Abstract
Objective: To identify and summarize biomechanical assessment approaches in interlimb coordination on poststroke gait. Introduction: Interlimb coordination involves complex neurophysiological mechanisms that can be expressed through the biomechanical output. The deepening of this concept would have a significant contribution in gait rehabilitation in patients with an asymmetric neurological impairment as poststroke adults. Inclusion criteria: Poststroke adults (>19 years old), with assessment of interlimb coordination during gait, in an open context, according to the Population, Concept, Context framework. Methods: A literature search was performed in PubMed, Web of Science™, Scopus, and gray literature in Google Scholar™, according to the PRISMA-ScR recommendations. Studies written in Portuguese or English language and published between database inception and 14 November 2021 were included. Qualitative studies, conference proceedings, letters, and editorials were excluded. The main conceptual categories were “author/year”, “study design”, “participant’s characteristics”, “walking conditions”, “instruments” and “outcomes”. Results: The search identified 827 potentially relevant studies, with a remaining seven fulfilling the established criteria. Interlimb coordination was assessed during walking in treadmill (n = 3), overground (n = 3) and both (n = 1). The instruments used monitored electromyography (n = 2), kinetics (n = 2), and kinematics (n = 4) to assess spatiotemporal parameters (n = 4), joint kinematics (n = 2), anteroposterior ground reaction forces (n = 2), and electromyography root mean square (n = 2) outcomes. These outcomes were mostly used to analyze symmetry indices or ratios, to calculate propulsive impulse and external mechanical power produced on the CoM, as well as antagonist coactivation. Conclusions: Assessment of interlimb coordination during gait is important for consideration of natural auto-selected overground walking, using kinematic, kinetic, and EMG instruments. These allow for the collection of the main biomechanical outcomes that could contribute to improve better knowledge of interlimb coordination assessment in poststroke patients.
Highlights
IntroductionDefined as the timing of lower limbs motor cycles in one relative to the other [4], interlimb coordination reflects the principles of central networks organization to generate muscle activity patterns, that determine body kinematics, kinetics, and efficiency [5]
Interaction between posture and movement during walking [1,2] requires a close coordination of muscle activity between the two lower limbs [3] in a complex control of a moving center of mass (CoM), which is not within the base of foot support [1,2].Defined as the timing of lower limbs motor cycles in one relative to the other [4], interlimb coordination reflects the principles of central networks organization to generate muscle activity patterns, that determine body kinematics, kinetics, and efficiency [5]
Walking conditions, the main instruments used, and the related outcomes have been analyzed. This information will allow a better understanding of the mechanisms underpinning interlimb coordination and its role in gait performance and rehabilitation, while its assessment promotes a reflection on key information to consider in future research
Summary
Defined as the timing of lower limbs motor cycles in one relative to the other [4], interlimb coordination reflects the principles of central networks organization to generate muscle activity patterns, that determine body kinematics, kinetics, and efficiency [5]. The relation between movement and postural control, depending, respectively, on the activation of the dorsolateral and ventromedial systems, is expressed through the functional unit composed by both lower limbs during walking to keep the body’s CoM over the feet [3]. This is critical for stable human bipedal walking during step-to-step transition, considering its impact on the mechanical work on gait [7,8]
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