scholarly journals The Relationship Between the Forward Displacement of the Center of Pressure and the Weight Bearing Capacity of the Paretic Limb during Sit-to-Stand in Stroke Patients

2014 ◽  
Vol 29 (2) ◽  
pp. 161-164
Author(s):  
Tatsuya KUSUNOKI ◽  
Ryoji KIYAMA ◽  
Yuichi KOMINATO ◽  
Toshiki HIYOSHI
Keyword(s):  
Bearing Capacity ◽  
Center Of Pressure ◽  
Weight Bearing ◽  
Stroke Patients ◽  
Forward Displacement ◽  
Sit To Stand ◽  
Paretic Limb ◽  
The Relationship

scholarly journals Body Weight Bearing on the Paretic Leg in Sit to Stand Movement of Stroke Patients

2006 ◽  
Vol 21 (2) ◽  
pp. 115-120
Author(s):  
Mutsumi UESUGI ◽  
Sumikazu AKIYAMA
Keyword(s):  
Body Weight ◽  
Weight Bearing ◽  
Stroke Patients ◽  
Sit To Stand

scholarly journals Biomechanical Control of Paretic Lower Limb During Imposed Weight Transfer in Individuals Post-Stroke

2020 ◽  
Author(s):  
Hao-Yuan Hsiao ◽  
Vicki L Gray ◽  
James Borrelli ◽  
Mark W Rogers
Keyword(s):  
Lower Limb ◽  
Center Of Pressure ◽  
Weight Bearing ◽  
Center Of Mass ◽  
Step Test ◽  
Control Group ◽  
Post Stroke ◽  
Paretic Limb ◽  
Four Square ◽  
Weight Transfer

Abstract Background: stroke is a leading cause of disability with associated hemiparesis resulting in difficulty bearing and transferring weight on to the paretic limb. Difficulties in weight bearing and weight transfer may result in impaired mobility and balance, increased fall risk, and decreased community engagement. Despite considerable efforts aimed at improving weight transfer after stroke, impairments in its neuromotor and biomechanical control remain poorly understood. In the present study, a novel experimental paradigm was used to characterize differences in weight transfer biomechanics in individuals with chronic stroke versus able-bodied controls. Methods: fifteen participants with stroke and fifteen age-matched able-bodied controls participated in the study. Participants stood with one foot on each of two custom built platforms. One of the platforms dropped 4.3 cm vertically to induce lateral weight transfer and weight bearing. Paretic lower extremity joint kinematics, vertical ground reaction forces, and center of pressure velocity were measured. All participants completed the clinical Step Test and Four-Square Step Test. Results: reduced paretic ankle, knee, and hip joint angular displacement and velocity, delayed ankle and knee inter-joint timing, and altered center of pressure (COP) and center of mass control were exhibited in the stroke group compared to the control group. In addition, paretic COP velocity stabilization time during induced weight transfer predicted Four-Square Step Test scores in individuals post-stroke. Conclusions: the induced weight transfer approach identified stroke-related abnormalities in the control of weight transfer towards the paretic limb side compared to controls. Decreased joint flexion of the paretic ankle and knee, altered inter-joint timing, and altered COP and center of mass control appear to limit rapid lower limb loading ability. Future work will investigate the potential of improving functional weight transfer through induced weight transfer training exercise.

Lateral Trunk Displacement and Stability During Sit-to-Stand Transfer in Relation to Foot Placement in Patients With Hemiparesis

2008 ◽  
Vol 22 (6) ◽  
pp. 715-722 ◽  
Author(s):  
Cyril Duclos ◽  
Sylvie Nadeau ◽  
Julie Lecours
Keyword(s):  
Center Of Pressure ◽  
Weight Bearing ◽  
Stability Index ◽  
Lateral Stability ◽  
Motor Impairments ◽  
Foot Placement ◽  
Sit To Stand ◽  
Trunk Kinematics ◽  
Lateral Displacements ◽  
The Stability

Background. In hemiparetic individuals, sit-to-stand (STS) transfer is characterized by asymmetric weight-bearing and altered trunk kinematics that can be improved by positioning the affected foot behind the nonaffected one. Objective. To examine the influence of frontal trunk kinematics on medio-lateral displacements of the center of pressure (CP) during STS performed with the feet placed in 2 different positions, as well as relationships between these parameters, medio-lateral stability, and clinical scores of the participants. Methods. Eighteen patients with chronic stroke and 15 control individuals were evaluated during sit-to-stand transfers either in spontaneous foot position or with their affected or dominant foot placed behind, respectively. Medio-lateral CP, pelvis, and shoulder displacement were analyzed using 3D kinematic and kinetic data recordings of the whole task. Motor and sensory impairment, spasticity, muscle strength, and equilibrium were evaluated by standard scales. The possible time during which a participant could prevent a fall (minimal time-to-contact) was used as a stability index. Results. Spontaneously, the deviation of the CP of stroke participants paralleled the tilt of the trunk toward the nonaffected side, as early as the first third of the task. With the affected foot placed behind, trunk position did not differ from those of control participants who executed the transfer spontaneously. Hemiparetic participants were less stable than control participants. Placement of the feet had no significant effect on the stability of either group. Stability was strongly associated with better motor scores on the Chedoke-McMaster Stroke Assessment. Conclusions. In hemiparetic individuals, improving STS symmetry by positioning the affected foot behind the nonaffected one did not decrease medio-lateral stability, which was associated with the level of stroke-related motor impairments.

scholarly journals Biomechanical Control of Paretic Lower Limb During Imposed Weight Transfer in Individuals Post-Stroke

2020 ◽  
Author(s):  
Hao-Yuan Hsiao ◽  
Vicki L Gray ◽  
James Borrelli ◽  
Mark W Rogers
Keyword(s):  
Lower Extremity ◽  
Center Of Pressure ◽  
Weight Bearing ◽  
Neuromuscular Control ◽  
Step Test ◽  
Stabilization Time ◽  
Post Stroke ◽  
Paretic Limb ◽  
Four Square ◽  
Weight Transfer

Abstract Background: stroke is a leading cause of disability with associated hemiparesis resulting in difficulty bearing and transferring weight on to the paretic limb. Difficulties in weight bearing and weight transfer may result in impaired mobility and balance, increased fall risk, and decreased community engagement. Despite considerable efforts aimed at improving weight transfer after stroke, impairments in its neuromotor and biomechanical control remain poorly understood. In the present study, a novel experimental paradigm was used to characterize differences in weight transfer biomechanics in individuals with chronic stroke versus able-bodied controls. Methods: fifteen participants with stroke and fifteen age-matched able-bodied controls participated in the study. Participants stood with one foot on each of two custom built platforms. One of the platforms dropped 4.3 cm vertically to induce lateral weight transfer and weight bearing. Trials involving a drop of the platform beneath the paretic lower extremity (non-dominant limb for control) were included in the analyses. Paretic lower extremity joint kinematics, vertical ground reaction forces, and center of pressure velocity were measured. All participants completed the clinical Step Test and Four-Square Step Test. Results: reduced paretic ankle, knee, and hip joint angular displacement and velocity, delayed ankle and knee inter-joint timing, increased downward displacement of center of mass, and increased center of pressure (COP) velocity stabilization time were exhibited in the stroke group compared to the control group. In addition, paretic COP velocity stabilization time during induced weight transfer predicted Four-Square Step Test scores in individuals post-stroke. Conclusions: the induced weight transfer approach identified stroke-related abnormalities in the control of weight transfer towards the paretic limb side compared to controls. Decreased joint flexion of the paretic ankle and knee, altered inter-joint timing, and increased COP stabilization times may reflect difficulties in neuromuscular control during weight transfer following stroke. Future work will investigate the potential of improving functional weight transfer through induced weight transfer training exercise.

scholarly journals Biomechanical control of paretic lower limb during imposed weight transfer in individuals post-stroke

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Hao-Yuan Hsiao ◽  
Vicki L. Gray ◽  
James Borrelli ◽  
Mark W. Rogers
Keyword(s):  
Lower Extremity ◽  
Center Of Pressure ◽  
Weight Bearing ◽  
Neuromuscular Control ◽  
Step Test ◽  
Stabilization Time ◽  
Post Stroke ◽  
Paretic Limb ◽  
Four Square ◽  
Weight Transfer

Abstract Background Stroke is a leading cause of disability with associated hemiparesis resulting in difficulty bearing and transferring weight on to the paretic limb. Difficulties in weight bearing and weight transfer may result in impaired mobility and balance, increased fall risk, and decreased community engagement. Despite considerable efforts aimed at improving weight transfer after stroke, impairments in its neuromotor and biomechanical control remain poorly understood. In the present study, a novel experimental paradigm was used to characterize differences in weight transfer biomechanics in individuals with chronic stroke versus able-bodied controls Methods Fifteen participants with stroke and fifteen age-matched able-bodied controls participated in the study. Participants stood with one foot on each of two custom built platforms. One of the platforms dropped 4.3 cm vertically to induce lateral weight transfer and weight bearing. Trials involving a drop of the platform beneath the paretic lower extremity (non-dominant limb for control) were included in the analyses. Paretic lower extremity joint kinematics, vertical ground reaction forces, and center of pressure velocity were measured. All participants completed the clinical Step Test and Four-Square Step Test. Results Reduced paretic ankle, knee, and hip joint angular displacement and velocity, delayed ankle and knee inter-joint timing, increased downward displacement of center of mass, and increased center of pressure (COP) velocity stabilization time were exhibited in the stroke group compared to the control group. In addition, paretic COP velocity stabilization time during induced weight transfer predicted Four-Square Step Test scores in individuals post-stroke. Conclusions The induced weight transfer approach identified stroke-related abnormalities in the control of weight transfer towards the paretic limb side compared to controls. Decreased joint flexion of the paretic ankle and knee, altered inter-joint timing, and increased COP stabilization times may reflect difficulties in neuromuscular control during weight transfer following stroke. Future work will investigate the potential of improving functional weight transfer through induced weight transfer training exercise.

Pre-Admission CHADS2 and CHA2DS2-VASc Scores on Early Neurological Worsening

2021 ◽  
pp. 1-8
Author(s):  
Ki-Woong Nam ◽  
Chi Kyung Kim ◽  
Sungwook Yu ◽  
Jong-Won Chung ◽  
Oh Young Bang ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Stroke Risk ◽  
Multivariable Analysis ◽  
National Institutes Of Health ◽  
Risk Scores ◽  
Stroke Patients ◽  
Nihss Score ◽  
Early Neurological Deterioration ◽  
Close Relationship ◽  
The Relationship

<b><i>Background:</i></b> Stroke risk scores (CHADS<sub>2</sub> and CHA<sub>2</sub>DS<sub>2</sub>-VASc) not only predict the risk of stroke in atrial fibrillation (AF) patients, but have also been associated with prognosis after stroke. <b><i>Objective:</i></b> The aim of this study was to evaluate the relationship between stroke risk scores and early neurological deterioration (END) in ischemic stroke patients with AF. <b><i>Methods:</i></b> We included consecutive ischemic stroke patients with AF admitted between January 2013 and December 2015. CHADS<sub>2</sub> and CHA<sub>2</sub>DS<sub>2</sub>-VASc scores were calculated using the established scoring system. END was defined as an increase ≥2 on the total National Institutes of Health Stroke Scale (NIHSS) score or ≥1 on the motor NIHSS score within the first 72 h of admission. <b><i>Results:</i></b> A total of 2,099 ischemic stroke patients with AF were included. In multivariable analysis, CHA<sub>2</sub>DS<sub>2</sub>-VASc score (adjusted odds ratio [aOR] = 1.17, 95% confidence interval [CI] = 1.04–1.31) was significantly associated with END after adjusting for confounders. Initial NIHSS score, use of anticoagulants, and intracranial atherosclerosis (ICAS) were also found to be closely associated with END, independent of the CHA<sub>2</sub>DS<sub>2</sub>-VASc score. Multivariable analysis stratified by the presence of ICAS demonstrated that both CHA<sub>2</sub>DS<sub>2</sub>-VASc (aOR = 1.20, 95% CI = 1.04–1.38) and CHADS<sub>2</sub> scores (aOR = 1.24, 95% CI = 1.01–1.52) were closely related to END in only patients with ICAS. In patients without ICAS, neither of the risk scores were associated with END. <b><i>Conclusions:</i></b> High CHA<sub>2</sub>DS<sub>2</sub>-VASc score was associated with END in ischemic stroke patients with AF. This close relationship is more pronounced in patients with ICAS.

scholarly journals Postural Control Disturbances Induced by Virtual Reality in Stroke Patients

2021 ◽  
Vol 11 (4) ◽  
pp. 1510
Author(s):  
Charles Morizio ◽  
Maxime Billot ◽  
Jean-Christophe Daviet ◽  
Stéphane Baudry ◽  
Christophe Barbanchon ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Postural Control ◽  
Virtual Environments ◽  
Center Of Pressure ◽  
Dynamic Condition ◽  
Static Condition ◽  
Stroke Patients ◽  
Post Stroke ◽  
Subacute Stroke

People who survive a stroke are often left with long-term neurologic deficits that induce, among other impairments, balance disorders. While virtual reality (VR) is growing in popularity for postural control rehabilitation in post-stroke patients, studies on the effect of challenging virtual environments, simulating common daily situations on postural control in post-stroke patients, are scarce. This study is a first step to document the postural response of stroke patients to different challenging virtual environments. Five subacute stroke patients and fifteen age-matched healthy adults were included. All participants underwent posturographic tests in control conditions (open and closed eyes) and virtual environment without (one static condition) and with avatars (four dynamic conditions) using a head-mounted device for VR. In dynamic environments, we modulated the density of the virtual crowd (dense and light crowd) and the avoidance space with the avatars (near or far). Center of pressure velocity was collected by trial throughout randomized 30-s periods. Results showed that more challenging conditions (dynamic condition) induced greater postural disturbances in stroke patients than in healthy counterparts. Our study suggests that virtual reality environments should be adjusted in light of obtaining more or less challenging conditions.

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