An investigation into the trunk kinematics of people with stroke during gait

Titus, Adnil W. (2015-12)

Thesis (MScPhysio)—Stellenbosch University, 2015.

Thesis

ENGLISH ABSTRACT: Introduction The trunk plays an important role in the symmetry, balance and stability of the lower and upper body during gait. Approximately two out of three people with stroke experience gait restrictions. Objective To describe the three dimensional kinematics of the trunk during gait in people with stroke. Methods Seventeen subjects that met the following inclusion criteria: males and females 18 years and older; a single cardiovascular incident; ability to follow simple instructions and to walk 10 metres without assistive devices; were recruited by means of convenience sampling for this observational pilot study. The eight-camera T-10 Vicon system with Nexus 1.8 software and the Plug-in-Gait (PiG) model (Vicon Motion System Limited, Oxford, UK) were used to capture the participants during walking at a self-selected speed. Thorax kinematics and temperospatial parameters were analysed in MATLAB (The Mathworks, Natrick, MA) using custom built scripts. The differences between the two sides of the trunk (affected and less-affected) were calculated using the Sign test (statistical significance level p<0.05) (Stata software). Results During the full gait cycle there were statistically significant differences of thorax motion between the affected and the less-affected side in the coronal plane (p=0.049) and pelvic motion in the sagittal plane (p=0.049). At initial contact and foot off there were statistically significant differences of thorax motion between the affected and the less-affected side in all three planes, whereas the pelvic motion was only significantly different in the sagittal plane (p=0.000). In terms of temperospatial parameters, the participants showed symmetry in step/stride length and step/stride time. They managed functional gait speeds although they presented with asymmetrical thorax kinematics. Conclusion This pilot study found significant asymmetry in thorax motion between the affected and less-affected sides of people with stroke.

AFRIKAANSE OPSOMMING: Inleiding Die romp speel `n belangrike rol in die simmitrie, balans en stabiliteit van die bo- en onderlyf gedurende loopgang. Ongeveer twee uit drie mense met beroerte ondervind ingekorte loopgang Oogmerk Om die drie dimensionele kinematika van die romp gedurende loopgang in mense met beroerte te beskryf. Metodologie Sewentien deelnemers wat aan die in- en uitsluit vereistes voldoen (mans en vroue 18 jaar en ouer, `n enkele kardiovaskulêre insident, die vermoë om `n eenvoudige opdrag te kan volg en om `n 10m afstand sonder hulpmiddels te kan loop) was deur middel van gerieflikheidsteekproefneming vir hierdie waarnemings loodstudie gewerf. Die agt-kamera T10 Vicon sisteem met Nexus 1.8 sagteware en die “Plug-in Gait” model (Vicon Motion System Limited, Oxford, UK) was gebruik om die deelnemers se loopgang gedurendie die selfgekose spoed op te neem. Torakal kinematika en tempero-ruimtelike parameters was in MATLAB (The Mathworks, Nastrick, MA) geanaliseer deur middel van spesiaal vervaardigde programme. Die verskille tussen die twee sye van die romp (geaffekteerd en minder-geaffekteerd) was bereken deur die Sign toets (statistiese beduidende verskille vlak p<0.05) (Stata sagteware). Resultate Gedurende die vollledige loopgang siklus was daar statistiese beduidende verskille van die toraks beweging tussen die geaffekteerde en minder-geaffekteerde kante in die koronale vlak (p=0.049) en pelvis beweging in die sagitale vlak (p=0.049). By aanvanklike kontak en die voorswaai was daar statisties beduidende verskille van die toraks tussen die geaffekteerde en die minder geaffekteerde sye, in al drie vlakke, waar die pelvis beweging slegs in die sagitale vlak beduidend verskillend was (p=0.000). In terme van tempero-ruimtelik parameters het die deelnemers simmetrie in tree/ aftree lengte en tree/ aftree tyd getoon. Hulle het funksionele loopspoed handhaaf alhoewel hulle met asimmetriese torakale kinematika getoon het. Gevolgtrekking Hierdie loodstudie het bevind dat beduidende asimmetrie in torakale beweging tussen die geaffekteerde en minder-geaffekteerde sye in mense met beroerte voorkom

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