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Mediolateral footpath stabilization during walking in people following stroke
Community dwelling stroke survivors most often fall while walking. Understanding how post-stroke individuals control mediolateral footpath during walking may help elucidate the mechanisms that contribute to walking instability. By applying the Uncontrolled Manifold (UCM) approach, we investigated (1...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6264822/ https://www.ncbi.nlm.nih.gov/pubmed/30496257 http://dx.doi.org/10.1371/journal.pone.0208120 |
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author | Kao, Pei-Chun Srivastava, Shraddha |
author_facet | Kao, Pei-Chun Srivastava, Shraddha |
author_sort | Kao, Pei-Chun |
collection | PubMed |
description | Community dwelling stroke survivors most often fall while walking. Understanding how post-stroke individuals control mediolateral footpath during walking may help elucidate the mechanisms that contribute to walking instability. By applying the Uncontrolled Manifold (UCM) approach, we investigated (1) how post-stroke individuals coordinate lower-extremity joint motions to stabilize mediolateral footpath of the swing leg, and (2) how the inter-joint coordination in footpath stabilization correlates to their walking stability. Nine stroke subjects and nine healthy controls walked on a treadmill at four different speeds. UCM analysis partitions the variance of kinematic configurations across gait cycles into “good variance” (i.e., the variance component leading to a consistent footpath) or “bad variance” (i.e., the variance component leading to an inconsistent footpath). We found that both groups had a significantly greater “good” than “bad” variance (p<0.05) for most of the swing phase, suggesting that mediolateral footpath is an important variable stabilized by the central nervous system during walking. Stroke subjects had significantly greater relative variance difference (ΔV) (i.e. normalized difference between “good” and “bad” variance) (p<0.05), indicating a stronger kinematic synergy in footpath stabilization, than the controls. In addition, the kinematic synergy in mediolateral footpath stabilization is strongest during mid-swing but weakest during late swing in healthy gait. However, this phase-dependent strategy is preserved for mid-swing but not for late swing in stroke gait. Moreover, stroke and healthy subjects demonstrated different relationships between UCM and walking stability measures. A stronger kinematic synergy in healthy gait is associated with better walking stability whereas having more “good variance” or stronger kinematic synergy in stroke gait is associated with less walking stability. The current findings suggest that walking with too much “good variance” in people following stroke, despite no effect on the footpath, may adversely affect their walking stability to some extent. |
format | Online Article Text |
id | pubmed-6264822 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-62648222018-12-19 Mediolateral footpath stabilization during walking in people following stroke Kao, Pei-Chun Srivastava, Shraddha PLoS One Research Article Community dwelling stroke survivors most often fall while walking. Understanding how post-stroke individuals control mediolateral footpath during walking may help elucidate the mechanisms that contribute to walking instability. By applying the Uncontrolled Manifold (UCM) approach, we investigated (1) how post-stroke individuals coordinate lower-extremity joint motions to stabilize mediolateral footpath of the swing leg, and (2) how the inter-joint coordination in footpath stabilization correlates to their walking stability. Nine stroke subjects and nine healthy controls walked on a treadmill at four different speeds. UCM analysis partitions the variance of kinematic configurations across gait cycles into “good variance” (i.e., the variance component leading to a consistent footpath) or “bad variance” (i.e., the variance component leading to an inconsistent footpath). We found that both groups had a significantly greater “good” than “bad” variance (p<0.05) for most of the swing phase, suggesting that mediolateral footpath is an important variable stabilized by the central nervous system during walking. Stroke subjects had significantly greater relative variance difference (ΔV) (i.e. normalized difference between “good” and “bad” variance) (p<0.05), indicating a stronger kinematic synergy in footpath stabilization, than the controls. In addition, the kinematic synergy in mediolateral footpath stabilization is strongest during mid-swing but weakest during late swing in healthy gait. However, this phase-dependent strategy is preserved for mid-swing but not for late swing in stroke gait. Moreover, stroke and healthy subjects demonstrated different relationships between UCM and walking stability measures. A stronger kinematic synergy in healthy gait is associated with better walking stability whereas having more “good variance” or stronger kinematic synergy in stroke gait is associated with less walking stability. The current findings suggest that walking with too much “good variance” in people following stroke, despite no effect on the footpath, may adversely affect their walking stability to some extent. Public Library of Science 2018-11-29 /pmc/articles/PMC6264822/ /pubmed/30496257 http://dx.doi.org/10.1371/journal.pone.0208120 Text en © 2018 Kao, Srivastava http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Kao, Pei-Chun Srivastava, Shraddha Mediolateral footpath stabilization during walking in people following stroke |
title | Mediolateral footpath stabilization during walking in people following stroke |
title_full | Mediolateral footpath stabilization during walking in people following stroke |
title_fullStr | Mediolateral footpath stabilization during walking in people following stroke |
title_full_unstemmed | Mediolateral footpath stabilization during walking in people following stroke |
title_short | Mediolateral footpath stabilization during walking in people following stroke |
title_sort | mediolateral footpath stabilization during walking in people following stroke |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6264822/ https://www.ncbi.nlm.nih.gov/pubmed/30496257 http://dx.doi.org/10.1371/journal.pone.0208120 |
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