The effects of symmetric center of pressure displacement training with feedback on the gait of stroke patients

Kim, Jin-Seop

doi:10.1589/jpts.27.855

Cited by 5 publications

(3 citation statements)

References 18 publications

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“…CoP data are structured two dimensional outputs that carry information about the mechanisms involved in the control of bipedal unperturbed stance. The analysis of postural sway has been used in many studies to understand impairments of motor control in patients with pathologies that affect balance such as Parkinson’s disease [11, 12], Huntington’s disease [13], stroke [14, 15], and lower-limb amputees [4, 16–24]. Fluctuations in CoP time series are highly irregular and non-stationary [1, 3, 25], appearing as random variability but emerging from actual deterministic processes [15].…”

Section: Introductionmentioning

confidence: 99%

Neuromuscular adaptations and sensorimotor integration following a unilateral transfemoral amputation

Claret

Herget

Kouba

et al. 2019

J NeuroEngineering Rehabil

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Background Following an amputation, the human postural control system develops neuromuscular adaptations to regain an effective postural control. We investigated the compensatory mechanisms behind these adaptations and how sensorimotor integration is affected after a lower-limb transfemoral amputation. Methods Center of pressure (CoP) data of 12 unilateral transfemoral amputees and 12 age-matched able-bodied subjects were recorded during quiet standing with eyes open (EO) and closed (EC). CoP adjustments under each leg were recorded to study their contribution to posture control. The spatial structure of the CoP displacements was characterized by measuring the mean distance, the mean velocity of the CoP adjustments, and the sway area. The Entropic Half-Life (EnHL) quantifies the temporal structure of the CoP adjustments and was used to infer disrupted sensory feedback loops in amputees. We expanded the analysis with measures of weight-bearing imbalance and asymmetry, and with two standardized balance assessments, the Berg Balance Scale (BBS) and Timed Up-and-Go (TUG). Results There was no difference in the EnHL values of amputees and controls when combining the contributions of both limbs (p = 0.754). However, amputees presented significant differences between the EnHL values of the intact and prosthetic limb (p < 0.001). Suppressing vision reduced the EnHL values of the intact (p = 0.001) and both legs (p = 0.028), but not in controls. Vision feedback in amputees also had a significant effect (increase) on the mean CoP distance (p < 0.001), CoP velocity (p < 0.001) and sway area (p = 0.007). Amputees presented an asymmetrical stance. The EnHL values of the intact limb in amputees were positively correlated to the BBS scores (EO: ρ = 0.43, EC: ρ = 0.44) and negatively correlated to the TUG times (EO: ρ = − 0.59, EC: ρ = − 0.69). Conclusion These results suggest that besides the asymmetry in load distribution, there exist neuromuscular adaptations after an amputation, possibly related to the loss of sensory feedback and an altered sensorimotor integration. The EnHL values suggest that the somatosensory system predominates in the control of the intact leg. Further, suppressing the visual system caused instability in amputees, but had a minimal impact on the CoP dynamics of controls. These findings points toward the importance of providing somatosensory feedback in lower-limb prosthesis to reestablish a normal postural control. Trial registration DRKS00015254, registered on September 20th, 2018.

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Section: Introductionmentioning

confidence: 99%

Neuromuscular adaptations and sensorimotor integration following a unilateral transfemoral amputation

Claret

Herget

Kouba

et al. 2019

J NeuroEngineering Rehabil

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“…We only examined the effect of a single-sided wedge insole during walking of a healthy young males without examining the effect of patients wearing a one-sided wedge insole. Patients with knee joint disharmony and knee instability might have different responses to the incisor wedge insole [29]. Moreover, this study only estimated the knee joint load by studying the knee joint adduction torque.…”

Section: Discussionmentioning

confidence: 99%

The Effects of Short-Term Wearing of Customized 3D Printed Single-Sided Lateral Wedge Insoles on Lower Limbs in Healthy Males: A Randomized Controlled Trial

Jin

Wang

2019

Med Sci Monit

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BackgroundUnbalanced standing and gait asymmetry are common in individuals with musculoskeletal disorders. Achieving symmetrical posture and gait is an important goal of rehabilitation. This study investigated the biomechanical differences in the lower extremities observed immediately after an insole was used and without the use of different one-sided insoles.Material/MethodsThirty young, healthy adult males received 3 different insole interventions: experimental group A had a customized 3-dimensional (3D)-printed single-sided lateral wedge insole (CLWI) inserted on the left side, and experimental group B had on the left side, a traditional single insert. The control had unilateral flat insoles; no insole inserted into the socks. Motion mechanics and gait parameters were collected at the 2-time points, after insertion of the insole and after 20 minutes of walking with the insole.ResultsAsymmetric posture and gait appeared immediately after using the 2 insoles (lower joint moment, P<0.05). Compared with the control group, the abnormal posture and gait of experimental group B after wearing the traditional insole for 20 minutes were not obvious (P>0.05). However, the asymmetrical posture and gait remained in experimental group A after wearing the CLWI for 20 minutes (P<0.05). The center of pressure (COP) trajectory of the left foot of experimental group A was significantly higher than that of experimental group B and the control group at the 2-time points (P<0.05).ConclusionsThe asymmetry of posture and gait can be observed in a short time using a customized 3D-printed single-sided lateral wedge insole. This experiment provides guidance for the application of customized 3D-printed single-sided lateral wedge insoles for gait rehabilitation.

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“…Recent studies about hemiplegia include multifaceted explorations of gait and balance problems. Studies have focused especially on the musculoskeletal effects of stroke, such as strength and muscle density, which are implicated in gait and balance problems 6 , 7 , 8 ) .…”

Section: Introductionmentioning

confidence: 99%

The effects of Pilates exercise training on static and dynamic balance in chronic stroke patients: a randomized controlled trial

2016

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[Purpose] The purpose of this study was to analyze the effects of Pilates exercise on static and dynamic balance in chronic stroke patients. [Subjects and Methods] Nineteen individuals with unilateral chronic hemiparetic stroke (age, 64.7 ± 6.9 years; height, 161.7 ± 7.9 cm; weight, 67.0 ± 11.1 kg) were randomly allocated to either a Pilates exercise group (PG, n=10) or a control group (CG, n=9). The PG attended 24 exercise sessions conducted over an 8-week period (3 sessions/week). Center of pressure (COP) sway and COP velocity were measured one week before and after the exercise program and compared to assess training effects. [Results] Pilates exercise positively affected both static and dynamic balance in patients with chronic stroke. For static balance, COP sway and velocity in the medial-lateral (M-L) and anterior-posterior (A-P) directions were significantly decreased in the PG after training while no significant differences were found in the CG. For dynamic balance, measured during treadmill walking, the PG showed significantly reduced COP sway and velocity in the M-L and A-P directions for both the paretic and non-paretic leg. [Conclusions] The findings provide initial evidence that Pilates exercise can enhance static and dynamic balance in patients with chronic stroke.

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The effects of symmetric center of pressure displacement training with feedback on the gait of stroke patients

Cited by 5 publications

References 18 publications

Neuromuscular adaptations and sensorimotor integration following a unilateral transfemoral amputation

Neuromuscular adaptations and sensorimotor integration following a unilateral transfemoral amputation

The Effects of Short-Term Wearing of Customized 3D Printed Single-Sided Lateral Wedge Insoles on Lower Limbs in Healthy Males: A Randomized Controlled Trial

The effects of Pilates exercise training on static and dynamic balance in chronic stroke patients: a randomized controlled trial

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