ArticleJournal of neurologic physical therapy : JNPT2017
Lateral Perturbation-Induced Stepping: Strategies and Predictors in Persons Poststroke.
Article in Journal of neurologic physical therapy : JNPT, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Exoskeleton frontal and sagittal plane hip torque improves propulsion and transient stability during walking in individuals with hemiparesis.Journal of neuroengineering and rehabilitation · 2026Article
- Comparative analysis of muscle coordination patterns underlying different types of stepping movements.Experimental brain research · 2025Article
- Righting Reaction in Hemiplegic Stroke Survivors: Impact of Lower Limb Motor Paralysis Severity.Cureus · 2025Article
- Normalization of the hip abductors rate of activation during a voluntary step task in older adults: Reliability and differences among approaches.Gait & posture · 2024Article
- The effects of stroke on weight transfer before voluntary lateral and forward steps.Frontiers in neurology · 2022Article
- Lateral Perturbation-Induced and Voluntary Stepping in Fallers and Nonfallers After Stroke.Physical therapy · 2020Article
- Directional Control Mechanisms in Multidirectional Step Initiating Tasks.Frontiers in human neuroscience · 2020Article
- Stepping characteristics during externally induced lateral reactive and voluntary steps in chronic stroke.Gait & posture · 2019Article
- Perturbation-Induced Stepping Post-stroke: A Pilot Study Demonstrating Altered Strategies of Both Legs.Frontiers in neurology · 2019Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
background and purposeFalls commonly occur as weight is transferred laterally, and impaired reactive stepping responses are associated with falls after stroke. The purpose of this study was to examine differences in and the determinants of mediolateral (M-L) protective stepping strategies when pulled off balance toward the paretic and nonparetic sides.
methodsEighteen individuals more than 6 months poststroke were pulled in the M-L direction by a lateral waist-pull perturbation system. Step type (crossover, medial, and lateral) and count were recorded, along with first-step initiation time, length, and clearance. Sensorimotor variables including hip adductor/abductor and ankle plantar flexor/dorsiflexor peak isokinetic torques, paretic foot plantar cutaneous sensation, and motor recovery were used to predict step type by discriminant function analyses (DFAs).
resultsRegardless of pull direction, nearly 70% of trials required 2 or more recovery steps, with more frequent nonparetic leg first steps, 63.5%. The step type was significantly different for pull direction (P = 0.005), with a greater percentage of lateral steps when pulled toward the nonparetic side (45.1%) compared with the paretic side (17.5%). The M-L step length of the lateral step was increased (P < 0.001), with a reduced step clearance (P = 0.05), when pulled toward the paretic side compared with a pull toward the nonparetic side. DFAs revealed that nonparetic and paretic-side pulls could respectively classify step type 64% and 60% of the time, with foot cutaneous sensation discriminating for pull direction. DISCUSSION AND
conclusionsBalance recovery initiated with the nonparetic leg occurred more frequently in response to M-L perturbations, and paretic foot cutaneous sensation was an important predictor of the stepping response regardless of the pull direction.Video Abstract available for more insights from the authors (see Video, Supplementary Digital Content 1, http://links.lww.com/JNPT/A190).
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