Effects of Novel Guidance Tubing Gait on EMG Neuromuscular Imbalance and Joint Angular Kinematics during Locomotion in Hemiparetic Stroke Patients

Publication date: Available online 25 May 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Jeong J. Lee, Joshua (Sung) H. You
ObjectiveTo compare the immediate effects of conventional treadmill gait (CTG) and guidance tubing gait (GTG) on electromyographic (EMG) neuromuscular imbalance and knee joint kinematics in hemiparetic gait.DesignCase control study.SettingUniversity medical center.ParticipantsEighteen patients with hemiparetic stroke (18 experimental, mean (SD) age 39.2 (16.8) years) and 15 healthy controls, mean age 26.3 (2.6) years); 19 men and 14 women.InterventionsThe GTG was provided for approximately 30 minutes and involved application of an assistive guidance force using the tubing, specifically to improve knee joint stabilization during midstance and increase knee joint flexion during mid-swing phase.Main outcome measuresClinical tests included the Korean Mini-Mental State Examination, Modified Ashworth Scale, Berg Balance Scale, Manual Muscle Test, and knee joint range of motion (ROM) and sensory tests. Knee joint muscle EMG and kinematic analyses were determined at pre-test and post-test.ResultsAfter the intervention, the experimental group showed significantly greater improvements in balanced quadriceps and hamstring EMG co-activation and knee joint kinematics relative to the control group (P = 0.005). The GTG intervention decreased overactive hamstring activity (P = 0.018) and reciprocally increased quadriceps activity (P = 0.000). The knee joint kinematic analysis showed significant changes in the hemiparetic stroke group (P = 0.004).ConclusionsThis study demonstrates the effectiveness of the tubing gait condition to restore knee joint muscle imbalance and kinematics in individuals with hemiparetic stroke who present abnormal hyperextension knee gait.



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