while split belt treadmills have demonstrated the ability to affect step length asymmetry on long time scales after training for people after stroke [11], kinetic measures such as weightbearing and propulsion asymmetry remain resistant to longterm correction [12]- [15] and to transfer to overground gait [11], [14]. This gap is critically important for rehabilitation outcomes, because asymmetric weight-bearing is correlated with increased risk for injury [16] and eventually developing additional impairments, such as knee osteoarthritis [17]- [19].…”

Section: Introductionmentioning

confidence: 99%

AdjuSST: An Adjustable Surface Stiffness Treadmill

Price,

Locurto,

Abdikadirova

et al. 2024

Preprint

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This paper presents and evaluates a novel adjustable surface stiffness treadmill design as a platform for conducting experiments involving asymmetric perturbations of surface stiffness. In context with alternative designs, the AdjuSST contributes meaningful improvements in effective walking surface length while maintaining a useful stiffness range and responsive spring suspension. Future work with this system will focus on experiments which perturb human gait with prolonged asymmetric stiffness changes to investigate adaptation effects and aftereffects relevant to neuromotor rehabilitation.

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Section: Introductionmentioning

confidence: 99%

AdjuSST: An Adjustable Surface Stiffness Treadmill

Price,

Locurto,

Abdikadirova

et al. 2024

Preprint

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“…Generally, individuals after a stroke have a more common pattern of overload in the non-paretic lower limb ( Birnbaum et al, 2021 ). Evaluation by posturography has shown to be an instrument with good reliability and reproducibility to quantify body weight distribution and displacement of the center of mass ( Genthon et al, 2008 ).…”

Section: Introductionmentioning

confidence: 99%

Application of the participatory design in the testing of a baropodometric insole prototype for weight-bearing asymmetry after a stroke: A qualitative study

Galvão,

Castro Silva,

Viana

et al. 2024

Hong Kong Journal of Occupational Therapy

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Introduction Currently studies indicate the need to incorporate the user`s perspective in the testing of new assistive technologies. The objective of this paper is to test a baropodometric insole prototype for monitoring and treatment weight-bearing asymmetry, according to the Participatory Design. Methods We used a qualitative case study approach during the testing phase of the baropodometric insole prototype. The focus group approach addressed topics related to the experience and accessibility of the potential user in conjunction with professionals, researchers, and physiotherapy students. Facilitators, barriers, and requirements for the device were collected through audio recordings of the discussions during and after prototype testing. Results Key steps in the prototype testing process were divided into (1) Test of the prototype according to the Participatory Design, divided into Who, When, How, and Why the potential user was involved in the study; and (2) Facilitators, barriers and requirements to improve the prototype. Conclusions The baropodometric insole prototype can be seen as a promising device for monitoring and treating weight-bearing asymmetry.

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“…In clinical studies, strokes that affect one or more postural control networks (visual, vestibular, and somatosensory) are known to present with lateropulsion (pusher syndrome) [ 11 ]. Lateropulsion is characterized by a contralesional bias in posture with stroke, active resistance to postural correction to upright vertical [ 12 ], and weight-bearing asymmetry (WBA) [ 13 ]. In particular, patients with lateropulsion and right parietal lesions show delayed functional recovery, necessitating prolonged rehabilitation efforts [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Unilateral cathodal transcranial direct current stimulation over the parietal area modulates postural control depending with eyes open and closed

Oka¹,

Ikeda

Mitsutake

et al. 2022

PLoS ONE

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Objective Cathodal transcranial direct current stimulation (C-tDCS) is generally assumed to inhibit cortical excitability. The parietal cortex contributes to multisensory information processing in the postural control system, and this processing is proposed to be different between the right and left hemispheres and sensory modality. However, previous studies did not clarify whether the effects of unilateral C-tDCS of the parietal cortex on the postural control system differ depending on the hemisphere. We investigated the changes in static postural stability after unilateral C-tDCS of the parietal cortex. Methods Ten healthy right-handed participants were recruited for right- and left-hemisphere tDCS and sham stimulation, respectively. The cathodal electrode was placed on either the right or left parietal area, whereas the anodal electrode was placed over the contralateral orbit. tDCS was applied at 1.5 mA for 15 min. We evaluated static standing balance by measuring the sway path length (SPL), mediolateral sway path length (ML-SPL), anteroposterior sway path length (AP-SPL), sway area, and the SPL per unit area (L/A) after 15-minute C-tDCS under eyes open (EO) and closed (EC) conditions. To evaluate the effects of C-tDCS on pre- and post-offline trials, each parameter was compared using two-way repeated-measures analysis of variance (ANOVA) with factors of intervention and time. A post-hoc evaluation was performed using a paired t-test. The effect sizes were evaluated according to standardized size-effect indices of partial eta-squared (ηp2) and Cohen’s d. The power analysis was calculated (1-β). Results A significant interaction was observed between intervention and time for SPL (F (2, 27) = 4.740, p = 0.017, ηp2 = 0.260), ML-SPL (F (2, 27) = 4.926, p = 0.015, ηp2 = 0.267), and sway area (F (2, 27) = 9.624, p = 0.001, ηp2 = 0.416) in the EO condition. C-tDCS over the right hemisphere significantly increased the SPL (p < 0.01, d = 0.51), ML-SPL (p < 0.01, d = 0.52), and sway area (p < 0.05, d = 0.83) in the EO condition. In contrast, C-tDCS over the left hemisphere significantly increased the L/A in both the EC and EO condition (EO; p < 0.05, d = 0.67, EC; p < 0.05, d = 0.57). Conclusion These results suggest that the right parietal region contributes to static standing balance through chiefly visual information processing during the EO condition. On the other hand, L/A increase during EC and EO by tDCS over the left parietal region depends more on somatosensory information to maintain static standing balance during the EC condition.

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Standing weight-bearing asymmetry in adults with lateropulsion following stroke

Cited by 7 publications

References 30 publications

AdjuSST: An Adjustable Surface Stiffness Treadmill

AdjuSST: An Adjustable Surface Stiffness Treadmill

Application of the participatory design in the testing of a baropodometric insole prototype for weight-bearing asymmetry after a stroke: A qualitative study

Unilateral cathodal transcranial direct current stimulation over the parietal area modulates postural control depending with eyes open and closed

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