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The effects of parallel bars, body weight support and speed on the modulation of the locomotor pattern of spastic paretic gait. A preliminary communication

Abstract

The effects of walking with and without parallel bars, providing 40% body weight support (BWS) and increasing speed on the gait pattern of spastic paretic subjects during treadmill locomotion were investigated. In asymmetrically involved subjects, walking without parallel bars led to a more symmetrical gait pattern with decreased compensation of the less involved side. This was accompanied by changes in electromyographic (EMG) and sagittal angular displacement profiles which favoured a more normal swing phase of the more involved limb. When symmetrically involved subjects walked without parallel bars, increases in EMG activity, with prolonged activation during the stance phase were noted, especially in the distal muscles. Providing 40% BWS facilitated gait when walking without parallel bars especially in the asymmetrically or severely involved subjects who showed marked difficulty at 0% BWS. Forty percent BWS led to a decrease in clonus associated with walking without parallel bars. Higher treadmill speeds increased clonus in some subjects while in others it only caused a small increase in EMG amplitude. Implications for gait training are discussed.

References

  1. 1

    Conrad B, Benecke R, Meinck H M (1985) Gait disturbances in paraspastic patients. In: Delwaide PJ, Young RR, editors. Clinical Neurophysiology in Spasticity. Vol 1. Restorative Neurology. Elsevier Science Publishers B.V. (Biomedical Division), Netherlands: 155–174.

  2. 2

    Knutsson E (1980) Muscle activation patterns of gait in spastic hemiparesis, paraparesis and cerebral palsy. In: Fugel-Meyer A, editor. Stroke with Hemiplegia. Scand J Rehabil (Suppl 7): 47–52.

  3. 3

    Conrad B, Benecke R, Carnehl J et al (1983) Pathophysiological aspects of human locomotion. In Desmedt JE, editor. Motor Control Mechanisms in Health and Disease. Raven Press, New York: 717–726.

    Google Scholar 

  4. 4

    Bobath B (1978) Adult Hemiplegia: Evaluation and Treatment. 2nd edn. Heinnemann Medical Books, London, UK.

  5. 5

    Visintin M, Barbeau H (1989) The effects of body weight support on the locomotor pattern of spastic paretic patients. Can J Neurol Sci 16: 315–325.

    CAS  Article  Google Scholar 

  6. 6

    Barbeau H, Fung J, Stewart J, Visintin M (1988) Impairment of spastic paraparetic gait: implications for new rehabilitation strategies. Proc Fifth Biennial Conf Can Soc Biomech: 12–16.

  7. 7

    Barbeau H, Wainberg M, Finch L (1987) Description and application of a system for rehabilitation. Med Bio Eng Comput 25: 341–344.

    CAS  Article  Google Scholar 

  8. 8

    Fung J, Barbeau H (1987) Quantification of the electromyographic activity in normal human gait. Proc IEEE ConfBiomed Technol, Montech: 41–44.

  9. 9

    Hirschberg G G, Nathanson M (1952) Electromyographic recording of muscular activity in normal and spastic gaits. Arch Phys Med Rehabil 33: 217–226.

    CAS  PubMed  Google Scholar 

  10. 10

    Benecke R, Conrad B (1986) Disturbances of posture and gait in spastic syndromes. In: Bles W, Brandt TH, editors. Disorders of Posture and Gait. Elsevier Science Publishers B.V. (Biomedical Division), Netherlands: 231–241.

  11. 11

    Berger W (1986) Development of gait in children. In: Bles W, Brandt TH, editors. Disorders of Posture and Gait. Elsevier Science Publishers B.V. (Biomedical Division): 315–324.

  12. 12

    Forssberg H (1985) Ontogeny of human locomotor control I. Infant stepping, supported locomotion and transition to independent locomotion. Exp Brain Res 57: 480–493.

    CAS  Article  Google Scholar 

  13. 13

    Sutherland D H, Olshen R, Cooper L B, Woo S L Y (1980) The development of mature gait. J Bone Joint Surg Am 62: 336–353.

    CAS  Article  Google Scholar 

  14. 14

    Frigo C, Eng D, Tesio L (1986) Speed-dependant variations of lower-limb joint angles during walking. Am J Phys Med 65: 51–62.

    CAS  PubMed  Google Scholar 

  15. 15

    Kirtley C, Whittle M W, Jefferson R J (1985) Influence of walking speed on gait parameters. J Biomed Eng 7: 282–288.

    CAS  Article  Google Scholar 

  16. 16

    Shiavi R, Bugle H J, Limbird T (1987) Electromyographic gait assessment, part 1: Adult EMG profiles and walking speed. J Rehabil Res Dev 24: 13–23.

    CAS  PubMed  Google Scholar 

  17. 17

    Yang J F, Winter D A (1985) Surface EMG profiles during different walking cadences in humans. EEG Clin Neurophysiol 60: 485–491.

    CAS  Article  Google Scholar 

  18. 18

    Dietz V (1986) Impaired reflex control of posture and gait in spastic paresis. In: Bles W, Brandt TH, editors. Disorders of Posture and Gait. Elsevier Science Publishers B.V. (Biomedical Division), Netherlands: 243–252.

  19. 19

    Burke D C, Lance J W (1973) Studies of the reflex effects of primary and secondary spindle endings in spasticity. In: Desmedt JE, editor. New Developments in Electromyography and Clinical Neurophysiology. Vol 3. Karger, Basal: 475–495.

  20. 20

    Andriacchi T P, Ogle J A, Galante J O (1977) Walking speed as a basis for normal and abnormal gait measurements. J Biomech 10: 261–264.

    CAS  Article  Google Scholar 

  21. 21

    Longhurst S (1980) Variability of EMG during slow walking. Proc Special Conf Can Soc Biomechan: 10–11.

  22. 22

    Shiavi R, Bugle H J, Limbird T (1987) Electromyographic gait assessment, part 2: Preliminary assessment of hemiparetic synergy patterns. J Rehabil Res Dev 24: 24–30.

    CAS  PubMed  Google Scholar 

  23. 23

    Knutsson E, Richards C (1979) Different types of disturbed motor control in gait of hemiparetic patients. Brain 102: 405–439.

    CAS  Article  Google Scholar 

  24. 24

    Knutsson E (1985) Studies of gait control in patients with spastic paresis. In: Delwaide PJ, Young RR, editors. Clinical Neurophysiology in Spasticity. Vol 1. Restorative Neurology. Elsevier Science Publishers B.V. (Biomedical Division), Netherlands: 175–183.

  25. 25

    Grimm R J (1983) Program disorders of movement. In: Desmedt JE, editor. Motor Control Mechanisms in Health and Disease. Raven Press, New York: 1–11.

  26. 26

    Barbeau H, Richards C L, Bedard P J (1982) Action of cyproheptadine in spastic paraparetic patients. J Neurol Neurosurg Psychiatry 45: 923–926.

    CAS  Article  Google Scholar 

  27. 27

    Wainberg M, Barbeau H, Gauthier S (1986) Quantitative assessment of the effects of cyproheptadine on spastic paretic gait: A prelimianry report. J Neurol 233: 311–314.

    CAS  Article  Google Scholar 

  28. 28

    Bach-y-Rita P (1983) Rehabilitation versus passive recovery of motor control following central nervous system lesions. In: Desmedt JE, editor. Motor Control Mechanisms in Health and Disease. Raven Press, New York: 1085–1092.

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Correspondence to M Visintin.

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Visintin, M., Barbeau, H. The effects of parallel bars, body weight support and speed on the modulation of the locomotor pattern of spastic paretic gait. A preliminary communication. Spinal Cord 32, 540–553 (1994). https://doi.org/10.1038/sc.1994.86

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Keywords

  • spastic gait
  • parallel bars
  • body weight support
  • speed
  • electromyography
  • spinal cord injury

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