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Article type: Research Article
Authors: Sakuma, Kaorua; * | Tateuchi, Hiroshigeb | Nishishita, Satorub; c; d | Okita, Yusukee | Kitatani, Ryosukeb; d | Koyama, Yumikof | Ibuki, Satokob | Ichihashi, Noriakib
Affiliations: [a] School of Rehabilitation, Hyogo University of Health Sciences, Kobe, Japan | [b] Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto, Japan | [c] Institute of Rehabilitation Science, Tokuyukai Medical Corporation, Toyonaka, Japan | [d] Department of Rehabilitation, Kansai Rehabilitation Hospital, Tokuyukai Medical Corporation, Toyonaka, Japan | [e] Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tokyo, Japan | [f] Department of Tokyo Physical Therapy, Faculty of Medical Science, Teikyo University of Science, Tokyo, Japan
Correspondence: [*] Address for correspondence: Kaoru Sakuma, School of Rehabilitation, Hyogo University of Health Sciences, 1-3-6 Minatojima Chuo-ku Kobe-shi Hyogo 650-8530, Japan. Tel.: +81 78 304 3126; Fax: +81 78 304 2826; E-mail: [email protected].
Abstract: BACKGROUND:Disturbed lower limb coordination is thought to limit gait ability in patients with stroke. However, the relationship of lower limb coordination with gait kinematics and physical function has not yet been clarified. OBJECTIVE:The purpose of the study was to clarify the gait kinematic and physical function variables that most affect intralimb coordination by using the continuous relative phase (CRP) between the thigh and shank. METHODS:Fifteen participants with stroke were enrolled in this study. Kinematic and kinetic measurements were recorded during gait at preferred speeds. CRP was defined as the difference between the thigh and shank phase angles. RESULTS:Stepwise analysis revealed that non-paretic CRP during the propulsive phase was a determinant of gait speed. The paretic knee extension and flexion angles were determinants of the CRP during the propulsive phase in the non-paretic limb. Stepwise analysis showed that the paretic knee extension angle was a determinant of the CRP during the propulsive phase in the paretic limb. Stepwise analysis revealed that the paretic knee extensor muscle strength was a determinant of the CRP during the propulsive phase in both limbs. CONCLUSIONS:Our study indicates that improvement in knee movement during the stance phase may improve coordination.
Keywords: Stroke, gait, coordination
DOI: 10.3233/NRE-192923
Journal: NeuroRehabilitation, vol. 45, no. 4, pp. 493-499, 2019
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