scholarly journals Foot-placement accuracy during planned and reactive target stepping during walking in stroke survivors and healthy adults

2020 ◽  
Vol 81 ◽  
pp. 261-267
Author(s):  
Susanne M. van der Veen ◽  
Ulrike Hammerbeck ◽  
Kristen L. Hollands
Keyword(s):  
Healthy Adults ◽  
Stroke Survivors ◽  
Foot Placement ◽  
Placement Accuracy

scholarly journals Associations Between Foot Placement Asymmetries and Metabolic Cost of Transport in Hemiparetic Gait

2016 ◽  
Vol 31 (2) ◽  
pp. 168-177 ◽  
Author(s):  
James M. Finley ◽  
Amy J. Bastian
Keyword(s):  
Walking Speed ◽  
Metabolic Cost ◽  
Positive Association ◽  
Stroke Survivor ◽  
Gas Analysis ◽  
Stroke Survivors ◽  
Cost Of Transport ◽  
Foot Placement ◽  
Hemiparetic Gait ◽  
All Speeds

Stroke survivors often have a slow, asymmetric walking pattern. They also walk with a higher metabolic cost than healthy, age-matched controls. It is often assumed that spatial-temporal asymmetries contribute to the increased metabolic cost of walking poststroke. However, elucidating this relationship is made challenging because of the interdependence between spatial-temporal asymmetries, walking speed, and metabolic cost. Here, we address these potential confounds by measuring speed-dependent changes in metabolic cost and implementing a recently developed approach to dissociate spatial versus temporal contributions to asymmetry in a sample of stroke survivors. We used expired gas analysis to compute the metabolic cost of transport (CoT) for each participant at 4 different walking speeds: self-selected speed, 80% and 120% of their self-selected speed, and their fastest comfortable speed. We also computed CoT for a sample of age- and gender-matched control participants who walked at the same speeds as their matched stroke survivor. Kinematic data were used to compute the magnitude of a number of variables characterizing spatial-temporal asymmetries. Across all speeds, stroke survivors had a higher CoT than controls. We also found that our sample of stroke survivors did not choose a self-selected speed that minimized CoT, contrary to typical observations in healthy controls. Multiple regression analyses revealed negative associations between speed and CoT and a positive association between asymmetries in foot placement relative to the trunk and CoT. These findings suggest that interventions designed to increase self-selected walking speed and reduce foot-placement asymmetries may be ideal for improving walking economy poststroke.

scholarly journals Measurement of passive ankle stiffness in subjects with chronic hemiparesis using a novel ankle robot

2011 ◽  
Vol 105 (5) ◽  
pp. 2132-2149 ◽  
Author(s):  
Anindo Roy ◽  
Hermano I. Krebs ◽  
Christopher T. Bever ◽  
Larry W. Forrester ◽  
Richard F. Macko ◽  
...  
Keyword(s):  
Ankle Joint ◽  
Frontal Plane ◽  
Chronic Stroke ◽  
Healthy Adults ◽  
Stroke Survivors ◽  
Passive Stiffness ◽  
Mechanical Stiffness ◽  
Treatment Protocols ◽  
Ankle Stiffness ◽  
Hemiparetic Stroke

Our objective in this study was to assess passive mechanical stiffness in the ankle of chronic hemiparetic stroke survivors and to compare it with those of healthy young and older (age-matched) individuals. Given the importance of the ankle during locomotion, an accurate estimate of passive ankle stiffness would be valuable for locomotor rehabilitation, potentially providing a measure of recovery and a quantitative basis to design treatment protocols. Using a novel ankle robot, we characterized passive ankle stiffness both in sagittal and in frontal planes by applying perturbations to the ankle joint over the entire range of motion with subjects in a relaxed state. We found that passive stiffness of the affected ankle joint was significantly higher in chronic stroke survivors than in healthy adults of a similar cohort, both in the sagittal as well as frontal plane of movement, in three out of four directions tested with indistinguishable stiffness values in plantarflexion direction. Our findings are comparable to the literature, thus indicating its plausibility, and, to our knowledge, report for the first time passive stiffness in the frontal plane for persons with chronic stroke and older healthy adults.

scholarly journals Lower Limb Inter-Joint Coordination of Unilateral Transfemoral Amputees: Implications for Adaptation Control

2020 ◽  
Vol 10 (12) ◽  
pp. 4072 ◽  
Author(s):  
Zhi Xu ◽  
Duo Wai-Chi Wong ◽  
Fei Yan ◽  
Tony Lin-Wei Chen ◽  
Ming Zhang ◽  
...  
Keyword(s):  
Lower Limb ◽  
Cross Correlation ◽  
Relative Phase ◽  
Lower Limbs ◽  
Foot Placement ◽  
Joint Coordination ◽  
Placement Accuracy ◽  
Transfemoral Amputees ◽  
Continuous Relative Phase ◽  
Coordination Patterns

The gait of transfemoral amputees can be made smoother by adjusting the inter-joint coordination of both lower limbs. In this study, we compared the inter-joint coordination of the amputated and non-amputated limbs of unilateral amputees to able-bodied controls. Eight amputees and eight able-bodied control participants were recruited. Walking speed, stance–swing time ratio, joint angle, joint angular velocity, and inter-joint coordination parameters—including continuous relative phase (CRP) and decomposition index (DI)—of the lower-limb joint pairs in stance and swing phases were investigated. Similarity of the CRP between groups was evaluated using cross-correlation measures and root-mean-square, and the variability of the CRP was examined by deviation phase (DP). There were significant differences between the amputated limbs and controls in CRP of hip–knee and knee–ankle in stance and swing, DP of knee–ankle and hip–ankle in stance, and DI of hip–knee in swing. For the non-amputated limbs, there were significant differences in CRP and DP of knee–ankle, and DI of hip–knee in swing compared to controls. The amputees utilized unique inter-joint coordination patterns for both limbs—particularly the hip joint—to compensate for the support-capability impairment due to limb salvage and ensure foot placement accuracy.

scholarly journals Can foot placement during gait be trained? Adaptations in stability control when ankle moments are constrained

2021 ◽  
Author(s):  
Laura A. Hoogstad ◽  
Anina Moira van Leeuwen ◽  
Jaap H. van Dieen ◽  
Sjoerd M. Bruijn
Keyword(s):  
Prolonged Exposure ◽  
Center Of Mass ◽  
Stability Control ◽  
Local Dynamic ◽  
Foot Placement ◽  
Ankle Moment ◽  
Training Tool ◽  
Local Dynamic Stability ◽  
After Effect ◽  
Placement Accuracy

Accurate coordination of mediolateral foot placement, relative to the center of mass kinematic state, is one of the mechanisms which ensures mediolateral stability during human walking. Previously, we found that shoes constraining ankle moments decreased foot placement accuracy, presumably by impairing control over movement of the swing leg. As such, ankle moment constraints can be seen as a perturbation of foot placement. Direct mechanical perturbations of the swing leg trajectory can improve foot placement accuracy as an after-effect. Here, we asked whether constrained ankle moments could have a similar effect. If confirmed, this would offer a simple training tool for individuals with impaired foot placement control. Participants (n=19) walked in three conditions; normal (baseline, 10 minutes), while wearing shoes constraining ankle moments (training, 15 minutes), and normal again (after-effects, 10 minutes). Foot placement accuracy was calculated as the percentage of variance in foot placement that could be predicted based on the center of mass kinematic state in the preceding swing phase. When walking with constrained ankle moments, foot placement accuracy decreased initially compared to baseline, but it gradually improved over time. In the after-effect condition, foot placement accuracy was higher than during baseline, but this difference was not significant. When walking with constrained ankle moments, we observed increased step width, decreased stride time and reduced local dynamic stability. In conclusion, constraining ankle moment control deteriorates foot placement accuracy. A non-significant trend towards improved foot placement accuracy after prolonged exposure to constrained ankle moments, allows for speculation on a training potential.

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