Body configuration at first stepping-foot contact predicts backward balance recovery capacity in people with chronic stroke

To determine the predictive value of leg and trunk inclination angles at stepping-foot contact for the capacity to recover from a backward balance perturbation with a single step in people after stroke. Twenty-four chronic stroke survivors and 21 healthy controls were included in a cross-sectional s...

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Published in:PloS one 2018-02, Vol.13 (2), p.e0192961-e0192961
Main Authors: de Kam, Digna, Roelofs, Jolanda M B, Geurts, Alexander C H, Weerdesteyn, Vivian
Format: Article
Language:English
Subjects:
Accidental falls
Analysis
Balance
Biology and Life Sciences
Body kinematics
Brain research
Cognition & reasoning
Configurations
Contact angle
Earth Sciences
Falls
Feet
Goodness of fit
Health risks
Inclination
Influence
Kinematics
Laboratories
Leg
Mathematical models
Medicine and Health Sciences
Older people
Parameter identification
Perturbation methods
Physical Sciences
Physiological aspects
Posture
Recovery
Recovery (Medical)
Rehabilitation
Research and Analysis Methods
Risk factors
Social Sciences
Stroke
Stroke patients
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Roelofs, Jolanda M B
Geurts, Alexander C H
Weerdesteyn, Vivian
description To determine the predictive value of leg and trunk inclination angles at stepping-foot contact for the capacity to recover from a backward balance perturbation with a single step in people after stroke. Twenty-four chronic stroke survivors and 21 healthy controls were included in a cross-sectional study. We studied reactive stepping responses by subjecting participants to multidirectional stance perturbations at different intensities on a translating platform. In this paper we focus on backward perturbations. Participants were instructed to recover from the perturbations with maximally one step. A trial was classified as 'success' if balance was restored according to this instruction. We recorded full-body kinematics and computed: 1) body configuration parameters at first stepping-foot contact (leg and trunk inclination angles) and 2) spatiotemporal step parameters (step onset, step length, step duration and step velocity). We identified predictors of balance recovery capacity using a stepwise logistic regression. Perturbation intensity was also included as a predictor. The model with spatiotemporal parameters (perturbation intensity, step length and step duration) could correctly classify 85% of the trials as success or fail (Nagelkerke R2 = 0.61). In the body configuration model (Nagelkerke R2 = 0.71), perturbation intensity and leg and trunk angles correctly classified the outcome of 86% of the recovery attempts. The goodness of fit was significantly higher for the body configuration model compared to the model with spatiotemporal variables (p
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Twenty-four chronic stroke survivors and 21 healthy controls were included in a cross-sectional study. We studied reactive stepping responses by subjecting participants to multidirectional stance perturbations at different intensities on a translating platform. In this paper we focus on backward perturbations. Participants were instructed to recover from the perturbations with maximally one step. A trial was classified as 'success' if balance was restored according to this instruction. We recorded full-body kinematics and computed: 1) body configuration parameters at first stepping-foot contact (leg and trunk inclination angles) and 2) spatiotemporal step parameters (step onset, step length, step duration and step velocity). We identified predictors of balance recovery capacity using a stepwise logistic regression. Perturbation intensity was also included as a predictor. 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Twenty-four chronic stroke survivors and 21 healthy controls were included in a cross-sectional study. We studied reactive stepping responses by subjecting participants to multidirectional stance perturbations at different intensities on a translating platform. In this paper we focus on backward perturbations. Participants were instructed to recover from the perturbations with maximally one step. A trial was classified as 'success' if balance was restored according to this instruction. We recorded full-body kinematics and computed: 1) body configuration parameters at first stepping-foot contact (leg and trunk inclination angles) and 2) spatiotemporal step parameters (step onset, step length, step duration and step velocity). We identified predictors of balance recovery capacity using a stepwise logistic regression. Perturbation intensity was also included as a predictor. The model with spatiotemporal parameters (perturbation intensity, step length and step duration) could correctly classify 85% of the trials as success or fail (Nagelkerke R2 = 0.61). In the body configuration model (Nagelkerke R2 = 0.71), perturbation intensity and leg and trunk angles correctly classified the outcome of 86% of the recovery attempts. The goodness of fit was significantly higher for the body configuration model compared to the model with spatiotemporal variables (p&lt;0.01). Participant group and stepping leg (paretic or non-paretic) did not significantly improve the explained variance of the final body configuration model. Body configuration at stepping-foot contact is a valid and clinically feasible indicator of backward fall risk in stroke survivors, given its potential to be derived from a single sagittal screenshot.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>29470535</pmid><doi>10.1371/journal.pone.0192961</doi><tpages>e0192961</tpages><orcidid>https://orcid.org/0000-0001-6383-0106</orcidid><oa>free_for_read</oa></addata></record>
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subjects Accidental falls
Analysis
Balance
Biology and Life Sciences
Body kinematics
Brain research
Cognition & reasoning
Configurations
Contact angle
Earth Sciences
Falls
Feet
Goodness of fit
Health risks
Inclination
Influence
Kinematics
Laboratories
Leg
Mathematical models
Medicine and Health Sciences
Older people
Parameter identification
Perturbation methods
Physical Sciences
Physiological aspects
Posture
Recovery
Recovery (Medical)
Rehabilitation
Research and Analysis Methods
Risk factors
Social Sciences
Stroke
Stroke patients
title Body configuration at first stepping-foot contact predicts backward balance recovery capacity in people with chronic stroke
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