Analise cinematica da movimentação dos membros superiores e inferiores, tronco e cabeça durante a marcha de hemipareticos / Kinematic analysis of upper and lower limbs, trunk and head motions during hemiparetic gait after stroke

AUTOR(ES)
DATA DE PUBLICAÇÃO

2009

RESUMO

The aim of this study was to analyze integrally the movement of upper and lower limbs, trunk and head using the following kinematics variables: joint angles, spatiotemporal variables, trajectory of total body center of mass and partial contributions of the segments for the trajectory of total body center of mass. In order to identify and analyze the gait pattern alterations developed by hemiparetic subjects affected by stroke, were analyzed 14 hemiparetics subjects, males, aged between 40 and 60 years old, who presented at least 3 years post-injury, and no walking aids used. To represent the normal gait were selected 7 able-bodies subjects, males, aged between 40 and 60 years old, without gait deviations. The data was obtained by videogrammetry through the DVideo system. The body segments orientation model used on this study consisted in 71 surface markers, whereas 15 articulated body segments. The data processing was done by Matlab software. The statistical analysis was based on the following comparisons: 1) right and left sides of the control group subjects and between the affected and unaffected sides of the hemiparetic group; 2)Comparisons between hemiparetic group and control group; 3) Continuous angle variables comparisons between the affected hemiparetic side versus control group and unaffected hemiparetic side versus control group; 4) Comparisons of the trajectory of total body center of mass and the percent of partial contributions of body segments between control group versus hemiparetic group (P<0.05). The results showed that the affected upper limb movement was significantly altered, with reduced flexion/extension range of motion in the glenohumeral and elbow joints, and it was associated with the elbow joint flexion and rotation tendency throughout the gait cycle. Were also detected significant changes on the three lower limbs movement planes and spatiotemporal variables that agree with the literature findings. The integrated analysis showed changes in stroke gait pattern could be related to the affected upper limb movement disturbances. This is another aggravating factor on the stroke gait pattern. The analysis of the trajectory of total body center of mass showed that the lateral and vertical directions curves of hemiparetic subjects were approximately sinusoidal, with two peaks of different amplitudes, associated with a lower anterior-posterior displacement of the total body center of mass during gait of hemiparetic. The percentual contribution of body segments for the trajectory of total body center of mass showed that the trunk contributed more to the lateral center of mass, and in vertical direction the leg and foot on the affected side contributed more to lower vertical displacement of center of mass. In the lateral direction the lower limbs compensed the upper limbs reduction.Changes in the direction of progression come from the combination of the disturbances observed in the other two directions.

ASSUNTO(S)

membros superiores cinematica - análise hemipareticos marcha upper limbs gait kinematical analysis stroke

ACESSO AO ARTIGO

Documentos Relacionados