Trunk Movement Characteristics of Post-stroke Hemiplegic Patients at Gait Initiation

Abstract

[Purpose] In this study, we aimed to verify the trunk motion characteristics of anticipatory postural adjustments (APAs) made by post-stroke hemiplegic patients at gait initiation. [Participants and Methods] The participants were 10 elderly controls and 30 stroke patients. Measurements were made using a center of gravity measurement instrument, a surface electromyograph, and an accelerometer. Accelerometers were attached to the neck (C7), lower back (L3) and pelvis (S1), and surface electromyograms of the bilateral gluteus medius and erector spinae muscles were recorded. [Results] In the elderly controls, activities of the stepping side gluteus medius and stance side erector spinae were recognized prior to the onset of movement of the center of pressure. Increased latency of the paretic gluteus medius muscle was observed when stroke patients led with the paretic leg, and the paretic erector spinae muscle when the non-paretic leg led. Accelerometer analysis showed displacement of the upper trunk toward the stepping side in the stroke patients when the non-paretic leg led, and to the stance side when the paretic leg led. [Conclusion] APAs of the stroke patients at gait initiation were characterized by delay of trunk muscle activity and upper trunk displacement.