title: Comparative biomechanical analysis of gait in patients with central cord and Brown-Séquard syndrome.
abstract: OBJECTIVE
  This is a pilot study with the aim to highlight the use of kinematic and kinetic analyses as an adjunct to the assessment of individual patients with central cord syndrome (CCS) and hemisection or Brown-Séquard syndrome (BSS) and to discuss their possible consequences for clinical management.
  
  
  METHODS
  The sample studied consisted of 17 patients with CCS, 13 with BSS and 20 control subjects (control group (CG)). Data were obtained using a three-dimensional motion analysis system and two force plates. Gait differences were compared between CCS, BSS walking at a self-selected speed and CG at both a self-selected and a similar speed to that of the patient groups.
  
  
  RESULTS
  The most relevant findings involved the knee and ankle, especially in the sagittal plane. In patients with CCS, knee flexion at initial contact was increased with respect to those in the BSS group (p < 0.01). The ankle in the BSS group made initial contact with a small degree of plantar flexion.
  
  
  CONCLUSIONS
  The use of gait biomechanical analysis to detect underlying impairments can help the physician to set a specific rehabilitation program in each CCS and BSS walking patient. In this group of patients, rehabilitation treatment should aim to improve gait control and optimise ankle positioning at initial contact. Implications for Rehabilitation In this study, gait differences between patients with CSS and BSS were evaluated with biomechanical equipment. The most remarkable differences were found in the knee and ankle sagittal plane due to ankle position at initial contact. In this group of patients, rehabilitation treatment should aim to improve gait control and to get a better ankle positioning at initial contact.
authors.affiliation: Biomechanics and Technical Aids Unit, Department of Physical Medicine and Rehabilitation, National Hospital for Spinal Cord Injury , SESCAM, Toledo , Spain and.
authors.forename: Angel
authors.initials: A
authors.lastname: Gil-Agudo
authors.forename: Soraya
authors.initials: S
authors.lastname: Pérez-Nombela
authors.forename: Enrique
authors.initials: E
authors.lastname: Pérez-Rizo
authors.forename: Antonio
authors.initials: A
authors.lastname: del Ama-Espinosa
authors.forename: Beatriz
authors.initials: B
authors.lastname: Crespo-Ruiz
authors.forename: José L
authors.initials: JL
authors.lastname: Pons
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D000843:Ankle Joint / Q000502:physiology; D001696:Biomechanical Phenomena / Q000502:physiology; D018437:Brown-Sequard Syndrome / Q000503:physiopathology* / Q000534:rehabilitation; D016022:Case-Control Studies; D020210:Central Cord Syndrome / Q000503:physiopathology* / Q000534:rehabilitation; D004185:Disability Evaluation; D005260:Female; D005684:Gait / Q000502:physiology*; D006621:Hip Joint / Q000502:physiology; D006801:Humans; D007719:Knee Joint / Q000502:physiology; D008297:Male; D008875:Middle Aged; D016138:Walking / Q000502:physiology*