Biomechanical factors behind toe clearance during the swing phase in hemiparetic patients

Fumihiro Matsuda, Masahiko Mukaino, Kei Ohtsuka, Hiroki Tanikawa, Kazuhiro Tsuchiyama, Toshio Teranishi, Yoshikiyo Kanada, Hitoshi Kagaya, Eiichi Saitoh

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: The toe clearance of a paretic limb in the swing phase of gait is related to tripping, which is considered a major cause of falls. The biomechanical factors for obtaining toe clearance are more complicated in hemiparetic gait than that in normal gait because of the compensatory movements during swing phase. Understanding the biomechanical factors should help in targeting the point for rehabilitative interventions. Objective: To clarify the biomechanical factors behind toe clearance during swing phase in hemiparetic gait. Methods: Fifty patients with hemiparesis after a stroke participated in this study. Three-dimensional motion analysis was used for the kinematic analysis of the hemiparetic gait. The correlation coefficients between limb shortening and angle changes and between limb shortening and hip elevation and foot lateral shift were calculated. Limb shortening was defined as the shortening of the hip-toe distance. The significant factors that determine toe clearance were examined by multiple regression analysis. Independent variables were limb shortening, hip elevation, and foot lateral shift. Results: Limb shortening was negatively correlated with hip elevation (r = −0.75) and foot lateral shift (r = −0.41). Multiple regression analysis showed a significant contribution of limb shortening and hip elevation to toe clearance. The coefficient of determination was 0. 95. Conclusions: Toe clearance was mainly determined by limb shortening and hip elevation, which were found to be in a trade-off relationship. These results warrant further investigation into the use of three-dimensional motion analysis in the rehabilitation clinic to facilitate targeted rehabilitative training to restore gait ability.

Original languageEnglish
Pages (from-to)177-182
Number of pages6
JournalTopics in Stroke Rehabilitation
Volume24
Issue number3
DOIs
Publication statusPublished - 01-01-2017

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Toes
Extremities
Gait
Hip
Foot
Regression Analysis
Paresis
Biomechanical Phenomena
Rehabilitation
Stroke

All Science Journal Classification (ASJC) codes

  • Rehabilitation
  • Community and Home Care
  • Clinical Neurology

Cite this

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title = "Biomechanical factors behind toe clearance during the swing phase in hemiparetic patients",
abstract = "Background: The toe clearance of a paretic limb in the swing phase of gait is related to tripping, which is considered a major cause of falls. The biomechanical factors for obtaining toe clearance are more complicated in hemiparetic gait than that in normal gait because of the compensatory movements during swing phase. Understanding the biomechanical factors should help in targeting the point for rehabilitative interventions. Objective: To clarify the biomechanical factors behind toe clearance during swing phase in hemiparetic gait. Methods: Fifty patients with hemiparesis after a stroke participated in this study. Three-dimensional motion analysis was used for the kinematic analysis of the hemiparetic gait. The correlation coefficients between limb shortening and angle changes and between limb shortening and hip elevation and foot lateral shift were calculated. Limb shortening was defined as the shortening of the hip-toe distance. The significant factors that determine toe clearance were examined by multiple regression analysis. Independent variables were limb shortening, hip elevation, and foot lateral shift. Results: Limb shortening was negatively correlated with hip elevation (r = −0.75) and foot lateral shift (r = −0.41). Multiple regression analysis showed a significant contribution of limb shortening and hip elevation to toe clearance. The coefficient of determination was 0. 95. Conclusions: Toe clearance was mainly determined by limb shortening and hip elevation, which were found to be in a trade-off relationship. These results warrant further investigation into the use of three-dimensional motion analysis in the rehabilitation clinic to facilitate targeted rehabilitative training to restore gait ability.",
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Biomechanical factors behind toe clearance during the swing phase in hemiparetic patients. / Matsuda, Fumihiro; Mukaino, Masahiko; Ohtsuka, Kei; Tanikawa, Hiroki; Tsuchiyama, Kazuhiro; Teranishi, Toshio; Kanada, Yoshikiyo; Kagaya, Hitoshi; Saitoh, Eiichi.

In: Topics in Stroke Rehabilitation, Vol. 24, No. 3, 01.01.2017, p. 177-182.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Biomechanical factors behind toe clearance during the swing phase in hemiparetic patients

AU - Matsuda, Fumihiro

AU - Mukaino, Masahiko

AU - Ohtsuka, Kei

AU - Tanikawa, Hiroki

AU - Tsuchiyama, Kazuhiro

AU - Teranishi, Toshio

AU - Kanada, Yoshikiyo

AU - Kagaya, Hitoshi

AU - Saitoh, Eiichi

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Background: The toe clearance of a paretic limb in the swing phase of gait is related to tripping, which is considered a major cause of falls. The biomechanical factors for obtaining toe clearance are more complicated in hemiparetic gait than that in normal gait because of the compensatory movements during swing phase. Understanding the biomechanical factors should help in targeting the point for rehabilitative interventions. Objective: To clarify the biomechanical factors behind toe clearance during swing phase in hemiparetic gait. Methods: Fifty patients with hemiparesis after a stroke participated in this study. Three-dimensional motion analysis was used for the kinematic analysis of the hemiparetic gait. The correlation coefficients between limb shortening and angle changes and between limb shortening and hip elevation and foot lateral shift were calculated. Limb shortening was defined as the shortening of the hip-toe distance. The significant factors that determine toe clearance were examined by multiple regression analysis. Independent variables were limb shortening, hip elevation, and foot lateral shift. Results: Limb shortening was negatively correlated with hip elevation (r = −0.75) and foot lateral shift (r = −0.41). Multiple regression analysis showed a significant contribution of limb shortening and hip elevation to toe clearance. The coefficient of determination was 0. 95. Conclusions: Toe clearance was mainly determined by limb shortening and hip elevation, which were found to be in a trade-off relationship. These results warrant further investigation into the use of three-dimensional motion analysis in the rehabilitation clinic to facilitate targeted rehabilitative training to restore gait ability.

AB - Background: The toe clearance of a paretic limb in the swing phase of gait is related to tripping, which is considered a major cause of falls. The biomechanical factors for obtaining toe clearance are more complicated in hemiparetic gait than that in normal gait because of the compensatory movements during swing phase. Understanding the biomechanical factors should help in targeting the point for rehabilitative interventions. Objective: To clarify the biomechanical factors behind toe clearance during swing phase in hemiparetic gait. Methods: Fifty patients with hemiparesis after a stroke participated in this study. Three-dimensional motion analysis was used for the kinematic analysis of the hemiparetic gait. The correlation coefficients between limb shortening and angle changes and between limb shortening and hip elevation and foot lateral shift were calculated. Limb shortening was defined as the shortening of the hip-toe distance. The significant factors that determine toe clearance were examined by multiple regression analysis. Independent variables were limb shortening, hip elevation, and foot lateral shift. Results: Limb shortening was negatively correlated with hip elevation (r = −0.75) and foot lateral shift (r = −0.41). Multiple regression analysis showed a significant contribution of limb shortening and hip elevation to toe clearance. The coefficient of determination was 0. 95. Conclusions: Toe clearance was mainly determined by limb shortening and hip elevation, which were found to be in a trade-off relationship. These results warrant further investigation into the use of three-dimensional motion analysis in the rehabilitation clinic to facilitate targeted rehabilitative training to restore gait ability.

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