scholarly journals Velocity Determinants in Spastic Patients after Stroke—A Gait Analysis Study

2020 ◽  
Vol 12 (3) ◽  
pp. 48-54
Author(s):  
Miguel Reis e Silva ◽  
Jorge Jacinto
Keyword(s):  
Gait Analysis ◽  
Knee Flexion ◽  
Stride Length ◽  
Stance Phase ◽  
Gait Training ◽  
Swing Phase ◽  
The Body ◽  
Gait Velocity ◽  
Stroke Patients ◽  
Exclusion Criteria

Introduction: Gait velocity in spastic patients after stroke is both a life quality and mortality predictor. However, the precise biomechanical events that impair a faster velocity in this population are not defined. This study goal is to find out which are the gait parameters associated with a higher velocity in stroke patients with spastic paresis. Methods: The registries of a Gait analysis laboratory were retrospectively analyzed. The inclusion criteria were: trials of adult stroke patients with unilateral deficits. The exclusion criteria were: trials when patients used an external walking device, an orthosis, or support by a third person. Of the 116 initial patients, after the application of the exclusion criteria, 34 patients were included in the cohort, all with spatiotemporal, static and dynamic kinematic and dynamometric studies. Results: There was a correlation of velocity with cadence, stride length of the paretic (P) limb, stride length, and time of the P and non-paretic (NP) limb, double support time, all the parameters related to hip extension during stance phase, knee flexion during swing phase, and parameters related to ankle plantarflexion during stance phase. Conclusions: The main gait analysis outcomes that have a correlation with speed are related to the formula velocity = step length × cadence or are related to stance phase events that allow the anterior projection of the body. The only swing phase outcome that has a correlation with speed is knee flexion. More studies are needed from gait analysis laboratories in order to point out the most relevant goals to achieve with gait training in spastic stroke patients.

scholarly journals Pushing a Sled: Assessing its Impact on Gait Temporospatial Parameters in Young Healthy Adults [Texas Woman's University]

2019 ◽  
Author(s):  
Aneesah Hyder ◽  
Chad Swank ◽  
Martin G Rosario
Keyword(s):  
Young Adults ◽  
Repeated Measures ◽  
Stride Length ◽  
Stance Phase ◽  
Gait Cycle ◽  
Gait Training ◽  
Swing Phase ◽  
Training Tool ◽  
Proportional Increase ◽  
The Impact

BACKGROUND: Resistance exercise (RE) has been demonstrated as a superior modality for increasing muscle strength, muscle endurance, power, and motor performance. The sled used in this study is a novel device that provides proportional increase in resistance with increased speed. PURPOSE: To examine the impact of resistance on gait temporospatial parameters using a resistance sled in healthy young adults while walking and running. METHODS: Fifteen young adults (ages 21-35) were recruited to participate in this study. Sensors (accelerometers and gyroscopes) were placed on each subject at the chest, waist, both wrists, and ankles. Each participant performed three trials of 40 feet for the following conditions: self-paced walking (W), self-paced walking while pushing the sled (WP), and maximal speed running while pushing the sled (RP). RESULTS: A repeated measures MANOVA was conducted to compare gait temporospatial parameters across conditions. Results indicate significant differences (P <0.005) between all conditions for stride length, cadence, double support time, swing %, and stance %. Stride length decreased across all conditions: W (85+/-3.0), WP (68+/-4.1), and RP (56+/-7.0). Cadence decreased while WP (92+/-10.1), yet increased during RP (169+/-14.9), compared to W (109+/-6.7). During WP and RP, participants demonstrated greater gait cycle percentage in stance phase [(WP, stance phase: 66+/-1.6, swing phase: 34+/-1.6) and (RP, stance phase: 57+/-2.7, swing phase: 42+/-2.7)] when compared to W (stance phase: 37+/-2.1, swing phase: 37+/-2.2). CONCLUSIONS: Longer stance phase with proportional increase in resistance could be utilized as a combined resistance and gait training tool as opposed to only gait training. Future studies should focus on neuromuscular activation of the lower extremity, specifically the muscles involved in the gait cycle stance phase, when walking or running with resistance.

scholarly journals The effect of pelvic movements of a gait training system for stroke patients: a single blind, randomized, parallel study

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Choonghyun Son ◽  
Anna Lee ◽  
Junkyung Lee ◽  
DaeEun Kim ◽  
Seung-Jong Kim ◽  
...  
Keyword(s):  
Stride Length ◽  
Stance Phase ◽  
Walking Speed ◽  
Gait Training ◽  
Training System ◽  
Transverse Plane ◽  
Gait Rehabilitation ◽  
Stroke Patients ◽  
Pelvic Movement ◽  
Robotic Gait

Abstract Background Aging societies lead to higher demand for gait rehabilitation as age-related neurological disorders such as stroke and spinal cord injury 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 evaluate 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. Gait trainings in Healbot T with and without pelvic movements are carried out with stroke patients having hemiparesis. Experiment Twenty-four stroke patients with hemiparesis were randomly assigned into two groups and 23 of them successfully completed the experiment except one subject who had dropped out due to personal reasons. 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. Electromyography (EMG) signals and interaction forces as well as the joint angles of the robot were measured. Gait parameters such as stride length, cadence, and walking speed were measured while walking on the ground without assistance of Healbot T after gait training on 1st, 5th, and 10th day. Result Stride length significantly increased in both groups. Furthermore, cadence and walking speed of the pelvis-on group were increased by 10.6% and 11.8%. Although interaction forces of both groups except the thighs showed no differences, EMG signals from gluteus medius of the pelvis-on group increased by 88.6% during stance phase. In addition, EMG signals of biceps femoris, gastrocnemius medial, and gastrocnemius lateral of the pelvis-on group increased whereas EMG signals of the pelvis-off group except gastrocnemius lateral showed no difference after gait trainings. Conclusion Gait training using a robotic gait training system with pelvic movements was conducted to investigate the effects of lateral and rotational pelvic movements in gait training of stroke patients. The pelvic movements affected to increase voluntary muscle activation during the stance phase as well as cadence and walking speed. Clinical trial registration KCT0003762, 2018-1254, Registered 28 October 2018, https://cris.nih.go.kr/cris/search/search_result_st01_kren.jsp?seq=14310&ltype=&rtype=

scholarly journals Effect of Functional Electrical Stimulation of the Gluteus Medius during Gait in Patients following a Stroke

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Sota Araki ◽  
Masayuki Kawada ◽  
Takasuke Miyazaki ◽  
Yuki Nakai ◽  
Yasufumi Takeshita ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Lower Limb ◽  
Stride Length ◽  
Gluteus Medius ◽  
Gait Velocity ◽  
Inertial Measurement Units ◽  
Stroke Patients ◽  
Inertial Measurement ◽  
Motion Range ◽  
Measurement Units

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.

Ankle–foot orthosis with dorsiflexion resistance using spring-cam mechanism increases knee flexion in the swing phase during walking in stroke patients with hemiplegia

2020 ◽  
Vol 81 ◽  
pp. 27-32 ◽  
Author(s):  
Yusuke Sekiguchi ◽  
Dai Owaki ◽  
Keita Honda ◽  
Kenichiro Fukushi ◽  
Noriyoshi Hiroi ◽  
...  
Keyword(s):  
Knee Flexion ◽  
Swing Phase ◽  
Stroke Patients ◽  
Ankle Foot Orthosis ◽  
Cam Mechanism ◽  
Foot Orthosis

Estimation of Gait Independence Using a Tri-Axial Accelerometer in Stroke Patients

2018 ◽  
Vol 26 (1) ◽  
pp. 61-67 ◽  
Author(s):  
Yoshifumi Kijima ◽  
Ryoji Kiyama ◽  
Masaki Sekine ◽  
Toshiyo Tamura ◽  
Toshiro Fujimoto ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Gait Analysis ◽  
Root Mean Square ◽  
Wireless Sensors ◽  
Gait Velocity ◽  
Mean Square ◽  
Key Factors ◽  
Stroke Patients ◽  
Gait Quality ◽  
Healthy Control

The purpose of this study was to clarify whether a gait analysis using an accelerometer could estimate gait independence. Eighty-six stroke patients and 21 healthy control subjects participated in this study. Stroke patients were identified as dependent or independent based on their gait ability. The acceleration of the trunk and bilateral thigh was measured using three wireless sensors during walking. The root mean square, gait regularity, and symmetry were calculated from the acceleration to estimate gait quality. ANCOVA showed that gait regularity of the trunk and bilateral thigh were significantly lowest in the dependent group, regardless of gait velocity. A logistic regression analysis showed that the regularity and root mean square of the anteroposterior acceleration of the unaffected thigh were the key factors for estimating gait independence. This study suggests that an acceleration-based gait analysis facilities gait independence estimation, and is a useful tool during the rehabilitation of stroke patients.

scholarly journals Effect of Kinesio Taping on the Walking Ability of Patients with Foot Drop after Stroke

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Yilan Sheng ◽  
Shifeng Kan ◽  
Zixing Wen ◽  
Wenhua Chen ◽  
Qi Qi ◽  
...  
Keyword(s):  
Stride Length ◽  
Stance Phase ◽  
Swing Phase ◽  
Foot Drop ◽  
Control Group ◽  
Walking Ability ◽  
Timed Up And Go ◽  
Kinesio Taping ◽  
Analysis System ◽  
Experimental Group

Objective. The purpose of this study was to investigate the effect of kinesio taping on the walking ability in patients with foot drop after stroke. Methods. Sixty patients were randomly divided into the experimental group (with kinesio taping) and the control group (without kinesio taping). The 10-Meter Walking Test (10MWT), Timed Up and Go Test (TUGT), stride length, stance phase, swing phase, and foot rotation of the involved side were measured with the German ZEBRIS gait running platform analysis system and were used to evaluate and compare the immediate effects of kinesio taping. All the measurements were made in duplicate for each patient. Results. The demographic variables of patients in both groups were comparable before the treatment (p>0.05). After kinesio taping treatment, significant improvement was found in the 10MWT and the TUGT for patients in the experimental group (p<0.05). There were significant differences in the 10MWT and TUGT between the experimental and control groups after treatment (p<0.05). In terms of gait, we found significant improvement in stride length (p<0.001), stance phase (p<0.001), swing phase (p<0.001), and foot rotation (p<0.001) of the involved side in experimental group after treatment compared with those before treatment. Further, the functional outcomes and gait ability were significantly improved in the experimental group after treatment (p<0.05), compared to the control group. Conclusion. Kinesio taping can immediately improve the walking function of patients with foot drop after stroke.

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 Assessment of hip muscles by surface EMG in gait analysis

2020 ◽  
Vol 14 (2) ◽  
pp. 86-90
Author(s):  
Menekşe Karahan ◽  
Bülent Sabri Cığalı
Keyword(s):  
Gait Analysis ◽  
Gluteus Maximus ◽  
Rectus Femoris ◽  
Surface Emg ◽  
Swing Phase ◽  
The Body ◽  
Spatiotemporal Parameters ◽  
Gluteus Maximus Muscle ◽  
Single Limb Support ◽  
Rectus Femoris Muscle

Objectives: The rectus femoris muscle flexes the thigh, while the gluteus maximus muscle extends it. Understanding the activations of these two muscles that function in opposition to each other during walking facilitates the interpretation of gait pathologies. The aim of this study was to evaluate the activations of these muscles during walking by using the surface electromyography (EMG) technique. Methods: Twenty female volunteers aged 18–26 years participated in our study. The electrical activation of the rectus femoris and gluteus maximus muscles of the participants was simultaneously evaluated by gait analysis. At the same time, spatiotemporal parameters and phase parameters were obtained. Results: The activation pattern of both muscles was found to be similar. Both muscles reached the highest activation in the swing phase. The lowest activation was also seen in the pre-swing phase. Both muscles were observed to be active in the loading and single-limb support phases. Conclusion: The fact that these two antagonists muscles are active at the same time suggests that one is functioning concentrically, while the other eccentrically. Thus, stabilization of hip joint is provided when the body moves forward.

scholarly journals Acute Effect of Robotic Therapy (G-EO System™) on the Lower Limb Temperature Distribution of a Patient with Stroke Sequelae

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Fábio Marcon Alfieri ◽  
Caren da Silva Dias ◽  
Artur Cesar Aquino dos Santos ◽  
Linamara Rizzo Battistella
Keyword(s):  
Hemorrhagic Stroke ◽  
Gait Training ◽  
Acute Effect ◽  
Rehabilitation Program ◽  
The Body ◽  
Infrared Sensor ◽  
Stroke Patients ◽  
Robotic Therapy ◽  
Rehabilitation Programs ◽  
Robotic Devices

Robotic therapy has been gaining prominence in poststroke rehabilitation programs. An example of these devices is the G-EO System™, which simulates gait as well as other more complexes standards of gait such as the steps on stairs. However, to the best of our knowledge, there are no studies that apply thermography as a tool to evaluate stroke patients who undertook rehabilitation programs with the aid of robotic devices. The patient IWPS undergoes sequelae of hemorrhagic stroke for 19 months and consequently hemiplegia, had scores of 93 points in the Fugl-Meyer scale, is undertaking a physical rehabilitation program for six months, has no complaints of discomfort due to thermic sensitivity imbalances between the plegic and the contralateral sides, and voluntarily reports that he realizes functionality improvements especially, according to his perception, due to the aid of the robotic therapy in his gait training with the G-EO System™. The thermographic images were captured by an infrared sensor FLIR T650SC. By analyzing the temperature differences between both hemispheres of the body, before, immediately after, and 30 minutes after a robotic therapy for gait training, we observed that the values firstly increased immediately after the training, but after the 30-minute rest an important thermoregulation was achieved.

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