This article and any supplementary material should be cited as follows: Raja B, Neptune RR, Kautz...
-
Upload
elwin-lucas -
Category
Documents
-
view
212 -
download
0
Transcript of This article and any supplementary material should be cited as follows: Raja B, Neptune RR, Kautz...
This article and any supplementary material should be cited as follows: Raja B, Neptune RR, Kautz SA. Quantifiable patterns of limb loading and unloading during hemiparetic gait: Relation to kinetic and kinematic parameters. J Rehabil Res Dev. 2012;49(9):1293–1304. http://dx.doi.org/10.1682/JRRD.2011.02.0018
Slideshow ProjectDOI:10.1682/JRRD.2011.02.0018JSP
Quantifiable patterns of limb loading and unloading during hemiparetic gait: Relation to
kinetic and kinematic parameters
Bhavana Raja, PT, PhD; Richard R. Neptune, PhD;
Steven A. Kautz, PhD
This article and any supplementary material should be cited as follows: Raja B, Neptune RR, Kautz SA. Quantifiable patterns of limb loading and unloading during hemiparetic gait: Relation to kinetic and kinematic parameters. J Rehabil Res Dev. 2012;49(9):1293–1304. http://dx.doi.org/10.1682/JRRD.2011.02.0018
Slideshow ProjectDOI:10.1682/JRRD.2011.02.0018JSP
• Aim– Determine magnitude and duration of asymmetry in limb
loading (LL) and limb unloading (LU) in hemiparesis. – Determine relationship with functional walking status and
specific kinematic and kinetic variables during walking.
• Relevance– Understanding LL and LU asymmetry will provide insight
into changes in poststroke individuals’ locomotion and inspire new walking rehabilitation strategies.
This article and any supplementary material should be cited as follows: Raja B, Neptune RR, Kautz SA. Quantifiable patterns of limb loading and unloading during hemiparetic gait: Relation to kinetic and kinematic parameters. J Rehabil Res Dev. 2012;49(9):1293–1304. http://dx.doi.org/10.1682/JRRD.2011.02.0018
Slideshow ProjectDOI:10.1682/JRRD.2011.02.0018JSP
Method• Participants: – 44 people with chronic hemiparesis and 18 nondisabled
controls.
• Protocol– Participants walked on instrumented split-belt treadmill
without assistive device or ankle foot orthosis for 3 walking trials at self-selected speed.• Controls walked at self-selected speed, 0.3 m/s, and 0.6 m/s.
– 12-camera motion analysis system collected data as subjects walked.
– Variables calculated during double-limb support phases of gait (when LL and LU occur).
This article and any supplementary material should be cited as follows: Raja B, Neptune RR, Kautz SA. Quantifiable patterns of limb loading and unloading during hemiparetic gait: Relation to kinetic and kinematic parameters. J Rehabil Res Dev. 2012;49(9):1293–1304. http://dx.doi.org/10.1682/JRRD.2011.02.0018
Slideshow ProjectDOI:10.1682/JRRD.2011.02.0018JSP
Results• LL Magnitude– At self-selected speeds:• Magnitude less in paretic vs nonparetic leg and controls.
– At matched speeds:• No significant difference between paretic leg and controls
when considering subjects with hemiparesis as single group. • When considered separately, reduced paretic leg LL was
related to functional walking status in hemiparesis group. • Slower individuals had significant differences in LL vs
controls.• Community ambulators not significantly different.
This article and any supplementary material should be cited as follows: Raja B, Neptune RR, Kautz SA. Quantifiable patterns of limb loading and unloading during hemiparetic gait: Relation to kinetic and kinematic parameters. J Rehabil Res Dev. 2012;49(9):1293–1304. http://dx.doi.org/10.1682/JRRD.2011.02.0018
Slideshow ProjectDOI:10.1682/JRRD.2011.02.0018JSP
Results (cont’d.)• LU Magnitude– At self-selected and matched speeds:
• For household and limited community ambulators, significantly lower in paretic vs nonparetic leg and controls
• No significant difference between community ambulators and nonparetic leg and controls.
• LL/LU Timing & Pattern– Household ambulators
• LL time of nonparetic leg significantly less than limited community ambulators and community ambulators.
• LU time greater than limited community ambulators and community ambulators.
This article and any supplementary material should be cited as follows: Raja B, Neptune RR, Kautz SA. Quantifiable patterns of limb loading and unloading during hemiparetic gait: Relation to kinetic and kinematic parameters. J Rehabil Res Dev. 2012;49(9):1293–1304. http://dx.doi.org/10.1682/JRRD.2011.02.0018
Slideshow ProjectDOI:10.1682/JRRD.2011.02.0018JSP
Results (cont’d.)• Mediolateral (M-L) GRF and LL/LU– No significant correlation.
• Knee Angle and LL/LU– No significant correlation.
• M-L Leg Angle and LL/LU– Subjects with reduced paretic leg LL placed paretic leg further
lateral relative to pelvis center of mass. – LL negatively associated with leg angle of paretic side in M-L
direction during 1st double-support phase. – Paretic leg M-L angle significantly greater than nonparetic leg and
controls at matched speeds.
This article and any supplementary material should be cited as follows: Raja B, Neptune RR, Kautz SA. Quantifiable patterns of limb loading and unloading during hemiparetic gait: Relation to kinetic and kinematic parameters. J Rehabil Res Dev. 2012;49(9):1293–1304. http://dx.doi.org/10.1682/JRRD.2011.02.0018
Slideshow ProjectDOI:10.1682/JRRD.2011.02.0018JSP
Conclusion• Paretic LL magnitude was reduced, while duration
was increased vs nonparetic leg and controls walking at matched speeds.
• 3 LL/LU patterns were identified: concave, convex, and linear.
• Results indicate that people with hemiparesis make biomechanical adjustments to maintain a steady walking state. – Characterization of these deviations may inspire new
strategies for rehabilitation.