Three-dimensional kinematic analysis of upper and lower limb motion during gait of post-stroke patients

Abstract

The aim of this study was to analyze the alterations of arm and leg movements of patients during stroke gait. Joint angles of upper and lower limbs and spatiotemporal variables were evaluated in two groups: hemiparetic group (HG, 14 hemiparetic men, 53 ± 10 years) and control group (CG, 7 able-bodied men, 50 ± 4 years). The statistical analysis was based on the following comparisons (P ≤ 0.05): 1) right versus left sides of CG; 2) affected (AF) versus unaffected (UF) sides of HG; 3) CG versus both the affected and unaffected sides of HG, and 4) an intracycle comparison of the kinematic continuous angular variables between HG and CG. This study showed that the affected upper limb motion in stroke gait was characterized by a decreased range of motion of the glenohumeral (HG: 6.3 ± 4.5, CG: 20.1 ± 8.2) and elbow joints (AF: 8.4 ± 4.4, UF: 15.6 ± 7.6) on the sagittal plane and elbow joint flexion throughout the cycle (AF: 68.2 ± 0.4, CG: 46.8 ± 2.7). The glenohumeral joint presented a higher abduction angle (AF: 14.2 ± 1.6, CG: 11.5 ± 4.0) and a lower external rotation throughout the cycle (AF: 4.6 ± 1.2, CG: 22.0 ± 3.0). The lower limbs showed typical alterations of the stroke gait patterns. Thus, the changes in upper and lower limb motion of stroke gait were identified. The description of upper limb motion in stroke gait is new and complements gait analysis.

Alteration in the center of mass trajectory of patients after stroke

“…The same symmetrical behavior was observed looking at the CoM oscillation of the unaffected side. In a previous study of the same research group of the present paper, 4 asymmetric alterations were observed in angular kinematics of lower and upper limbs, as well as asymmetrical lateral trunk motion with respect to zero, in post-stroke patients.…”

“…The stroke patients presented lower CoM elevation than CG when supporting their weight with the affected limb. Spasticity and muscle weakness are often pathological disturbances from stroke 4 and may be the primary cause of these alterations in the CoM trajectory observed in this study. The total range of CoM motion of the HG was lower than CG in the forward direction as expected since the HG subjects walked slower than CG and consequently covered smaller distance.…”

“…Reduction in gait speed, asymmetry of gait, impairment in kinematics and kinetics, abnormality in electromyographic patterns, increase in energy cost, and reduction in ambulatory activity have all been reported. [2][3][4][5][6] These movement disorders may lead alterations in the motion of the center of mass of the body and for this reason can constitute an important and different way to analyze the pathological gait. 7 Several methods exist for the estimation of Center of Mass (CoM) movement that differs in the underlying assumptions.…”

Effects of Flooring and Hemi Body on Ground Reaction Forces and Coefficient of Friction in Stroke Gait

“…These results are related to the stroke gait features, specially the main alterations found in the affected lower limb joints as decreased ankle, knee and hip flexion/extension range of motion [19].…”

A New Measure to Evaluate Subthreshold Resonance in Neurons

“…As a matter of fact, such parameters have been defined and studied in the literature to describe the characteristics of the hemiparetic gait (CARMO et al, 2012;LUCARELI AND GREVE, 2006;CHEN et al, 2003). The peak values of angular trajectories of stroke subjects walking at self-selected speed have been analyzed and it has been found that faster walkers compensated for poor knee flexion and ankle dorsiflexion with larger amounts of circumduction (STANHOPE et al, 2015).…”