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Journal of geriatric physical therapy (2001) · 2010

Bridging performance of adults with hemiparesis: sliding of the paretic limb.

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Kozol Menachem Z, Filer Maya, Ring Haim

Аннотация

BACKGROUND: Individuals with hemiparesis resulting from cerebrovascular accident often demonstrate uncontrollable sliding of the paretic lower extremity when attempting to lift their pelvis from a hook-lying position (bridging), during bed mobility. This disorder is often attributed to hypertonicity of the knee extensors, though this assumption has not been confirmed experimentally.

PURPOSE: To determine the interaction of limb sliding during bridging with impairments of motor control, knee moments, and spasticity.

METHODS: Twenty-seven adults with hemiparesis were assigned to 2 groups on the basis of their ability to perform bridging on a smooth surface. The association of the dichotomous parameter of bridging performance (success/failure) with the other parameters was determined by point biserial correlation, and the predictability of limb sliding was estimated from binary logistic regression. A 2-way repeated-measures analysis of variance was used to determine the differences between knee moments.

RESULTS: The group that could perform bridging without sliding had higher moments of the paretic knee flexors and a higher level of motor control than the other group (P = .001). The moments of the paretic flexors and the level of motor control were also correlated with limb-sliding occurrence (r = 0.61 and 0.74, respectively) and served as the best predictors of bridging performance. The paretic knee's flexion moment was found to be more affected than the extension moment (P= .04).

CONCLUSION: Low level of motor control and reduced strength of the knee flexors are 2 major deterrents of successful bridging in persons with hemiparesis. The predominant decline of the flexors' moment may reflect a more severe disruption of the flexors' cortical innervation or superior recovery of the extensors.

Предметные рубрики MeSH

ИП Урсолов Владлен Сергеевич

ИНН 500118482352 · ОГРНИП 314500117700049

Реквизиты и контакты