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Locomotor circumvention strategies are altered by stroke: II. Postural Coordination.

Abstract：

BACKGROUND:Locomotor strategies for obstacle circumvention require appropriate postural coordination that depends on sensorimotor integration within the central nervous system. It is not known how these strategies are affected by a stroke. The objective of this study was to contrast postural coordination strategies used for obstacle circumvention between post-stroke participants (n = 12) and healthy controls (n = 12). METHODS:Participants walked towards a target in a virtual environment (11 × 8 m room) with cylindrical obstacles that were stationary or approaching from head-on, or diagonally 30° left/right. RESULTS:Two stepping strategies for obstacle circumvention were identified: 1) side step: increase in step width by the foot ipsilateral to the side of circumvention; 2) cross step: decrease in step width by the foot contralateral to the side of circumvention. The side step strategy was favoured by post-stroke individuals in circumventing stationary and head-on approaching obstacles. In circumventing diagonally approaching obstacles, healthy controls generally veered opposite to obstacle approach (>60% trials), whereas the majority of post-stroke participants (7/12) veered to the same side of obstacle approach (Vsame). Post-stroke participants who veered to the opposite side (Vopp, 5/12) were more independent and faster ambulators who favoured the side step strategy in circumventing obstacles approaching from the paretic side and cross step strategy for obstacles approaching from the non-paretic side. Vsame participants generally favoured the side step strategy for both diagonal approaches. Segmental rotation amplitudes and latencies were largest in the Vsame group, and significantly greater in post-stroke participants than controls for all obstacle conditions. All participants initiated circumvention with the feet followed by the pelvis and thorax, demonstrating a caudal-rostral sequence of reorientation. CONCLUSION:Postural coordination strategies for obstacle circumvention were altered post stroke, depending on the residual or restored functional abilities. Segmental re-orientations are also affected by the motion and direction of obstacle.

journal_name

J Neuroeng Rehabil

journal_title

Journal of neuroengineering and rehabilitation

authors

Darekar A,Lamontagne A,Fung J

doi

10.1186/s12984-017-0265-7

subject

Has Abstract

pub_date

2017-06-15 00:00:00

pages

issue

issn

1743-0003

pii

10.1186/s12984-017-0265-7

journal_volume

pub_type

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Locomotor circumvention strategies are altered by stroke: II. Postural Coordination.