scholarly journals Influences of visual and supporting surface conditions on standing postural control and correlation with walking ability in patients with post-stroke hemiplegia

2015 ◽  
Vol 27 (5) ◽  
pp. 1323-1327 ◽  
Author(s):  
Nanami Okawara ◽  
Shigeru Usuda
Keyword(s):  
Postural Control ◽  
Walking Ability ◽  
Supporting Surface ◽  
Surface Conditions ◽  
Post Stroke

scholarly journals Postural Control Disturbances Induced by Virtual Reality in Stroke Patients

2021 ◽  
Vol 11 (4) ◽  
pp. 1510
Author(s):  
Charles Morizio ◽  
Maxime Billot ◽  
Jean-Christophe Daviet ◽  
Stéphane Baudry ◽  
Christophe Barbanchon ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Postural Control ◽  
Virtual Environments ◽  
Center Of Pressure ◽  
Dynamic Condition ◽  
Static Condition ◽  
Stroke Patients ◽  
Post Stroke ◽  
Subacute Stroke

People who survive a stroke are often left with long-term neurologic deficits that induce, among other impairments, balance disorders. While virtual reality (VR) is growing in popularity for postural control rehabilitation in post-stroke patients, studies on the effect of challenging virtual environments, simulating common daily situations on postural control in post-stroke patients, are scarce. This study is a first step to document the postural response of stroke patients to different challenging virtual environments. Five subacute stroke patients and fifteen age-matched healthy adults were included. All participants underwent posturographic tests in control conditions (open and closed eyes) and virtual environment without (one static condition) and with avatars (four dynamic conditions) using a head-mounted device for VR. In dynamic environments, we modulated the density of the virtual crowd (dense and light crowd) and the avoidance space with the avatars (near or far). Center of pressure velocity was collected by trial throughout randomized 30-s periods. Results showed that more challenging conditions (dynamic condition) induced greater postural disturbances in stroke patients than in healthy counterparts. Our study suggests that virtual reality environments should be adjusted in light of obtaining more or less challenging conditions.

Effects of hypothermic anesthesia of the feet on vibration-induced body sway and adaptation

2003 ◽  
Vol 13 (1) ◽  
pp. 39-52 ◽  
Author(s):  
F. Stål ◽  
P.A. Fransson ◽  
M. Magnusson ◽  
M. Karlberg
Keyword(s):  
Postural Control ◽  
Sensory Loss ◽  
Body Sway ◽  
Cutaneous Mechanoreceptors ◽  
Supporting Surface ◽  
Eyes Closed ◽  
Somatosensory Input ◽  
Eyes Open ◽  
Sensor Information ◽  
Ice Water

The aim of this study was to investigate the significance of information from the plantar cutaneous mechanoreceptors in postural control and whether postural control could compensate for reduced cutaneous information by adaptation. Sixteen healthy subjects were tested with eyes open or eyes closed with hypothermic and normal feet temperature during posturography where body sway was induced by vibratory proprioceptive stimulation towards both calf muscles. The hypothermic anesthesia was obtained by cooling the subject's feet in ice water for 20 minutes. Body movements were evaluated by analyzing the anteroposterior and lateral torques induced towards the supporting surface by a force platform during the posturography tests. The reduction of cutaneous sensor information from the mechanoreceptors of the feet significantly increased the vibration-induced torque variance mainly in the anteroposterior direction. However, the effects of disturbed mechanoreceptors information was rapidly compensated for through postural adaptation and torque variance was in level with that without anesthesia within 50 to 100 seconds of stimulation, both when standing with eyes open and eyes closed. Our findings suggest that somatosensory input from mechanoreceptors in the foot soles contribute significantly in maintaining postural control, but the sensory loss could be compensated for.

scholarly journals The relationship between relative aerobic load, energy cost, and speed of walking in individuals post-stroke

2021 ◽  
Author(s):  
Ilse Johanna Blokland ◽  
Arianne S Gravesteijn ◽  
Mathijs C Busse ◽  
Floor P Groot ◽  
Coen AM van Bennekom ◽  
...  
Keyword(s):  
Energy Expenditure ◽  
Aerobic Capacity ◽  
Energy Cost ◽  
Walking Speed ◽  
Ventilatory Threshold ◽  
Research Question ◽  
Walking Ability ◽  
Cross Sectional ◽  
Relative Load ◽  
Post Stroke

Background: Individuals post-stroke walk slower than their able-bodied peers, which limits participation. This might be attributed to neurological impairments, but could also be caused by a mismatch between aerobic capacity and aerobic load of walking. Research question: What is the potential impact of aerobic capacity and aerobic load of walking on walking ability post-stroke? Methods: In a cross-sectional study, forty individuals post-stroke (more impaired N=21; preferred walking speed (PWS)<0.8m/s, less impaired N=19), and 15 able-bodied individuals performed five, 5-minute treadmill walking trials at 70%, 85%, 100%, 115% and 130% of PWS. Energy expenditure (mlO2/kg/min) and energy cost (mlO2/kg/m) were derived from oxygen uptake (VO2). Relative load was defined as energy expenditure divided by peak aerobic capacity (%VO2peak) and by VO2 at ventilatory threshold (%VO2-VT). Relative load and energy cost at PWS were compared between groups with one-way ANOVAs. The effect of speed on these parameters was modeled with GEE. Results: Both more and less impaired individuals post-stroke showed lower PWS than able-bodied controls (0.44[0.19-0.76] and 1.04[0.81-1.43] vs 1.36[0.89-1.53] m/s) and higher relative load at PWS (50.2±14.4 and 51.7±16.8 vs 36.2±7.6 %VO2 peak and 101.9±20.5 and 97.0±27.3 vs 64.9±13.8 %VO2-VT). No differences in relative load were found between stroke groups. Energy cost at PWS of more impaired (0.30[.19-1.03] mlO2/kg/m) was higher than less-impaired (0.19[0.10-0.24] mlO2/kg/m) and able-bodied (0.15[0.13-0.18] mlO2/kg/m). For post-stroke individuals, increasing walking speed above PWS decreased energy cost, but resulted in a relative load above endurance threshold. Significance: Individuals post-stroke seem to reduce walking speed to prevent unsustainably high relative aerobic loads at the expense of reduced economy. When aiming to improve walking ability in individuals post-stroke, it is important to consider training aerobic capacity.

Abstract TP150: Two Weeks of Ischemic Preconditioning Training on the Paretic Leg Improves Leg Strength and Delays Muscle Fatigue in Chronic Stroke

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Matthew J Durand ◽  
Spencer A Murphy ◽  
Brian D Schmit ◽  
David D Gutterman ◽  
Allison S Hyngstrom
Keyword(s):  
Motor Function ◽  
Ischemic Preconditioning ◽  
Vascular Function ◽  
Knee Extensor ◽  
Chronic Stroke ◽  
Muscle Performance ◽  
Walking Ability ◽  
Post Stroke ◽  
Leg Strength ◽  
Improve Motor Function

Introduction: Individuals living with chronic stroke have weakness and increased neuromuscular fatigue in the paretic leg, which can limit walking ability and endurance. In cardiac and healthy populations, ischemic preconditioning (IPC) is a widely studied, effective, non-invasive stimulus which not only improves vascular function, but also motor performance. IPC occurs when the tissue of interest is exposed to repeated, short bouts of ischemia, which can improve motor function by enhancing vascular, neural and muscle function. IPC has not been tested as a method to improve motor function in individuals post-stroke. Hypothesis: Two weeks of IPC training on the paretic leg will improve leg strength and time-to-task failure (TTF) during a fatiguing muscle contraction. Methods: A feasibility study of 4 individuals (3 female, 1 male) with chronic stroke (20 ± 4 years) was conducted. A Biodex dynamometer was used to assess paretic leg knee extensor maximal voluntary contraction (MVC). To assess muscle fatigability, subjects maintained a sustained contraction equal to 30% of their MVC until failure using visual feedback. After baseline testing, subjects made six visits to the laboratory over a two week period to have IPC performed on their paretic leg. A blood pressure cuff was inflated on the thigh to 225 mmHg for five, five-minute bouts per session. Five minutes of rest was given between inflation cycles. After the last session, subjects returned within 48 hours to have MVC and TTF reassessed. Results: Three subjects completed all study procedures. One subject withdrew for medical reasons unrelated to the study. The IPC procedure was well tolerated by all subjects. After two-week IPC training, knee extensor MVC increased in the paretic leg (45.0 ± 2.7 Nm vs. 52.6 ± 5.7 Nm). Fatigability of the muscles was dramatically reduced after IPC training as TTF tripled (359 ± 180 seconds vs. 1097 ± 343 seconds). Conclusions: We are the first group to show that IPC is a well-tolerated and effective stimulus to improve paretic leg strength and reduce muscle fatigability in subjects with chronic stroke. The results of this pilot study warrant a larger study to determine whether IPC improves muscle performance post-stroke through neural, vascular, or muscle-related mechanisms.

scholarly journals Exoskeleton use in post-stroke gait rehabilitation: a qualitative study of the perspectives of persons post-stroke and physiotherapists

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Julie Vaughan-Graham ◽  
Dina Brooks ◽  
Lowell Rose ◽  
Goldie Nejat ◽  
Jose Pons ◽  
...  
Keyword(s):  
Lower Limb ◽  
Stakeholder Participation ◽  
Patient Characteristics ◽  
Evidence Base ◽  
End Users ◽  
Gait Rehabilitation ◽  
Walking Ability ◽  
Locomotor Training ◽  
Post Stroke ◽  
Single Use

Abstract Background Wearable powered exoskeletons are a new and emerging technology developed to provide sensory-guided motorized lower limb assistance enabling intensive task specific locomotor training utilizing typical lower limb movement patterns for persons with gait impairments. To ensure that devices meet end-user needs it is important to understand and incorporate end-users perspectives, however research in this area is extremely limited in the post-stroke population. The purpose of this study was to explore in-depth, end-users perspectives, persons with stroke and physiotherapists, following a single-use session with a H2 exoskeleton. Methods We used a qualitative interpretive description approach utilizing semi-structured face to face interviews, with persons post-stroke and physiotherapists, following a 1.5 h session with a H2 exoskeleton. Results Five persons post-stroke and 6 physiotherapists volunteered to participate in the study. Both participant groups provided insightful comments on their experience with the exoskeleton. Four themes were developed from the persons with stroke participant data: (1) Adopting technology; (2) Device concerns; (3) Developing walking ability; and, (4) Integrating exoskeleton use. Five themes were developed from the physiotherapist participant data: (1) Developer-user collaboration; (2) Device specific concerns; (3) Device programming; (4) Patient characteristics requiring consideration; and, (5) Indications for use. Conclusions This study provides an interpretive understanding of end-users perspectives, persons with stroke and neurological physiotherapists, following a single-use experience with a H2 exoskeleton. The findings from both stakeholder groups overlap such that four over-arching concepts were identified including: (i) Stakeholder participation; (ii) Augmentation vs. autonomous robot; (iii) Exoskeleton usability; and (iv) Device specific concerns. The end users provided valuable perspectives on the use and design of the H2 exoskeleton, identifying needs specific to post-stroke gait rehabilitation, the need for a robust evidence base, whilst also highlighting that there is significant interest in this technology throughout the continuum of stroke rehabilitation.

Action observation training of community ambulation for improving walking ability of patients with post-stroke hemiparesis: a randomized controlled pilot trial

2016 ◽  
Vol 31 (8) ◽  
pp. 1078-1086 ◽  
Author(s):  
Hyun-Ju Park ◽  
Duck-Won Oh ◽  
Jong-Duk Choi ◽  
Jong-Man Kim ◽  
Suhn-Yeop Kim ◽  
...  
Keyword(s):  
Action Observation ◽  
Control Group ◽  
Walking Ability ◽  
Walk Test ◽  
Balance Confidence ◽  
Post Stroke ◽  
Video Clips ◽  
Randomized Controlled ◽  
Observation Training ◽  
Experimental Group

Purpose: To investigate the effects of action observation training involving community-based ambulation for improving walking ability after stroke. Design: Randomized, controlled pilot study. Setting: Inpatient rehabilitation hospital. Subjects: A total of 25 inpatients with post-stroke hemiparesis were randomly assigned to either the experimental group ( n = 12) or control group ( n = 13). Intervention: Subjects of the experimental group watched video clips demonstrating four-staged ambulation training with a more complex environment factor for 30 minutes, three times a week for four weeks. Meanwhile, subjects of the control group watched video clips, which showed different landscape pictures. Main measures: Walking function was evaluated before and after the four-week intervention using a 10-m walk test, community walk test, activities-specific balance confidence scale, and spatiotemporal gait measures. Results: Changes in the values for the 10-m walk test (0.17 ±0.19 m/s vs. 0.05 ±0.08 m/s), community walk test (–151.42 ±123.82 seconds vs. 67.08 ±176.77 seconds), and activities-specific balance confidence (6.25 ±5.61 scores vs. 0.72 ±2.24 scores) and the spatiotemporal parameters (i.e. stride length (19.00 ±11.34 cm vs. 3.16 ±11.20 cm), single support (5.87 ±5.13% vs. 0.25 ±5.95%), and velocity (15.66 ±12.34 cm/s vs. 2.96 ±10.54 cm/s)) indicated a significant improvement in the experimental group compared with the control group. In the experimental group, walking function and ambulation confidence was significantly different between the pre- and post-intervention, whereas the control group showed a significant difference only in the 10-m walk test. Conclusions: Action observation training of community ambulation may be favorably used for improving walking function of patients with post-stroke hemiparesis.

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