title: Trunk biomechanics during hemiplegic gait after stroke: A systematic review.
abstract: Stroke commonly results in trunk impairments that are associated with decreased trunk coordination and limited trunk muscle strength. These impairments often result in biomechanical changes during walking. Additionally, the so-called pelvic step might be influenced by these impairments. Therefore, the aim of this review was twofold. First, to gain more insight into trunk biomechanics during walking in stroke patients compared to healthy individuals. Second, to investigate the influence of walking speed on trunk biomechanics. The search strategy was performed by the PRISMA guidelines and registered in the PROSPERO database (no. CRD42016035797). Databases MEDLINE, Web of Science, Cochrane Library, ScienceDirect, and Rehabdata were systematically searched until December 2016. Sixteen of the 1099 studies met the eligibility criteria and were included in this review. Risk of bias was assessed by the Newcastle-Ottawa Scale. The majority of studies reported on trunk kinematics during walking, data on trunk kinetics and muscle activity is lacking. Following stroke, patients walk with increased mediolateral trunk sway and larger sagittal motion of the lower trunk. Although rotation of the upper trunk is increased, the trunk shows a more in-phase coordination. Acceleration of the trunk diminishes while instability and asymmetry increase as there are less movement towards the paretic side. However, it is of great importance to differentiate between compensatory trunk movements and intrinsic trunk control deficits. Specific exercise programs, assistive devices and orthoses might be of help in controlling these deficits. Importantly, studies suggested that more natural trunk movements were observed when walking speed was increased.
authors.affiliation: Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium. Electronic address: tamaya.vancriekinge@uantwerpen.be.
authors.forename: Tamaya
authors.initials: T
authors.lastname: Van Criekinge
authors.affiliation: Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium. Electronic address: wim.saeys@uantwerpen.be.
authors.forename: Wim
authors.initials: W
authors.lastname: Saeys
authors.affiliation: Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium. Electronic address: ann.hallemans@uantwerpen.be.
authors.forename: Ann
authors.initials: A
authors.lastname: Hallemans
authors.affiliation: Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium.
authors.forename: Silke
authors.initials: S
authors.lastname: Velghe
authors.affiliation: Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium.
authors.forename: Pieter-Jan
authors.initials: PJ
authors.lastname: Viskens
authors.affiliation: Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium. Electronic address: luc.vereeck@uantwerpen.be.
authors.forename: Luc
authors.initials: L
authors.lastname: Vereeck
authors.affiliation: Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium. Electronic address: willem.dehertogh@uantwerpen.be.
authors.forename: Willem
authors.initials: W
authors.lastname: De Hertogh
authors.affiliation: Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium. Electronic address: steven.truijen@uantwerpen.be.
authors.forename: Steven
authors.initials: S
authors.lastname: Truijen
mesh_terms: D000328:Adult; D000368:Aged; D001696:Biomechanical Phenomena / Q000502:physiology*; D005260:Female; D020233:Gait Disorders, Neurologic / Q000503:physiopathology* / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010388:Pelvis / Q000503:physiopathology*; D004856:Postural Balance / Q000502:physiology; D020521:Stroke / Q000503:physiopathology*; D000071939:Stroke Rehabilitation; D013909:Thorax / Q000503:physiopathology*; D016138:Walking / Q000502:physiology; D000072797:Walking Speed / Q000502:physiology
keywords: Biomechanics; Kinematics; Stroke; Trunk; Walking