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Analysis of Vertical Ground Reaction Force Variables Using Foot Scans in Hemiplegic Patients.

Kim HD, Kim JG, Jeon DM, Shin MH, Han N, Eom MJ, Jo GY - Ann Rehabil Med (2015)

Bottom Line: The GRF results were compared between the hemiplegic patients and control individuals, and between the affected and unaffected limbs of hemiplegic patients.The MAS, Brunnstrom stage and Timed Up and Go Test results were significantly correlated with the VFI of the unaffected limbs (p<0.05).Therefore, these results suggest that unaffected limbs should also be taken into consideration in these patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Physical Medicine and Rehabilitation, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.

ABSTRACT

Objective: To analyze the differences in the vertical ground reaction force (GRF) variables of hemiplegic patients compared with a control group, and between the affected and unaffected limbs of hemiplegic patients using foot scans.

Methods: Patients (n=20) with hemiplegia and healthy volunteers (n=20) underwent vertical force analysis. We measured the following: the first and second peak forces (F1, F2) and the percent stances at which they occurred (T1, T2); the vertical force impulse (VFI) and stance times. The GRF results were compared between the hemiplegic patients and control individuals, and between the affected and unaffected limbs of hemiplegic patients. Additionally, we analyzed the impulse of the unaffected limb according to the motor assessment scale (MAS), Brunnstrom stage, and a Timed Up and Go Test.

Results: The F1s and F2s of the affected and unaffected limbs were significantly less than those of the normal control individuals (p<0.05). The T1s of both the affected and unaffected limbs of the patients were greater than control individuals, whilst the T2s were lower (p<0.05). Greater impulses and stance times were recorded on both sides of the patients than in the limbs of the control individuals (p<0.05). The MAS, Brunnstrom stage and Timed Up and Go Test results were significantly correlated with the VFI of the unaffected limbs (p<0.05).

Conclusion: The high impulse values of the unaffected limb were associated with complications during gait rehabilitation. Therefore, these results suggest that unaffected limbs should also be taken into consideration in these patients.

No MeSH data available.


Related in: MedlinePlus

Graph demonstrating the selected components of the vertical ground reaction force-time curve during stance phase. N, newton; BW, body weight (kg); F1, peak force at the moment of foot flat; F2, peak force at the moment of toe off; T1, time between the moment of heel contact and foot flat; T2, time until the toe off; Impulse, area under the curve.
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Figure 3: Graph demonstrating the selected components of the vertical ground reaction force-time curve during stance phase. N, newton; BW, body weight (kg); F1, peak force at the moment of foot flat; F2, peak force at the moment of toe off; T1, time between the moment of heel contact and foot flat; T2, time until the toe off; Impulse, area under the curve.

Mentions: Most stroke patients with hemiplegia develop a gait disability. However, the degree of gait disability varies due to differences in muscle weakness and muscle tone among patients [7]. A number of studies have objectively assessed the relationship of gait ability with various diseases [891011121314]. The most widely used methods involve the use of an F-Scan system or a force plate to measure the pressure and time duration applied to both legs [1516 17]. Several studies compared the pros and cons of the force plate and F-Scan methods, and Orlin and McPoil [18] indicated that use of a force plate has many disadvantages for patients with neurological abnormalities. Therefore, we used the F-Scan system in the present study. The usefulness of the ground reaction force (GRF) has been proven in a previous study. Mizrahi et al. [1920] measured various factors related to gait cycle time and distance and used them to prove the close relationships with their clinical assessment results. In addition, Wall and Ashburn [21] stated that the most basic method for gait analysis is the assessment of the categories related to gait time and distance. In the present study, various GRF categories were tested and compared to objectively assess gait disability in patients with hemiplegia. The time/pressure graph of normal GRF values obtained from the F-Scan shows a bimodal pattern. The part that shows the pressure increasing from the beginning is the phase in which the heel absorbs the shock as it touches the ground, while the latter half is the push-off phase in which thrust is generated (Fig. 3).


Analysis of Vertical Ground Reaction Force Variables Using Foot Scans in Hemiplegic Patients.

Kim HD, Kim JG, Jeon DM, Shin MH, Han N, Eom MJ, Jo GY - Ann Rehabil Med (2015)

Graph demonstrating the selected components of the vertical ground reaction force-time curve during stance phase. N, newton; BW, body weight (kg); F1, peak force at the moment of foot flat; F2, peak force at the moment of toe off; T1, time between the moment of heel contact and foot flat; T2, time until the toe off; Impulse, area under the curve.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4496512&req=5

Figure 3: Graph demonstrating the selected components of the vertical ground reaction force-time curve during stance phase. N, newton; BW, body weight (kg); F1, peak force at the moment of foot flat; F2, peak force at the moment of toe off; T1, time between the moment of heel contact and foot flat; T2, time until the toe off; Impulse, area under the curve.
Mentions: Most stroke patients with hemiplegia develop a gait disability. However, the degree of gait disability varies due to differences in muscle weakness and muscle tone among patients [7]. A number of studies have objectively assessed the relationship of gait ability with various diseases [891011121314]. The most widely used methods involve the use of an F-Scan system or a force plate to measure the pressure and time duration applied to both legs [1516 17]. Several studies compared the pros and cons of the force plate and F-Scan methods, and Orlin and McPoil [18] indicated that use of a force plate has many disadvantages for patients with neurological abnormalities. Therefore, we used the F-Scan system in the present study. The usefulness of the ground reaction force (GRF) has been proven in a previous study. Mizrahi et al. [1920] measured various factors related to gait cycle time and distance and used them to prove the close relationships with their clinical assessment results. In addition, Wall and Ashburn [21] stated that the most basic method for gait analysis is the assessment of the categories related to gait time and distance. In the present study, various GRF categories were tested and compared to objectively assess gait disability in patients with hemiplegia. The time/pressure graph of normal GRF values obtained from the F-Scan shows a bimodal pattern. The part that shows the pressure increasing from the beginning is the phase in which the heel absorbs the shock as it touches the ground, while the latter half is the push-off phase in which thrust is generated (Fig. 3).

Bottom Line: The GRF results were compared between the hemiplegic patients and control individuals, and between the affected and unaffected limbs of hemiplegic patients.The MAS, Brunnstrom stage and Timed Up and Go Test results were significantly correlated with the VFI of the unaffected limbs (p<0.05).Therefore, these results suggest that unaffected limbs should also be taken into consideration in these patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Physical Medicine and Rehabilitation, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.

ABSTRACT

Objective: To analyze the differences in the vertical ground reaction force (GRF) variables of hemiplegic patients compared with a control group, and between the affected and unaffected limbs of hemiplegic patients using foot scans.

Methods: Patients (n=20) with hemiplegia and healthy volunteers (n=20) underwent vertical force analysis. We measured the following: the first and second peak forces (F1, F2) and the percent stances at which they occurred (T1, T2); the vertical force impulse (VFI) and stance times. The GRF results were compared between the hemiplegic patients and control individuals, and between the affected and unaffected limbs of hemiplegic patients. Additionally, we analyzed the impulse of the unaffected limb according to the motor assessment scale (MAS), Brunnstrom stage, and a Timed Up and Go Test.

Results: The F1s and F2s of the affected and unaffected limbs were significantly less than those of the normal control individuals (p<0.05). The T1s of both the affected and unaffected limbs of the patients were greater than control individuals, whilst the T2s were lower (p<0.05). Greater impulses and stance times were recorded on both sides of the patients than in the limbs of the control individuals (p<0.05). The MAS, Brunnstrom stage and Timed Up and Go Test results were significantly correlated with the VFI of the unaffected limbs (p<0.05).

Conclusion: The high impulse values of the unaffected limb were associated with complications during gait rehabilitation. Therefore, these results suggest that unaffected limbs should also be taken into consideration in these patients.

No MeSH data available.


Related in: MedlinePlus