Kelley Kempski1, Louis N Awad2, Thomas S Buchanan3, Jill S Higginson3, Brian A Knarr4. 1. Department of Biomedical Engineering, University of Delaware, Newark, DE, United States. 2. Department of Physical Therapy & Athletic Training, Boston University, Boston, MA, United States; Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, United States. 3. Department of Biomedical Engineering, University of Delaware, Newark, DE, United States; Department of Mechanical Engineering, University of Delaware, Newark, DE, United States. 4. Department of Biomechanics, University of Nebraska at Omaha, Omaha, NE, United States. Electronic address: bknarr@unomaha.edu.
Abstract
BACKGROUND: Variability in joint kinematics is necessary for adaptability and response to everyday perturbations; however, intrinsic neuromotor changes secondary to stroke often cause abnormal movement patterns. How these abnormal movement patterns relate to joint kinematic variability and its influence on post-stroke walking impairments is not well understood. OBJECTIVE: The purpose of this study was to evaluate the movement variability at the individual joint level in the paretic and non-paretic limbs of individuals post-stroke. METHODS: Seven individuals with hemiparesis post-stroke walked on a treadmill for two minutes at their self-selected speed and the average speed of the six-minute walk test while kinematics were recorded using motion-capture. Variability in hip, knee, and ankle flexion/extension angles during walking were quantified with the Lyapunov exponent (LyE). Interlimb differences were evaluated. RESULTS: The paretic side LyE was higher than the non-paretic side at both self-selected speed (Hip: 50%; Knee: 74%), and the average speed of the 6-min walk test (Hip: 15%; Knee: 93%). CONCLUSION: Differences in joint kinematic variability between limbs of persons post-stroke supports further study of the source of non-paretic limb deviations as well as the clinical implications of joint kinematic variability in persons post-stroke. The development of bilaterally-targeted post-stroke gait interventions to address variability in both limbs may promote improved outcomes.
BACKGROUND: Variability in joint kinematics is necessary for adaptability and response to everyday perturbations; however, intrinsic neuromotor changes secondary to stroke often cause abnormal movement patterns. How these abnormal movement patterns relate to joint kinematic variability and its influence on post-stroke walking impairments is not well understood. OBJECTIVE: The purpose of this study was to evaluate the movement variability at the individual joint level in the paretic and non-paretic limbs of individuals post-stroke. METHODS: Seven individuals with hemiparesis post-stroke walked on a treadmill for two minutes at their self-selected speed and the average speed of the six-minute walk test while kinematics were recorded using motion-capture. Variability in hip, knee, and ankle flexion/extension angles during walking were quantified with the Lyapunov exponent (LyE). Interlimb differences were evaluated. RESULTS: The paretic side LyE was higher than the non-paretic side at both self-selected speed (Hip: 50%; Knee: 74%), and the average speed of the 6-min walk test (Hip: 15%; Knee: 93%). CONCLUSION: Differences in joint kinematic variability between limbs of persons post-stroke supports further study of the source of non-paretic limb deviations as well as the clinical implications of joint kinematic variability in persons post-stroke. The development of bilaterally-targeted post-stroke gait interventions to address variability in both limbs may promote improved outcomes.
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