Tag: lokomocja

Biomechanical analysis of two-point alternate crutch gait – comparison with standard gait

Lechosław B. Dworak, Michał Murawa, Jacek Mączyński

Lechosław B. Dworak, Michał Murawa, Jacek Mączyński – Biomechanical analysis of two-point alternate crutch gait – comparison with standard gait. Fizjoterapia Polska 2006; 6(4); 310-316

Abstract
Background. This paper presents the results of a biomechanical investigation of two-point alternate crutch gait by comparing selected parameters of the crutch-assisted gait and standard gait as well as seeking to determine the efficacy of unloading in crutch-assisted gait. Material and methods. 7 healthy physiotherapists participated in the experiment. Some dynamic parameters of simulated two-point alternate crutch-assisted gait and standard gait were measured using force plates (Kistler) and video-recording. Maximum and average values of ground reaction forces (GRF) as well as indices of asymmetry were calculated for both gaits. Results. Maximum values of the vertical component of the GRF (Rz-p i Rz-I) were 13 and 15%, respectively, lower during crutch gait compared to standard gait. The difference increased to around 20% for the mean values of the <Rz> index. The mean values of the remaining horizontal components of the GRF (<Ry>i <Rx>) were 32% (<Ryh-l>) and as much as 60% (<Rx-p>) lower during crutch gait. The mean values of all GRF components during crutch-assisted gait were around 25% of the corresponding values observed during standard gait. The vast majority of the asymmetry indices assumed higher values for the crutch gait. Conclusions. The analysis shows that during two-point alternative crutch gait a patient gets a great unloading of the lower limbs (1/5 of the BM). Simultaneously upper limbs get considerable overloading.

Key words:
locomotion, crutches, unloading, ground reaction forces, asymmetry

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Effectiveness of PNF method in improving symmetry of lower extremity loading in late-stage post-stroke patients

Tomasz Wolny, Edward Saulicz, Rafał Gnat, Mirosław Kokosz, Andrzej Myśliwiec, Michał Kuszewski

Tomasz Wolny, Edward Saulicz, Rafał Gnat, Mirosław Kokosz, Andrzej Myśliwiec, Michał Kuszewski – Effectiveness of PNF method in improving symmetry of lower extremity loading in late-stage post-stroke patients. Fizjoterapia Polska 2010; 10(4); 263-270

Abstract
Early comprehensive multidisciplinary rehabilitation is crucial for achieving satisfactory results in the conservative management of post-stroke patients. Gait re-education is a major goal in post-stroke rehabilitation regardless of how much time has elapsed since the stroke. The study hypothesis was that therapy based on PNF (Proprioceptive Neuromuscular Facilitation) would significantly improve loading symmetry of the lower limbs, thus enabling faster restoration of the support and locomotor function and improving gait efficiency in post-stroke patients. A total of 64 stroke patients were randomly divided into two groups. A Loading Symmetry Index (LSI) of the lower limbs was calculated basing on data recorded in the ‘two-scales’ test. Patients were followed up for a mean of 21 days (during which they stayed at a Neurological Rehabilitation Ward). Group A received conventional rehabilitation while Group B also received individual kinesiotherapy based on the PNF method. Analysis of variance showed significant differences in LSI values (interaction: group x measurement – p=0.0075). Post hoc Tukey test revealed significant intra-group differences in Group B (p=0.0002). There were no significant intra-group differences in Group A or significant differences between the groups. PNF-based rehabilitation of late-stage post-stroke patients significantly improved loading symmetry of the lower extre – mities.
Key words:
PNF, physiotherapy, symmetry, Locomotion
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