Article

OBJECTIVE: To evaluate the relationship between body mass index (BMI) and
spatiotemporal, kinematic, and kinetic gait parameters in chronic hemiparetic
stroke survivors. DESIGN: Secondary analysis of data collected in a randomized
controlled trial comparing two 12-week ambulation training treatments. SETTING:
Academic medical center. PARTICIPANTS: Chronic hemiparetic stroke survivors (N =
108, >3 months poststroke) METHODS: Linear regression analyses were performed of
BMI, and selected pretreatment gait parameters were recorded using quantitative
gait analysis. MAIN OUTCOME MEASURES: Spatiotemporal, kinematic, and kinetic gait
parameters. RESULTS: A series of linear regression models that controlled for
age, gender, stroke type (ischemic versus hemorrhagic), interval poststroke,
level of motor impairment (Fugl-Meyer score), and walking speed found BMI to be
positively associated with step width (m) (beta = 0.364, P < .001), positively
associated with peak hip abduction angle of the nonparetic limb during stance
(deg) (beta = 0.177, P = .040), negatively associated with ankle dorsiflexion
angle at initial contact of the paretic limb (deg) (beta = -0.222, P = .023), and
negatively associated with peak ankle power at push-off (W/kg) of the paretic
limb (W/kg)(beta = -0.142, P = .026). CONCLUSIONS: When walking at a similar
speed, chronic hemiparetic stroke subjects with a higher BMI demonstrated greater
step width, greater hip hiking of the paretic lower limb, less paretic limb
dorsiflexion at initial contact, and less paretic ankle power at push-off as
compared to stroke subjects with a lower BMI and similar level of motor
impairment. Further studies are necessary to determine the clinical relevance of
these findings with respect to rehabilitation strategies for gait dysfunction in
hemiparetic patients with higher BMIs.
CI - Copyright (c) 2014 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS