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Cited by 102Stroke Rehabilitation and RecoveryBalance, Gait, and Falls PreventionMotor Control and Adaptation

Disentangling the contribution of the paretic and non-paretic ankle to balance control in stroke patients

VANASSELDONK, E, BUURKE, J, BLOEM, B, RENZENBRINK, G, NENE, A, VANDERHELM, F, VANDERKOOIJ, H·2006·Experimental Neurology
DOI 10.1016/j.expneurol.2006.04.036
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Abstract

During stroke recovery, restoration of the paretic ankle and compensation in the non-paretic ankle may contribute to improved balance maintenance. We examine a new approach to disentangle these recovery mechanisms by objectively quantifying the contribution of each ankle to balance maintenance. Eight chronic hemiparetic patients were included. Balance responses were elicited by continuous random platform movements. We measured body sway and ground reaction forces below each foot to calculate corrective ankle torques in each leg. These measurements yielded the Frequency Response Function (FRF) of the stabilizing mechanisms, which expresses the amount and timing of the generated corrective torque in response to sway at the specified frequencies. The FRFs were used to calculate the relative contribution of the paretic and non-paretic ankle to the total amount of generated corrective torque to correct sway. All patients showed a clear asymmetry in the balance contribution in favor of the non-paretic ankle. Paretic balance contribution was significantly smaller than the contribution of the paretic leg to weight bearing, and did not show a clear relation with the contribution to weight bearing. In contrast, a group of healthy subjects instructed to distribute their weight asymmetrically showed a one-on-one relation between the contribution to weight bearing and to balance. We conclude that the presented approach objectively quantifies the contribution of each ankle to balance maintenance. Application of this method in longitudinal surveys of balance rehabilitation makes it possible to disentangle the different recovery mechanisms. Such insights will be critical for the development and evaluation of rehabilitation strategies.

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Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • The perceived relationship between symmetry in weight distribution while standing and walking and balance has not been proven.

    “Bobath therapists have assumed that a symmetrical weight distribution implies better postural control, but this perceived relationship between symmetry in weight distribution while standing and walking and balance has not been proven.56,[63][64][65]”

    From The Effectiveness of the Bobath Concept in Stroke Rehabilitation: What is the Evidence? (2009) · cites this paper as [65]

  • Maintaining balance during perturbations of the platform heavily relies on the contribution of the nonparetic leg by shifting the center of gravity toward the sound side.

    “Maintaining balance during perturbations of the platform heavily relies on the contribution of the nonparetic leg by shifting the center of gravity toward the sound side.65”

    From The Effectiveness of the Bobath Concept in Stroke Rehabilitation: What is the Evidence? (2009) · cites this paper as [65]

  • Ground reaction forces and body sway measured during biped standing on a platform that elicited continuous random movements are difficult to explain by an active contribution of the paretic leg.

    “van Asseldonk and colleagues 65 showed that ground reaction forces and body sway measured during biped standing on a platform (that elicited continuous random movements) are difficult to explain by an active contribution of the paretic leg.”

    From The Effectiveness of the Bobath Concept in Stroke Rehabilitation: What is the Evidence? (2009) · cites this paper as [65]

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Authors
VANASSELDONK, E., BUURKE, J., BLOEM, B., RENZENBRINK, G., NENE, A., VANDERHELM, F., & VANDERKOOIJ, H.
Affiliations
  • University of Twente (NL)
  • Roessingh Research and Development (NL)
  • Radboud University Medical Center (NL)
Corresponding author
VANASSELDONK, E
ORCID
Venue
Experimental Neurology
Publisher
Elsevier BV
Published
2006-10
Volume
201
Issue
2
Pages
441-451
ISSN
0014-4886 (ISSN-L)
DOI
10.1016/j.expneurol.2006.04.036
OpenAlex
W2121861062
Cited by
102
References
37
Citations by year
2026: 1 · 2024: 1 · 2023: 2 · 2022: 3 · 2021: 3 · 2020: 5 · 2019: 4 · 2018: 9 · 2017: 10 · 2016: 7 · 2015: 12 · 2014: 15 · 2013: 8 · 2012: 3
FWCI
4.13
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Experimental Neurology (publishedVersion)
  • PubMed (publishedVersion)
  • University of Twente Research Information (publishedVersion)
  • Radboud Repository (Radboud University) (submittedVersion)
  • University of Twente Research Information (submittedVersion)
Topics
  • Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Motor Control and Adaptation
Keywords
stroke, balance control, ankle torque, frequency response function, postural sway, ground reaction force, weight bearing, hemiparesis, balance rehabilitation, compensatory mechanisms
MeSH terms
Adult, Aged, Ankle, Postural Balance, Humans, Male, Middle Aged, Models, Biological, Movement, Paresis, Weight-Bearing, Torque, Recovery of Function, Stroke

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