1
|
Couto AGB, Vaz MAP, Pinho L, Félix J, Moreira J, Pinho F, Mesquita IA, Mesquita Montes A, Crasto C, Sousa ASP. Interlimb Coordination during Double Support Phase of Gait in People with and without Stroke. J Mot Behav 2023; 56:195-210. [PMID: 37990958 DOI: 10.1080/00222895.2023.2282088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 10/12/2023] [Indexed: 11/23/2023]
Abstract
This study aims to identify differences between participants with and without stroke regarding the ipsilesional and contralesional lower limbs kinematics, kinetics, muscle activity and their variability during double support phase of gait. Eleven post-stroke and thirteen healthy participants performed 10 gait trials at a self-selected speed while being monitored by an optoelectronic motion capture system, two force plates and an electromyographic system. The following outcomes were evaluated during the double support: the time and the joint position; the external mechanical work on the centre of mass; and the relative electromyographic activity. Both, contralesional/ipsilesional and dominant/non-dominant of participants with and without stroke, respectively, were evaluated during double support phase of gait in trailing or leading positions. The average value of each parameter and the coefficient of variation of the 10 trials were analysed. Post-stroke participants present bilateral decreased mechanical work on the centre of mass and increased variability, decreased contralesional knee and ankle flexion in trailing position, increased ipsilesional knee flexion in leading position and increased variability. Increased relative muscle activity was observed in post-stroke participants with decreased variability. Mechanical work on the centre of mass seems to be the most relevant parameter to identify interlimb coordination impairments in post-stroke subjects.
Collapse
Affiliation(s)
- Ana G B Couto
- Department of Physiotherapy and Research Center and Projects (NIP), Santa Maria Health School, Porto, Portugal
- Center for Rehabilitation Research (CIR), ESS, Polytechnic of Porto, rua Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal
- Faculty of Engineering, University of Porto, Porto, Portugal
| | - Mário A P Vaz
- Institute of Mechanical Engineering and Industrial Management, Faculty of Engineering, University of Porto, Porto, Portugal
- Porto Biomechanics Laboratory (LABIOMEP), University of Porto, Porto, Portugal
| | - Liliana Pinho
- Center for Rehabilitation Research (CIR), ESS, Polytechnic of Porto, rua Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal
- College of Health Sciences - Escola Superior de Saúde do Vale do Ave, Cooperative for Higher, Polytechnic and University Education, Vila Nova de Famalicão, Portugal
- Faculty of Sport, University of Porto, Porto, Portugal
| | - José Félix
- Department of Physics and Center for Rehabilitation Research (CIR), ESS, Polytechnic of Porto, rua Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal
- Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
| | - Juliana Moreira
- Department of Physiotherapy and Center for Rehabilitation Research (CIR), ESS, Polytechnic of Porto, rua Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal
| | - Francisco Pinho
- College of Health Sciences - Escola Superior de Saúde do Vale do Ave and Health and Human Movement Unit (H2M), Cooperative for Higher, Polytechnic and University Education, Vila Nova de Famalicão, Portugal
| | - Inês Albuquerque Mesquita
- Research Center and Projects (NIP), Santa Maria Health School, Porto, Portugal
- Department of Functional Sciences and Center for Rehabilitation Research (CIR), ESS, Polytechnic of Porto, rua Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal
| | - António Mesquita Montes
- Department of Physiotherapy and Center for Rehabilitation Research (CIR), ESS, Polytechnic of Porto, rua Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal
- Research Center and Projects (NIP), Santa Maria Health School, Porto, Portugal
| | - Carlos Crasto
- Department of Physiotherapy and Center for Rehabilitation Research (CIR), ESS, Polytechnic of Porto, rua Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal
- Research Center and Projects (NIP), Santa Maria Health School, Porto, Portugal
| | - Andreia S P Sousa
- Department of Physiotherapy and Center for Rehabilitation Research (CIR), ESS, Polytechnic of Porto, rua Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal
| |
Collapse
|
2
|
Molina-Rueda F, Fernández-Vázquez D, Navarro-López V, López-González R, Carratalá-Tejada M. Muscle Coactivation Index during Walking in People with Multiple Sclerosis with Mild Disability, a Cross-Sectional Study. Diagnostics (Basel) 2023; 13:2169. [PMID: 37443563 DOI: 10.3390/diagnostics13132169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 06/23/2023] [Accepted: 06/24/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Multiple sclerosis (MS) is a progressive neurodegenerative disease characterized by axonal degeneration and demyelination. Changes in gait, related to joint kinematics and kinetics, especially at the ankle and knee, have been observed in people with MS (pwMS). Muscle coactivation plays an important role in joint stabilization; however, excessive coactivation may interfere with gait. The aim of this study was to analyze the differences in muscle activation during gait in pwMS compared to healthy individuals. METHODS A cross-sectional study was conducted involving pwMS and healthy controls. Surface electromyography was used to record muscle activity during gait. The main outcome measures were the coactivation index (CI) and the area under the curve (AUC), which were calculated for several pairs of lower extremity muscles. RESULTS Nine pwMS and nine healthy controls were included. When comparing the MS group to the control group, the AUC was significantly higher in the lateral gastrocnemius (p = 0.023) and the CI for the lateral gastrocnemius-anterior tibialis (p = 0.022) and gluteus maximus-lateral gastrocnemius (p = 0.047). CONCLUSION Mildly affected pwMS have altered muscle coactivation patterns during gait, especially in the most affected limb. The results highlight the importance of muscle coactivation in pwMS and its possible role in the early detection of gait abnormalities.
Collapse
Affiliation(s)
- Francisco Molina-Rueda
- Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine Department, Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain
- Movement Analysis, Biomechanics, Ergonomics, and Motor Control Laboratory, Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain
| | - Diego Fernández-Vázquez
- Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine Department, Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain
- Movement Analysis, Biomechanics, Ergonomics, and Motor Control Laboratory, Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain
| | - Víctor Navarro-López
- Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine Department, Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain
- Movement Analysis, Biomechanics, Ergonomics, and Motor Control Laboratory, Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain
| | - Raúl López-González
- Movement Analysis, Biomechanics, Ergonomics, and Motor Control Laboratory, Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain
| | - María Carratalá-Tejada
- Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine Department, Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain
- Movement Analysis, Biomechanics, Ergonomics, and Motor Control Laboratory, Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain
| |
Collapse
|
3
|
Muscle Co-Activation around the Knee during Different Walking Speeds in Healthy Females. SENSORS 2021; 21:s21030677. [PMID: 33498231 PMCID: PMC7863926 DOI: 10.3390/s21030677] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 01/11/2021] [Accepted: 01/16/2021] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to examine the changes in co-activation around the knee joint during different walking speeds in healthy females using the co-activation index. Ten healthy females (age: 21.20 ± 7.21 years, height: 164.00 ± 4.00 cm, mass: 60.60 ± 4.99 kg) participated in this study and performed three walking speeds (slow, normal, and fast). A Qualisys 11-camera motion analysis system sampling at a frequency of 200 Hz was synchronized with a Trigno EMG Wireless system operating at a 2000 Hz sampling frequency. A significant decrease in the co-activation index of thigh muscles was observed between the slow and fast, and between the normal and fast, walking speeds during all walking phases. A non-significant difference was observed between the slow and normal walking speeds during most walking phases, except the second double support phase, during which the difference was significant. A negative relationship was found between walking speed and the co-activation index of thigh muscles in all speeds during walking phases: first double support (r = −0.3386, p < 0.001), single support (r = −0.2144, p < 0.01), second double support (r = −0.4949, p < 0.001), and Swing (r = −0.1639, p < 0.05). In conclusion, the results indicated high variability of thigh muscle co-activation in healthy females during the different walking speeds, and a decrease in the co-activation of the thigh muscles with the increase of speed.
Collapse
|
4
|
Ghai S. Effects of Real-Time (Sonification) and Rhythmic Auditory Stimuli on Recovering Arm Function Post Stroke: A Systematic Review and Meta-Analysis. Front Neurol 2018; 9:488. [PMID: 30057563 PMCID: PMC6053522 DOI: 10.3389/fneur.2018.00488] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 06/05/2018] [Indexed: 01/15/2023] Open
Abstract
Background: External auditory stimuli have been widely used for recovering arm function post-stroke. Rhythmic and real-time auditory stimuli have been reported to enhance motor recovery by facilitating perceptuomotor representation, cross-modal processing, and neural plasticity. However, a consensus as to their influence for recovering arm function post-stroke is still warranted because of high variability noted in research methods. Objective: A systematic review and meta-analysis was carried out to analyze the effects of rhythmic and real-time auditory stimuli on arm recovery post stroke. Method: Systematic identification of published literature was performed according to PRISMA guidelines, from inception until December 2017, on online databases: Web of science, PEDro, EBSCO, MEDLINE, Cochrane, EMBASE, and PROQUEST. Studies were critically appraised using PEDro scale. Results: Of 1,889 records, 23 studies which involved 585 (226 females/359 males) patients met our inclusion criteria. The meta-analysis revealed beneficial effects of training with both types of auditory inputs for Fugl-Meyer assessment (Hedge's g: 0.79), Stroke impact scale (0.95), elbow range of motion (0.37), and reduction in wolf motor function time test (-0.55). Upon further comparison, a beneficial effect of real-time auditory feedback was found over rhythmic auditory cueing for Fugl-meyer assessment (1.3 as compared to 0.6). Moreover, the findings suggest a training dosage of 30 min to 1 h for at least 3-5 sessions per week with either of the auditory stimuli. Conclusion: This review suggests the application of external auditory stimuli for recovering arm functioning post-stroke.
Collapse
Affiliation(s)
- Shashank Ghai
- Institute for Sports Science, Leibniz University Hannover, Hannover, Germany
| |
Collapse
|
5
|
Hedjazi N, Benali A, Bouzit M, Dibi Z. Model identification and evaluation of postural dynamics of healthy and post-stroke individuals under unidirectional perturbations. Biomed Signal Process Control 2018. [DOI: 10.1016/j.bspc.2018.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
6
|
Dynamic Analysis of the Abnormal Isometric Strength Movement Pattern between Shoulder and Elbow Joint in Patients with Hemiplegia. JOURNAL OF HEALTHCARE ENGINEERING 2018; 2018:1817485. [PMID: 29610654 PMCID: PMC5827879 DOI: 10.1155/2018/1817485] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 11/14/2017] [Accepted: 12/12/2017] [Indexed: 11/18/2022]
Abstract
Patients with hemiplegia usually have weak muscle selectivity and usually perform strength at a secondary joint (secondary strength) during performing a strength at one joint (primary strength). The abnormal strength pattern between shoulder and elbow joint has been analyzed by the maximum value while the performing process with strength changing from 0 to maximum then to 0 was a dynamic process. The objective of this study was to develop a method to dynamically analyze the strength changing process. Ten patients were asked to perform four group asks (maximum and 50% maximum voluntary strength in shoulder abduction, shoulder adduction, elbow flexion, and elbow extension). Strength and activities from seven muscles were measured. The changes of secondary strength had significant correlation with those of primary strength in all tasks (R > 0.76, p < 0.01). The antagonistic muscles were moderately influenced by the primary strength (R > 0.4, p < 0.01). Deltoid muscles, biceps brachii, triceps brachii, and brachioradialis had significant influences on the abnormal strength pattern (all p < 0.01). The dynamic method was proved to be efficient to analyze the different influences of muscles on the abnormal strength pattern. The muscles, deltoid muscles, biceps brachii, triceps brachii, and brachioradialis, much influenced the stereotyped movement pattern between shoulder and elbow joint.
Collapse
|
7
|
Hedjazi N, Kharboutly H, Benali A, Dibi Z. PCA-based selection of distinctive stability criteria and classification of post-stroke pathological postural behaviour. AUSTRALASIAN PHYSICAL & ENGINEERING SCIENCES IN MEDICINE 2018; 41:189-199. [PMID: 29460209 DOI: 10.1007/s13246-018-0628-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Accepted: 02/11/2018] [Indexed: 11/26/2022]
Abstract
In this paper, we study the postural behaviour of two categories of people: Post-CVA subjects suffering from cerebrovascular accident syndromes and healthy individuals under several levels of anterior-posterior and medial-lateral sinusoidal disturbances (0.1-0.5 Hz). These perturbations were produced from an omnidirectional platform called Isiskate. Afterwards, we have quantified seventy postural parameters, they were combined of linear stabilometric parameters and non-linear time dependent stochastic parameters using stabilogram diffusion analysis and some spectral attributes using power spectral density. The aim of our analysis is to reduce data dimensionality using principal component analysis (PCA). Furthermore, we proposed a new PCA-related criterion named: criterion of contribution in order to evaluate the contribution of every variable in the resulted system structure, and thus to eliminate the redundant postural characteristics. Afterwards, we highlighted some interesting distinctive parameters. The selected parameters were used thereafter in comparison between the studied groups. Finally, we created a classification model using support vector machines to distinguish stroke patients. Our proposed techniques help in understanding the human postural dynamics and facilitate the diagnosis of pathologies related to equilibrium which can be used to improve the rehabilitation services.
Collapse
Affiliation(s)
- Naceur Hedjazi
- Department of electronics, University of Batna 2, 05000, Batna, Algeria.
- LISV laboratory, UVSQ, Paris, France.
| | | | | | - Zohir Dibi
- Department of electronics, University of Batna 2, 05000, Batna, Algeria
| |
Collapse
|
8
|
Silva A, Sousa ASP, Silva CC, Santos R, Tavares JMRS, Sousa F. The role of the ipsilesional side in the rehabilitation of post-stroke subjects. Somatosens Mot Res 2017; 34:185-188. [PMID: 29025294 DOI: 10.1080/08990220.2017.1384721] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Most stroke lesions occur in the middle cerebral artery territory, presenting a high probability of damage of pathways with predominant ipsilesional disposition, mainly related to postural control. Despite the high probability of bilateral postural control dysfunction based on neuroanatomical fundaments, both research and clinical rehabilitation involving stroke subjects have been focused on contralesional side (also named affected side) impairments, while ipsilesional side (also named non-affected side) impairments have been attributed to an adaptive strategy. This paper aims to present a critical understanding about the state-of-the-art that sustains the hypothesis that stroke subjects with middle cerebral artery territory lesion at the subcortical level show an atypical behaviour in the ipsilateral side associated with the lesion itself and the possible implications.
Collapse
Affiliation(s)
- Augusta Silva
- a Physiotherapy, Escola Superior de Saúde do Porto, Centro de Estudos de Movimento e Actividade Humana , Instituto Politécnico do Porto , Porto , Portugal
| | - Andreia S P Sousa
- a Physiotherapy, Escola Superior de Saúde do Porto, Centro de Estudos de Movimento e Actividade Humana , Instituto Politécnico do Porto , Porto , Portugal
| | - Cláudia Costa Silva
- a Physiotherapy, Escola Superior de Saúde do Porto, Centro de Estudos de Movimento e Actividade Humana , Instituto Politécnico do Porto , Porto , Portugal
| | - Rubim Santos
- b Physics, Escola Superior de Saúde do Porto, Centro de Estudos de Movimento e Actividade Humana , Instituto Politécnico do Porto , Porto , Portugal
| | - João Manuel R S Tavares
- c Instituto de Ciência e Inovação em Engenharia Mecânica e Engenharia Industrial, Departamento de Engenharia Mecânica , Faculdade de Engenharia, Universidade do Porto , Porto , Portugal
| | - Filipa Sousa
- d Laboratório de Biomecânica do Porto , Faculdade de Desporto da Universidade do Porto , Porto , Portugal
| |
Collapse
|
9
|
Intrathecal baclofen bolus reduces exaggerated extensor coactivation during pre-swing and early-swing of gait after acquired brain injury. Clin Neurophysiol 2017; 128:725-733. [DOI: 10.1016/j.clinph.2017.02.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 01/30/2017] [Accepted: 02/22/2017] [Indexed: 01/05/2023]
|
10
|
Sousa ASP, Santos R, Silva A. Ankle Intrinsic Stiffness in Subcortical Poststroke Subjects. J Mot Behav 2016; 49:265-272. [PMID: 27588813 DOI: 10.1080/00222895.2016.1191421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The authors' purpose was to evaluate bilateral ankle intrinsic stiffness in subcortical poststroke subjects. Ten subcortical poststroke subjects and 10 healthy controls participated in this study. The ankle passive stiffness at 3 different speeds and the electromyographic activity of the soleus, the gastrocnemius, and the tibialis anterior muscles of poststroke contralesional (CONTRA) and ipsilesional (IPSI) limbs and of one limb of healthy subjects were assessed. Ankle electromyographic activity was collected to ensure that reflexive or voluntary muscle activity was not being elicited during the passive movements. A significant interaction was observed between the effects of the limb (IPSI vs. CONTRA vs. control) and ankle position, F(4, 28) = 3.285, p = .025, and between the effects of the limb and the velocity of stretch, F(2, 14) = 4.209, p = .037. While increased intrinsic stiffness was observed in the CONTRA limb of poststroke subjects at ankle neutral position when the passive stretch was applied with a velocity of 1°/s (p = .021), the IPSI limb of poststroke subjects presented increased stiffness at 20º of plantar flexion when the stretch was applied with a velocity of 5°/s (p = .009) when compared to healthy group. Subcortical poststroke subjects present increased intrinsic stiffness in both the CONTRA and IPSI limbs in specific ankle amplitudes.
Collapse
Affiliation(s)
- Andreia S P Sousa
- a Centro de Estudos de Movimento e Atividade Humana , Área Científica de Fisioterapia, Instituto Politécnico do Porto, Escola Superior de Saúde do Porto , Vila Nova de Gaia , Portugal
| | - Rubim Santos
- b Centro de Estudos de Movimento e Atividade Humana , Área Científica de Física, Escola Superior de Saúde do Porto , Vila Nova de Gaia , Portugal
| | - Augusta Silva
- a Centro de Estudos de Movimento e Atividade Humana , Área Científica de Fisioterapia, Instituto Politécnico do Porto, Escola Superior de Saúde do Porto , Vila Nova de Gaia , Portugal
| |
Collapse
|
11
|
Kitatani R, Ohata K, Sato S, Watanabe A, Hashiguchi Y, Yamakami N, Sakuma K, Yamada S. Ankle muscle coactivation and its relationship with ankle joint kinematics and kinetics during gait in hemiplegic patients after stroke. Somatosens Mot Res 2016; 33:79-85. [PMID: 27189650 DOI: 10.1080/08990220.2016.1178636] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Increased ankle muscle coactivation during gait is a compensation strategy for enhancing postural stability in patients after stroke. However, no previous studies have demonstrated that increased ankle muscle coactivation influenced ankle joint movements during gait in patients after stroke. PURPOSE To investigate the relationship between ankle muscle coactivation and ankle joint movements in hemiplegic patients after stroke. METHODS Seventeen patients after stroke participated. The coactivation index (CoI) at the ankle joint was calculated separately for the first and second double support (DS1 and DS2, respectively) and single support (SS) phases on the paretic and non-paretic sides during gait using surface electromyography. Simultaneously, three-dimensional motion analysis was performed to measure the peak values of the ankle joint angle, moment, and power in the sagittal plane. Ground reaction forces (GRFs) of the anterior and posterior components and centers of pressure (COPs) trajectory ranges and velocities were also measured. RESULTS The CoI during the SS phase on the paretic side was negatively related to ankle dorsiflexion angle, ankle plantarflexion moment, ankle joint power generation, and COP velocity on the paretic side. Furthermore, the CoI during the DS2 phase on both sides was negatively related to anterior GRF amplitude on each side. CONCLUSION Increased ankle muscle coactivation is related to decreased ankle joint movement during the SS phase on the paretic side to enhance joint stiffness and compensate for stance limb instability, which may be useful for patients who have paretic instability during the stance phase after stroke.
Collapse
Affiliation(s)
- Ryosuke Kitatani
- a Department of Physical Therapy , Kyoto University , Kyoto , Japan ;,b Japan Society for the Promotion of Science , Tokyo , Japan
| | - Koji Ohata
- a Department of Physical Therapy , Kyoto University , Kyoto , Japan
| | | | | | - Yu Hashiguchi
- a Department of Physical Therapy , Kyoto University , Kyoto , Japan ;,b Japan Society for the Promotion of Science , Tokyo , Japan
| | | | - Kaoru Sakuma
- a Department of Physical Therapy , Kyoto University , Kyoto , Japan ;,f Department of Rehabilitation Sciences , Kansai University of Welfare Sciences , Osaka , Japan
| | - Shigehito Yamada
- a Department of Physical Therapy , Kyoto University , Kyoto , Japan
| |
Collapse
|
12
|
Sousa ASP, Silva A, Santos R. Ankle anticipatory postural adjustments during gait initiation in healthy and post-stroke subjects. Clin Biomech (Bristol, Avon) 2015. [PMID: 26220907 DOI: 10.1016/j.clinbiomech.2015.07.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Anticipatory postural adjustments during gait initiation have an important role in postural stability but also in gait performance. However, these first phase mechanisms of gait initiation have received little attention, particularly in subcortical post-stroke subjects, where bilateral postural control pathways can be impaired. This study aims to evaluate ankle anticipatory postural adjustments during gait initiation in chronic post-stroke subjects with lesion in the territory of middle cerebral artery. METHODS Eleven subjects with post-stroke hemiparesis with the ability to walk independently and twelve healthy controls participated in this study. Bilateral electromyographic activity of tibialis anterior, soleus and medial gastrocnemius was collected during gait initiation to assess the muscle onset timing, period of activation/deactivation and magnitude of muscle activity during postural phase of gait initiation. This phase was identified through centre of pressure signal. FINDINGS Post-stroke group presented only half of the tibialis anterior relative magnitude observed in healthy subjects in contralesional limb (t=2.38, P=0.027) and decreased soleus deactivation period (contralesional limb, t=2.25, P=0.04; ipsilesional limb, t=3.67, P=0.003) as well its onset timing (contralesional limb, t=3.2. P=0.005; ipsilesional limb, t=2.88, P=0.033) in both limbs. A decreased centre of pressure displacement backward (t=3.45, P=0.002) and toward the first swing limb (t=3.29, P=0.004) was observed in post-stroke subjects. INTERPRETATION These findings indicate that chronic post-stroke subjects with lesion at middle cerebral artery territory present dysfunction in ankle anticipatory postural adjustments in both limbs during gait initiation.
Collapse
Affiliation(s)
- Andreia S P Sousa
- Escola Superior da Tecnologia de Saúde do Instituto Politécnico do Porto, Área Científica de Fisioterapia, Centro de Estudos de Movimento e Actividade Humana, Rua Valente Perfeito, 322, 4400-330 Vila Nova de Gaia, Portugal.
| | - Augusta Silva
- Escola Superior da Tecnologia de Saúde do Instituto Politécnico do Porto, Área Científica de Fisioterapia, Centro de Estudos de Movimento e Actividade Humana, Rua Valente Perfeito, 322, 4400-330 Vila Nova de Gaia, Portugal.
| | - Rubim Santos
- Escola Superior da Tecnologia de Saúde do Porto, Área Científica de Física, Centro de Estudos de Movimento e Actividade Humana, Rua Valente Perfeito, 322, 4400-330 Vila Nova de Gai, Portugal.
| |
Collapse
|
13
|
Silva A, Sousa ASP, Silva C, Tavares JMRS, Santos R, Sousa F. Ankle antagonist coactivation in the double-support phase of walking: Stroke vs. healthy subjects. Somatosens Mot Res 2015; 32:153-7. [PMID: 26290312 DOI: 10.3109/08990220.2015.1012492] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Lesions in ipsilateral systems related to postural control in the ipsilesional side may justify the lower performance of stroke subjects during walking. PURPOSE To analyze bilateral ankle antagonist coactivation during double support in stroke subjects. METHODS Sixteen (8 females; 8 males) subjects with a first isquemic stroke and 22 controls (12 females; 10 males) participated in this study. The double-support phase was assessed through ground reaction forces and the electromyography of ankle muscles was assessed in both limbs. RESULTS The ipsilesional limb presented statistically significant differences from the control when assuming specific roles during double support. The tibialis anterior and soleus pair was the one in which this atypical behavior was more pronounced. CONCLUSION The ipsilesional limb presents a dysfunctional behavior when a higher postural control activity was demanded.
Collapse
Affiliation(s)
- Augusta Silva
- a Escola Superior de Tecnologia da Saúde do Instituto Politécnico do Porto by Escola Superior de Tecnologia da Saúde do Porto, Instituto Politécnico do Porto, Área Científica de Fisioterapia, Centro de Estudos de Movimento e Atividade Humana , Vila Nova de Gaia , Portugal
| | - Andreia S P Sousa
- a Escola Superior de Tecnologia da Saúde do Instituto Politécnico do Porto by Escola Superior de Tecnologia da Saúde do Porto, Instituto Politécnico do Porto, Área Científica de Fisioterapia, Centro de Estudos de Movimento e Atividade Humana , Vila Nova de Gaia , Portugal
| | - Cláudia Silva
- a Escola Superior de Tecnologia da Saúde do Instituto Politécnico do Porto by Escola Superior de Tecnologia da Saúde do Porto, Instituto Politécnico do Porto, Área Científica de Fisioterapia, Centro de Estudos de Movimento e Atividade Humana , Vila Nova de Gaia , Portugal
| | - João Manuel R S Tavares
- b Instituto de Engenharia Mecânica e Gestão Industrial, Departamento de Engenharia Mecânica, Faculdade de Engenharia, Universidade do Porto , Porto , Portugal
| | - Rubim Santos
- c Escola Superior da Tecnologia de Saúde do Instituto Politécnico do Porto, Área Científica de Física, Centro de Estudos de Movimento e Atividade Humana , Vila Nova de Gaia , Portugal , and
| | - Filipa Sousa
- d Laboratório de Biomecânica do Porto, Faculdade de Desporto , Universidade do Porto , Porto , Portugal
| |
Collapse
|
14
|
Sousa ASP, Tavares JMRS. Interlimb Coordination During Step-to-Step Transition and Gait Performance. J Mot Behav 2015; 47:563-74. [PMID: 25893693 DOI: 10.1080/00222895.2015.1023391] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Most energy spent in walking is due to step-to-step transitions. During this phase, the interlimb coordination assumes a crucial role to meet the demands of postural and movement control. The authors review studies that have been carried out regarding the interlimb coordination during gait, as well as the basic biomechanical and neurophysiological principles of interlimb coordination. The knowledge gathered from these studies is useful for understanding step-to-step transition during gait from a motor control perspective and for interpreting walking impairments and inefficiency related to pathologies, such as stroke. This review shows that unimpaired walking is characterized by a consistent and reciprocal interlimb influence that is supported by biomechanical models, and spinal and supraspinal mechanisms. This interlimb coordination is perturbed in subjects with stroke.
Collapse
Affiliation(s)
- Andreia S P Sousa
- a Escola Superior de Tecnologia da Saúde do Porto, Instituto Politécnico do Porto, Área Científica de Fisioterapia, Centro de Estudos de Movimento e Atividade Humana , Portugal
| | | |
Collapse
|
15
|
Silva CC, Silva A, Sousa A, Pinheiro AR, Bourlinova C, Silva A, Salazar A, Borges C, Crasto C, Correia MV, Vilas-Boas JP, Santos R. Co-activation of upper limb muscles during reaching in post-stroke subjects: an analysis of the contralesional and ipsilesional limbs. J Electromyogr Kinesiol 2014; 24:731-8. [PMID: 24882699 DOI: 10.1016/j.jelekin.2014.04.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Revised: 04/01/2014] [Accepted: 04/15/2014] [Indexed: 10/25/2022] Open
Abstract
The purpose of this study was to analyze the change in antagonist co-activation ratio of upper-limb muscle pairs, during the reaching movement, of both ipsilesional and contralesional limbs of post-stroke subjects. Nine healthy and nine post-stroke subjects were instructed to reach and grasp a target, placed in the sagittal and scapular planes of movement. Surface EMG was recorded from postural control and movement related muscles. Reaching movement was divided in two sub-phases, according to proximal postural control versus movement control demands, during which antagonist co-activation ratios were calculated for the muscle pairs LD/PM, PD/AD, TRIlat/BB and TRIlat/BR. Post-stroke's ipsilesional limb presented lower co-activation in muscles with an important role in postural control (LD/PM), comparing to the healthy subjects during the first sub-phase, when the movement was performed in the sagittal plane (p<0.05). Conversely, the post-stroke's contralesional limb showed in general an increased co-activation ratio in muscles related to movement control, comparing to the healthy subjects. Our findings demonstrate that, in post-stroke subjects, the reaching movement performed with the ipsilesional upper limb seems to show co-activation impairments in muscle pairs associated to postural control, whereas the contralesional upper limb seems to have signs of impairment of muscle pairs related to movement.
Collapse
Affiliation(s)
- Cláudia C Silva
- Centro de Estudos do Movimento e Actividade Humana (CEMAH), ESTSP-IPP, V. N. Gaia, Portugal.
| | - Augusta Silva
- Centro de Estudos do Movimento e Actividade Humana (CEMAH), ESTSP-IPP, V. N. Gaia, Portugal
| | - Andreia Sousa
- Centro de Estudos do Movimento e Actividade Humana (CEMAH), ESTSP-IPP, V. N. Gaia, Portugal
| | - Ana Rita Pinheiro
- Centro de Estudos do Movimento e Actividade Humana (CEMAH), ESTSP-IPP, V. N. Gaia, Portugal
| | - Catarina Bourlinova
- Escola de Educação Física e Esporte, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Ana Silva
- INESC-TEC and Faculty of Engineering, University of Porto, Porto, Portugal
| | - António Salazar
- INESC-TEC and Faculty of Engineering, University of Porto, Porto, Portugal
| | - Carla Borges
- INESC-TEC and Faculty of Engineering, University of Porto, Porto, Portugal
| | - Carlos Crasto
- Centro de Estudos do Movimento e Actividade Humana (CEMAH), ESTSP-IPP, V. N. Gaia, Portugal
| | | | - João Paulo Vilas-Boas
- CIFI2D, Faculty of Sport, and Porto Biomechanics Laboratory, University of Porto, Porto, Portugal
| | - Rubim Santos
- Centro de Estudos do Movimento e Actividade Humana (CEMAH), ESTSP-IPP, V. N. Gaia, Portugal
| |
Collapse
|
16
|
Fang J, Galen S, Vuckovic A, Conway BA, Hunt KJ. Kinetic analysis of supine stepping for early rehabilitation of walking. Proc Inst Mech Eng H 2014; 228:456-464. [PMID: 24424356 DOI: 10.1177/0954411913518031] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In order to promote gait restoration in patients who cannot maintain an upright position in the early post-injury phase, a Gait Orthosis for Early Rehabilitation was proposed for supine stepping. Although supine stepping can generate lower-limb joint trajectories which are close to normal gait, the inter-segmental dynamics of supine stepping are believed to be different from those of upright walking. Furthermore, training in a supine position requires a certain loading on the foot to mimic the ground reaction forces, where different loading amplitudes influence the joint dynamics. This work analysed the kinetics of supine stepping with variable loading and investigated structural modifications for the Gait Orthosis for Early Rehabilitation system to address this kinetic difference. Three able-bodied subjects walked overground while their walking performance was recorded. Based on the experimental data, a leg-linkage model was developed to simulate the dynamics of upright walking. This model was then rotated by 90° with different foot loadings to investigate the kinetics of supine stepping. Compared to upright walking, supine stepping had a large kinetic difference at the hip joint due to the supine leg position. The ankle joint during supine stepping was sensitive to the force amplitude simulated on the foot. Thus, the Gait Orthosis for Early Rehabilitation system requires a leg frame to compensate the position change and a shoe platform to activate the leg muscles, especially at the ankle joint. This study provided important structural information for the further development of the Gait Orthosis for Early Rehabilitation system.
Collapse
Affiliation(s)
- Juan Fang
- Division of Mechanical Engineering, Department of Engineering and Information Technology, Institute for Rehabilitation and Performance Technology, Bern University of Applied Sciences, Burgdorf, Switzerland Centre for Rehabilitation Engineering, School of Engineering, University of Glasgow, Glasgow, UK
| | - Sujay Galen
- Biomedical Engineering, University of Strathclyde, Glasgow, UK Physical Therapy Program, Wayne State University, Detroit, MI, USA
| | - Aleksandra Vuckovic
- Centre for Rehabilitation Engineering, School of Engineering, University of Glasgow, Glasgow, UK
| | | | - Kenneth J Hunt
- Division of Mechanical Engineering, Department of Engineering and Information Technology, Institute for Rehabilitation and Performance Technology, Bern University of Applied Sciences, Burgdorf, Switzerland
| |
Collapse
|
17
|
Sousa ASP, Silva A, Santos R, Sousa F, Tavares JMRS. Interlimb coordination during the stance phase of gait in subjects with stroke. Arch Phys Med Rehabil 2013; 94:2515-2522. [PMID: 23871877 DOI: 10.1016/j.apmr.2013.06.032] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2013] [Accepted: 06/17/2013] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To analyze the relation between contralesional and ipsilesional limbs in subjects with stroke during step-to-step transition of walking. DESIGN Observational, transversal, analytical study with a convenience sample. SETTING Physical medicine and rehabilitation clinic. PARTICIPANTS Subjects (n=16) with poststroke hemiparesis with the ability to walk independently and healthy controls (n=22). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Bilateral lower limbs electromyographic activity of the soleus (SOL), gastrocnemius medialis, tibialis anterior, biceps femoris, rectus femoris, and vastus medialis (VM) muscles and the ground reaction force were analyzed during double-support and terminal stance phases of gait. RESULTS The propulsive impulse of the contralesional trailing limb was negatively correlated with the braking impulse of the leading limb during double support (r=-.639, P=.01). A moderate functional relation was observed between thigh muscles (r=-.529, P=.035), and a strong and moderate dysfunctional relation was found between the plantar flexors of the ipsilesional limb and the vastus medialis of the contralesional limb, respectively (SOL-VM, r=-.80, P<.001; gastrocnemius medialis-VM, r=-.655, P=.002). Also, a functional moderate negative correlation was found between the SOL and rectus femoris muscles of the ipsilesional limb during terminal stance and between the SOL (r=-.506, P=.046) and VM (r=-.518, P=.04) muscles of the contralesional limb during loading response, respectively. The trailing limb relative impulse contribution of the contralesional limb was lower than the ipsilesional limb of subjects with stroke (P=.02) and lower than the relative impulse contribution of the healthy limb (P=.008) during double support. CONCLUSIONS The findings obtained suggest that the lower performance of the contralesional limb in forward propulsion during gait is related not only to contralateral supraspinal damage but also to a dysfunctional influence of the ipsilesional limb.
Collapse
Affiliation(s)
- Andreia S P Sousa
- Escola Superior da Tecnologia de Saúde do Instituto Politécnico do Porto, Área Científica de Fisioterapia, Centro de Estudos de Movimento e Actividade Humana, Vila Nova de Gaia, Portugal; Faculdade de Engenharia, Universidade do Porto, Porto, Portugal
| | - Augusta Silva
- Escola Superior da Tecnologia de Saúde do Instituto Politécnico do Porto, Área Científica de Fisioterapia, Centro de Estudos de Movimento e Actividade Humana, Vila Nova de Gaia, Portugal
| | - Rubim Santos
- Escola Superior da Tecnologia de Saúde do Instituto Politécnico do Porto, Área Científica de Fisioterapia, Centro de Estudos de Movimento e Actividade Humana, Vila Nova de Gaia, Portugal
| | - Filipa Sousa
- Laboratório de Biomecânica do Porto, Faculdade de Desporto, Universidade do Porto, Porto, Portugal
| | - João Manuel R S Tavares
- Instituto de Engenharia Mecânica e Gestão Industrial, Departamento de Engenharia Mecânica, Faculdade de Engenharia, Universidade do Porto, Porto, Portugal.
| |
Collapse
|
18
|
Silva A, Sousa ASP, Pinheiro R, Ferraz J, Tavares JMRS, Santos R, Sousa F. Activation timing of soleus and tibialis anterior muscles during sit-to-stand and stand-to-sit in post-stroke vs. healthy subjects. Somatosens Mot Res 2013; 30:48-55. [DOI: 10.3109/08990220.2012.754755] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|