Document Type : Original Articles

Authors

• Hossein Asghar Hosseini ¹
• Esmaeil Ebrahimi Takamjani ²
• Mahyar Salavati ³
• Gholamali Shahidi ⁴
• Mohammad Ali Sanjari ⁵
• Mania Sheikh ¹

¹ Assistant Professor, Department of Physiotherapy, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran

² Professor, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran

³ Professor, Department of Physiotherapy, University of Welfare and Rehabilitation Sciences, Tehran, Iran

⁴ Professor, Department of Neurology, Rasul-e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran

⁵ Assistant Professor, Department of Rehabilitation Basic Sciences, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran

Abstract

Introduction: Asymmetric weight bearing is one of the prominent characteristics of impaired postural control in hemi-paresis after stroke. Considering the important effect of load exerted on limbs in correcting postural reflexes, the effect of sole on weight bearing symmetry and also the effect of increased load on paretic limb on the postural responses of lower limb muscles against an internal perturbation were investigated. Materials and Methods: 27 hemi-paretic post-stroke patients, who were able to stand independently without assistive devices for one minute, participated in this study. Evaluations included measuring symmetry index, the latency and amplitude of postural responses of lower limb muscles that was carried out before and after placing a 10-mm-thick sole under intact lower limb of patients. To measure symmetry index, the patients were asked to stand on force platform for 20 seconds. Electromyographic recordings from medial gastrocnemius, soleus and lateral hamstring muscles of paretic and non-paretic limbs were obtained for evaluating postural responses. Rapid flexion movement of non-paretic upper limb was used as an internal perturbation for exciting postural muscle responses. Results: The effect of lift on improving symmetry index was significant (P = 0.001). Increasing load on paretic limb did not exert any effects on the latency and amplitude of postural responses. Conclusion: Inserting a lift improved symmetry by shifting center of gravity toward midline. The results of the present study show that decreased load on a paretic limb following stroke cannot fully explain the weak and latent responses of postural muscles. Keywords: Postural responses, Weight bearing asymmetry, Stroke