Altered biomechanical strategies of the paretic hip and knee joints during a step-up task.
Vatsala Goyal, Andrew Dragunas, Robert L Askew and 2 others
PMID 36744516WHAT IT FOUND
People with chronic stroke use inefficient strategies when stepping up.
The affected leg bends less at the hip and knee, forcing the pelvis to hike higher. This leg also generates less power at the knee, shifting the load to the hip.
Key findings
01The paretic limb showed reduced hip and knee flexion angles during the swing phase of stepping up.
02To compensate for reduced knee flexion, participants with stroke exhibited exaggerated pelvic obliquity (hip hiking) with the paretic limb.
03The paretic limb generated significantly less peak power in the knee sagittal plane during the pull-up phase compared to the non-paretic limb.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Very small sample size (5 participants per group). Participants had moderate-to-high functional mobility (LE Fugl-Meyer ~21), so results may not apply to those with more severe impairments. Use of ankle-foot orthoses (AFOs) was allowed, which may influence biomechanics. Only the first step was analyzed; strategies may differ for subsequent steps.
Declared interests
There are no conflicts of interest.
The easy way to misread this
Do not assume these findings apply to all people with stroke. The participants had relatively high functional mobility and could walk 300 meters independently. Patients with more severe impairments may use different strategies or may not be able to perform this task at all.