ArticlePhysical therapy2020
Lateral Perturbation-Induced and Voluntary Stepping in Fallers and Nonfallers After Stroke.
Article in Physical therapy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
5 citing papers in PubMed.
- Is lateral external perturbation training more beneficial for protective stepping responses than voluntary stepping training in stroke? A pilot randomized control study.Journal of neuroengineering and rehabilitation · 2024Trial
- Does the rate of hip abductor and adductor muscle activation during weight transfer influence voluntary lateral stepping in chronic stroke?Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology · 2025Article
- Associated factors and gender differences of falls in older adults with hypertension: a national cross-sectional survey.Frontiers in public health · 2025Article
- A Cross-Sectional Study on Fall Direction and Lower Limb Loading in Response to a Perturbation on Laterally Inclined Platform.Applied bionics and biomechanics · 2023Article
- The effects of stroke on weight transfer before voluntary lateral and forward steps.Frontiers in neurology · 2022Article
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
objectiveA loss of balance poststroke from externally induced perturbations or during voluntary movements is often recovered by stepping. The purpose of this study was to characterize stepping behavior during lateral induced waist-pull perturbations and voluntary steps in community-dwelling fallers and nonfallers with chronic stroke.
methodsThis study used a cohort design. Thirty participants >6 months poststroke were exposed to 24 externally triggered lateral waist-pull perturbations and 20 voluntary steps. Balance tolerance limit (BTL) (transition from single to multiple steps) and first step type were determined for the waist-pull perturbations. Step parameters of initiation time, velocity, first step length, and clearance were calculated at and above BTL and for the voluntary steps. Hip abductor/adductor torque, foot cutaneous sensation, and self-reported falls that occurred 6 months prior were evaluated.
resultsTwelve participants were classified retrospectively as fallers and 18 as nonfallers. Fallers had a reduced BTL and took more medial first steps than nonfallers. Above BTL, no between-group differences were found in medial steps. At BTL, the nonparetic step clearance was reduced in fallers. Above BTL, fallers took longer to initiate a paretic and nonparetic step and had a reduced nonparetic step length and clearance compared with nonfallers. There was a between-group difference in step initiation time for voluntary stepping with the paretic leg (P < .05). Fallers had a reduced paretic abductor torque and impaired paretic foot cutaneous sensation.
conclusionA high fall rate poststroke necessitates effective fall prevention strategies. Given that more differences were found during perturbation-induced stepping between fallers and nonfallers, further research assessing perturbation-induced training on reducing falls is needed. IMPACT: Falls assessments should include both externally induced perturbations along with voluntary movements in determining the fall risk.
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