Browsing by Author "Binder-Macleod, Stuart A."
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Item Baseline predictors of treatment gains in peak propulsive force in individuals poststroke(BioMed Central, 2016-01-15) Hsiao, HaoYuan; Higginson, Jill S.; Binder-Macleod, Stuart A.; HaoYuan Hsiao, Jill S. Higginson and Stuart A. Binder-Macleod; Hsiao, HaoYuan; Higginson, Jill S.; Binder-Macleod, Stuart A.BACKGROUND: Current rehabilitation for individuals poststroke focuses on increasing walking speed because it is an indicator of community walking ability and quality of life. Propulsive force generated from the paretic limb is critical to walking speed and may reflect actual neural recovery that restores the affected neural systems. A wide variation across individuals in the improvements in paretic propulsive force was observed following an intervention that targeted paretic propulsive force. This study aimed to determine if specific baseline characteristics can be used to predict patients who would respond to the intervention. METHODS: Participants (N = 19) with chronic poststroke hemiparesis walked at their self-selected and maximal walking speeds on a treadmill before and after a 12-week gait training program. Propulsive forces from the paretic limb were analyzed. Pearson correlation coefficient was used to determine the relationships between (1) treatment gains in walking speed and propulsive force following intervention, and (2) treatment gains in propulsive force and baseline propulsive forces. RESULTS: Treatment gains in self-selected walking speed were correlated to treatment gains in paretic propulsive force following intervention. In addition, changes in paretic propulsive force between self-selected and maximal walking speeds at baseline were strongly correlated to treatment gains in paretic propulsive force. CONCLUSIONS: The capacity to modulate paretic propulsive force, rather than the absolute propulsive force during self-selected or maximal walking speed, predicted treatment gains in propulsive force following the intervention. Findings from this research could help to inform clinicians and researchers to target the appropriate patient population for rehabilitation interventions.Item Mechanisms to increase propulsive force for individuals poststroke(BioMed Central Ltd., 2015-04-18) Hsiao, HaoYuan; Knarr, Brian A.; Higginson, Jill S.; Binder-Macleod, Stuart A.; HaoYuan Hsiao, Brian A Knarr, Jill S Higginson3 and Stuart A Binder-Macleod4; Hsiao, HaoYuan; Higginson, Jill S.; Binder-Macleod, Stuart A.BACKGROUND: Propulsive 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. METHODS: A 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. RESULTS: Both 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%. CONCLUSIONS: Individuals 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.