Analysis of Balance during Functional Walking in Stroke Survivors.

An important objective of rehabilitation care is to regain adequate balance function to safely ambulate in community. However, in rehabilitation practice, it remains unclear if a stroke survivor functionally recovers by restitution or by learning to compensate for the lack of restoration of body fun...

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Main Authors: Fokke B van Meulen, Dirk Weenk, Edwin H F van Asseldonk, H Martin Schepers, Peter H Veltink, Jaap H Buurke
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2016-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC5113974?pdf=render
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author Fokke B van Meulen
Dirk Weenk
Edwin H F van Asseldonk
H Martin Schepers
Peter H Veltink
Jaap H Buurke
author_facet Fokke B van Meulen
Dirk Weenk
Edwin H F van Asseldonk
H Martin Schepers
Peter H Veltink
Jaap H Buurke
author_sort Fokke B van Meulen
collection DOAJ
description An important objective of rehabilitation care is to regain adequate balance function to safely ambulate in community. However, in rehabilitation practice, it remains unclear if a stroke survivor functionally recovers by restitution or by learning to compensate for the lack of restoration of body function. Aim of this study is to propose and evaluate methods for the objective evaluation of balance during functional walking in stroke survivors.Stroke survivors performed twice a Timed "Up & Go" (TUG) test. Ground reaction forces and position changes of both feet were measured using instrumented shoes and used to estimate the position of the center of mass (CoM). Balance control and efficiency metrics were defined to evaluate functional walking under variable conditions. Metrics were corrected based on the instantaneous velocity direction of CoM. Intra- and inter-participant variations for different phases of the TUG test were examined. Metrics were related to the Berg balance scale (BBS).Participants with higher BBS scores show a more efficient walking pattern. Their walking velocity and walking direction is less variable and they are more frequently unstable when walking in a straight line or when turning. Furthermore, the less affected participants are able to move their CoM more towards their affected side.We developed and demonstrated a method to assess walking balance of stroke survivors. System design and evaluation methods allow balance evaluation during functional walking in daily life. Some presented metrics show correlations with BBS scores. Clear inter- and intra-patient variations in metric values are present that cannot be explained by BBS scores, which supports the additional value of the presented system. Presented methods may be used for objective evaluation of restitution and compensation of walking balance and have a potential application in individual evidence-based therapy.
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spelling doaj.art-92a4622825834e99ac8240052ab532f52022-12-21T22:46:57ZengPublic Library of Science (PLoS)PLoS ONE1932-62032016-01-011111e016678910.1371/journal.pone.0166789Analysis of Balance during Functional Walking in Stroke Survivors.Fokke B van MeulenDirk WeenkEdwin H F van AsseldonkH Martin SchepersPeter H VeltinkJaap H BuurkeAn important objective of rehabilitation care is to regain adequate balance function to safely ambulate in community. However, in rehabilitation practice, it remains unclear if a stroke survivor functionally recovers by restitution or by learning to compensate for the lack of restoration of body function. Aim of this study is to propose and evaluate methods for the objective evaluation of balance during functional walking in stroke survivors.Stroke survivors performed twice a Timed "Up & Go" (TUG) test. Ground reaction forces and position changes of both feet were measured using instrumented shoes and used to estimate the position of the center of mass (CoM). Balance control and efficiency metrics were defined to evaluate functional walking under variable conditions. Metrics were corrected based on the instantaneous velocity direction of CoM. Intra- and inter-participant variations for different phases of the TUG test were examined. Metrics were related to the Berg balance scale (BBS).Participants with higher BBS scores show a more efficient walking pattern. Their walking velocity and walking direction is less variable and they are more frequently unstable when walking in a straight line or when turning. Furthermore, the less affected participants are able to move their CoM more towards their affected side.We developed and demonstrated a method to assess walking balance of stroke survivors. System design and evaluation methods allow balance evaluation during functional walking in daily life. Some presented metrics show correlations with BBS scores. Clear inter- and intra-patient variations in metric values are present that cannot be explained by BBS scores, which supports the additional value of the presented system. Presented methods may be used for objective evaluation of restitution and compensation of walking balance and have a potential application in individual evidence-based therapy.http://europepmc.org/articles/PMC5113974?pdf=render
spellingShingle Fokke B van Meulen
Dirk Weenk
Edwin H F van Asseldonk
H Martin Schepers
Peter H Veltink
Jaap H Buurke
Analysis of Balance during Functional Walking in Stroke Survivors.
PLoS ONE
title Analysis of Balance during Functional Walking in Stroke Survivors.
title_full Analysis of Balance during Functional Walking in Stroke Survivors.
title_fullStr Analysis of Balance during Functional Walking in Stroke Survivors.
title_full_unstemmed Analysis of Balance during Functional Walking in Stroke Survivors.
title_short Analysis of Balance during Functional Walking in Stroke Survivors.
title_sort analysis of balance during functional walking in stroke survivors
url http://europepmc.org/articles/PMC5113974?pdf=render
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AT hmartinschepers analysisofbalanceduringfunctionalwalkinginstrokesurvivors
AT peterhveltink analysisofbalanceduringfunctionalwalkinginstrokesurvivors
AT jaaphbuurke analysisofbalanceduringfunctionalwalkinginstrokesurvivors