Karen J Nolan1, Mathew Yarossi2, Patrick Mclaughlin3. 1. Human Performance and Engineering Research, Kessler Foundation, West Orange, NJ, USA; Department of Physical Medicine and Rehabilitation, Rutgers - New Jersey Medical School, Newark, NJ, USA. Electronic address: knolan@kesslerfoundation.org. 2. Human Performance and Engineering Research, Kessler Foundation, West Orange, NJ, USA; Graduate School of Biomedical Sciences, Rutgers - New Jersey Medical School, Newark, NJ, USA. 3. College of Health and Biomedicine/ISEAL, Victoria University, Melbourne, Australia.
Abstract
BACKGROUND: Center of pressure measured during gait can provide information about underlying control mechanisms and the efficacy of a foot drop stimulator. This investigation evaluated changes in center of pressure displacement in individuals with stroke with and without a foot drop stimulator. METHODS: Individuals with stroke-related foot drop (n=11) using a foot drop stimulator and healthy controls (n=11). Walking speed and bilateral center of pressure variables: 1) net displacement; 2) position and maximum displacement; and 3) mean velocity during walking. FINDINGS: On the affected limb with the foot drop stimulator as compared to the affected limb without the foot drop stimulator: 1) increased anterior/posterior maximum center of pressure excursion 8% during stance; 2) center of pressure at initial contact was 6% more posterior; 3) medial/lateral mean, maximum and minimum center of pressure position during stance all significantly decreased; 4) anterior/posterior net displacement increased during stance and single support; and 5) anterior/posterior velocity of the center of pressure increased during stance. INTERPRETATION: Individuals with stroke using a foot drop stimulator contacted the ground more posterior at initial contact and utilized more of the anterior/posterior plantar surface of the foot on the affected limb during stance. With the foot drop stimulator there was a shift in center of pressure toward the medial side possibly indicating an improvement in equinovarus gait where there is a tendency to load the lateral foot throughout stance. For individuals with stroke a foot drop stimulator can improve displacement of the center of pressure which indicates improved forward progression and stability during walking.
BACKGROUND: Center of pressure measured during gait can provide information about underlying control mechanisms and the efficacy of a foot drop stimulator. This investigation evaluated changes in center of pressure displacement in individuals with stroke with and without a foot drop stimulator. METHODS: Individuals with stroke-related foot drop (n=11) using a foot drop stimulator and healthy controls (n=11). Walking speed and bilateral center of pressure variables: 1) net displacement; 2) position and maximum displacement; and 3) mean velocity during walking. FINDINGS: On the affected limb with the foot drop stimulator as compared to the affected limb without the foot drop stimulator: 1) increased anterior/posterior maximum center of pressure excursion 8% during stance; 2) center of pressure at initial contact was 6% more posterior; 3) medial/lateral mean, maximum and minimum center of pressure position during stance all significantly decreased; 4) anterior/posterior net displacement increased during stance and single support; and 5) anterior/posterior velocity of the center of pressure increased during stance. INTERPRETATION: Individuals with stroke using a foot drop stimulator contacted the ground more posterior at initial contact and utilized more of the anterior/posterior plantar surface of the foot on the affected limb during stance. With the foot drop stimulator there was a shift in center of pressure toward the medial side possibly indicating an improvement in equinovarus gait where there is a tendency to load the lateral foot throughout stance. For individuals with stroke a foot drop stimulator can improve displacement of the center of pressure which indicates improved forward progression and stability during walking.
Authors: Robin L Webb; Erin E Kaiser; Brian J Jurgielewicz; Samantha Spellicy; Shelley L Scoville; Tyler A Thompson; Raymond L Swetenburg; David C Hess; Franklin D West; Steven L Stice Journal: Stroke Date: 2018-04-12 Impact factor: 7.914