Published Online
on February 2, 2006

A more recent version of this article appeared on March 1, 2006

This Article Full Text (PDF) All Versions of this Article: 37/3/872    most recent 01.STR.0000204063.75779.8dv1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Bowden, M. G. Articles by Kautz, S. A. Search for Related Content PubMed PubMed Citation Articles by Bowden, M. G. Articles by Kautz, S. A. Related Collections Exercise/exercise testing/rehabilitation

Submitted on December 1, 2005
Revised on December 21, 2005
Accepted on December 22, 2005

Anterior-Posterior Ground Reaction Forces as a Measure of Paretic Leg Contribution in Hemiparetic Walking

Mark G. Bowden MS, PT; Chitralakshmi K. Balasubramanian PT; Richard R. Neptune PhD; and Steven A. Kautz PhD^*

From the Brain Rehabilitation Research Center (M.G.B., S.A.K.), Malcom Randall VA Medical Center, Gainesville Fla; Rehabilitation Science Doctoral Program (C.K.B.) and Department of Physical Therapy (S.A.K.) and Brooks Center for Rehabilitation Studies (S.A.K.), University of Florida, Gainesville; and Department of Mechanical Engineering (R.R.N.), University of Texas, Austin.

^* To whom correspondence should be addressed. E-mail: skautz{at}phhp.ufl.edu.

Background and Purpose--Walking after stroke is characterized by slow gait speed, poor endurance, reduced quality and adaptability of walking patterns, and an inability to coordinate the legs. Estimates based on mechanical work calculations have suggested that the paretic leg does 30% to 40% of the total mechanical work over the gait cycle, regardless of hemiparetic severity, but these work estimates may not describe the contribution of each leg to forward propulsion. The purpose of this study was to establish a quantifiable link between hemiparetic severity and paretic leg contribution to propulsion during walking, which we propose to quantify using a measure based on the anterior-posterior ground reaction forces (A-P GRFs).

Methods--A total of 47 participants with chronic hemiparesis walked at self-selected speeds to collect spatiotemporal parameters and 3D GRFs. A 16-person subset also participated in a pedaling protocol to compare A-P GRF measures to established measures of paretic leg output.

Results--A-P GRF measures were correlated with both walking speed and hemiparetic severity. These measures were also strongly correlated with positive work and net work values obtained during the pedaling task. The percentage of total propulsion generated by the paretic leg (P_P) was calculated and found to be 16%, 36%, and 49% for those with high, moderate, and low hemiparetic severity, respectively.

Conclusion--P_P was found to provide a quantitative measure of the coordinated output of the paretic leg. Further research on this measure of forward propulsion may lead to the provision of an effective tool for distinguishing functional compensation from physiological restitution.

Key words: hemiplegia • locomotion • motor activity

This article has been cited by other articles:

				T. M. Kesar, R. Perumal, D. S. Reisman, A. Jancosko, K. S. Rudolph, J. S. Higginson, and S. A. Binder-Macleod Functional Electrical Stimulation of Ankle Plantarflexor and Dorsiflexor Muscles: Effects on Poststroke Gait Stroke, December 1, 2009; 40(12): 3821 - 3827. [Abstract] [Full Text] [PDF]

				D. S. Reisman, R. Wityk, K. Silver, and A. J. Bastian Split-Belt Treadmill Adaptation Transfers to Overground Walking in Persons Poststroke Neurorehabil Neural Repair, September 1, 2009; 23(7): 735 - 744. [Abstract] [PDF]

				B. J. Kollen, S. Lennon, B. Lyons, L. Wheatley-Smith, M. Scheper, J. H. Buurke, J. Halfens, A. C.H. Geurts, and G. Kwakkel The Effectiveness of the Bobath Concept in Stroke Rehabilitation: What is the Evidence? Stroke, April 1, 2009; 40(4): e89 - e97. [Abstract] [Full Text] [PDF]

				M. G. Bowden, C. K. Balasubramanian, A. L. Behrman, and S. A. Kautz Validation of a Speed-Based Classification System Using Quantitative Measures of Walking Performance Poststroke Neurorehabil Neural Repair, November 1, 2008; 22(6): 672 - 675. [Abstract] [PDF]

				T. G. Hornby, D. D. Campbell, J. H. Kahn, T. Demott, J. L. Moore, and H. R. Roth Enhanced Gait-Related Improvements After Therapist- Versus Robotic-Assisted Locomotor Training in Subjects With Chronic Stroke: A Randomized Controlled Study Stroke, June 1, 2008; 39(6): 1786 - 1792. [Abstract] [Full Text] [PDF]

				P. Plummer, A. L. Behrman, P. W. Duncan, P. Spigel, D. Saracino, J. Martin, E. Fox, M. Thigpen, and S. A. Kautz Effects of Stroke Severity and Training Duration on Locomotor Recovery After Stroke: A Pilot Study Neurorehabil Neural Repair, March 1, 2007; 21(2): 137 - 151. [Abstract] [PDF]