Article

OBJECTIVE: To investigate the determinants of limb preference for initiating
compensatory stepping poststroke. DESIGN: Retrospective chart review. SETTING: Inpatient rehabilitation. PARTICIPANTS: Convenience sample of individuals
admitted to inpatient rehabilitation with poststroke hemiparesis. INTERVENTIONS:
Not applicable. MAIN OUTCOME MEASURES: Compensatory stepping responses were
evoked using a lean-and-release postural perturbation. The limb used to initiate
compensatory stepping was determined. The relationships between stepping with the
paretic limb and premorbid limb dominance, weight bearing on the paretic limb in
quiet standing, ability to bear weight on the paretic limb, preperturbation
weight bearing on the paretic limb, and lower-limb motor recovery scores were
determined. RESULTS: The majority (59.1%) of responses were steps initiated with
the nonparetic limb. Increased lower-limb motor recovery scores and
preperturbation weight bearing on the nonparetic limb were significantly related
to increased frequency of stepping with the paretic limb. When the preferred limb
was physically blocked, an inappropriate response was initiated in 21% of trials
(ie, nonstep responses or an attempt to step with the blocked limb). CONCLUSIONS:
This study reveals the challenges that individuals with poststroke hemiparesis
face when executing compensatory stepping responses to prevent a fall after a
postural perturbation. The inability or challenges to executing a compensatory
step with the paretic limb may increase the risk for falls poststroke.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS