Kinematic head and trunk strategies used by hemiplegic stroke patients crossing over obstacles of different heights.
Jin-Tae Han, Jung-Hoon Lee, Dennis W Fell
PMID 28210053WHAT IT FOUND
Stroke patients crossing a 20%-height obstacle showed more head forward bending than with no obstacle, and more head side bending and pelvis rotation on the non-paretic side than at 10% height.
At 10%-height, head, trunk, and pelvis motion did not clearly increase.
Key findings
01When the obstacle was 10% of body height, head, trunk, and pelvis movement measurements did not increase significantly compared with no obstacle.
02When the obstacle was 20% of body height, maximum head forward bending was significantly higher than with no obstacle.
03When the obstacle was 20% of body height, maximum head side bending and maximum pelvis rotation on the non-paretic side were significantly higher than at 10% height.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only nine people were studied, and the authors say the number is too small to generalize. Knee and ankle joint motion were not recorded, so lower-limb contributions are unknown. Obstacle depth was not varied, so the effect of width or depth is unknown. Muscle activity was not measured, so the study cannot say which muscles produced the observed movement. The study observed movement patterns during obstacle crossing; it did not test a treatment or fall outcomes.
Declared interests
No funding or conflict-of-interest declaration is reported in the supplied text.
The easy way to misread this
Do not conclude that setting an obstacle to 20% of a patient's height improves safety or balance. This was a nine-person movement study with no intervention and no fall outcomes, and the authors say the sample is too small to generalize.