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N. Hida1, H. Matsumoto1, M. Kubo1, K. Nishikata1, M. Watanabe1, K. Sugawara2
1Shonan Keiiku Hospital, Rehabilitation, Huzisawa, Japan, 2Kanagawa University of Human Services, Yokosuka, Japan
Background: Reconstruction of hemiplegic gait is the main goal in neurological rehabilitation. One of the major characteristics of hemiplegic gait is the small hip extension angle of the paralyzed leg in the stance phase. In order to improve the hip extension angle, it is necessary to relearn the hip extension movement by performing high frequency of hip extension exercises. Since sling exercise therapy (SET) can perform high frequency of hip extension exercises by supporting paralyzed leg weight, we hypothesized that SET would contribute to an improvement of the hip extension angle during gait.
Purpose: The purpose of this study is to clarify the effects of SET on the paralyzed side of the hip extension angle during gait in stroke patients.
Methods: Two female hemiplegic patients (57 and 80 years old) in the subacute phase participated in this study. The selection criteria for hemiplegic patients were as follows: those with motor paralysis (Lower-extremity motor subscale of Fugl-Meyer Assessment score of 21 or higher), those who could walk with a cane under observation, and those with Mini-Mental State Examination score of 24 or higher.
Ten days of SET sessions (100 repetitions of hip extension exercise with the knee flexed at 90 degrees in the side-lying position) were applied to patients. Before and after the 10-day SET session, patients were asked to walk barefoot with a cane along a straight 7 m walkway. Three-dimensional (3-D) position data were obtained using reflective markers and a 3-D motion capture system (VICON MX, Oxford, UK) with a sampling frequency of 100 Hz. A total of 35 reflective markers were attached in accordance with the guidelines of Visual 3D software (C-motion Inc., Germantown, MD, USA). Ground reaction forces (GRFs) were recorded using two force plates (AMTI, Watertown, MA, USA) sampled at 1000 Hz. Raw data were digitally filtered using a fourth-order zero-lag Butterworth filter with a cut-off frequency of 6 Hz for the marker trajectories and 18 Hz for the GRFs, respectively.
We calculated the maximum hip extension angle, trunk extension angle, and height of the center of mass (COM) during the stance phase using the Visual 3d software.
Ten days of SET sessions (100 repetitions of hip extension exercise with the knee flexed at 90 degrees in the side-lying position) were applied to patients. Before and after the 10-day SET session, patients were asked to walk barefoot with a cane along a straight 7 m walkway. Three-dimensional (3-D) position data were obtained using reflective markers and a 3-D motion capture system (VICON MX, Oxford, UK) with a sampling frequency of 100 Hz. A total of 35 reflective markers were attached in accordance with the guidelines of Visual 3D software (C-motion Inc., Germantown, MD, USA). Ground reaction forces (GRFs) were recorded using two force plates (AMTI, Watertown, MA, USA) sampled at 1000 Hz. Raw data were digitally filtered using a fourth-order zero-lag Butterworth filter with a cut-off frequency of 6 Hz for the marker trajectories and 18 Hz for the GRFs, respectively.
We calculated the maximum hip extension angle, trunk extension angle, and height of the center of mass (COM) during the stance phase using the Visual 3d software.
Results: Both patients' maximum hip extension angle in the stance phase increased after the SET session. In addition, the maximum trunk extension angle and the height of the center of mass in the stance phase increased after the SET session.
Conclusions: The results of this study indicate that SET sessions may improve hip and trunk extension angle in the stance phase, increasing the height of COM. Therefore, a high frequency of hip extension exercise with SET may contribute to gait reconstruction in stroke patients.
Implications: To reconstruct gait, we believe that not only increasing the frequency of gait training but also relearning hip extension movements using SET is important as a preliminary step.
Funding acknowledgements: This work was unfunded.
Keywords:
Sling Exercise
Gait analysis
Hemiplegia
Sling Exercise
Gait analysis
Hemiplegia
Topics:
Neurology: stroke
Neurology: stroke
Did this work require ethics approval? Yes
Institution: Shonan Keiiku Hospital
Committee: Shonan Keiiku Hosipital Ethhics committee
Ethics number: 21-007
All authors, affiliations and abstracts have been published as submitted.
