When Might a Cane Be Necessary for Walking Following a Stroke?

Guillebastre, Bastien; Rougier, P.; Sibille, B.; Chrispin, A. R.; Detante, Olivier; Pérennou, Dominic

doi:10.1177/1545968311412786

Cited by 23 publications

(13 citation statements)

References 17 publications

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“…(1989) and higher than the 57.6% reported by Adegoke and Akinkoye (2003) . Guillebastre et al . (2011) opined that the probability of a stroke survivor walking without a cane is less than 5% when the paretic lower limb is not loaded more than 40%.…”

Section: Discussionmentioning

confidence: 99%

Weight Bearing Asymmetry and Functional Ambulation Performance in Stroke Survivors

Adegoke¹,

Olaniyi

Akosile³

2012

GJHS

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This study evaluated asymmetry of weight bearing on the lower limbs and the association between percentage weight bearing asymmetry (PWBA) and functional ambulation performance in ambulant stroke survivors. Participants were 53 stroke survivors (male = 35, female = 18) aged 40-86 years (mean=58.87; SD=9.21years) with hemiparesis. Weight bearing through the lower limbs in standing was assessed by two juxtaposed bathroom weighing scales while functional ambulation performance was evaluated with the Emory Functional Ambulation Profile (E-FAP). Data were summarized with mean and standard deviation and further analyzed using the Pearson product moment correlation at 0.05 alpha level. Participants bore 60.3% (SD =7.1%) of their body weights on the unaffected legs and had a mean PWBA of 20.8 % (SD=14.7%). There was a significant positive correlation (r = 0.675, p < 0.0001) between PWBA and total E-FAP scores of participants. PWBA could hence be used to monitor functional ambulation recovery in stroke survivors.

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Section: Discussionmentioning

confidence: 99%

Weight Bearing Asymmetry and Functional Ambulation Performance in Stroke Survivors

Adegoke¹,

Olaniyi

Akosile³

2012

GJHS

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“…We chose variance along the mediolateral axis because in stroke patients a more marked instability was found at rest in the frontal plane than in the sagittal plane (Marigold and Eng, 2005, de Haart et al, 2004, Manor et al, 2010. Instability was diagnosed when variance was >7 mm 2 along the ML axis (Guillebastre, 2012).…”

Section: Stability Of Standing Posturementioning

confidence: 99%

Sensory reweighting in controls and stroke patients

Bonan

Marquer

Eskiizmirliler

et al. 2013

Clinical Neurophysiology

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“…Haptic supplementation in elderly subjects or in patients with moderate to severe balance and gait impairment, as well as in blind subjects, is often dependent on their use of a cane (Jeka et al, 1996 ; Maeda et al, 1998 ; Hirahara et al, 2006 ; Albertsen et al, 2012 ; Guillebastre et al, 2012 ; Perreira et al, 2017 ; see Berglund, 2017 , for an interesting point of view on the use of a cane). The cane would help these persons to compensate for their diminished cutaneous sensation from the feet (Peters et al, 2016 ) and to move independently while reducing their risk of falling, but it is normally used when standing as well, particularly in an unfamiliar environment or in presence of joint pain, or so.…”

Section: Introductionmentioning

confidence: 99%

Haptic Cues for Balance: Use of a Cane Provides Immediate Body Stabilization

Sozzi

Crisafulli

Schieppati³

2017

Front. Neurosci.

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Haptic cues are important for balance. Knowledge of the temporal features of their effect may be crucial for the design of neural prostheses. Touching a stable surface with a fingertip reduces body sway in standing subjects eyes closed (EC), and removal of haptic cue reinstates a large sway pattern. Changes in sway occur rapidly on changing haptic conditions. Here, we describe the effects and time-course of stabilization produced by a haptic cue derived from a walking cane. We intended to confirm that cane use reduces body sway, to evaluate the effect of vision on stabilization by a cane, and to estimate the delay of the changes in body sway after addition and withdrawal of haptic input. Seventeen healthy young subjects stood in tandem position on a force platform, with eyes closed or open (EO). They gently lowered the cane onto and lifted it from a second force platform. Sixty trials per direction of haptic shift (Touch → NoTouch, T-NT; NoTouch → Touch, NT-T) and visual condition (EC-EO) were acquired. Traces of Center of foot Pressure (CoP) and the force exerted by cane were filtered, rectified, and averaged. The position in space of a reflective marker positioned on the cane tip was also acquired by an optoelectronic device. Cross-correlation (CC) analysis was performed between traces of cane tip and CoP displacement. Latencies of changes in CoP oscillation in the frontal plane EC following the T-NT and NT-T haptic shift were statistically estimated. The CoP oscillations were larger in EC than EO under both T and NT (p < 0.001) and larger during NT than T conditions (p < 0.001). Haptic-induced effect under EC (Romberg quotient NT/T ~ 1.2) was less effective than that of vision under NT condition (EC/EO ~ 1.5) (p < 0.001). With EO cane had little effect. Cane displacement lagged CoP displacement under both EC and EO. Latencies to changes in CoP oscillations were longer after addition (NT-T, about 1.6 s) than withdrawal (T-NT, about 0.9 s) of haptic input (p < 0.001). These latencies were similar to those occurring on fingertip touch, as previously shown. Overall, data speak in favor of substantial equivalence of the haptic information derived from both “direct” fingertip contact and “indirect” contact with the floor mediated by the cane. Cane, finger and visual inputs would be similarly integrated in the same neural centers for balance control. Haptic input from a walking aid and its processing time should be considered when designing prostheses for locomotion.

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When Might a Cane Be Necessary for Walking Following a Stroke?

Abstract: This study suggests that patients who do not load more than 40% of their body weight on their paretic lower limb may benefit from the prescription of a cane.

Cited by 23 publications

References 17 publications

Weight Bearing Asymmetry and Functional Ambulation Performance in Stroke Survivors

Weight Bearing Asymmetry and Functional Ambulation Performance in Stroke Survivors

Sensory reweighting in controls and stroke patients

Haptic Cues for Balance: Use of a Cane Provides Immediate Body Stabilization

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