Deficiencies in standing weight shifts by ambulant hemiplegic subjects

Abstract

Objective: To compare weight shifts of hemiplegic subjects with controls in parallel and diagonal stance.

Design: Case-control study.

Setting: All subjects were functionally independent in the general community. Hemiplegic subjects had qualified for and had received rehabilitation.

Participants: Independently ambulant hemiplegic subjects, who exhibited an asymmetrical gait pattern, were compared with age-and sex-matched controls recruited from the same community.

Interventions: Subjects maintained a series of weight shift postures, each for a duration of 10sec, while standing on a transduced platform with feet both parallel and placed diagonally, the latter position designed to mimic the double support phases of the gait cycle.

Main outcome measures: Locations of center of pressure (CP) were measured in relation to each subject's center of base of support and, ranges of weight shift in each direction were calculated.

Results: With feet parallel, the hemiplegic sample was deficient in shifting weight towards the hemiplegic leg and posteriorly (p<.05). The diagonal tests revealed deficiencies in shifting weight posterolaterally over both lower limbs (p<.05) but particularly over the affected leg. The ranges over which weight could be significantly below the values for the normal sample in both cardinal plane and diagonal directions (P<.05).

Conclusions: Even functionally ambulant hemiplegic subjects demonstrate marked limitations in the capacity to shift weight and possess a reduced range of weight shift. The diagonal tests emphasized deficiencies in shifting weight posteriorly over both limbs and toward the affected side, specific rehabilitation of which may improve gait.