scholarly journals Effects of taping and proprioceptive neuromuscular facilitation for stance phase duration of stroke patients

2017 ◽  
Vol 29 (11) ◽  
pp. 2031-2034
Author(s):  
Youn-Bum Sung ◽  
Jun-Cheol Lee ◽  
Kyoung Kim
Keyword(s):  
Stance Phase ◽  
Stroke Patients ◽  
Phase Duration ◽  
Proprioceptive Neuromuscular Facilitation

scholarly journals A Study of Biofeedback Gait Training in Cerebral Stroke Patients in the Early Recovery Phase with Stance Phase as Target Parameter

Sensors ◽  
2021 ◽  
Vol 21 (21) ◽  
pp. 7217
Author(s):  
Dmitry V. Skvortsov ◽  
Sergey N. Kaurkin ◽  
Galina E. Ivanova
Keyword(s):  
Stance Phase ◽  
Recovery Period ◽  
Biomechanical Analysis ◽  
Control Group ◽  
Cerebral Stroke ◽  
Stroke Patients ◽  
Early Recovery ◽  
Phase Duration ◽  
Gait Symmetry ◽  
Early Recovery Period

Walking function disorders are typical for patients after cerebral stroke. Biofeedback technology (BFB) is currently considered effective and promising for training walking function, including in patients after cerebral stroke. Most studies recognize that BFB training is a promising tool for improving walking function; however, the data on the use of highly selective walking parameters for BFB training are very limited. The aim of our study was to investigate the feasibility of using BFB training targeting one of the basic parameters of gait symmetry—stance phase duration—in cerebral stroke patients in the early recovery period. The study included 20 hemiparetic patients in the early recovery period after the first hemispheric ischemic stroke. The control group included 20 healthy subjects. The BFB training and biomechanical analysis of walking (before and after all BFB sessions) were done using an inertial system. The mean number of BFB sessions was nine (from 8 to 11) during the three weeks in clinic. There was not a single negative response to BFB training among the study patients, either during the sessions or later. The spatiotemporal parameters of walking showed the whole syndrome complex of slow walking and typical asymmetry of temporal walking parameters, and did not change significantly as a result of the study therapy. The changes were more significant for the functioning of hip and knee joints. The contralateral hip amplitude returned to the normal range. For the knee joint, the amplitude of the first flexion increased and the value of the amplitude of hyperextension decreased in the middle of the stance phase. Concerning muscle function, the observed significant decrease in the function of m. Gastrocnemius and the hamstring muscles on the paretic side remained without change at the end of the treatment course. We obtained positive dynamics of the biomechanical parameters of walking in patients after the BFB training course. The feasibility and efficacy of their use for targeted correction need further research.

scholarly journals Assessment of the Effects of Rehabilitation on Balance Impairment in Patients After Ischemic Stroke According to Selected Tests and Scales

2015 ◽  
Vol 51 (2) ◽  
pp. 55-63 ◽  
Author(s):  
Magdalena Jaworska ◽  
Tomasz Tuzim ◽  
Małgorzata Starczyńska ◽  
Magdalena Wilk-Frańczuk ◽  
Agnieszka Pedrycz
Keyword(s):  
Test Group ◽  
Berg Balance Scale ◽  
Modern Medicine ◽  
Cerebral Stroke ◽  
Stroke Patients ◽  
Timed Up And Go ◽  
Balance Test ◽  
Raising Awareness ◽  
Proprioceptive Neuromuscular Facilitation ◽  
Age Range

Abstract Cerebral stroke is one of the most important issues for modern medicine. Despite the fact that numerous activities have been undertaken for the purpose of raising awareness and significance of prevention, this condition still remains one of the main reasons behind disability. The objective of the work was to assess the effects of the type of therapy, age and period from the incident occurrence, on the progress of rehabilitation of imbalance and body stability observed in a group of researched patients, on the basis of results obtained according to the Berg Balance Scale, tandem balance test, Kwolek’s loading symmetry index and Timed Up and Go test. The test group comprised of 55 post-stroke patients. The group consisted of 29 women (52.73%) and 26 men (47.27%). The average age of the subjects was 61.02 years (age range between 33-85 years). A number of the patients were subjected to rehabilitation with the use of classic kinesitherapy, whereas the remaining group underwent rehabilitation based on the proprioceptive neuromuscular facilitation method (PNF).

Biomechanical responses of young adults with unilateral transfemoral amputation using two types of mechanical stance control prosthetic knee joints

2020 ◽  
Vol 44 (5) ◽  
pp. 314-322
Author(s):  
Jan Andrysek ◽  
Daniela García ◽  
Claudio Rozbaczylo ◽  
Carlos Alvarez-Mitchell ◽  
Rebeca Valdebenito ◽  
...  
Keyword(s):  
Young Adults ◽  
Knee Joint ◽  
Stance Phase ◽  
Pelvic Tilt ◽  
Swing Phase ◽  
Knee Joints ◽  
Transfemoral Amputation ◽  
Phase Duration ◽  
Prosthetic Knee ◽  
Stance Control

Background: Prosthetic knee joint function is important in the rehabilitation of individuals with transfemoral amputation. Objectives: The objective of this study was to assess the gait patterns associated with two types of mechanical stance control prosthetic knee joints—weight-activated braking knee and automatic stance-phase lock knee. It was hypothesized that biomechanical differences exist between the two knee types, including a prolonged swing-phase duration and exaggerated pelvic movements for the weight-activated braking knee during gait. Study design: Prospective crossover study. Methods: Spatiotemporal, kinematic, and kinetic parameters were obtained via instrumented gait analysis for 10 young adults with a unilateral transfemoral amputation. Discrete gait parameters were extracted based on their magnitudes and timing. Results: A 1.01% ± 1.14% longer swing-phase was found for the weight-activated braking knee (p < 0.05). The prosthetic ankle push-off also occurred earlier in the gait cycle for the weight-activated braking knee. Anterior pelvic tilt was 3.3 ± 3.0 degrees greater for the weight-activated braking knee. This range of motion was also higher (p < 0.05) and associated with greater hip flexion angles. Conclusions: Stance control affects biomechanics primarily in the early and late stance associated with prosthetic limb loading and unloading. The prolonged swing-phase time for the weight-activated braking knee may be associated with the need for knee unloading to initiate knee flexion during gait. The differences in pelvic tilt may be related to knee stability and possibly the different knee joint stance control mechanisms. Clinical relevance Understanding the influence of knee function on gait biomechanics is important in selecting and improving treatments and outcomes for individuals with lower-limb amputations. Weight-activated knee joints may result in undesired gait deviations associated with stability in early stance-phase, and swing-phase initiation in the late stance-phase of gait.

scholarly journals Gait kinematics of the hip, pelvis, and trunk associated with external hip adduction moment in patients with secondary hip osteoarthritis: toward determination of the key point in gait modification

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Hiroshige Tateuchi ◽  
Haruhiko Akiyama ◽  
Koji Goto ◽  
Kazutaka So ◽  
Yutaka Kuroda ◽  
...  
Keyword(s):  
Body Weight ◽  
Stance Phase ◽  
Pelvic Tilt ◽  
Reaction Force ◽  
Hip Osteoarthritis ◽  
Frontal Plane ◽  
Phase Duration ◽  
Basic Model ◽  
Gait Parameters ◽  
Gait Modification

Abstract Background A larger daily cumulative hip loading, which is the product of the external hip adduction moment (HAM) impulse during gait and the number of steps per day has been identified as a factor associated with the progression of secondary hip osteoarthritis (OA). The cause of the increased HAM impulse in patients with hip OA has not been identified. The purpose of this study was to identify the gait parameters associated with HAM impulse during gait in patients with secondary hip OA. Methods Fifty-five patients (age 22–65 years) with mild-to-moderate secondary hip OA participated in this cross-sectional study. The HAM impulse during gait was measured using a three-dimensional gait analysis system. To identify the gait parameters associated with HAM impulse, hierarchical multiple regression analysis was performed. The first model (basic model) included body weight and stance phase duration. The second models included gait parameters (gait speed; ground reaction force [GRF] in frontal plane; and hip, pelvic, and trunk angle in frontal plane) and hip pain in addition to the basic model. Results Body weight and stance phase duration explained 61% of the variance in HAM impulse. In the second model, which took into account body weight and stance phase duration, hip adduction angle (9.4%), pelvic tilt (6.5%), and trunk lean (3.2%) in addition to GRF explained the variance in the HAM impulse. Whereas larger hip adduction angle and pelvic tilt toward the swing limb were associated with a larger HAM impulse, larger trunk lean toward the stance limb was associated with smaller HAM impulse. Conclusion In patients with excessive hip adduction and pelvic tilt toward the swing limb during gait, gait modification may contribute to the reduction of hip joint loading.

scholarly journals The Effect of Pelvic Movements of a Gait Training System for Stroke Patients

2021 ◽  
Author(s):  
Choonghyun Son ◽  
Anna Lee ◽  
Junkyung Lee ◽  
DaeEun Kim ◽  
Seung-Jong Kim ◽  
...  
Keyword(s):  
Stance Phase ◽  
Gait Training ◽  
Training System ◽  
Transverse Plane ◽  
Gait Rehabilitation ◽  
Stroke Patients ◽  
Interaction Forces ◽  
Flexion Extension ◽  
Pelvic Movement ◽  
Robotic Gait

Abstract Background: Aging societies lead to higher demand for gait rehabilitation as age-related neurological disorders such as stroke increase. Since conventional methods for gait rehabilitation are physically and economically burdensome, robotic gait training systems have been studied and commercialized, many of which provided movements confined in the sagittal plane. For better outcomes of gait rehabilitation with more natural gait patterns, however, it is desirable to provide pelvic movements in the transverse plane. In this study, a robotic gait training system capable of pelvic motions in the transverse plane was used to evaluated the effect of the pelvic motions on stroke patients. Method: Healbot T, which is a robotic gait training system and capable of providing pelvic movements in the transverse plane as well as flexion/extension of the hip and knee joints and adduction/abduction of the hip joints, is introduced and used to evaluate the effect of the pelvic movement on gait training of stroke patients.Experiment: 23 stroke patients with hemiparesis participated in this study and were assigned into two groups. Pelvis-on group was provided with pelvic motions whereas no pelvic movement was allowed for pelvis-off group during 10 sessions of gait trainings in Healbot T. EMG signals and interaction forces as well as the joint angles of the robot were measured. Gait parameters such as stride length, gait period, cadence, and walking speed were measured after gait training. Result: 37.5 % lower interaction forces of pelvis were observed in the pelvis-on group than the pelvis-off group. Furthermore, the interaction forces at the thighs and calves of both groups showed significant decrease. The EMG signals of gluteus medius of the pelvis-on group increased by 77.2 %. Furthermore, statistically significant increases in various muscles were measured in the pelvis-on group during the stance phase. Conclusion: Gait training using a robotic gait training system with pelvic movements was conducted to study the effects of lateral and rotational pelvic movements in gait training of stroke patients. The pelvic movements made gait training less interfered by the exoskeleton while stimulating the voluntary muscle activation during the stance phase. Clinical trial registration: KCT0003762, 2018-1254, Registered 28 October 2018, https://cris.nih.go.kr/cris/search/search_result_st01_kren.jsp?seq=14310

scholarly journals Development of a Mechanistic Hypothesis Linking Compensatory Biomechanics and Stepping Asymmetry during Gait of Transfemoral Amputees

2019 ◽  
Vol 2019 ◽  
pp. 1-15 ◽  
Author(s):  
Abeer Mohamed ◽  
Andrew Sexton ◽  
Kirsten Simonsen ◽  
Chris A. McGibbon
Keyword(s):  
Stance Phase ◽  
Heel Strike ◽  
Knee Prostheses ◽  
Phase Duration ◽  
Double Support ◽  
Working Hypothesis ◽  
Intact Knee ◽  
Intact Limb ◽  
Support Phase ◽  
Double Support Phase

Objective. Gait asymmetry is a common adaptation observed in lower-extremity amputees, but the underlying mechanisms that explain this gait behavior remain unclear for amputees that use above-knee prostheses. Our objective was to develop a working hypothesis to explain chronic stepping asymmetry in otherwise healthy amputees that use above-knee prostheses. Methods. Two amputees (both through-knee; one with microprocessor knee, one with hydraulic knee) and fourteen control subjects participated. 3D kinematics and kinetics were acquired at normal, fast, and slow walking speeds. Data were analyzed for the push-off and collision limbs during a double support phase. We examined gait parameters to identify the stepping asymmetry then examined the external work rate (centre of mass) and internal (joint) power profiles to formulate a working hypothesis to mechanistically explain the observed stepping asymmetry. Results. Stepping asymmetry at all three gait speeds in amputees was characterized by increased stance phase duration of the intact limb versus relatively normal stance phase duration for the prosthesis limb. The prosthesis limb contributed very little to positive and negative work during the double support phase of gait. To compensate, the intact leg at heel strike first provided aid to the deficient prosthetic ankle/foot during its push-off by doing positive work with the intact knee, which caused a delayed stance phase pattern. The resulting delay in toe-off of the intact limb then facilitated the energy transfer from the more robust intact push-off limb to the weaker colliding prosthesis side. This strategy was observed for both amputees. Conclusions. There is a sound scientific rationale for a mechanistic hypothesis that stepping asymmetry in amputee participants is a result of a motor adaptation that is both facilitating the lower-leg trajectory enforced by the prosthesis while compensating for the lack of work done by the prosthesis, the cost of which is increased energy expenditure of the intact knee and both hips.

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