Skip to main content
Log in

Intersegmental coordination of gait after hemorrhagic stroke

  • Research Article
  • Published:
Experimental Brain Research Aims and scope Submit manuscript

Abstract

We compared gait using the planar law of intersegmental coordination between 14 hemorrhagic stroke subjects walking at a self-selected normal speed (56 ± 21 cm/s) and 15 age-matched healthy controls walking at a very slow speed (56 ± 19 cm/s). Sagittal plane elevation angles of the thigh, shank, and foot segments were submitted to principal component analysis. Additional outcome measures included the range of elevation angle and timing of peak elevation angle of the thigh, shank, and foot segments. The range of elevation angles at the shank and foot was significantly smaller in the paretic leg than non-paretic and control legs. Also, the peak elevation angle at the thigh occurred significantly later in the gait cycle in the paretic than control leg. Gait of both stroke and control subjects followed the planar law with the first two principal components explaining approximately 99 % of the variance. However, the three-dimensional trajectory of elevation angles (gait loop) in stroke subjects deviated from the typical teardrop shape bilaterally, which was more exaggerated in the paretic leg. Compared to the non-paretic and control legs, the paretic leg showed significantly increased absolute loading of the thigh elevation angle and decreased absolute loadings of the shank and foot elevation angles on the first principal component, whereas the opposite was observed for the second principal component. Despite following the planar law, the gait of chronic stroke subjects is characterized by atypical timing of the thigh motion and disrupted intersegmental coordination of both legs.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  • Allen JL, Kautz SA, Neptune RR (2011) Step length asymmetry is representative of compensatory mechanisms used in post-stroke hemiparetic walking. Gait Posture 33:538–543

    Article  PubMed Central  PubMed  Google Scholar 

  • Bianchi L, Angelini D, Lacquaniti F (1998) Individual characteristics of human walking mechanics. Pflugers Arch 436:343–356

    Article  CAS  PubMed  Google Scholar 

  • Bleyenheuft C, Cockx S, Caty G, Stoquart G, Lejeune T, Detrembleur C (2009) The effect of botulinum toxin injections on gait control in spastic stroke patients presenting with a stiff-knee gait. Gait Posture 30:168–172

    Article  PubMed  Google Scholar 

  • Bleyenheuft C, Deltombe T, Detrembleur C (2013) Influence of ankle-foot orthoses on kinematic segmental covariation among stroke patients. Ann Phys Rehabil Med 56:3–13

    Article  CAS  PubMed  Google Scholar 

  • Borghese NA, Bianchi L, Lacquaniti F (1996) Kinematic determinants of human locomotion. J Physiol 494(Pt 3):863–879

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Chau T (2001) A review of analytical techniques for gait data. Part 1: fuzzy, statistical and fractal methods. Gait Posture 13:49–66

    Article  CAS  PubMed  Google Scholar 

  • Cheron G, Bouillot E, Dan B, Bengoetxea A, Draye JP, Lacquaniti F (2001) Development of a kinematic coordination pattern in toddler locomotion: planar covariation. Exp Brain Res 137:455–466

    Article  CAS  PubMed  Google Scholar 

  • Chow JW, Yablon SA, Horn TS, Stokic DS (2010) Temporospatial characteristics of gait in patients with lower limb muscle hypertonia after traumatic brain injury. Brain Inj 24:1575–1584

    Article  PubMed  Google Scholar 

  • Courtine G, Schieppati M (2003a) Human walking along a curved path. I. Body trajectory, segment orientation and the effect of vision. Eur J Neurosci 18:177–190

    Article  PubMed  Google Scholar 

  • Courtine G, Schieppati M (2003b) Human walking along a curved path. II. Gait features and EMG patterns. Eur J Neurosci 18:191–205

    Article  PubMed  Google Scholar 

  • Courtine G, Schieppati M (2004) Tuning of a basic coordination pattern constructs straight-ahead and curved walking in humans. J Neurophysiol 91:1524–1535

    Article  PubMed  Google Scholar 

  • Dan B, Bouillot E, Bengoetxea A, Cheron G (2000) Effect of intrathecal baclofen on gait control in human hereditary spastic paraparesis. Neurosci Lett 280:175–178

    Article  CAS  PubMed  Google Scholar 

  • De Wit L, Molas M, Dejaeger E, De Weerdt W, Feys H, Jenni W, Lincoln N, Putman K, Schupp W, Lesaffre E (2009) The use of a biplot in studying outcomes after stroke. Neurorehabil Neural Repair 23:825–830

    Article  PubMed  Google Scholar 

  • Dominici N, Ivanenko YP, Cappellini G, Zampagni ML, Lacquaniti F (2010) Kinematic strategies in newly walking toddlers stepping over different support surfaces. J Neurophysiol 103:1673–1684

    Article  PubMed  Google Scholar 

  • Grasso R, Bianchi L, Lacquaniti F (1998) Motor patterns for human gait: backward versus forward locomotion. J Neurophysiol 80:1868–1885

    CAS  PubMed  Google Scholar 

  • Grasso R, Peppe A, Stratta F, Angelini D, Zago M, Stanzione P, Lacquaniti F (1999) Basal ganglia and gait control: apomorphine administration and internal pallidum stimulation in Parkinson’s disease. Exp Brain Res 126:139–148

    Article  CAS  PubMed  Google Scholar 

  • Grasso R, Zago M, Lacquaniti F (2000) Interactions between posture and locomotion: motor patterns in humans walking with bent posture versus erect posture. J Neurophysiol 83:288–300

    CAS  PubMed  Google Scholar 

  • Hicheur H, Terekhov AV, Berthoz A (2006) Intersegmental coordination during human locomotion: does planar covariation of elevation angles reflect central constraints? J Neurophysiol 96:1406–1419

    Article  PubMed  Google Scholar 

  • Hyngstrom A, Onushko T, Chua M, Schmit BD (2010) Abnormal volitional hip torque phasing and hip impairments in gait post stroke. J Neurophysiol 103:1557–1568

    Article  PubMed  Google Scholar 

  • Hyngstrom AS, Kuhnen HR, Kirking KM, Hunter SK (2014) Functional implications of impaired control of submaximal hip flexion following stroke. Muscle Nerve 49:225–232

    Article  PubMed  Google Scholar 

  • Ivanenko YP, Grasso R, Macellari V, Lacquaniti F (2002) Control of foot trajectory in human locomotion: role of ground contact forces in simulated reduced gravity. J Neurophysiol 87:3070–3089

    CAS  PubMed  Google Scholar 

  • Ivanenko YP, d’Avella A, Poppele RE, Lacquaniti F (2008) On the origin of planar covariation of elevation angles during human locomotion. J Neurophysiol 99:1890–1898

    Article  CAS  PubMed  Google Scholar 

  • Jonkers I, Delp S, Patten C (2009) Capacity to increase walking speed is limited by impaired hip and ankle power generation in lower functioning persons post-stroke. Gait Posture 29:129–137

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Jonsdottir J, Recalcati M, Rabuffetti M, Casiraghi A, Boccardi S, Ferrarin M (2009) Functional resources to increase gait speed in people with stroke: strategies adopted compared to healthy controls. Gait Posture 29:355–359

    Article  CAS  PubMed  Google Scholar 

  • Kadaba MP, Ramakrishnan HK, Wootten ME (1990) Measurement of lower extremity kinematics during level walking. J Orthop Res 8:383–392

    Article  CAS  PubMed  Google Scholar 

  • Lacquaniti F, Grasso R, Zago M (1999) Motor Patterns in Walking. News Physiol Sci 14:168–174

    PubMed  Google Scholar 

  • Lacquaniti F, Ivanenko YP, Zago M (2002) Kinematic control of walking. Arch Ital Biol 140:263–272

    CAS  PubMed  Google Scholar 

  • Leung J, Moseley A (2003) Impact of ankle-foot orthoses on gait and leg muscle activity in adults with hemiplegia: systematic literature review. Physiotherapy 89:39–55

    Article  Google Scholar 

  • Maclellan MJ, McFadyen BJ (2010) Segmental control for adaptive locomotor adjustments during obstacle clearance in healthy young adults. Exp Brain Res 202:307–318

    Article  PubMed  Google Scholar 

  • Maclellan MJ, Richards CL, Fung J, McFadyen BJ (2013) Use of segmental coordination analysis of nonparetic and paretic limbs during obstacle clearance in community-dwelling persons after stroke. PM R 5:381–391

    Article  PubMed  Google Scholar 

  • Nadeau S, Gravel D, Arsenault AB, Bourbonnais D (1999) Plantarflexor weakness as a limiting factor of gait speed in stroke subjects and the compensating role of hip flexors. Clin Biomech (Bristol Avon) 14:125–135

    Article  CAS  Google Scholar 

  • Noble JW, Prentice SD (2008) Intersegmental coordination while walking up inclined surfaces: age and ramp angle effects. Exp Brain Res 189:249–255

    Article  PubMed  Google Scholar 

  • Paolucci S, Antonucci G, Grasso MG et al (2003) Functional outcome of ischemic and hemorrhagic stroke patients after inpatient rehabilitation: a matched comparison. Stroke 34:2861–2865

    Article  PubMed  Google Scholar 

  • Petersen NT, Butler JE, Marchand-Pauvert V, Fisher R, Ledebt A, Pyndt HS, Hansen NL, Nielsen JB (2001) Suppression of EMG activity by transcranial magnetic stimulation in human subjects during walking. J Physiol 537:651–656

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  • Pijnappels M, Van Wezel BM, Colombo G, Dietz V, Duysens J (1998) Cortical facilitation of cutaneous reflexes in leg muscles during human gait. Brain Res 787:149–153

    Article  CAS  PubMed  Google Scholar 

  • Raja B, Neptune RR, Kautz SA (2012) Coordination of the non-paretic leg during hemiparetic gait: expected and novel compensatory patterns. Clin Biomech (Bristol, Avon) 27:1023–1030

  • Sainani KL (2014) Introduction to principal components analysis. PM R 6:275–278

    Article  PubMed  Google Scholar 

  • Tyson SF, Kent RM (2013) Effects of an ankle-foot orthosis on balance and walking after stroke: a systematic review and pooled meta-analysis. Arch Phys Med Rehabil 94:1377–1385

    Article  PubMed  Google Scholar 

  • Zeni JA Jr, Richards JG, Higginson JS (2008) Two simple methods for determining gait events during treadmill and overground walking using kinematic data. Gait Posture 27:710–714

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Acknowledgments

We are grateful to Mark Hemleben, Terry Horn, PhD, and L. Anthony Smith for their assistance and to Stuart A Yablon, MD, for recruiting some of the subjects for this study. This work was supported in part by the Wilson Research Foundation, Jackson, MS, USA.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to John W. Chow.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Chow, J.W., Stokic, D.S. Intersegmental coordination of gait after hemorrhagic stroke. Exp Brain Res 233, 125–135 (2015). https://doi.org/10.1007/s00221-014-4099-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00221-014-4099-2

Keywords

Navigation