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Query: UMLS:C0018991 (hemiplegia)
 3,997 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Multiple parameters of gait were evaluated in 50 adult acquired hemiplegic patients and 30 control patients with no history of gait abnormality and no deviation from normal gait by observational analysis. Findings in the hemiplegic group include: 1) increase in the proportion of the gait cycle spent in stance and double-limb support phases in both the normal and affected limb; 2) consistent deviation from normal gait pattern by observation and objective pattern analysis; 3) abnormal phasic activity of specific muscles and muscle groups in the affected limb; and 4) a consistent electrogoniometric deviation from normal joint ankle progression in the affected hip, knee and ankle. These data lend credence to the hypothesis that gait deviation in adult acquired hemiplegia follows a consistent pattern varying with the severity of central nervous system involvement. These data also provide a baseline from which to measure therapeutic intervention in this complex patient population.
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PMID:Gait changes in adult onset hemiplegia. 332 70

Forty patients with cerebral palsy, who had been trained in our clinic and attained to walk in recent 10 years, were presented. Forty-five percent of the patients had a history of preterm delivery, and another 45% had no causes suggestive of cerebral palsy. The mean age of the initiation of practical walk was 2 years and 2 months, and that of spastic hemiplegia was 1 year and 10 months. About 60% of the patients with spastic hemiplegia visited our clinic because of abnormal gait. Their brain CT and EEG showed a higher incidence of abnormality than those in other types of cerebral palsy. The type of cerebral palsy and their IQ (DQ) level had no correlation with presence of epilepsy. About 60% of the cases showed normal IQ (DQ) level. Seventy percent of school-aged children belonged to public school, but they received no special training for their physical handicaps. Therefore it was necessary for our hospital to offer them rehabilitation therapy.
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PMID:[A clinical study on children with cerebral palsy able to walk practically]. 791 90

Hip flexion contractures accompanying various orthopedic and neurologic conditions not only limits the physical activities of the patients but also distorts their postures and gait patterns. The purposes of this study were to characterize the appearance patterns of flexion contracture at the hip joints and to elucidate how this disability affects their postural and gait abnormalities. Seventy-eight patients (mean age of 68.1 +/- 10.5 years) with hemiplegia, femoral neck fractures, osteoarthritis of the hip and other conditions causing hip flexion contractures were studied. The presence and degree of hip flexion contracture were estimated in the supine position using the Thomas maneuver with a goniometer. Relationship between appearance patterns and 12-survey variables was also analyzed statistically. As a result, it was revealed that whether lack of mobility caused by hip flexion contracture was compensated for by pelvic tilt an an increase of lumbar lordosis or not was affected by four factors. It was also revealed that whether it appeared unilaterally or bilaterally was affected by five factors. In addition, some postural and gait abnormalities caused by hip flexion contracture were observed in many patients. These results suggest that clinical pictures of the patient's posture and gait abnormality depend on his ability to regulate the position of the trunk and knees as well as the mobility of his spine.
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PMID:Factors affecting appearance patterns of hip-flexion contractures and their effects on postural and gait abnormalities. 902 58

It has been asserted that speed alone is an effective indicator of the degree of gait abnormality. To determine the validity of this assertion, relationships between velocity and 18 other temporal gait parameters were determined in 25 patients with a first hemispheric stroke resulting in hemiplegia or hemiparesis of at least one month duration. Gait characteristics were recorded using footswitchs connected to a portable computerized monitoring device. Velocity was found to be significantly correlated with cadence, mean cycle duration, mean cycle length, hemiplegic limb stance phase duration, nonhemiplegic limb stance phase duration and percent, nonhemiplegic limb swing phase percent, double support phase duration and percent, hemiplegic limb swing/stance phase ratio, nonhemiplegic limb swing/stance phase ratio, and swing phase symmetry ratio but not with the hemiplegic limb stance phase percent, hemiplegic limb swing phase duration and percent, nonhemiplegic limb swing phase duration, stance phase symmetry ratio, and overall asymmetry ratio. Velocity is related to most, but not all, of the other temporal measures of hemiplegic gait. A comprehensive gait evaluation should also include characterization of the degree of asymmetry and descriptions of individual phase durations and proportions (particularly hemiplegic stance and swing percentages).
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PMID:Hemiplegic gait. Relationships between walking speed and other temporal parameters. 912 19

Most children with spastic hemiplegia have high levels of function and independence but fixed deformities and gait abnormalities are common. The classification proposed by Winters et al is widely used to interpret hemiplegic gait patterns and plan intervention. However, this classification is based on sagittal kinematics and fails to consider important abnormalities in the transverse plane. Using three-dimensional gait analysis, we studied the incidence of transverse-plane deformity and gait abnormality in 17 children with group IV hemiplegia according to Winters et al before and after multilevel orthopaedic surgery. We found that internal rotation of the hip and pelvic retraction were consistent abnormalities of gait in group-IV hemiplegia. A programme of multilevel surgery resulted in predictable improvement in gait and posture, including pelvic retraction. In group IV hemiplegia pelvic retraction appeared in part to be a compensating mechanism to control foot progression in the presence of medial femoral torsion. Correction of this torsion can improve gait symmetry and function.
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PMID:Multilevel orthopaedic surgery in group IV spastic hemiplegia. 1579 9

The aim of this study was to test the inter- and intraobserver reliability of the Physician Rating Scale (PRS) and the Edinburgh Visual Gait Analysis Interval Testing (GAIT) scale for use in children with cerebral palsy (CP). Both assessment scales are quantitative observational scales, evaluating gait. The study involved 24 patients ages 3 to 10 years (mean age 6.7 years) with an abnormal gait caused by CP. They were all able to walk independently with or without walking aids. Of the children 15 had spastic diplegia and 9 had spastic hemiplegia. With a minimum time interval of 6 weeks, video recordings of the gait of these 24 patients were scored twice by three independent observers using the PRS and the GAIT scale. The study showed that both the GAIT scale and the PRS had excellent intraobserver reliability but poor interobserver reliability for children with CP. In the total scores of the GAIT scale and the PRS, the three observers showed systematic differences. Consequently, the authors recommend that longitudinal assessments of a patient should be done by one observer only.
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PMID:Gait in children with cerebral palsy: observer reliability of Physician Rating Scale and Edinburgh Visual Gait Analysis Interval Testing scale. 1583 35

Trunk mobility impairment can cause balance, postural and gait challenges during overground level walking in patients with different pathologies. Assessment of the rotations of the trunk during walking with an abnormal gait can provide knowledge required for a better understanding of the nature of the motor control deficit and support decision-making in patient rehabilitation. A method based on the use of a weighted Fourier linear combiner (WFLC) adaptive filter is proposed in this paper for the estimation of lower trunk angles during pathological overground level walking, using angular velocities measured at the lower trunk level with a wearable inertial sensor. This method was validated for a group of 24 patients, 13 with hemiplegia and 11 with Parkinson's disease, by comparing the estimated angles to those simultaneously obtained from a stereophotogrammetric system. Analysis of the root mean square error, correlation coefficient and offset results revealed that the WFLC approach is highly accurate in estimating lateral and frontal bending and axial rotations of the lower trunk in pathological level walking.
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PMID:Estimate of lower trunk angles in pathological gaits using gyroscope data. 2349 3

This study was conducted to investigate the effects of asymmetrical body posture alone, i.e., the effects seen in children with mild scoliosis, vs. the effects of body posture control impairment, i.e., those seen in children with unilateral cerebral palsy on gait patterns. Three-dimensional instrumented gait analysis (3DGA) was conducted in 45 children with hemiplegia and 51 children with mild scoliosis. All the children were able to walk without assistance devices. A set of 35 selected spatiotemporal gait and kinematics parameters were evaluated when subjects walked on a treadmill. A cluster analysis revealed 3 different gait patterns: a scoliotic gait pattern and 2 different hemiplegic gait patterns. The results showed that the discrepancy in gait patterns was not simply a lower limb kinematic deviation in the sagittal plane, as expected. Additional altered kinematics, such as pelvic misorientation in the coronal plane in both the stance and swing phases and inadequate stance phase hip ad/abduction, which resulted from postural pattern features, were distinguished between the 3 gait patterns. Our study provides evidence for a strong correlation between postural and gait patterns in children with unilateral cerebral palsy. Information on differences in gait patterns may be used to improve the guidelines for early therapy for children with hemiplegia before abnormal gait patterns are fully established. The gait pathology characteristic of scoliotic children is a potential new direction for treating scoliosis that complements the standard posture and walking control therapy exercises with the use of biofeedback.
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PMID:Gait pattern differences between children with mild scoliosis and children with unilateral cerebral palsy. 2508 8

Patients with pontine hemorrhage usually experience severe disturbances of consciousness, pupillary abnormalities, quadriparesis, and respiratory failure. However, little is known regarding cognitive dysfunction in patients with pontine hemorrhage. We report the case of a rehabilitation patient presenting with hemiplegia, ataxia, and cognitive dysfunction caused by a pontine hemorrhage. A 55-year-old, right-handed male suffered sudden onset of vertigo, dysarthria, and hemiplegia on the right side. He was diagnosed with brain stem hemorrhage, and conservative treatment was administered. The vertigo improved, but dysarthria, ataxia, hemiplegia, and gait disorder persisted. He was disoriented with respect to time and place and showed a poor attention span, impaired executive function, and reduced volition. A computed tomography revealed hematomas across the pons on both sides, but no lesions were obvious in the cerebellum and cerebrum. Single-photon emission tomography showed decreased perfusion in the brain stem, bilateral basal ganglia, and frontal and parietal lobes in the left hemisphere. The patient received exercise therapy and cognitive rehabilitation, and home modifications were performed to allow him to continue living at home under the supervision of his family. His symptoms improved, along with enhanced regional cerebral blood flow to the frontal and temporal lobes. These findings suggest that the pontine hemorrhage caused diaschisis resulting in secondary reduction of activity in the cerebral hemisphere and the occurrence of cortical symptoms. Therefore, rehabilitation is necessary, along with active instructions for the family members of patients with severe neurological deficits.
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PMID:Rehabilitation for a Patient with Hemiplegia, Ataxia, and Cognitive Dysfunction Caused by Pontine Hemorrhage. 2660 Jul 85

Pelvic retraction during walking is a common finding seen in patients with spastic hemiplegia. However, potential factors related to this condition have not been comprehensively examined in a systemic manner in previous studies. The purpose of this study was to elucidate any clinical and gait parameters related to pelvic retraction in patients with hemiplegic cerebral palsy. A total of 212 independent ambulatory patients were enrolled in the study. Group I consisted of 113 patients who had persistent pelvic retraction, and Group II of 99 with a normal range of pelvic rotation throughout the gait cycle as evidenced by kinematic analysis. A multivariate logistic regression analysis using a clustering technique was performed, with use of eight gait factors and five clinical factors. Decreased ankle dorsiflexion, increased hip internal rotation, increased anterior pelvic tilt, the Winters classification type II, and asymmetrical posturing of the upper extremity during gait were found to be related to pelvic retraction. This is the only study including a broader array of assessment domains of both clinical and gait parameters with a considerably large and homogenous population with hemiplegia. Further studies will be needed to see whether the rectification of those parameters may improve abnormal gait and pelvic retraction in hemiplegia.
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PMID:Clinical and Gait Parameters Related to Pelvic Retraction in Patients with Spastic Hemiplegia. 3109 87


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