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Main Library
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Foot placement control and gait instability among people with stroke.
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- Author(s): Dean, Jesse C.; Kautz, Steven A.
- Source:
Journal of Rehabilitation Research & Development. 2015, Vol. 52 Issue 5, p577-590. 14p. 2 Diagrams, 2 Charts, 2 Graphs. - Source:
- Additional Information
- Subject Terms: RISK factors of falling down; ANALYSIS of variance; BIOMECHANICS; DIAGNOSIS; ELECTROMYOGRAPHY; FOOT; GAIT disorders; GAIT in humans; HEMIPLEGIA; MOTOR ability; PSYCHOLOGY of movement; MULTIVARIATE analysis; NEUROLOGICAL disorders; PROBABILITY theory; RESEARCH funding; RISK assessment; STATISTICS; STROKE; DATA analysis; MULTIPLE regression analysis; QUANTITATIVE research; CASE-control method; MOTION capture (Human mechanics); SKELETAL muscle; STROKE patients; DESCRIPTIVE statistics; DISEASE complications; INNERVATION
- Abstract: Gait instability is a common problem following stroke, as evidenced by increases in fall risk and fear of falling. However, the mechanism underlying gait instability is currently unclear. We recently found that young, healthy humans use a consistent gait stabilization strategy of actively controlling their mediolateral foot placement based on the concurrent mechanical state of the stance limb. In the present work, we tested whether people with stroke (n = 16) and age-matched controls (n = 19) used this neuromechanical strategy. Specifically, we used multiple linear regressions to test whether (1) swing phase gluteus medius (GM) activity was influenced by the simultaneous state of the stance limb and (2) mediolat-eral foot placement location was influenced by swing phase GM activity and the mechanical state of the swing limb at the start of the step. We found that both age-matched controls and people with stroke classified as having a low fall risk (Dynamic Gait Index [DGI] score >19) essentially used the stabilization strategy previously described in young controls. In contrast, this strategy was disrupted for people with stroke classified as higher fall risk (DGI
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