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Mechanisms to increase propulsive force for individuals poststroke.

HaoYuan Hsiao1, Brian A Knarr2, Jill S Higginson3

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Individuals post-stroke increase walking speed primarily by adjusting their trailing limb angle, not ankle moment. This gait strategy may lead to walking inefficiency after stroke.

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Area of Science:

  • Biomechanics
  • Neurology
  • Rehabilitation Science

Background:

  • Propulsive force generation is key for walking speed.
  • Trailing limb angle and ankle moment significantly influence propulsive force during gait.
  • For able-bodied individuals, trailing limb angle is a greater contributor to propulsive force increases than ankle moment during speed changes.

Purpose of the Study:

  • To quantify the relative contributions of ankle moment and trailing limb angle to propulsive force increases in individuals post-stroke.
  • To compare these contributions between paretic and non-paretic limbs.

Main Methods:

  • A biomechanical model for able-bodied individuals was adapted and validated for post-stroke subjects.
  • Gait analysis was conducted on 24 individuals with chronic hemiparesis post-stroke.
  • Subjects walked at self-selected and fast speeds on a treadmill.

Main Results:

  • Both trailing limb angle and ankle moment increased with walking speed modulation.
  • In the paretic limb, trailing limb angle contributed 74% and ankle moment 17% to propulsive force increases.
  • In the non-paretic limb, trailing limb angle contributed 67% and ankle moment 22% to propulsive force increases.

Conclusions:

  • Individuals post-stroke primarily use trailing limb angle adjustments to increase propulsive force in both limbs.
  • This reliance on trailing limb angle may contribute to inefficient post-stroke walking patterns.
  • Further research is needed to explore interventions that could modify these gait characteristics.