Postural organization and inter-limb coordination are altered after stroke when an isometric maximum bilateral pushing effort of the upper limbs is performed

Bruyneel, Anne-Violette (Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland) ; Higgins, Johanne (Faculté de médecine, Université de Montréal ; Institut universitaire sur la réadaptation en déficience physique de Montréal-Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain) ; Akremi, Haifa (Faculté de médecine, Université de Montréal ; Laboratoire de pathokinésiologie, Institut universitaire sur la réadaptation en déficience physique de Montréal-Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain) ; Aissaoui, Rachid (École de Technologie Supérieure, Montréal, Canada ; Centre for Interdisciplinary Research in Rehabilitation (CRIR) of Greater Montreal, Montréal, Canada ; Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Canada) ; Nadeau, Sylvie (École de réadaptation, Faculté de médecine, Université de Montréal ; Laboratoire de pathokinésiologie, Institut universitaire sur la réadaptation en déficience physique de Montréal-Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain)

Background : Postural strategies of the trunk and the lower limbs are linked to upper limb motor activities. The objective was to analyze the postural organization at the lower limbs as well as the inter-limb coordination during isometric maximal bilateral pushing of upper limbs. Methods : Fifteen individuals after stroke and 17 healthy participants were assessed with an instrumented exerciser paired with an instrumented sitting surface while they executed isometric bilateral pushes with the upper limbs. The anteroposterior, vertical and mediolateral forces were recorded at the handles, the thighs and the feet. Force values at maximal bilateral pushing efforts at each segment and inter-limb coordination between sides were compared. Findings : During the isometric pushes, the paretic maximal forces at the handles for stroke participants were lower than the nonparetic side and lower than both sides of the control participants (p < 0.036). The control and stroke participants had moderate to good coordination for the anteroposterior forces (hands and thighs). While they used similar postural strategies to the controls except for a decreased weight on the paretic foot, vertical forces were less coordinated at the handles and feet in the stroke group (p < 0.050). The inter-trial variability was also higher in the stroke group. Interpretation : Bilateral pushing with gradual efforts induces impaired postural strategies and coordination between limbs in individuals after stroke. It may reveal to be a promising strategy to assess and train post-stroke individuals in a clinical setting. Also, providing feedback would help better control symmetry during efforts.


Keywords:
Article Type:
scientifique
Faculty:
santé
School:
HEdS - Genève
Institute:
Aucun institut
Date:
2021-06
Pagination:
9 p.
Published in:
Clinical Biomechanics
Numeration (vol. no.):
2021, vol. 86, article 105388
DOI:
ISSN:
0268-0033
Appears in Collection:



 Record created 2021-06-07, last modified 2021-06-09

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