Deficits in Motor Response to Avoid Sudden Obstacles During Gait in Functional Walkers Poststroke
- 16 October 2012
- journal article
- research article
- Published by SAGE Publications in Neurorehabilitation and Neural Repair
- Vol. 27 (3), 230-239
- https://doi.org/10.1177/1545968312462070
Abstract
Background. Safe community ambulation requires the capacity to adapt gait to environmental changes on short notice. Reduced adaptability may contribute to an increased risk for falls. Objective. This study investigated gait adaptability in community-dwelling persons poststroke and sought to understand some of the mechanisms of reduced adaptability. Methods. Participants were 25 poststroke persons (Functional Ambulation Categories score 5) and 25 healthy controls of similar age. During treadmill walking, 30 obstacles were suddenly dropped in front of the affected leg or left leg of controls. The participants had to avoid the obstacle by either lengthening or shortening the ongoing stride. The obstacle avoidance success rates were determined. Electromyography activity of bilateral biceps femoris, rectus femoris, tibialis anterior, and gastrocnemius medialis muscles was recorded as well as concomitant knee and hip angle courses and spatial characteristics of the avoiding stride. Results. Poststroke persons demonstrated markedly decreased obstacle avoidance success rates, most prominently under time pressure. They showed normal avoidance strategies but had delayed and reduced electromyography responses, smaller joint angle deviations from unperturbed walking, and smaller horizontal margins from the foot to the obstacle. Conclusions. Even in persons who were only mildly affected by stroke, gait adaptability may be reduced, which may place them at risk of falling. Delayed and decreased muscle responses were identified as one possible mechanism with diminished ability to adapt the length of the avoiding stride. Rehabilitation interventions could focus on these impairments.Keywords
This publication has 31 references indexed in Scilit:
- Disparity Between Functional Recovery and Daily Use of the Upper and Lower Extremities During Subacute Stroke RehabilitationNeurorehabilitation and Neural Repair, 2011
- Braking and propulsive impulses increase with speed during accelerated and decelerated walkingGait & Posture, 2011
- Is transcutaneous peroneal stimulation beneficial to patients with chronic stroke using an ankle-foot orthosis? A within-subjects study of patients’ satisfaction, walking speed and physical activity levelJournal of Rehabilitation Medicine, 2010
- Deficits Underlying Impaired Visually Triggered Step Adjustments in Mildly Affected Stroke PatientsNeurorehabilitation and Neural Repair, 2009
- Hemiparetic Stepping to the Beat: Asymmetric Response to Metronome Phase Shift During Treadmill GaitNeurorehabilitation and Neural Repair, 2009
- Rhythm Perturbations in Acoustically Paced Treadmill Walking After StrokeNeurorehabilitation and Neural Repair, 2009
- The effects of an auditory startle on obstacle avoidance during walkingThe Journal of Physiology, 2008
- A Five-Week Exercise Program Can Reduce Falls and Improve Obstacle Avoidance in the ElderlyGerontology, 2006
- Visual control of locomotion: Strategies for changing direction and for going over obstacles.Journal of Experimental Psychology: Human Perception and Performance, 1991
- Mobility after stroke: Reliability of measures of impairment and disabilityInternational Disability Studies, 1990