Abstract
BackgroundPropulsive force generation is critical to walking speed. Trialing limb angle and ankle moment are major contributors to increases in propulsive force during gait. For able-bodied individuals, trailing limb angle contributes twice as much as ankle moment to increases in propulsive force during speed modulation. The aim of this study was to quantify the relative contribution of ankle moment and trailing limb angle to increases in propulsive force for individuals poststroke.MethodsA biomechanical-based model previously developed for able-bodied individuals was evaluated and enhanced for individuals poststroke. Gait analysis was performed as subjects (N = 24) with chronic poststroke hemiparesis walked at their self-selected and fast walking speeds on a treadmill.ResultsBoth trailing limb angle and ankle moment increased during speed modulation. In the paretic limb, the contribution from trailing limb angle versus ankle moment to increases in propulsive force is 74% and 17%. In the non-paretic limb, the contribution from trailing limb angle versus ankle moment to increases in propulsive force is 67% and 22%.ConclusionsIndividuals poststroke increase propulsive force mainly by changing trailing limb angle in both the paretic and non-paretic limbs. This strategy may contribute to the inefficiency in poststroke walking patterns. Future work is needed to examine whether these characteristics can be modified via intervention.
Highlights
Propulsive force generation is critical to walking speed
The model predicted peak anterior component of the ground reaction force (AGRF) was the product of ankle moment and sin (TLAcop) divided by the lever arm length (d) (Eq 2)
In this study we found that the biomechanical-based model developed from able-bodied individuals over-estimated the propulsive force in stroke survivors
Summary
Trialing limb angle and ankle moment are major contributors to increases in propulsive force during gait. For able-bodied individuals, trailing limb angle contributes twice as much as ankle moment to increases in propulsive force during speed modulation. The aim of this study was to quantify the relative contribution of ankle moment and trailing limb angle to increases in propulsive force for individuals poststroke. Previous studies have shown that walking speed is related to propulsive force, defined as the anterior component of the ground reaction force (AGRF) during gait [3]. A recent study showed that improvements in paretic propulsive force are correlated to changes in self-selected walking speed and changes in fastest comfortable walking speed following a 12-week locomotor intervention [4]. Paretic propulsive force can be modified through intervention and is related to the improvement in walking speed. Understanding the mechanism to increase propulsive force would allow for the design of rehabilitation strategies for improving paretic propulsion and lead to increase walking speed
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