The relation between limb loading and control parameters of gait initiation in persons with stroke

Brunt, Denis; Linden, Darl W. Vander; Behrman, Andrea L.

doi:10.1016/s0003-9993(95)80631-8

Cited by 71 publications

(52 citation statements)

References 11 publications

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“…From the mediolateral GRF and COP data we can conclude that limb-loading in favour of the non-affected limb was already present in double-limb stance. More limb-loading on the trailing limb in doublelimb stance requires less mediolateral GRF to shift the COM above the trailing limb in single-limb stance [29]. In amputees, mediolateral GRF in the leading non-affected limb condition was increased, suggesting that a large shift COM toward the trailing prosthetic limb was needed due to the asymmetric limb-loading in double-limb stance.…”

Section: Discussionmentioning

confidence: 96%

Gait initiation in lower limb amputees

et al. 2008

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Section: Discussionmentioning

confidence: 96%

Gait initiation in lower limb amputees

et al. 2008

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“…2 In the early phase of gait initiation, the swing limb pushes against the ground to accelerate the centre of mass (COM) forward and laterally over the stance foot. [2][3][4] The lateral component of the associated centre of pressure (COP) excursion shifts toward the swing limb to generate the necessary force to move the COM towards the stance limb. This shift in COP and associated movement of the COM prior to limb unloading is known as an anticipatory postural adjustment (APA), and functions to minimize lateral instability created when the swing foot is lifted from the ground.…”

Section: Introductionmentioning

confidence: 99%

Atypical anticipatory postural adjustments during gait initiation among individuals with sub-acute stroke

et al. 2017

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Anticipatory postural adjustments, executed prior to gait initiation, help preserve lateral stability when stepping. Atypical patterns of anticipatory activity prior to gait initiation may occur in individuals with unilateral impairment (e.g., stroke). This study aimed to determine the prevalence, correlates, and consequences of atypical anticipatory postural adjustment patterns prior to gait initiation in a sub-acute stroke population. Forty independently-ambulatory individuals with subacute stroke stood on two force plates and initiated gait at a self-selected speed. Medio-lateral centre of pressure displacement was calculated and used to define anticipatory postural adjustments (shift in medio-lateral centre of pressure >10 mm from baseline). Stroke severity, motor recovery, and functional balance and mobility status were also obtained. Three patterns were identified: single (typical), absent (atypical), and multiple (atypical) anticipatory postural adjustments. Thirty-five percent of trials had atypical anticipatory postural adjustments (absent and multiple). Frequency of absent anticipatory postural adjustments was negatively correlated with walking speed. Multiple anticipatory postural adjustments were more prevalent when leading with the non-paretic than the paretic limb. Trials with multiple anticipatory postural adjustments had longer duration of anticipatory postural adjustment and time to foot-off, and shorter unloading time than trials with single anticipatory postural adjustments. A high prevalence of atypical anticipatory control prior to gait initiation was found in individuals with stroke. Temporal differences were identified with multiple anticipatory postural adjustments, indicating altered gait initiation. These findings provide insight into postural control during gait initiation in individuals with sub-acute stroke, and may inform interventions to improve ambulation in this population.

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“…11,25,26 When a subject initiates walking, the soleus is inhibited bilaterally and a large burst of tibialis anterior EMG is typically seen bilaterally. 1,3,11 It has been suggested that the central command to initiate walking inhibits the soleus and activates the tibialis anterior in parallel, 2 possibly by descending projections to the tibialis anterior motoneurons and Ia inhibitory interneurons. 11 Centrally mediated inhibition of the soleus has been suspected, as the inhibition of the soleus precedes the onset of tibialis anterior EMG.…”

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confidence: 99%

Modulations of soleus H‐reflex excitability during gait initiation: Central versus peripheral influences

et al. 2001

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Soleus and tibialis anterior electromyogram (EMG) and soleus H-reflexes were recorded from the stance limb of an individual who suffered a traumatic peroneal nerve injury and of four nonimpaired individuals during gait initiation. The control subjects also initiated walking after swaying forward (sway-gait initiation), which eliminated the initial tibialis anterior activation. During the initial period of gait initiation, H-reflexes were depressed to 43% of standing values during normal-gait initiation and 86% during sway-gait initiation in the nonimpaired subjects. H-reflexes of the nerve-injured subject were depressed to 37%, even though no tibialis anterior EMG was observed. The findings support the view that reciprocal inhibition of the soleus during a task, which normally involves tibialis anterior activation, is due to a centrally mediated process.

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The relation between limb loading and control parameters of gait initiation in persons with stroke

Cited by 71 publications

References 11 publications

Gait initiation in lower limb amputees

Gait initiation in lower limb amputees

Atypical anticipatory postural adjustments during gait initiation among individuals with sub-acute stroke

Modulations of soleus H‐reflex excitability during gait initiation: Central versus peripheral influences

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