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Abnormal volitional hip torque phasing and hip impairments in gait post stroke. J Neurophysiol 2010 Mar;103(3):1557-68

Date

01/22/2010

Pubmed ID

20089823

DOI

10.1152/jn.00528.2009

Abstract

The purpose of this study was to quantify how volitional control of hip torque relates to walking function poststroke. Volitional phasing of hip flexion and extension torques was assessed using a load-cell-instrumented servomotor drive system in 11 chronic stroke subjects and 5 age-matched controls. Hips were oscillated from approximately 40 degrees of hip flexion to 10 degrees of hip extension at a frequency of 0.50 Hz during three movement conditions [hips in phase (IP), 180 degrees out of phase (OP), and unilateral hip movement (UN)] while the knees and ankles were held stationary. The magnitude and phasing of hip, knee, and ankle torques were measured during each movement condition. Surface electromyography was measured throughout the legs. Over ground gait analysis was done for all stroke subjects. During robotic-assisted movement conditions, the paretic limb produced peak hip torques when agonist hip musculature was stretched instead of midway through the movement as seen in the nonparetic and control limbs (P < 0.012). However, mean torque magnitudes of the paretic and nonparetic limbs were not significantly different. Abnormalities of paretic hip torque phasing were more pronounced during bilateral movement conditions and were associated with quadriceps overactivity. The magnitude of flexion torque produced during maximal hip extension was correlated with the Fugl Meyer Score, self-selected walking speed, and maximal hip extension during over ground walking. These results suggest that hyperexcitable stretch reflexes in the paretic limb impair coordinated hip torque phasing and likely interfere with walking function post stroke.

Author List

Hyngstrom A, Onushko T, Chua M, Schmit BD

Authors

Allison Hyngstrom PhD Associate Professor in the Physical Therapy department at Marquette University
Brian Schmit PhD Professor in the Biomedical Engineering department at Marquette University




MESH terms used to index this publication - Major topics in bold

Aged
Ankle
Biomechanical Phenomena
Electromyography
Female
Functional Laterality
Gait
Gait Disorders, Neurologic
Hip
Humans
Knee
Male
Middle Aged
Movement
Neurons, Afferent
Paresis
Robotics
Stroke
Stroke Rehabilitation
Walking