Upper Body Rotation for Obstacle Avoidance in Individuals With Stroke With Different Degrees of Upper Extremity...

Individuals with stroke have difficulty adapting their walking to their environment; the upper extremity on the paretic side is particularly prone to colliding with surfaces when walking through openings.

We aim to investigate how individuals with stroke with different levels of upper extremity motor paralysis rotate each part of their upper body for safe obstacle avoidance.

Participants included eight, 17, and 19 individuals in the moderate (MDR), mild (MLD), and control groups, respectively. Participants were asked to walk through door-like openings of four different widths without colliding with them. Each participant performed the task by entering either from the paretic side or the nonparetic side. To examine the effects of the group, entering direction, and opening width on rotation angles we conducted a statistical analysis using a Generalized Linear Mixed Model.

For the head angle, the main effect of group was significant (p = .011). Post hoc multiple comparisons showed that the angle was significantly larger in the MDR than that in the MLD and control groups (both p < .001). Shoulder and hip rotation angles did not differ significantly between groups. Although some interaction effects between the group and opening width were observed, no consistent interaction patterns were found across body segments.

The results were interpreted in terms of motor difficulty and visual attention. Therefore, individuals with stroke who had moderate upper extremity paralysis may have rotated their heads at higher angles due to difficulty with movement adjustments and increased visual attention demands.