Characterization and clinical implications of ankle impedance during walking in chronic stroke

Abstract Individuals post-stroke experience persisting gait deficits due to altered joint mechanics, known clinically as spasticity, hypertonia, and paresis. In engineering, these concepts are described as stiffness and damping, or collectively as joint mechanical impedance, when considered with lim...

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Autores principales:	Amanda L. Shorter, James K. Richardson, Suzanne B. Finucane, Varun Joshi, Keith Gordon, Elliott J. Rouse
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/e8fae3e74bc94c7a8a082e87dafd6cb5
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spelling	oai:doaj.org-article:e8fae3e74bc94c7a8a082e87dafd6cb52021-12-02T16:45:47ZCharacterization and clinical implications of ankle impedance during walking in chronic stroke10.1038/s41598-021-95737-62045-2322https://doaj.org/article/e8fae3e74bc94c7a8a082e87dafd6cb52021-08-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-95737-6https://doaj.org/toc/2045-2322Abstract Individuals post-stroke experience persisting gait deficits due to altered joint mechanics, known clinically as spasticity, hypertonia, and paresis. In engineering, these concepts are described as stiffness and damping, or collectively as joint mechanical impedance, when considered with limb inertia. Typical clinical assessments of these properties are obtained while the patient is at rest using qualitative measures, and the link between the assessments and functional outcomes and mobility is unclear. In this study we quantify ankle mechanical impedance dynamically during walking in individuals post-stroke and in age-speed matched control subjects, and examine the relationships between mechanical impedance and clinical measures of mobility and impairment. Perturbations were applied to the ankle joint during the stance phase of walking, and least-squares system identification techniques were used to estimate mechanical impedance. Stiffness of the paretic ankle was decreased during mid-stance when compared to the non-paretic side; a change independent of muscle activity. Inter-limb differences in ankle joint damping, but not joint stiffness or passive clinical assessments, strongly predicted walking speed and distance. This work provides the first insights into how stroke alters joint mechanical impedance during walking, as well as how these changes relate to existing outcome measures. Our results inform clinical care, suggesting a focus on correcting stance phase mechanics could potentially improve mobility of chronic stroke survivors.Amanda L. ShorterJames K. RichardsonSuzanne B. FinucaneVarun JoshiKeith GordonElliott J. RouseNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-13 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Amanda L. Shorter James K. Richardson Suzanne B. Finucane Varun Joshi Keith Gordon Elliott J. Rouse Characterization and clinical implications of ankle impedance during walking in chronic stroke
description	Abstract Individuals post-stroke experience persisting gait deficits due to altered joint mechanics, known clinically as spasticity, hypertonia, and paresis. In engineering, these concepts are described as stiffness and damping, or collectively as joint mechanical impedance, when considered with limb inertia. Typical clinical assessments of these properties are obtained while the patient is at rest using qualitative measures, and the link between the assessments and functional outcomes and mobility is unclear. In this study we quantify ankle mechanical impedance dynamically during walking in individuals post-stroke and in age-speed matched control subjects, and examine the relationships between mechanical impedance and clinical measures of mobility and impairment. Perturbations were applied to the ankle joint during the stance phase of walking, and least-squares system identification techniques were used to estimate mechanical impedance. Stiffness of the paretic ankle was decreased during mid-stance when compared to the non-paretic side; a change independent of muscle activity. Inter-limb differences in ankle joint damping, but not joint stiffness or passive clinical assessments, strongly predicted walking speed and distance. This work provides the first insights into how stroke alters joint mechanical impedance during walking, as well as how these changes relate to existing outcome measures. Our results inform clinical care, suggesting a focus on correcting stance phase mechanics could potentially improve mobility of chronic stroke survivors.
format	article
author	Amanda L. Shorter James K. Richardson Suzanne B. Finucane Varun Joshi Keith Gordon Elliott J. Rouse
author_facet	Amanda L. Shorter James K. Richardson Suzanne B. Finucane Varun Joshi Keith Gordon Elliott J. Rouse
author_sort	Amanda L. Shorter
title	Characterization and clinical implications of ankle impedance during walking in chronic stroke
title_short	Characterization and clinical implications of ankle impedance during walking in chronic stroke
title_full	Characterization and clinical implications of ankle impedance during walking in chronic stroke
title_fullStr	Characterization and clinical implications of ankle impedance during walking in chronic stroke
title_full_unstemmed	Characterization and clinical implications of ankle impedance during walking in chronic stroke
title_sort	characterization and clinical implications of ankle impedance during walking in chronic stroke
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/e8fae3e74bc94c7a8a082e87dafd6cb5
work_keys_str_mv	AT amandalshorter characterizationandclinicalimplicationsofankleimpedanceduringwalkinginchronicstroke AT jameskrichardson characterizationandclinicalimplicationsofankleimpedanceduringwalkinginchronicstroke AT suzannebfinucane characterizationandclinicalimplicationsofankleimpedanceduringwalkinginchronicstroke AT varunjoshi characterizationandclinicalimplicationsofankleimpedanceduringwalkinginchronicstroke AT keithgordon characterizationandclinicalimplicationsofankleimpedanceduringwalkinginchronicstroke AT elliottjrouse characterizationandclinicalimplicationsofankleimpedanceduringwalkinginchronicstroke
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Characterization and clinical implications of ankle impedance during walking in chronic stroke

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