Echigoya K1,2, Okada K2, Wakasa M2, Saito A2, Kimoto M2, Okura K2, Suda T2, Namba A2, Komdo R2
1Akita Prefectural Center for Rehabilitation and Psychiatric Medicine, Department of Physical Therapy, Daisen, Japan, 2Akita University Graduate School of Health Sciences, Department of Physical Therapy, Akita, Japan
Background: Walking disability is a common sequela after stroke. To improve walking disability after stroke, intensive and repetitive walking exercises are widely recommended. Plantar loading during gait is an important factor for improving walking ability. In individuals with moderate-to-severe paralysis, abnormal muscle hyperactivity is associated with inadequate plantar loading during gait. Therefore, it is extremely important to clarify the relationship between changes in foot pressure distribution and the severity of motor dysfunction.
Purpose: The purpose of this study was to investigate the characteristics of foot pressure distribution in individuals who achieved independent walking ability during the recovery period after stroke associated with moderate-to-severe hemiplegia.
Methods: The present study included 16 individuals who had experienced initial stroke. They had achieved independent walking ability during the recovery period. The severity of motor dysfunction was assessed according to the Brunnstrom recovery stage of the lower limbs, and participants were divided into the following two groups: stage III group (n = 8, mean age: 57 ± 10 years) and stage IV group (n = 8, 61 ± 12 years). The primary outcome was foot pressure distribution assessed using F-scan II (Nitta Co.). The patients could comfortably walk for 10 m without any orthosis. The anteroposterior length of the center of pressure (COP) path was measured and expressed as a percentage of foot length (%long). The partial backward moving distance of the COP path was expressed as a percentage of the anteroposterior length of the COP path (retrogression). Foot pressure distribution was assessed on the day of achieving independent walking ability for the first time after stroke and the day of discharge. Measurements were performed thrice, and the mean value was used. The secondary outcome was fall history after achieving independent walking ability, which was judged from clinical records.
Results: Four patients from each group showed abnormal patterns of foot pressure distribution on one or both sides. One patient from the stage III group and three from the stage IV group experienced falls after achieving independent walking ability. Compared with the initial assessment, three patients who experienced falls had abnormal patterns of foot pressure distribution, including a reduction in %long on the non-affected side and an increase in the retrogression ratio on the affected side.
Conclusion(s): Our findings suggest that abnormal patterns of foot pressure distribution in post-stroke patients reflect motor dysfunction while walking.
Implications: Half of our post-stroke patients who achieved independent walking ability during the recovery period showed abnormal patterns of the COP path and had a high risk of falling. Thus, it is important to assess foot pressure distribution after stroke.
Keywords: Independent walking, foot pressure distribution, stroke
Funding acknowledgements: No funding obtained.
Purpose: The purpose of this study was to investigate the characteristics of foot pressure distribution in individuals who achieved independent walking ability during the recovery period after stroke associated with moderate-to-severe hemiplegia.
Methods: The present study included 16 individuals who had experienced initial stroke. They had achieved independent walking ability during the recovery period. The severity of motor dysfunction was assessed according to the Brunnstrom recovery stage of the lower limbs, and participants were divided into the following two groups: stage III group (n = 8, mean age: 57 ± 10 years) and stage IV group (n = 8, 61 ± 12 years). The primary outcome was foot pressure distribution assessed using F-scan II (Nitta Co.). The patients could comfortably walk for 10 m without any orthosis. The anteroposterior length of the center of pressure (COP) path was measured and expressed as a percentage of foot length (%long). The partial backward moving distance of the COP path was expressed as a percentage of the anteroposterior length of the COP path (retrogression). Foot pressure distribution was assessed on the day of achieving independent walking ability for the first time after stroke and the day of discharge. Measurements were performed thrice, and the mean value was used. The secondary outcome was fall history after achieving independent walking ability, which was judged from clinical records.
Results: Four patients from each group showed abnormal patterns of foot pressure distribution on one or both sides. One patient from the stage III group and three from the stage IV group experienced falls after achieving independent walking ability. Compared with the initial assessment, three patients who experienced falls had abnormal patterns of foot pressure distribution, including a reduction in %long on the non-affected side and an increase in the retrogression ratio on the affected side.
Conclusion(s): Our findings suggest that abnormal patterns of foot pressure distribution in post-stroke patients reflect motor dysfunction while walking.
Implications: Half of our post-stroke patients who achieved independent walking ability during the recovery period showed abnormal patterns of the COP path and had a high risk of falling. Thus, it is important to assess foot pressure distribution after stroke.
Keywords: Independent walking, foot pressure distribution, stroke
Funding acknowledgements: No funding obtained.
Topic: Neurology: stroke; Neurology: stroke
Ethics approval required: Yes
Institution: Akita Prefectural Center for Rehabilitation and Psychiatric Medicine
Ethics committee: Akita Prefectural Center for Rehabilitation and Psychiatric Medicine
Ethics number: 44709
All authors, affiliations and abstracts have been published as submitted.
