4.6 Article

The Crucial Changes of Sit-to-Stand Phases in Subacute Stroke Survivors Identified by Movement Decomposition Analysis

Journal

FRONTIERS IN NEUROLOGY
Volume 9, Issue -, Pages -

Publisher

FRONTIERS MEDIA SA
DOI: 10.3389/fneur.2018.00185

Keywords

sit-to-stand; subacute stroke; kinematic; kinetic; rehabilitation

Funding

  1. National Natural Science Foundation of China [30973165, 81372108, 31771016]
  2. 5010 Planning Project of Sun Yat-sen University of China [2014001]
  3. Science and Technology Planning Project of Guangdong Province, China [2016A020220009, 2015B020233006, 2015B020214003, 2014B090901056]
  4. Guangzhou Research Collaborative Innovation Projects [201604020108]

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Objective: The aim of this study was to detect the key changes during sit-to-stand (STS) movement cycle in hemiparetic stroke survivors using a five-phase kinematic and kinetic analysis. Methods: Twenty-five subacute stroke survivors and 17 age-matched healthy adults participated in this study. The kinematic and kinetic parameters during STS cycle were measured using three-dimensional motion analysis system with force plates. The five standard phases of STS cycle were identified by six timing transitional points. Results: Longer total time as well as larger changes were observed at the initial phase (phase I, 0.76 +/- 0.62 VS 0.43 +/- 0.09 s; p = 0.049) and at the end of hip and knee extension phase (phase IV, 0.93 +/- 0.41 VS 0.63 +/- 0.14 s; p = 0.008) in the stroke group than healthy group. Time to maximal knee joint moment was significantly delayed in the stroke group than in the control group (1.14 +/- 1.06 VS 0.60 +/- 0.09 s, p < 0.001). The maximal hip flexion was lower during the rising phase from seated position on the affected side in the stroke group than in the control group (84.22 degrees +/- 11.64 degrees VS 94.11 degrees +/- 9.40 degrees; p = 0.022). Ground reaction force was lower (4.61 +/- 0.73 VS 5.85 +/- 0.53 N, p < 0.001) in the affected side of the stroke group than in the control group. In addition, knee joint flexion was significantly lower at just-standing phase (T-4) and at end point (T-5) (5.12 degrees +/- 5.25 degrees VS 8.21 degrees +/- 7.28 degrees, p = 0.039; 0.03 degrees +/- 5.41 degrees VS 3.07 degrees +/- 6.71 degrees, p = 0.042) on the affected side than the unaffected side. Crucial decrease of knee joint moment at abrupt transitory (T-2) and the maximal moment was also observed on the affected side in comparison with the unaffected side (0.39 +/- 0.29 VS 0.77 +/- 0.25 Nm/kg, p < 0.001; 0.42 +/- 0.38 VS 0.82 +/- 0.24 Nm/kg, p < 0.001). Conclusion: The findings of movement decomposition analysis provided useful information to clinical evaluation of STS performance, and may potentially contribute to the design of rehabilitation intervention program for optimum functional recovery of STS after stroke.

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