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Temporal coordination of the sit-to-walk task in subjects with stroke and in 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.
Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Automatic control. (Swedish School of Sport and Health Sciences, Stockholm, Sweden)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Rehabilitation Medicine.
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2009 (English)In: Archives of Physical Medicine and Rehabilitation, ISSN 0003-9993, E-ISSN 1532-821X, Vol. 90, no 6, 1009-1017 p.Article in journal (Refereed) Published
Abstract [en]

Objectives: To explore events and describe phases for temporal coordination of the sit-to-walk (STW) task, within a semistandardized set up, in subjects with stroke and matched controls. In addition, to assess variability of STW phase duration and to compare the relative duration of STW phases between the 2 groups.

Design: Cross-sectional.

Setting: Research laboratory.

Participants: A convenience sample of persons with hemiparesis (n=10; age 50–67y), more than 6 months after stroke and 10 controls matched for sex, age, height, and body mass index.

Interventions: Not applicable.

Main Outcome Measures: Relative duration of STW phases, SE of measurement in percentage of the mean, and intraclass correlation coefficients (ICCs).

Results: Four STW phases were defined: rise preparation, transition, primary gait initiation, and secondary gait initiation. The subjects with stroke needed 54% more time to complete the STW task than the controls did. ICCs ranged from .38 to .66 and .22 to .57 in the stroke and control groups, respectively. SEs of measurement in percentage of the mean values were high, particularly in the transition phase: 54.1% (stroke) and 50.4% (controls). The generalized linear model demonstrated that the relative duration of the transition phase was significantly longer in the stroke group.

Conclusions: The present results extend existing knowledge by presenting 4 new phases of temporal coordination of STW, within a semistandardized set-up, in persons with stroke and in controls. The high degree of variability regarding relative STW phase duration was probably a result of both the semistandardized set up and biological variability. The significant difference in the transition phase across the 2 groups requires further study.

Place, publisher, year, edition, pages
2009. Vol. 90, no 6, 1009-1017 p.
Keyword [en]
stroke, motor activity, rehabilitation, reproducibility of results
National Category
Physiotherapy Control Engineering
Research subject
Rehabilitation Medicine
Identifiers
URN: urn:nbn:se:uu:diva-120712DOI: 10.1016/j.apmr.2008.12.023ISI: 000266787000016PubMedID: 19480878OAI: oai:DiVA.org:uu-120712DiVA: diva2:303872
Available from: 2010-03-16 Created: 2010-03-16 Last updated: 2016-03-18Bibliographically approved
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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Elmgren Frykberg, GunillaHalvorsen, Kjartan

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