Article

PURPOSE: To study the adaptation process for standing postural control in
patients with hemiparesis after stroke. METHODS: The changes of a standing
posture developed in nine hemiparetic patients who had never maintained an
upright stance alone (aged 48-62 years; 6-19 days after stroke) was evaluated by
recording ground reaction forces and surface electromyographic (EMG) from lower
limbs. A 60-s standing trial without any instruction about body alignment was
repeated five times, and the experience-related changes of centre of pressure
(COP) and integrated EMG data were estimated. RESULTS: In the early standing
trials, patients balanced themselves by managing the average COP position around
the midline of both feet, accompanied by increased muscular activity of the
non-paretic leg. COP displacement gradually decreased in the later standing
trials (P < 0.05). Postural adaptations were achieved by shifting the centre of
body sway to the side of the non-paretic foot (P < 0.05) while reducing biceps
femoris muscular activity (P < 0.01) in the non-paretic leg. CONCLUSIONS: This
study revealed that weight-bearing asymmetry might contribute to improving
increased body sway and muscular over-activity of the non-paretic leg. When
planning rehabilitative treatment for hemiparetic patients, we should consider
that weight-bearing asymmetry may be a result of systematic postural control.

Langue : ANGLAIS