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Walking through Apertures in Individuals with Stroke.

Daisuke Muroi1,2, Yasuhiro Hiroi2, Teruaki Koshiba2

  • 1Department of Health Promotion Science, Tokyo Metropolitan University, Tokyo, Japan.

Plos One
|January 20, 2017
PubMed
Summary

Stroke survivors, especially fallers, struggle with body rotation when walking through narrow openings, leading to more frequent contacts. This suggests locomotor, not perceptual, issues contribute to their difficulties navigating obstacles.

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Area of Science:

  • Neuroscience
  • Biomechanics
  • Rehabilitation Science

Background:

  • Navigating narrow spaces requires precise postural adjustments, including body rotation.
  • Stroke survivors often exhibit motor deficits, impacting their ability to perform such rotations effectively.
  • Understanding these challenges is crucial for developing targeted rehabilitation strategies.

Purpose of the Study:

  • To investigate the success of stroke survivors in walking through apertures of varying widths.
  • To analyze the body rotation strategies employed by stroke survivors during aperture negotiation.
  • To identify factors contributing to accidental contacts with aperture frames.

Main Methods:

  • Participants included stroke fallers, stroke non-fallers, and healthy controls.

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  • Kinematic data and accidental contacts were recorded as participants walked through apertures (0.9-1.3 times shoulder width).
  • A perceptual judgment task assessed participants' accuracy in judging aperture passability.

    • Main Results:

    • Stroke fallers experienced more frequent contacts on their paretic side, but fewer when entering from that side.
    • Both stroke groups used multi-step rotations to compensate for motor paralysis.
    • Stroke fallers required wider minimum passable widths, yet rotation angles were similar across groups, indicating insufficient rotation contributed to contacts.

    Conclusions:

    • Frequent contacts in stroke fallers are attributed to insufficient body rotation, not perceptual deficits.
    • Locomotor factors, rather than perceptual judgment, are the primary cause of accidental contacts.
    • Vision and/or attention may explain the reduced frequency of paretic side contacts when entering apertures from that side.