Walking velocity and lower limb coordination in hemiparesis

Hutin, Émilie; Pradon, Didier; Barbier, Franck; Bussel, B.; Graciès, Jean-Michel; Roche, Nicolás

doi:10.1016/j.gaitpost.2012.02.016

Cited by 47 publications

(34 citation statements)

References 28 publications

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“…The values of the spatio-temporal parameters for the hemiplegic patients in this study were consistent with those reported in previous studies [26], [43], [44]. Gait velocity, cadence and stride length were significantly lower during the three first trials compared to the six last trials with no differences between the middle 3 and last 3 trials.…”

Section: Discussionsupporting

confidence: 92%

Variations in Kinematics during Clinical Gait Analysis in Stroke Patients

Boudarham¹,

Roche²,

Pradon³

et al. 2013

PLoS ONE

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111

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In addition to changes in spatio-temporal and kinematic parameters, patients with stroke exhibit fear of falling as well as fatigability during gait. These changes could compromise interpretation of data from gait analysis. The aim of this study was to determine if the gait of hemiplegic patients changes significantly over successive gait trials. Forty two stroke patients and twenty healthy subjects performed 9 gait trials during a gait analysis session. The mean and variability of spatio-temporal and kinematic joint parameters were analyzed during 3 groups of consecutive gait trials (1–3, 4–6 and 7–9). Principal component analysis was used to reduce the number of variables from the joint kinematic waveforms and to identify the parts of the gait cycle which changed during the gait analysis session. The results showed that i) spontaneous gait velocity and the other spatio-temporal parameters significantly increased, and ii) gait variability decreased, over the last 6 gait trials compared to the first 3, for hemiplegic patients but not healthy subjects. Principal component analysis revealed changes in the sagittal waveforms of the hip, knee and ankle for hemiplegic patients after the first 3 gait trials. These results suggest that at the beginning of the gait analysis session, stroke patients exhibited phase of adaptation,characterized by a “cautious gait” but no fatigue was observed.

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Section: Discussionsupporting

confidence: 92%

Variations in Kinematics during Clinical Gait Analysis in Stroke Patients

Boudarham¹,

Roche²,

Pradon³

et al. 2013

PLoS ONE

Self Cite

111

View full text Add to dashboard Cite

show abstract

“…This experiment used belt speeds of 0.9 and 1.8 m/s. A previous study of symmetric walking with treadmill speeds similar to those in our study reported that the lower limb joint angle changes depending on the walking speed [24]. Our result on each hip flexion angle on HS remained the same (i.e., symmetry) despite each leg moving at different speeds in the split-belt treadmill.…”

Section: Kinematical Mechanism For Re-establishingsupporting

confidence: 83%

Contribution of Lower Limb Joint Movement in Adapting to Re-establish Step Length Symmetry During Split-Belt Treadmill Walking

Hirata

Kokubun

Miyazawa³

et al. 2018

J. Med. Biol. Eng.

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People walking on a split-belt treadmill, where each belt moves at a different speed, adapt step length to re-establish symmetry. However, kinematic changes that occur when re-establishing step length symmetry have not yet been clarified. This study aims to clarify the changing lower limb joint kinematics of each leg when re-establishing step length symmetry. We examined ten young adults who walked on a double-belt treadmill under symmetric and asymmetric conditions of belt velocity using a motion capture system. The results showed that the hip flexion angle at heel strike on one side was not significantly different between the symmetric and asymmetric conditions (p = 0.38) thereby demonstrating that the hip flexion angle of the leading leg re-established symmetry at heel strike (HS) of the fast and slow sides. However, the knee extension angle of the leading leg expanded asymmetrically at HS on both sides. The shank of the fast leg possibly accelerated more to move the heel further forward. The results indicated that subjects with limited knee extension function must increase their hip flexion movement of the fast-side limb to accelerate the shank in the swing phase. The present study suggests securing the range of motion and treatment of the knee extension to reduce the spasticity of hamstrings or plantarflexor before split-belt training. Moreover, split-belt training may be undesirable for improving step length symmetry in impaired subjects who are unlikely to improve the function of knee extension movement. The present study contributes toward developing a rehabilitation protocol that improves the gait asymmetry of patients through split-belt training.

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“…This seems to suggest that the quadriceps fatigue protocol induced a decrease in spasticity which was at the origin of the observed gait improvement, mainly walking velocity. Several studies have shown that the increase of the gait velocity is associated with an increase in knee flexion velocity at toe-off and an increase in peak knee flexion during swing phase of the gait cycle in stroke patients [64], [65]. Therefore, we may hypothesize that the kinematic changes observed in the present study are the result of the velocity increase.…”

Section: Discussionsupporting

confidence: 51%

Effects of Quadriceps Muscle Fatigue on Stiff-Knee Gait in Patients with Hemiparesis

Boudarham¹,

Roche²,

Pradon³

et al. 2014

PLoS ONE

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The relationship between neuromuscular fatigue and locomotion has never been investigated in hemiparetic patients despite the fact that, in the clinical context, patients report to be more spastic or stiffer after walking a long distance or after a rehabilitation session. The aim of this study was to evaluate the effects of quadriceps muscle fatigue on the biomechanical gait parameters of patients with a stiff-knee gait (SKG). Thirteen patients and eleven healthy controls performed one gait analysis before a protocol of isokinetic quadriceps fatigue and two after (immediately after and after 10 minutes of rest). Spatiotemporal parameters, sagittal knee and hip kinematics, rectus femoris (RF) and vastus lateralis (VL) kinematics and electromyographic (EMG) activity were analyzed. The results showed that quadriceps muscle weakness, produced by repetitive concentric contractions of the knee extensors, induced an improvement of spatiotemporal parameters for patients and healthy subjects. For the patient group, the increase in gait velocity and step length was associated with i) an increase of sagittal hip and knee flexion during the swing phase, ii) an increase of the maximal normalized length of the RF and VL and of the maximal VL lengthening velocity during the pre-swing and swing phases, and iii) a decrease in EMG activity of the RF muscle during the initial pre-swing phase and during the latter 2/3 of the initial swing phase. These results suggest that quadriceps fatigue did not alter the gait of patients with hemiparesis walking with a SKG and that neuromuscular fatigue may play the same functional role as an anti-spastic treatment such as botulinum toxin-A injection. Strength training of knee extensors, although commonly performed in rehabilitation, does not seem to be a priority to improve gait of these patients.

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Walking velocity and lower limb coordination in hemiparesis

Cited by 47 publications

References 28 publications

Variations in Kinematics during Clinical Gait Analysis in Stroke Patients

Variations in Kinematics during Clinical Gait Analysis in Stroke Patients

Contribution of Lower Limb Joint Movement in Adapting to Re-establish Step Length Symmetry During Split-Belt Treadmill Walking

Effects of Quadriceps Muscle Fatigue on Stiff-Knee Gait in Patients with Hemiparesis

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