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

Digna de Kam, Jolanda M B Roelofs, Alexander C H Geurts, Vivian Weerdesteyn
PloS One 2018, 13 (2): e0192961

OBJECTIVE: 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.

METHODS: 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.

RESULTS: 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<0.01). Participant group and stepping leg (paretic or non-paretic) did not significantly improve the explained variance of the final body configuration model.

CONCLUSIONS: 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.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"