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Whole body coordination during turning while walking in stroke survivors

Hollands, Kristen (2010)
Ph.D. thesis, University of Birmingham.

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Abstract

This body of work sought to explore kinematic impairments which may underlie falls incidences during turning following stroke and review the evidence for the effectiveness of interventions aimed at improving aspects of locomotor coordination which are key to controlling turning. A systematic review of the literature identified insufficient homogeneity of high quality evidence to determine if task specific locomotor practice interventions are effective in improving aspects of gait coordination which are key to the controlling turning. The review highlighted a need for a better understanding of the nature of coordination deficits in functional walking tasks, such as turning, after stroke. In order to provide a base of knowledge regarding abnormalities in the coordination of locomotor patterns during turning while walking, two experimental studies were undertaken. The studies employed analysis of full-body kinematics during turns made under pre-planned and reactive conditions as well as turns of different magnitudes and those made by participants with and without a falls history. Findings from Study 1 showed a strong trend for participants with stroke (in particular those with lesions involving the basal ganglia) to initiate pre-planned turns later than their age-match counterpart. Turns made in response to an external cue were made in a similar manner to healthy controls. Results from study 2 indicate that while participants with stroke and falls history took significantly longer to turn, all other aspects of the movement pattern were similar to healthy controls and non-fallers. Therefore, incidences of falls during turning following stroke may not be due to impaired movement patterns alone. On this basis, we suggest that rehabilitation efforts and further studies should address the interplay of impaired movement production with other factors such as attention.

Type of Work:Ph.D. thesis.
Supervisor(s):Van Vliet, Paulette and Wing, Alan
School/Faculty:Colleges (2008 onwards) > College of Medical & Dental Sciences
Department:School of Health and Population Sciences
Subjects:RA Public aspects of medicine
Institution:University of Birmingham
ID Code:1312
This unpublished thesis/dissertation is copyright of the author and/or third parties. The intellectual property rights of the author or third parties in respect of this work are as defined by The Copyright Designs and Patents Act 1988 or as modified by any successor legislation. Any use made of information contained in this thesis/dissertation must be in accordance with that legislation and must be properly acknowledged. Further distribution or reproduction in any format is prohibited without the permission of the copyright holder.
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