Table 4.
Changes in Paretic Limb Stance Control.
| Users | Baseline | After Treatment |
|---|---|---|
S1
|
Uncontrolled/forceful knee hyperextension during weight shift/forward stepping and during mid- to terminal stance at chosen gait speed | Knee maintained in neutral position (no hyperextension) during weight shift/forward stepping at slow speed with focused attention/ upper limb support. Knee hyperextension only in very late stance with less force at chosen gait speed |
S2
|
Knee hyperextension, pelvic retraction, +Trendelenberg sign * and forward flexed trunk when attempting to bear weight on the paretic limb. | Improved alignment of trunk/pelvis/hip/knee/ankle during weight shift and stepping practice; controlling knee in neutral with upper limb support while shifting weight onto paretic limb. |
S3
|
Severe/forceful knee hyperextension, +Trendelenberg sign, and pelvic retraction when attempting to bear weight on the paretic limb. | Able to protect the knee joint from excessive hyperextension forces during weight bearing by working on stance with the knee in 10° flexion. Improved alignment of paretic pelvis/hip/knee/ankle during forward weight shift to midstance. |
S4
|
Knee hyperextension, pelvic retraction with hip external rotation, +Trendelenberg sign with center of mass between quad cane, and non-paretic limb. Step-to gait pattern with decreased time in single limb support on paretic limb. | Improved alignment of paretic pelvis/hip/knee/ankle during weight bearing with upper limb support. During chosen speed walking, taking longer steps with uninvolved limb, and pelvic retraction lessened. |
S5
|
Knee hyperflexion,+Trendeleberg sign, with center of mass maintained between the non-paretic limb and quad cane. | Improved alignment of paretic pelvis/hip/knee/ankle during weight bearing with upper limb support, demonstrating knee control at neutral. During chosen speed walking, exhibited improved knee position (less flexion) during stance phase. |
* +Trendelberg sign = hip abductor weakness (gluteal muscles) in the weightbearing limb (paretic limb) which results in a drop of the swinging limb pelvis (non-paretic limb) in the coronal plane.