Strategies for maintaining dynamic balance in persons with neurological disorders during overground walking

Author:

Lencioni Tiziana1ORCID,Anastasi Denise1,Carpinella Ilaria1ORCID,Castagna Anna1,Crippa Alessandro1,Gervasoni Elisa1,Marzegan Alberto1,Rabuffetti Marco1ORCID,Pelosin Elisa23,Cattaneo Davide1,Ferrarin Maurizio1ORCID

Affiliation:

1. IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy

2. Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genoa, Genoa, Italy

3. Ospedale Policlinico San Martino-IRCCS, Genoa, Italy

Abstract

Maintaining a stable gait requires a dynamic balance control, that can be altered in persons with Multiple Sclerosis (MS), Stroke (ST), and Parkinson’s disease (PD). The understanding of the strategy for Center of Mass (CoM) positioning adopted by patients during walking is important to be able to program treatments aimed at improving gait control and preventing falls. Forty-four persons with a mild-to-moderate neurological disorder (20 with MS, 14 with ST, 10 with PD) underwent clinical examination and gait analysis. Ten Healthy Subjects (HS) walking at matched speed provided the normative data. Dynamic balance was assessed using the margin of stability (MoS). It was calculated as the distance between the extrapolated Center of Pressure and the extrapolated CoM at mid-stance. The MoS values for lower limbs were calculated in patients and compared with speed-matched values of HS. Persons with neurological disorder showed increased MoS in the medio-lateral direction with respect to HS. Within-group comparison analysis showed a symmetry between lower limbs in HS (Mean (95%CI) [mm], dominant vs non-dominant limb, 43.3 (31.9–54.6) vs 42.9 (28.8–56.9)) and PD (less affected vs more affected limb, 71.1 (59.8–82.5) vs 72.5 (58.5–86.6)), while a significant asymmetry was found in MS (54.4 (46.4–62.4) vs 81.1 (71.2–91.1)) and ST (52.1 (42.6–61.7) vs 74.7 (62.8–86.6)) participants. The history of falls was comparable among PD, MS, and ST groups, and the MoS in the frontal plane showed a strong correlation with these records. Objective assessment of MoS revealed pathology-specific strategies showing different impacts in MS, ST, and PD on the ability to control CoM information to manage the balance between limbs during gait. MoS evaluation will provide useful information to address a tailored rehabilitation program and to monitor disease progression.

Funder

Italian Ministry of Health

Publisher

SAGE Publications

Subject

Mechanical Engineering,General Medicine

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3