Index > Vol. 38/2006 > Iss. 5/September > pp. 287-294 > Abstract
 

KINEMATIC AND KINETIC ASYMMETRIES IN HEMIPLEGIC PATIENTS' GAIT INITIATION PATTERNS

Issue: Volume 38, Issue 5, September 2006

Pages: 287-294

DOI: 10.1080/16501970600694859

Abstract:

Objective: To assess the kinetic and kinematic characteristics of hemiplegic stroke patients' gait initiation patterns during the various gait initiation phases.

Design and subjects: Gait initiation was studied in 3 hemiplegic subjects with a spastic equinus varus foot and 3 control subjects.

Methods: Temporal and kinetic analysis of gait initiation was performed with 2 AMTI® force plates, and kinematic analysis of gait initiation with an ELITE® optoelectronic system. A one-way ANOVA was performed directly on the phase durations, forces, centre of pressure displacements, stride length, and ankle motion range.

Results: Duration of the monopodal phase was shorter in hemiplegic patients when the affected leg rather than the sound one was used as the supporting leg. Propulsion forces were exerted by the hemiplegic patients' sound leg during the postural phase. Hemiplegic patients' body weight was supported more by the sound leg than by the affected leg. Knee was lifted higher on the affected side during the swing phase to compensate for the equinus. Initial contact was performed with a flat foot on the affected side.

Conclusion: Quantitative data obtained on the gait initiation phase suggest that hemiplegic patients develop asymmetrical adaptive posturo-motor strategies to compensate for their impairments.

Authors:

Laurent Bensoussan A1, Serge Mesure A2, Jean-Michel Viton A1, Alain Delarque A1
A1 From the Department of Physical and Rehabilitation Medicine, Faculty of Medicine, University of the Mediterranean, Public Hospital System of Marseilles, University Hospital la Timone, Marseilles, France
A2 Movement and perception, UMR 6152 – Faculty of Sport Science, Marseilles, France

Key words:

hemiplegic, equinus varus foot, gait initiation, kinetic, kinematic

References:

  1. Pélissier, J and Pérennou, D and Laassel, EM. (1997) Lab analysis of gait in hemiplegic adults: review of literature Ann Readapt Med Phys, 40, pp. 297 - 313.
  2. Perennou, D and Benaim, C and Rouget, E and Rousseaux, M and Blard, JM and Pelissier, J. (1999) Postural balance following stroke: towards a disadvantage of the right brain-damaged hemisphere Rev Neurol (Paris), 155, pp. 281 - 290.
  3. Perennou, DA and Amblard, B and Laassel el, M and Benaim, C and Herisson, C and Pelissier, J. (2002) Understanding the pusher behavior of some stroke patients with spatial deficits: a pilot study Arch Phys Med Rehabil, 83, pp. 570 - 575.
    [CrossRef]
  4. Feigin, L and Sharon, B and Czaczkes, B and Rosin, AJ. (1996) Sitting equilibrium 2 weeks after a stroke can predict the walking ability after 6 months Gerontology, 42, pp. 348 - 353.
  5. Viton, JM and Timsit, M and Mesure, S and Massion, J and Franceschi, JP and Delarque, A. (2000) Asymmetry of gait initiation in patients with unilateral knee arthritis Arch Phys Med Rehabil, 81, pp. 194 - 200.
    [CrossRef]
  6. Rogers, MW and Paï, YC. (1990) Dynamic transitions in stance support accompanying leg flexion movements in man Exp Brain Res, 81, pp. 398 - 402.
    [CrossRef] [SpringerLink]
  7. Brenière, Y and Do, MC and Sanchez, J. (1981) A biomechanical study of the gait initiation process J Biophys Med Nucl, 5, pp. 197 - 205.
  8. Brenière, Y and Do, MC and Bouisset, S. (1987) Are dynamic phenomena prior to stepping essential to walking? J Mot Behav, 19, pp. 67 - 76.
  9. Jian, Y and Winter, DA and Ishac, MG and Gilchrist, L. (1993) Trajectory of the body COG and COP during initiation and termination of gait Gait Posture, 1, pp. 9 - 22.
    [CrossRef]
  10. Mann, RA and Hagy, JL and White, V and Liddell, D. (1979) The initiation of gait J Bone Joint Surg Am, 61, pp. 232 - 239.
  11. Massion, J. (1994) Postural control system Curr Opin Neurobiol, 4, pp. 877 - 887.
    [CrossRef]
  12. Winter, DA. (1983) Biomechanical motor patterns in normal walking J Mot Behav, 15, pp. 302 - 330.
  13. Brenière, Y and Do, MC. (1991) Control of gait initiation J Mot Behav, 23, pp. 235 - 240.
  14. Massion, J. (1992) Movement, posture and equilibrium: interaction and coordination Prog Neurobiol, 38, pp. 35 - 56.
    [CrossRef]
  15. Toussaint, HM and Van Barr, CE and Van Langen, PP and De Looze, MP and Van Dieën, JH. (1992) Coordination of the leg muscles in backlift and leglift J Biomech, 25, pp. 1279 - 1289.
    [CrossRef]
  16. Toussaint, HM and Commissaris, DA and Van Dieen, JH and Reijnen, JS and Praet, SFE and Beek, PJ. (1995) Controling the ground reaction force during lifting J Mot Behav, 27, pp. 225 - 234.
  17. Crenna, P and Frigo, C and Giovannini, P and Piccolo, I.(1990) The initiation of gait in Parkinson's disease. In Motor disturbances II. ( pp. 161 - 173 ).