Ryo Onuma, Tadashi Masuda, Fumihiko Hoshi, Tadamitsu Matsuda, Tomoko Sakai, Atsushi Okawa, Tetsuya Jinno
Department of Physical Medicine and Rehabilitation, Geriatric Health Services Facility, Caretown Yuyu, Hasuda, Japan.
DOI: 10.2340/16501977-2856

Objectives: To determine whether individual measurements of the centre of pressure for the stance and stepping legs can reveal new characteristics of reduced anticipatory postural adjustments during gait initiation in post-stroke hemiplegic patients.
Methods: Subjects included 30 stroke patients and 10 healthy age-matched controls. The acceleration of the trunk, and the centre of pressure of each leg, were measured during gait initiation, 3 times each with the paretic and non-paretic legs leading. Anticipatory postural adjustments were characterized using trunk acceleration and centre of pressure displacement data.
Results: Latency of the posterior displacement peak of the paretic leg centre of pressure with either the paretic or non-paretic leg leading was significantly longer in stroke patients compared with controls, and was also longer than that of the non-paretic leg. The magnitude of the posterior displacement peak of the paretic leg centre of pressure was smaller than that of the non-paretic leg. Peak latency of the paretic stepping leg centre of pressure correlated with the clinical measures of motor dysfunction, postural balance, and gait ability.
Conclusion: Measurements of the latency and magnitude of centre of pressure displacement peak individually for the paretic and non-paretic legs can help elucidate the mechanism behind reduced anticipatory postural adjustments. This information will be useful in designing new treatment strategies for stroke patients.

Measuring the centre of pressure individually for the stance and stepping legs can reveal what happens during initiation of gait in stroke patients. The latency and magnitude of the centre of pressure displacement peak showed characteristic differences between stroke patients and control subjects, and between paretic and non-paretic legs. The peak latency of the paretic stepping leg centre of pressure correlated significantly with clinical measures of motor dysfunction, postural balance, and gait ability. These findings may contribute to the development of effective rehabilitation exercises for stroke patients.