Article

Many stroke and neuromuscular patients with paraplegia or severe
hemiparesis cannot control trunk balance. OBJECTIVE: To support the pelvis/hip of
paresis patients, a new pelvic/hip support system was developed bearing a convex
pressing member placed over the post-trochanteric groove, a cutaneous landmark
sited on the lateral portion of the gluteus maximus muscle and indicating the
posterior aspect of the greater trochanter. STUDY DESIGN: Preliminary study.
METHODS: Stance control differences in two paretic patients (Guillain-Barre
syndrome and stroke sequelae) with or without post-trochanteric groove support
were examined. The contact pressure on the post-trochanteric groove was examined
in eight healthy volunteers using an impact force sensor.
The pelvic-lumbar
movement was also examined using three-dimensional motion analysis, and the
gluteus muscles activity was evaluated using surface electromyography. RESULTS:
Without post-trochanteric groove support, total three-dimensional displacement of
the sacral marker was longer in the paresis patients than in normal controls,
while post-trochanteric groove support decreased this distance. Post-trochanteric
groove support provided compression pressure on the post-trochanteric groove, and
all subjects showed a more upright trunk position, providing more anterior pelvic
tilting. Six of eight subjects showed increased lumbar lordosis. Five of eight
subjects showed gluteus maximus and/or gluteus medius muscle activation.
CONCLUSION: The mechanisms of post-trochanteric groove support were suggested to
be spino-pelvic coordination and gluteal muscle activation. CLINICAL RELEVANCE:
The post-trochanteric groove is a cutaneous landmark located behind the
pelvis/hip joint. Applying pressure to the post-trochanteric groove from behind
pushes the trunk to adopt a more upright position, leading to improved stance
control. Underlining mechanisms appear to be spino-pelvic coordination and
gluteal muscle activation.
CI - (c) The International Society for Prosthetics and Orthotics 2014.

Langue : ANGLAIS