Article

Anticipatory postural adjustments, executed prior to gait initiation, help
preserve lateral stability when stepping. Atypical patterns of anticipatory
activity prior to gait initiation may occur in individuals with unilateral
impairment (e.g., stroke).
This study aimed to determine the prevalence,
correlates, and consequences of atypical anticipatory postural adjustment
patterns prior to gait initiation in a sub-acute stroke population. Forty
independently-ambulatory individuals with sub-acute stroke stood on two force
plates and initiated gait at a self-selected speed. Medio-lateral centre of
pressure displacement was calculated and used to define anticipatory postural
adjustments (shift in medio-lateral centre of pressure >10mm from baseline).
Stroke severity, motor recovery, and functional balance and mobility status were
also obtained. Three patterns were identified: single (typical), absent
(atypical), and multiple (atypical) anticipatory postural adjustments.
Thirty-five percent of trials had atypical anticipatory postural adjustments
(absent and multiple). Frequency of absent anticipatory postural adjustments was
negatively correlated with walking speed. Multiple anticipatory postural
adjustments were more prevalent when leading with the non-paretic than the
paretic limb. Trials with multiple anticipatory postural adjustments had longer
duration of anticipatory postural adjustment and time to foot-off, and shorter
unloading time than trials with single anticipatory postural adjustments. A high
prevalence of atypical anticipatory control prior to gait initiation was found in
individuals with stroke. Temporal differences were identified with multiple
anticipatory postural adjustments, indicating altered gait initiation. These
findings provide insight into postural control during gait initiation in
individuals with sub-acute stroke, and may inform interventions to improve
ambulation in this population.
CI - Copyright (c) 2016 Elsevier B.V. All rights reserved.

Langue : ANGLAIS