Pre-swing deficits in forward propulsion, swing initiation and power generation by individual muscles during hemiparetic walking

Peterson, Carrie L.; Hall, Allison L.; Kautz, Steven A.; Neptune, Richard R.

Affiliations

¹Department of Mechanical Engineering, The University of Texas at Austin, TX, USA

²Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, FL, USA

³Department of Physical Therapy, University of Florida, Gainesville, FL, USA

⁴Brooks Center for Rehabilitation Studies, University of Florida, Gainesville, FL, USA

Abstract

Clinical studies of hemiparetic walking have shown pre-swing abnormalities in the paretic leg suggesting that paretic muscle contributions to important biomechanical walking subtasks are different than those of non-disabled individuals. Three-dimensional forward dynamics simulations of two representative hemiparetic subjects with different levels of walking function classified by self-selected walking speed (i.e., limited community=0.4–0.8 m/s and community walkers=>0.8 m/s) and a speed-matched control were generated to quantify individual muscle contributions to forward propulsion, swing initiation and power generation during the pre-swing phase (i.e., double support phase proceeding toe-off). Simulation analyses identified decreased paretic soleus and gastrocnemius contributions to forward propulsion and power generation as the primary impairment in the limited community walker compared to the control subject. The non-paretic leg did not compensate for decreased forward propulsion by paretic muscles during pre-swing in the limited community walker. Paretic muscles had the net effect to absorb energy from the paretic leg during pre-swing in the community walker suggesting that deficits in swing initiation are a primary impairment. Specifically, the paretic gastrocnemius and hip flexors (i.e., iliacus, psoas and sartorius) contributed less to swing initiation and the paretic soleus and gluteus medius absorbed more power from the paretic leg in the community walker compared to the control subject. Rehabilitation strategies aimed at diminishing these deficits have much potential to improve walking function in these hemiparetic subjects and those with similar deficits.

Links

DOI: 10.1016/j.jbiomech.2010.04.027

PubMed: 20466377

WoS: 000282112300016

History

Accepted: 2010-04-22

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2012	Silverman AK, Neptune RR. Muscle and prosthesis contributions to amputee walking mechanics: a modeling study. J Biomech. August 31, 2012;45(13):2271-2278.
2018	Hegarty AK. Biomechanical Modeling of Gait in Children With Cerebral Palsy [PhD thesis]. Colorado School of Mines; 2018.
2021	McCain EM. Understanding the Neuromechanics and Energetics of Clinical Gait Using Joint Restrictions to Impose Asymmetric Stepping [PhD thesis]. North Carolina State University; 2021.
2015	Nelson CM. An Investigation of Musculoskeletal Adaptation At the Paretic Elbow After Chronic Hemiparetic Stroke Using Imaging, Biomechanical and Simulation Approaches [PhD thesis]. Evanston, IL: Northwestern University; December 2015.
2017	Schloemer SA. Differences in Lower Extremity Muscle Function and Coordination During Gait Between Older and Young Adults [PhD thesis]. The Ohio State University; 2017.
2012	Hamner SR. Muscle Contributions to Propulsion and Support Over a Range of Running Speeds [PhD thesis]. Stanford University; August 2012.
2012	Knarr BA. Development of Musculoskeletal Models to Assess Muscle Weakness, Coordination, and Response to Rehabilitation in Persons Post-Stroke [PhD thesis]. University of Delaware; 2012.
2014	Ramsay JW. Muscle Morphological Changes, Compensatory Strategies and the Use of Predictive Simulations to Direct the Rehabilitation of Individuals Post-Stroke [PhD thesis]. University of Delaware; 2014.
2015	Khoeilar R. Changes in Muscle Coordination of Stroke Patients Due to Robotic and Body Weight Supported Treadmill Training [Master's thesis]. University of Delaware; 2015.
2023	Pariser K. Optimal Adaptive Treadmill Control to Maximize Propulsion During Gait [PhD thesis]. University of Delaware; Summer 2023.
2010	Hall AL. Understanding Changes in Post-Stroke Walking Ability Through Simulation and Experimental Analyses [PhD thesis]. University of Texas at Austin; December 2010.
2010	Silverman AK. Compensatory Mechanisms in Below-Knee Amputee Walking and Their Effects on Knee Joint Loading, Metabolic Cost and Angular Momentum [PhD thesis]. University of Texas at Austin; August 2010.
2012	Allen JL. Simulation and Experimental Analyses to Assess Walking Performance Post-Stroke Using Step Length Asymmetry and Module Composition [PhD thesis]. University of Texas at Austin; August 2012.
2014	Routson RL. An Analysis of Modular Patterns in Healthy and Post-Stroke Hemiparetic Gait [PhD thesis]. University of Texas at Austin; August 2014.
2014	Vistamehr A. Understanding Dynamic Balance During Walking Using Whole-Body Angular Momentum [Master's thesis]. University of Texas at Austin; August 2014.
2015	Harper NG. Muscle Function and Coordination of Amputee and Non-Amputee Stair Ascent [PhD thesis]. University of Texas at Austin; August 2015.
2016	Ranz EC. Mobility in Individuals With Traumatic Lower-Limb Injuries: Implications for Device Design, Surgical Intervention and Rehabilitation Therapies [PhD thesis]. University of Texas at Austin; May 2016.
2016	Shell CE. Tuning Prosthetic Foot Stiffness to Improve Lower-Limb Amputee Mobility [PhD thesis]. University of Texas at Austin; May 2016.
2018	Brough LG. Merged Plantarflexor Muscle Activity is Predictive of Poor Walking Performance in Post-Stroke Hemiparetic Subjects [Master's thesis]. University of Texas at Austin; May 2018.
2021	Brough LG. Muscle Contributions to Balance Control, Propulsion and Leg Swing During Healthy and Post-Stroke Walking [PhD thesis]. University of Texas at Austin; December 2021.