The influence of locomotor training on dynamic balance during steady-state walking post-stroke
| Autor: | Richard R. Neptune, Mark G. Bowden, Steven A. Kautz, Arian Vistamehr |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Steady state (electronics) 0206 medical engineering Biomedical Engineering Biophysics Physical Therapy Sports Therapy and Rehabilitation 02 engineering and technology Kinematics medicine.disease_cause Article Weight-bearing Weight-Bearing 03 medical and health sciences 0302 clinical medicine Physical medicine and rehabilitation Medicine Humans Orthopedics and Sports Medicine Dynamic balance Postural Balance Balance (ability) business.industry Rehabilitation Biomechanics Stroke Rehabilitation Middle Aged 020601 biomedical engineering Gait Biomechanical Phenomena Walking Speed Preferred walking speed Stroke Locomotor training Hemiparesis Coronal plane Female medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | J Biomech |
| Popis: | Slow walking speed and lack of balance control are common impairments post-stroke. While locomotor training often improves walking speed, its influence on dynamic balance is unclear. The goal of this study was to assess the influence of a locomotor training program on dynamic balance in individuals post-stroke during steady-state walking and determine if improvements in walking speed are associated with improved balance control. Kinematic and kinetic data were collected pre- and post-training from seventeen participants who completed a 12-week locomotor training program. Dynamic balance was quantified biomechanically (peak-to-peak range of frontal plane whole-body angular-momentum) and clinically (Berg-Balance-Scale and Dynamic-Gait-Index). To understand the underlying biomechanical mechanisms associated with changes in angular-momentum, foot placement and ground-reaction-forces were quantified. As a group, biomechanical assessments of dynamic balance did not reveal any improvements after locomotor training. However, improved dynamic balance post-training, observed in a sub-group of 10 participants (i.e., Responders), was associated with a narrowed paretic foot placement and higher paretic leg vertical ground-reaction-force impulse during late stance. Dynamic balance was not improved post-training in the remaining seven participants (i.e., Non-responders), who did not alter their foot placement and had an increased reliance on their nonparetic leg during weight-bearing. As a group, increased walking speed was not correlated with improved dynamic balance. However, a higher pre-training walking speed was associated with higher gains in dynamic balance post-training. These findings highlight the importance of the paretic leg weight bearing and mediolateral foot placement in improving frontal plane dynamic balance post-stroke. |
| Databáze: | OpenAIRE |
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