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Locomotor coordination during the sit-to-walk transfer is different in subjects with stroke and controls
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
Department of Energy and Technology, Swedish University of Agricultural Sciences, Uppsala.
Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Division of Systems and Control. Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Automatic control.
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(English)Manuscript (preprint) (Other academic)
Abstract [en]

Objectives: To describe and to compare coordination of centre of mass (COM) horizontal and vertical momenta, and fluidity during the sit-to-walk (STW) transfer in subjects with stroke and in matched controls.

Design: Cross-sectional.

Setting: Research laboratory.

Participants: Ten subjects with stroke in the post-acute phase (> 6 months) and ten control subjects, matched for sex, age, height and weight, were recruited through a convenience sample.

Interventions: Not applicable.

Main Outcome Measures: Magnitudes and timing of COM peak horizontal and peak vertical momenta, scores on the Fluidity Scale (FS) and values of the Fluidity Index (FI).

Results: The stroke subjects generated significantly less COM peak horizontal and peak vertical momenta. Latencies from STW-onset and seat-off to the peaks differed significantly between the two groups. The subjects with stroke displayed significantly lower scores on the FS as well as lower percentages of the FI.

Conclusions: While rising to walk, scaling and timing parameters of COM horizontal and vertical momenta differed significantly between subjects with stroke and matched controls. This atypical motor strategy needs to be further investigated before it is possible to make clinical recommendations.

 

Keyword [en]
Stroke, motor activity, rehabilitation
National Category
Physiotherapy
Research subject
Rehabilitation Medicine
Identifiers
URN: urn:nbn:se:uu:diva-120630OAI: oai:DiVA.org:uu-120630DiVA: diva2:303853
Available from: 2010-03-16 Created: 2010-03-15 Last updated: 2010-03-21
In thesis
1. Movement Control after Stroke: Studies on Sit-to-walk and on the Relations between Clinical and Laboratory Measures
Open this publication in new window or tab >>Movement Control after Stroke: Studies on Sit-to-walk and on the Relations between Clinical and Laboratory Measures
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aims: The principal aims of this research were 1) to extend existing knowledge of the everyday sit-to-walk (STW) transfer in subjects with stroke and in matched controls by exploring temporal, kinematic, and kinetic aspects, and 2) to investigate the relations between some clinical and laboratory measures of postural control and locomotion in stroke rehabilitation and research.

Methods: Ten community-living subjects with stroke (mean age 59 years) and ten matched controls were enrolled in the STW studies (Studies I, II, and IV). In the study regarding relations between clinical and laboratory measures the same samples (part of Study II) and also 20 outpatient subjects with stroke (mean age 50 years) participated (Study III). Data collections were performed in laboratory environments with clinical assessment instruments, video cameras, force plates and a movement analysis system.

Results: 1) Study I: A temporal aspect of STW was studied. Four phases were defined. The subjects with stroke used significantly more time during the 2nd STW phase, defined from seat-off to the loading peak of the 1st swing leg. Study II: A movement aspect of STW was investigated. The stroke subjects generated significantly less centre of mass momenta in horizontal and vertical directions, and the momenta peaks occurred significantly earlier than in the controls. Study IV: A force aspect of STW was explored. The subjects with stroke generated significantly larger propulsive impulse beneath the (non-paretic) stance buttock and significantly more braking impulses were exerted by both buttocks and particularly by the stance foot.

2) Part of Study II: A strong correlation was found between the clinical measure Fluidity Scale and the laboratory measure Fluidity Index. Study III: Moderate correlations were shown between Berg Balance Scale, ratings of weight distribution during quiet stance, and force measures.

Conclusions: The findings of the STW studies show a changed force interaction between the lower extremities post-stroke, likely influencing movement patterns and temporal characteristics of the everyday transfer. The results are considered to reflect compensatory motor strategies. The results of the studies on relations between some clinical and laboratory measures indicate that the strength of the relation is multidimensional.

 

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2010. 101 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 539
Keyword
stroke, sit-to-walk, movement analysis, force analysis, postural control, Berg Balance Scale
National Category
Physiotherapy
Research subject
Rehabilitation Medicine
Identifiers
urn:nbn:se:uu:diva-120715 (URN)978-91-554-7752-3 (ISBN)
Public defence
2010-04-29, Uppsala University, Sal IX, Övre Slottsgatan 2, Uppsala, 09:15 (Swedish)
Opponent
Supervisors
Available from: 2010-04-08 Created: 2010-03-16 Last updated: 2010-04-08Bibliographically approved

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Frykberg, GunillaHalvorsen, Kjartan

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