P-2-01-19
SUCCESSIVE CHANGES OF MAXIMUM WALKING SPEED, SWAY-PATH, AND MUSCLE STRENGTH FOR KNEE EXTENSION AFTER STROKE
Nakamura Y. (Okinawa Prefectural Miyako Hospital, Hirara, Japan), Kawai N., Sekiguchi S., Mizukami M., Koyama N., Nakamura R. (National Rehabilitation Center for the Disabled, Tokorozawa, Japan)
The maximum walking speed for 10 m distance was related to the sway-path of center of gravity at standing, isokinetic strength for knee extension of the affected side in post-stroke hemiplegic patients. We examined the maximum walking speed (MWS), the sway-path for 10 sec station (SP), and the maximum isokinetic strength (30 deg/sec) for knee extension of the affected (A-IK) and the non-affected side (N-IK) once a I - 4 weeks successively in 32 stroke patients aged from 23 to 72 years. Based on data analysis, the patients were divided into two groups, 19 cases belonging to A group and 13 to B. In group A, MWS became more than 30 m/min and SP less than 30 cm/10 sec during follow-up, whereas MWS remained within 30 m/min and SP above 30 cm/10 sec in group B. Using the data of group A, we obtained the difference between the date when MWS exceeded 30 m/min and when SP decreased below 30 cm/10 sec. The mean difference of date was 1.2±3.3 weeks. SP within upper limit of normal range could be indispensable for the independent gait of the patients.
P-2-01-20
AN EXPERIMENTAL ASSESSMENT OF STANDING POSTURAL STABILITY ON MOVABLE PLATFORM FOR THE STROKE
Toshiyasu Yamamoto, Jyunichi Ohshima, Hiroshi Asano (Toyama Prefectural Koshi Rehab Hosp, Toyama, Japan)
Abstract: The purpose of this study is to find the clinical indicies of dynamic postural stability in standing position for the stroke. The movable platform was swayed in the forward/backward direction in upright standing on 2 sets of force plates. The angular displacement of the joints were also measured, to find an sway response strategy The subjects are 52 (22-the young, 30-the elderly,) normal, 55 hemiplegic persons.
The indicies estimated are (1) the vertical reaction force, (2) the 1st and 2nd peak values, (3) the average sway distance, and (4) settling time of the center of foot pressure, (5) the angular displacements of the hip and ankle. Also, on the biomechanical analysis, the 5-rigid-bodies-model was developed to assess (6) the joint torques of the angular accerelation components of the ankle joint. This kinetic estimation makes it possible to observe variations of the sway patterns, and have a better understanding of the experimental results of the center of foot pressure, etc.
The results show that the stroke patients have a tendency to make irregular response patterns of the hip anf ankle strategies, which controls the upper body to be stable. The peak values and the average sway distance were ascertained to be useful in clinical assessment. It concluded that an application of the dynamic sway is very effective to estimate postural stability quantitatively.
