title: Use of segmental coordination analysis of nonparetic and paretic limbs during obstacle clearance in community-dwelling persons after stroke.
abstract: OBJECTIVE
  To use a segment coordination analysis to identify coordination differences between the paretic and nonparetic limbs for obstacle clearance in community-dwelling persons after stroke.
  
  
  METHODS
  Within-participant design.
  
  
  METHODS
  Gait analysis laboratory.
  
  
  METHODS
  Six community-dwelling persons with a stroke (excluding cerebellar stroke).
  
  
  METHODS
  Participants stepped over obstacles of 2 different heights (7.5% and 15% of leg length), leading alternately with their paretic and nonparetic limbs.
  
  
  METHODS
  Kinematic data were collected, and segment elevation angles (absolute segment angular position with respect to vertical) were calculated for the thigh, shank, and foot segments. Established mathematical techniques related to the planar law of intersegmental coordination (principal component analysis to quantify covariance and temporal phase relationships among elevation angles) were then applied to compare and contrast the coordination of these segment elevation angle trajectories between paretic and nonparetic limbs.
  
  
  RESULTS
  Segment covariance in elevation angles followed the planar law of intersegmental coordination during level walking (ie, 3 elevation angles that form a plane and the variance explained by 2 principal components) for both paretic and nonparetic limbs. During obstacle clearance, however, relationships between covariance plane characteristics and phase differences for elevation angles of adjacent segments differed in the nonparetic limb, likely related to a need for greater limb elevation for obstacle clearance during paretic limb support or an altered foot trajectory, which resulted from preobstacle foot placement.
  
  
  CONCLUSIONS
  The present coordination analysis suggests the preservation of basic control mechanisms in the paretic limb during obstacle clearance after stroke and also reveals its specific motor control compensations. However, a larger study with differing levels of stroke severity must be conducted to understand how the evaluation of intersegmental coordination during walking could guide treatment of specific locomotor control deficits in stroke rehabilitation.
authors: Neuromotor Physiology Laboratory, IRCCS Fondazione Santa Lucia, Via Ardeatina, 306, 00179, Rome, Italy. m.maclellan@hsantalucia.it
authors: Michael J
authors: MJ
authors: MacLellan
authors: Carol L
authors: CL
authors: Richards
authors: Joyce
authors: J
authors: Fung
authors: Bradford J
authors: BJ
authors: McFadyen
mesh_terms: D001696:Biomechanical Phenomena; D004185:Disability Evaluation; D005260:Female; D020233:Gait Disorders, Neurologic / Q000503:physiopathology*; D006801:Humans; D007866:Leg / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000503:physiopathology*; D011597:Psychomotor Performance / Q000502:physiology*; D020521:Stroke / Q000503:physiopathology*