Does the environment cause changes in hemiparetic lower limb muscle activity and gait velocity during walking in stroke survivors?

D’souza, Jennifer and Natarajan, Manikandan and Kumaran, Senthil D (2020) Does the environment cause changes in hemiparetic lower limb muscle activity and gait velocity during walking in stroke survivors? Journal of Stroke and Cerebrovascular Diseases, 29. pp. 1-7. ISSN 1052-3057

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Abstract

Stroke survivors often face difficulty in community ambulation though they attain steady-state walking in clinical setups. Compliance and unpredictability of the envi�ronment may alter the muscle activity and challenge the individual's gait. Success�ful reintegration into the community requires gait assessment and training in a real�life challenging environment. Little is known about the assessment and training of gait in the community environment under challenging mobility dimensions. Hence, we aimed to study the changes that real-life environmental dimensions have on the activity of selected muscles in hemiparetic lower limb and gait velocity in stroke survivors. Methods: An observational cross-sectional study was conducted on 16 ambulatory stroke survivors to assess the hemiparetic lower limb muscle activity during walking in real-life environmental dimensions. Participants were made to walk in the community on a walkway consisting of even surface, ramp, stairs, uneven terrain and obstacles. They were also made to manoeuvre through traffic and pick a load while walking for a distance in the walkway. Muscle activity of Rec�tus Femoris, Biceps Femoris, Gastrocnemius Medialis and Tibialis Anterior of the paretic lower limb were continuously recorded while walking using wireless sur�face electromyography. Gait velocity for the entire walkway and level of perceived difficulty while walking in different dimensions were also measured. Paired t-test was used to compare the percentage Maximum Voluntary Contraction (%MVC) of lower limb muscles between even surface and real-life environment dimensions while walking. One sample t-test was used to compare the gait velocity in real-life dimensions versus gait velocity in even surface measured in an earlier study. Results: There was a significant reduction (p < 0.01) in the activity of all four hemi�paretic lower limb muscles while walking under the influence of real-life environ�mental dimensions compared to even surface. Gait velocity (0.33 § 0.17 m/s) was significantly lower than that is essential to be a community ambulator. The level of perceived difficulty across all dimensions was reported qualitatively with the high�est difficulty reported during stair and obstacle clearance. Conclusion: Real-life envi�ronmental dimensions lead to the reduction of paretic lower limb muscle activities and gait velocity during walking in community-dwelling stroke survivors. Stroke survivors perceived more difficulty while walking in real-life environment dimen�sions particularly while negotiating stairs and obstacles. Significance: Knowledge about the influence of real-life environmental dimensions will help the clinicians to target rehabilitation methods to improve walking adaptability.

Item Type: Article
Uncontrolled Keywords: Hemiparesis; community ambulation; electromyography; uneven terrains;walking adaptability.
Subjects: Allied Health > MCOAHS Manipal > Physiotherapy
Depositing User: KMC Library
Date Deposited: 15 Oct 2020 06:34
Last Modified: 15 Oct 2020 06:34
URI: http://eprints.manipal.edu/id/eprint/155906

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