The difference of gait pattern according to the state of the corticospinal tract in chronic hemiparetic stroke patients

Title
The difference of gait pattern according to the state of the corticospinal tract in chronic hemiparetic stroke patients
Author(s)
장성호서정표도경희정길수서상완김경[김경]손수민김영기[김영기]
Keywords
ANKLE-FOOT ORTHOSES; MOTOR CORTEX; LOCOMOTOR MOVEMENTS; WALKING FUNCTION; RECOVERY; BRAIN; REHABILITATION; STIMULATION; PERFORMANCE; HEMIPLEGIA
Issue Date
201405
Publisher
IOS PRESS
Citation
NEUROREHABILITATION, v.34, no.2, pp.259 - 266
Abstract
OBJECTIVES: The lateral corticospinal tract (CST) is one of the most important neuronal pathways that mediate voluntary movements in the human brain. However, little is known about the role of the lateral CST on the gait. We attempted to investigate differences in gait pattern using a motion analysis system according to the integrity of the contralateral CST, which was classified using diffusion tensor tractography (DTT) in chronic hemiparetic stroke patients. METHODS: We recruited 16 chronic hemiparetic stroke patients and 12 normal subjects for this study. DTT findings of the CST for patients were classified into two groups: group A (eight patients); the integrity of the CST was preserved, group B (eight patients) - the CST was discontinued at or below the stroke lesion. We compared variables of gait between group A, group B, and normal controls using the motion analysis system. RESULTS: Group A and the control group showed a significantly higher peak angle for ankle dorsiflexion, knee internal rotation, and hip flexion, compared with group B (p < 0.05). On the other hand, the peak angle for ankle plantarflexion/external rotation, knee flexion/abduction, and hip extension of group A and group B were significantly lower than those of the control group (p < 0.05). CONCLUSION: We found that severe injury of the contralateral CST caused decreased movement of ankle dorsiflexion, knee internal rotation, and hip flexion in chronic hemiparetic stroke patients. As a result, the circumduction and abduction gait pattern in stroke patients is closely associated with severe injury of the contralateral CST.
URI
http://hdl.handle.net/YU.REPOSITORY/32196http://dx.doi.org/10.3233/NRE-131046
ISSN
1053-8135
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의과대학 > 재활의학교실 > Articles
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