Article

Stroke has significant impact on dynamic balance during locomotion, with a 73%
incidence rate for falls post-stroke. Current clinical assessments often rely on
tasks and/or questionnaires that relate to the statistical probability of falls
and provide little insight into the mechanisms that impair dynamic balance.
Current quantitative measures that assess medial-lateral balance performance do
not consider the angular motion of the body, which can be particularly impaired
after stroke. Current control methods in bipedal robotics rely on the regulation
of angular momentum (H) to maintain dynamic balance during locomotion. This study
tests whether frontal-plane H is significantly correlated to clinical balance
tests that could be used to provide a detailed assessment of medial-lateral
balance impairments in hemiparetic gait. H was measured in post-stroke (n=48) and
control (n=20) subjects. Post-stroke there were significant negative
relationships between the change in frontal-plane H during paretic single-leg
stance and two clinical tests: the Dynamic Gait Index (DGI) (r=-0.57, p<0.001)
and the Berg Balance Scale (BBS) (r=-0.54, p<0.001). Control subjects showed
timely regulation of frontal-plane H during the first half of single-leg stance,
with the level of regulation depending on the initial magnitude. In contrast, the
post-stroke subjects who made poorer adjustments to frontal-plane H during
initial paretic leg single stance exhibited lower DGI and BBS scores (r=0.45,
p=0.003). We conclude that H is a promising balance indicator during steady-state
hemiparetic walking and that paretic single-leg stance is a period with higher
instability for stroke patients.
CI - Published by Elsevier B.V.

Langue : ANGLAIS