Gait Patterns of Chronic Ambulatory Hemiplegic Elderly Compared with Normal Age-Matched Elderly

다국어 초록 (Multilingual Abstract)

This study compares the gait of chronic ambulatory hemiplegic elderly (HE) with those of non-hemiplegic elderly (NHE) usingVicon® 512 motion analysis system to track movement trajectories. Subjects walked with self-selected gait speeds while temporal,spatial, and kinematic variables were analyzed. HE showed significantly decreased walking speed, cadence, stride length, and steplength, and increased stride time, step time, and double limb support periods in comparison with NHE. Double limb support of stancephase was significantly increased in HE. In HE, affected pelvis showed marked upward elevation from terminal stance to mid swingphase, and greater external rotation than the NHE (p<0.05). Affected hip showed increased external rotation than the NHE. Affectedknee showed loss of first and second flexion waves in sagittal plane. Affected ankle also showed reduced first rocker, and outwardfoot progression angle compared to NHE. Our results suggest that the major coping mechanism of HE to maintain balance and tocontinue walking is to increase the stance time of affected limb inevitably sacrificing walking speed. This study points to theimportance and necessity of building a rehabilitation program that decrease the double limb support of affected limb whilemaintaining gait speed in the HE.

참고문헌 (Reference)

1 Murray, M. P., "Walking Patterns in Healthy Old Men" 24 (24): 169-178, 1969

2 Balasubramanian, C. K., "Variability in Spatiotemporal Step Characteristics and Its Relationship to Walking Performance Post-Stroke" 29 (29): 408-414, 2009

3 Perry, J., "The Mechanics of Walking in Hemiplegia" 63 : 23-31, 1969

4 Dettmann, M. A., "Relationships Among Walking Performance, Postural Stability, and Functional Assessments of the Hemiplegic Patient" 66 (66): 77-90, 1987

5 Liu, M. Q., "Muscles that Support the Body also Modulate Forward Progression during Walking" 39 (39): 2623-2630, 2006

6 Brandstater, M., "Hemiplegic Gait: Analysis of Temporal Variables" 64 (64): 583-587, 1983

7 Harris-Love, M. L., "Hemiparetic Gait Parameters in Overground Versus Treadmill Walking" 15 (15): 105-112, 2001

8 Goldie, P. A., "Gait after STROKE:Initial Deficit and Changes in Temporal Patterns for each Gait Phase" 82 (82): 1057-1065, 2001

9 Chen, C. L., "Gait Performance with Compensatory Adaptations in Stroke Patients with Different Degrees of Motor Recovery" 82 (82): 925-935, 2003

10 Chen, G., "Gait Differences between Individuals with Post-Stroke Hemiparesis and Non-Disabled Controls at Matched Speeds" 22 (22): 51-56, 2005

11 Chen, G., "Gait Deviations Associated with Post-Stroke Hemiparesis: Improvement during Treadmill Walking using Weight Support, Speed, Support Stiffness, and Handrail Hold" 22 (22): 57-62, 2005

12 Kwolek, A., "Gait Characteristics in Hemiparetic Patients after Stroke" 36 (36): 337-347, 2002

13 Wall, J. C., "Gait Asymmetries in Residual Hemiplegia" 67 (67): 550-553, 1986

14 Öberg, T., "Basic Gait Parameters:Reference Data for Normal Subjects, 10-79 Years of Age" 30 (30): 210-223, 1993

15 Pang, M. Y., "A Communitybased Fitness and Mobility Exercise Program for Older Adults with Chronic Stroke: A Randomized, Controlled Trial" 53 (53): 1667-1674, 2005