scholarly journals The effects of sand surface training on changes in the muscle activity of the paretic side lower limb and the improvement of dynamic stability and gait endurance in stroke patients

2019 ◽  
Vol 15 (3) ◽  
pp. 439-444
Author(s):  
Byoung-Ha Hwang ◽  
Tae-Ho Kim
2021 ◽  
Author(s):  
Ben P.F. O'Callaghan ◽  
Matthew W. Flood ◽  
Michele Tonellato ◽  
Caitríona Fingleton ◽  
Madeleine M Lowery ◽  
...  

Abstract BackgroundThe level of assistance provided to the user is an important decision in rehabilitation training using robotic devices. Both fully assistive and assist-as-needed paradigms have shown benefits in functional outcomes in healthy individuals and users with chronic stroke and spinal cord injury. The effect of assistance level on muscle activity and kinematic gait parameters has not yet been directly examined during overground exoskeletal gait in a stroke population. Furthermore, it is not clear whether an assist-as-needed approach could elicit increased voluntary activity in individuals in the acute stages of stroke. The aim of this study was to examine the effect of assistance level on muscle activity and kinematic parameters during exoskeleton gait in individuals in the acute stage of stroke care.MethodsNine individuals in the acute stage of post-stroke care performed walking tasks in the EKSO GTTM exoskeleton using both maximal assistance and adaptive assistance control paradigms. Temporal gait parameters and muscle activity were recorded using accelerometers and surface EMG on the lower limb muscles.ResultsShorter swing times and longer double support times were observed on the non-paretic side during adaptive assist mode than with maximum assist mode (p<0.0065). No significant effect of exoskeleton mode was observed on the remaining temporal gait parameters. On the paretic side, proximal lower limb muscles (RF and ST) and plantar-flexors (SO) (p<0.00125) exhibited greater activation in adaptive assist mode than in maximum assist mode. On the non-paretic side however, the lower limb distal muscles (TA and SO) displayed greater activity during maximum assist mode than adaptive assist mode (p<0.00125). ConclusionsThe level of assistance provided by an exoskeleton in the acute stages of stroke care is an important clinical decision. The results indicate that an adaptive or assist-as-needed approach elicits higher levels of activation in muscles acting around the knee joint and plantar-flexors on the paretic side than a maximal, fixed assistance paradigm, in the acute stage post-stroke. Increased activity around the ankle joint during maximum assistance mode was also noted. Improved understanding of the effect of assistance level can help inform future control paradigms for exoskeleton gait in acute stroke.


2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Eun Pyeong Choi ◽  
Seong Ju Yang ◽  
A. Hyun Jung ◽  
Hye Su Na ◽  
Yeong Ok Kim ◽  
...  

This study was aimed at investigating the changes in the degree of weight support loaded on the cane and paretic-side lower limb muscle activation according to the types of cane and cane-supported gait using a weight-support feedback cane (WSFC). Eleven hemiparetic stroke patients were recruited from a local rehabilitation hospital. WSFC can measure the degree of weight support loaded on the cane during cane-supported walking in units of kg, through a force sensor installed inside the handle. This study measured the degree of weight support loaded on the cane and lower limb muscle activation under four conditions: two-point and three-point gait with mono and quadripod canes. In the two-point gait with mono and quadripod canes, subjects were asked to move the WSFC and paretic-side foot forward at the same time and then move the nonparetic-side foot. In the three-point gait with mono and quadripod canes, subjects were asked to first move the WSFC forward, then the paretic-side foot, and finally the nonparetic-side foot. The degree of weight support loaded on the cane was significantly higher in the three-point gait with WSFC than in the two-point gait with WSFC for both mono (P=.047) and quadripod canes (P=.002). Additionally, the paretic-side lower limb muscle activation during the stance phase was significantly higher in the two-point gait with WSFC than in the three-point gait with WSFC for both mono (P=.008~.044) and quadripod canes (P=.008~.026). Our results suggest that applying the three-point gait with high cane dependence in the early stages of training for stability and subsequently applying the two-point gait for the enhancement of lower limb muscle activation and training of normal gait pattern could be effective.


2016 ◽  
Vol 31 (7) ◽  
pp. 1293-1300 ◽  
Author(s):  
Marcele Florêncio das Neves ◽  
Mariana César Ribeiro dos Reis ◽  
Eliana Aparecida Fonseca de Andrade ◽  
Fernanda Pupio Silva Lima ◽  
Renata Amadei Nicolau ◽  
...  

2021 ◽  
pp. 1-9
Author(s):  
James R. Forsyth ◽  
Christopher J. Richards ◽  
Ming-Chang Tsai ◽  
John W. Whitting ◽  
Diane L. Riddiford-Harland ◽  
...  

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Sota Araki ◽  
Masayuki Kawada ◽  
Takasuke Miyazaki ◽  
Yuki Nakai ◽  
Yasufumi Takeshita ◽  
...  

Many stroke patients rely on cane or ankle-foot orthosis during gait rehabilitation. The purpose of this study was to investigate the immediate effect of functional electrical stimulation (FES) to the gluteus medius (GMed) and tibialis anterior (TA) on gait performance in stroke patients, including those who needed assistive devices. Fourteen stroke patients were enrolled in this study (mean poststroke duration: 194.9 ± 189.6   d ; mean age: 72.8 ± 10.7   y ). Participants walked 14 m at a comfortable velocity with and without FES to the GMed and TA. After an adaptation period, lower-limb motion was measured using magnetic inertial measurement units attached to the pelvis and the lower limb of the affected side. Motion range of angle of the affected thigh and shank segments in the sagittal plane, motion range of the affected hip and knee extension-flexion angle, step time, and stride time were calculated from inertial measurement units during the middle ten walking strides. Gait velocity, cadence, and stride length were also calculated. These gait indicators, both with and without FES, were compared. Gait velocity was significantly faster with FES ( p = 0.035 ). Similarly, stride length and motion range of the shank of the affected side were significantly greater with FES (stride length: p = 0.018 ; motion range of the shank: p = 0.02 6). Meanwhile, cadence showed no significant difference ( p = 0.238 ) in gait with or without FES. Similarly, range of motion of the affected hip joint, knee joint, and thigh did not differ significantly depending on FES condition ( p = 0.115 ‐ 0.529 ). FES to the GMed and TA during gait produced an improvement in gait velocity, stride length, and motion range of the shank. Our results will allow therapists to use FES on stroke patients with varying conditions.


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