OBJECTIVE: To investigate the determinants of limb preference for initiating compensatory stepping poststroke. DESIGN: Retrospective chart review. SETTING: Inpatient rehabilitation. PARTICIPANTS: Convenience sample of individuals admitted to inpatient rehabilitation with poststroke hemiparesis. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Compensatory stepping responses were evoked using a lean-and-release postural perturbation. The limb used to initiate compensatory stepping was determined. The relationships between stepping with the paretic limb and premorbid limb dominance, weight bearing on the paretic limb in quiet standing, ability to bear weight on the paretic limb, preperturbation weight bearing on the paretic limb, and lower-limb motor recovery scores were determined. RESULTS: The majority (59.1%) of responses were steps initiated with the nonparetic limb. Increased lower-limb motor recovery scores and preperturbation weight bearing on the nonparetic limb were significantly related to increased frequency of stepping with the paretic limb. When the preferred limb was physically blocked, an inappropriate response was initiated in 21% of trials (ie, nonstep responses or an attempt to step with the blocked limb). CONCLUSIONS: This study reveals the challenges that individuals with poststroke hemiparesis face when executing compensatory stepping responses to prevent a fall after a postural perturbation. The inability or challenges to executing a compensatory step with the paretic limb may increase the risk for falls poststroke.
OBJECTIVE: To investigate the determinants of limb preference for initiating compensatory stepping poststroke. DESIGN: Retrospective chart review. SETTING: Inpatient rehabilitation. PARTICIPANTS: Convenience sample of individuals admitted to inpatient rehabilitation with poststroke hemiparesis. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Compensatory stepping responses were evoked using a lean-and-release postural perturbation. The limb used to initiate compensatory stepping was determined. The relationships between stepping with the paretic limb and premorbid limb dominance, weight bearing on the paretic limb in quiet standing, ability to bear weight on the paretic limb, preperturbation weight bearing on the paretic limb, and lower-limb motor recovery scores were determined. RESULTS: The majority (59.1%) of responses were steps initiated with the nonparetic limb. Increased lower-limb motor recovery scores and preperturbation weight bearing on the nonparetic limb were significantly related to increased frequency of stepping with the paretic limb. When the preferred limb was physically blocked, an inappropriate response was initiated in 21% of trials (ie, nonstep responses or an attempt to step with the blocked limb). CONCLUSIONS: This study reveals the challenges that individuals with poststroke hemiparesis face when executing compensatory stepping responses to prevent a fall after a postural perturbation. The inability or challenges to executing a compensatory step with the paretic limb may increase the risk for falls poststroke.
Authors: David A E Bolton; David M Cole; Blake Butler; Mahmoud Mansour; Garrett Rydalch; Douglas W McDannald; Sarah E Schwartz Journal: Cortex Date: 2019-03-21 Impact factor: 4.027
Authors: Jamie Pigman; Darcy S Reisman; Ryan T Pohlig; John J Jeka; Tamara R Wright; Benjamin C Conner; Drew A Petersen; Jeremy R Crenshaw Journal: Clin Biomech (Bristol, Avon) Date: 2019-07-26 Impact factor: 2.063
Authors: Avril Mansfield; Anthony Aqui; Andrew Centen; Cynthia J Danells; Vincent G DePaul; Svetlana Knorr; Alison Schinkel-Ivy; Dina Brooks; Elizabeth L Inness; William E McIlroy; George Mochizuki Journal: BMC Neurol Date: 2015-06-06 Impact factor: 2.474