OBJECTIVE: To examine the effect of a light touch cue provided through a cane on mediolateral (ML) pelvic stability during walking in subjects poststroke. DESIGN: Crossover trial examining ML pelvic stability during walking using a cane with the force contact and touch contact methods. SETTING: Physical therapy clinic, tertiary care center. PARTICIPANTS: Subacute patients (N=40) with stroke with a mean age of 59.6 years and mean stroke duration of 46.8 days. The average gait speed with a cane was .13 m/s (.05-.29 m/s). INTERVENTION: Using a cane with the force contact and touch contact methods during walking. MAIN OUTCOME MEASURES: ML pelvic stability as measured by averaged peak-to-peak pelvic acceleration, muscle activation of bilateral tensor fascia latae (TFL), semitendinosus (ST), and vastus medialis (VM) using an electromyography system, and vertical cane force. RESULTS: The average amount of cane force during touch contact and force contact cane use conditions was 2.3N and 49.3N, respectively. A light touch cue through a cane was required only when the paretic leg accepted the body weight, and this cue can provide ML pelvic stability (.16 g of average pelvic acceleration) during walking to the same degree as the force contact method of cane use. However, significant increases in single-limb support duration with higher activations of TFL, VM, and ST muscles on the paretic leg were found during the paretic stance phase when using a cane in the touch contact fashion (P<.05). CONCLUSIONS: A light touch cue can be provided during walking through the use of a cane. This augmented somatosensory information provides lateral stability during walking for subjects with stroke by facilitating the activations of weight-bearing muscles on the paretic leg during the stance phase.
RCT Entities:
OBJECTIVE: To examine the effect of a light touch cue provided through a cane on mediolateral (ML) pelvic stability during walking in subjects poststroke. DESIGN: Crossover trial examining ML pelvic stability during walking using a cane with the force contact and touch contact methods. SETTING: Physical therapy clinic, tertiary care center. PARTICIPANTS: Subacute patients (N=40) with stroke with a mean age of 59.6 years and mean stroke duration of 46.8 days. The average gait speed with a cane was .13 m/s (.05-.29 m/s). INTERVENTION: Using a cane with the force contact and touch contact methods during walking. MAIN OUTCOME MEASURES: ML pelvic stability as measured by averaged peak-to-peak pelvic acceleration, muscle activation of bilateral tensor fascia latae (TFL), semitendinosus (ST), and vastus medialis (VM) using an electromyography system, and vertical cane force. RESULTS: The average amount of cane force during touch contact and force contact cane use conditions was 2.3N and 49.3N, respectively. A light touch cue through a cane was required only when the paretic leg accepted the body weight, and this cue can provide ML pelvic stability (.16 g of average pelvic acceleration) during walking to the same degree as the force contact method of cane use. However, significant increases in single-limb support duration with higher activations of TFL, VM, and ST muscles on the paretic leg were found during the paretic stance phase when using a cane in the touch contact fashion (P<.05). CONCLUSIONS: A light touch cue can be provided during walking through the use of a cane. This augmented somatosensory information provides lateral stability during walking for subjects with stroke by facilitating the activations of weight-bearing muscles on the paretic leg during the stance phase.
Authors: Thitimard Winairuk; Marco Y C Pang; Vitoon Saengsirisuwan; Fay B Horak; Rumpa Boonsinsukh Journal: J Rehabil Med Date: 2019-10-04 Impact factor: 2.912
Authors: T IJmker; C J Lamoth; H Houdijk; M Tolsma; L H V van der Woude; A Daffertshofer; P J Beek Journal: J Neuroeng Rehabil Date: 2015-08-23 Impact factor: 4.262