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21. Quantified clinical measures linked to ambulation speed in hemiparesis.

Author

Ghédira, Mouna, Pradines, Maud, Mardale, Valentina, Gracies, Jean-Michel, Bayle, Nicolas, and Hutin, Emilie

Subjects
WALKING speed, RANGE of motion of joints, RECTUS femoris muscles, MULTIVARIATE analysis, RETROSPECTIVE studies, REGRESSION analysis, SPASTICITY, MUSCLE weakness, LEG, WALKING, CALF muscles, GLUTEAL muscles, DESCRIPTIVE statistics, DATA analysis software, HEMIPLEGIA
Abstract

In spastic paresis, the respective contributions to active function of antagonist hypoextensibility, spasticity, and impaired descending command remain unknown. Objectives: We explored correlations between ambulation speed and coefficients of shortening, spasticity and, weakness for three lower limb extensors. This retrospective study identified 140 subjects with chronic hemiparesis (>6 months since injury) assessed during a single visit with barefoot 10-meter ambulation at comfortable and fast speed, and measurements of passive range of motion (XV1), angle of catch at fast stretch (XV3) and active range of motion (XA) against the resistance of gastrocnemius, rectus femoris, and gluteus maximus. Coefficients of shortening (CSH=[XN-XV1]/XN; XN, normal expected amplitude based on anatomical values), spasticity (CSP=[XV1-XV3]/XV1), and weakness (CWK=[XV1-XA]/XV1) were derived. For each muscle, multivariable analysis explored CSH, CSP, and CWK as potential predictors of ambulation speed. Ambulation speed was 0.62±0.28m/s (mean±SD, comfortable) and 0.84±0.38m/s (fast) and was correlated with CSH and CWK against gastrocnemius (CSH, comfortable, ns; fast, β=−0.20, p=.03; CWK, comfortable, β=−0.21, p=.010; fast, β=−0.21, p =.012), rectus femoris (CSH, comfortable, β=−0.41, p=6E−7; fast, β=−0.43, p=5E−7; CWK, comfortable, β=−0.36, p=5E−5; fast, β=−0.33, p=.0003) and gluteus maximus (CSH, comfortable, β=−0.19, p=.02; fast, β=−0.26, p=.002; CWK, comfortable, β=−0.26, p=.002; fast, β=−0.22, p=.010). Ambulation speed was not correlated with CSP. In chronic hemiparesis, ambulation speed correlates with coefficients of shortening and of weakness in lower limb extensors, but not with their spasticity level. This may encourage therapists to focus treatment primarily on muscle shortening by stretching programs and on impaired descending command by active training. [ABSTRACT FROM AUTHOR]

Published
2022
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23. Do Patients With COVID-19 Benefit from Rehabilitation? Functional Outcomes of the First 100 Patients in a COVID-19 Rehabilitation Unit

Author

Piquet, Violaine, primary, Luczak, Cédric, additional, Seiler, Fabien, additional, Monaury, Jordan, additional, Martini, Alexandre, additional, Ward, Anthony B., additional, Gracies, Jean-Michel, additional, Motavasseli, Damien, additional, Piquet, Violaine, additional, Lépine, Estelle, additional, Chambard, Lucile, additional, Baude, Marjolaine, additional, Hutin, Emilie, additional, Samaniego, Andrés, additional, and Bayle, Nicolas, additional

Published
2021
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29. Supplemental_Materials – Supplemental material for Ultrasound Structural Changes in Triceps Surae After a 1-Year Daily Self-stretch Program: A Prospective Randomized Controlled Trial in Chronic Hemiparesis

Author

Pradines, Maud, Ghedira, Mouna, Portero, Raphaël, Masson, Ingrid, Marciniak, Christina, Hicklin, Dawn, Hutin, Emilie, Portero, Pierre, Jean-Michel Gracies, and Bayle, Nicolas

Subjects
FOS: Clinical medicine, 110308 Geriatrics and Gerontology, 110904 Neurology and Neuromuscular Diseases, Neuroscience
Abstract

Supplemental material, Supplemental_Materials for Ultrasound Structural Changes in Triceps Surae After a 1-Year Daily Self-stretch Program: A Prospective Randomized Controlled Trial in Chronic Hemiparesis by Maud Pradines, Mouna Ghedira, Raphaël Portero, Ingrid Masson, Christina Marciniak, Dawn Hicklin, Emilie Hutin, Pierre Portero, Jean-Michel Gracies and Nicolas Bayle in Neurorehabilitation and Neural Repair

Published
2019
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30. Ultrasound Structural Changes in Triceps Surae After a 1-Year Daily Self-stretch Program: A Prospective Randomized Controlled Trial in Chronic Hemiparesis

Author

Pradines, Maud, primary, Ghedira, Mouna, additional, Portero, Raphaël, additional, Masson, Ingrid, additional, Marciniak, Christina, additional, Hicklin, Dawn, additional, Hutin, Emilie, additional, Portero, Pierre, additional, Gracies, Jean-Michel, additional, and Bayle, Nicolas, additional

Published
2019
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31. FeetMe® Monitor-connected insoles are a valid and reliable alternative for the evaluation of gait speed after stroke.

Author

Farid, Leila, Jacobs, Damien, Do Santos, Johana, Simon, Olivier, Gracies, Jean-Michel, and Hutin, Emilie

Subjects
ACADEMIC medical centers, ATHLETIC shoes, CONFIDENCE intervals, LONGITUDINAL method, RESEARCH methodology, QUESTIONNAIRES, SYSTEM analysis, WEARABLE technology, STATISTICAL reliability, MULTITRAIT multimethod techniques, STROKE rehabilitation, DESCRIPTIVE statistics, WALKING speed, INTRACLASS correlation, EQUIPMENT & supplies
Abstract

One of the main challenges after stroke is gait recovery. To provide patients with an individualized rehabilitation program, it is helpful to have real-life objective evaluations at baseline and at regular follow-ups to adjust the program and verify potential improvements. To evaluate the accuracy and reliability of a fully stand-alone system of connected insoles (FeetMe® Monitor) against a widely used clinical walkway system (GAITRite®). Twenty-nine subjects with a stroke that occurred >6 months prior participated in the study. Their comfortable gait over three 8-m trials was evaluated by four raters, on Day 1 and Day 7, using simultaneously FeetMe® Monitor and GAITRite®. Velocity, stride length, cadence, stance, and swing duration were calculated on both sides over three sequences of gait: one single stride, 8 m, and three 8-m trials pooled. The Intra-class Correlation Coefficient (ICC) and the Bland–Altman plot evaluated the construct validity (inter-device) and the reliability (test–retest and inter-rater) of FeetMe® Monitor. Through all gait analysis sequences, the inter-device ICCs were >0.95 for velocity, stride length, and cadence. Ranges of inter-device ICCs were [0.77–0.94] for stance duration for both limbs, and for swing duration [0.32–0.57] on the non-paretic side and [0.75–0.90] on the paretic side. Test–retest and inter-rater ICCs for all parameters were >0.73 for one single stride, >0.88 for 8-m trials and >0.94 for three 8-m trials. FeetMe® Monitor is an accurate and reliable system for measurement of gait velocity, stride length, cadence, and stance duration in chronic hemiparesis. [ABSTRACT FROM AUTHOR]

Published
2021
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34. Lower limb coordination in hemiparetic subjects: impact of botulinum toxin injections into rectus femoris

Author

Hutin, Emilie, Pradon, Didier, Barbier, Franck, Gracies, Jean-Michel, Bussel, Bernard, and Roche, Nicolas

Subjects
Hemiplegia -- Care and treatment, Botulinum toxin -- Health aspects, Botulinum toxin -- Usage, Gait -- Analysis, Extremities, Lower -- Muscles, Extremities, Lower -- Research, Extremities, Lower -- Physiological aspects, Leg -- Muscles, Leg -- Research, Leg -- Physiological aspects, Psychology and mental health
Published
2010

50. Caractérisation de la coordination motrice des membres inférieurs lors de la marche des patients hémiparétiques

Author

Hutin, Emilie, Laboratoire d'Automatique, de Mécanique et d'Informatique industrielles et Humaines - UMR 8201 (LAMIH), Université de Valenciennes et du Hainaut-Cambrésis (UVHC)-Centre National de la Recherche Scientifique (CNRS)-INSA Institut National des Sciences Appliquées Hauts-de-France (INSA Hauts-De-France), Université de Valenciennes et du Hainaut-Cambrésis, and Franck Barbier

Subjects
[SPI.OTHER]Engineering Sciences [physics]/Other, Hemiparesis, hyperactivité musculaire, Inter-segmental coordination, Continous relative phase, hémiparésie, marche, vitesse de marche, Hyperactivity, [SPI]Engineering Sciences [physics], Gait velocity, Botulinum toxin, rétraction des tissus mous, Toxine botulique, coordination inter-segmentaire, Soft tissue retraction, Gait, phase relative continue
Abstract

Paresis, muscle hyperactivity and soft tissue retraction are the main mechanisms responsible for the gait disturbance in hemiparesis. In the rehabilitation management of hemiparetic patients, clinicians try to determine the responsibility of each mechanism, and to quantify the impact of treatments on movement organization and gait efficiency. Inter-segmental coordination analysis, using measurement of the continuous relative phase in the sagittal plan, can assist in reaching these objectives. The amount of dephasing between lower limb segments, in each phase of the gait cycle, sheds light on the coordination pattern. Relevant parameters of the inter-segmental continuous relative phase may reveal specific information such as the predominance of neurological and orthopedic factors implied in the kinematic deficits, the impact of various gait rehabilitation conditions, or treatment-related benefits. This analysis, complementary to routine clinical examination, may also disclose specific motor deficits in the paretic lower limb, and compensatory strategies at work in the non-paretic lower limb. The findings reported in this thesis may encourage rehabilitation clinicians to carefully study coordination patterns, which may help define optimized treatments to lessen gait impairment in spastic paresis.; La parésie, l'hyperactivité musculaire et la rétraction des tissus mous sont les principaux mécanismes physiopathologiques responsables de la dégradation de la marche dans l'hémiparésie. Lors de la prise en charge du patient hémiparétique, le questionnement du clinicien s'articule autour de la part de responsabilité de chaque mécanisme, et de l'impact des traitements sur l'organisation globale du mouvement et la qualité de la marche. L'analyse de la coordination inter-segmentaire, utilisant la mesure de la phase relative continue dans le plan sagittal, apporte des éléments de réponse à cette problématique clinique. La quantité et les variations du déphasage entre les segments des membres inférieurs dans les phases du cycle de marche décrivent les stratégies de coordination motrice. Des paramètres issus de la phase relative continue inter-segmentaire, apportent des informations spécifiques quant à l'origine physiopathologique des déficits cinématiques pour aider au choix du traitement, à l'incidence des conditions de réentraînement de la marche, et aux bénéfices d'un traitement. Cette analyse, complémentaire aux évaluations cliniques réalisées dans la pratique courante, met en évidence la restriction de possibilités de modulation par les mécanismes physiopathologiques dans le membre inférieur parétique, et des mécanismes de compensation dans le membre inférieur non-parétique. Les résultats de ce travail pourraient inciter les cliniciens à déterminer les stratégies de coordination motrice, pour définir les traitements permettant au mieux de réduire les anomalies de la marche des patients présentant une lésion motrice du système nerveux central.

Published
2011

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