Research Report Abstracts - Gesundheit

eS352
increase of 164 ± 183% of Sol unconditioned EMG) than
in control subjects (60 ± 92%). In both groups, the facilitation
was significantly modulated throughout the conditions
before, during and after vibration. In stroke subjects, facilitation
before vibration was higher than facilitation during
vibration (81 ± 92%) but not different from the one measured
30 minutes after vibration (162 ± 178%). In control subjects,
facilitation before vibration tended to be higher although not
significantly different from the facilitation during vibration
(29 ± 41) and was not different from the facilitation measured
30 minutes (47 ± 57%) after vibration. The facilitation was
not different between the stroke and the control groups during
the vibration condition but it was significantly different
30 minutes after vibration.
Conclusions: These results show that vibration can reduce
the heteronymous facilitation of soleus by quadriceps afferents
either in control or stroke subjects. Vibration can regulate
the abnormal increased facilitation in stroke subjects to a level
closer to that observed in control subjects. This suggests that
the mechanisms underlying the vibration-induced reduction
of the facilitation, namely presynaptic inhibition and homosynaptic
depression, can be activated in stroke subjects.
Implications: Vibration could be a useful therapeutic tool
to modulate the hyperexcitability of spinal pathways after
stroke. More specifically, this modality can regulate the
increase intersegmental excitatory influences projecting from
quadriceps to soleus in the paretic leg. Future studies should
investigate whether vibration can help to reduce the abnormal
coactivation of leg extensors while stroke subjects attempt to
move the paretic leg.
Keywords: Hemiparesis; Tendon vibration; Propriospinal
influence
Funding acknowledgements: Eric Maupas was supported
by a bursary from IPSEN-SOFMER and REPAR. Sibele de
Andrade Melo and the project were supported by the CRIR.
Joseph-Omer Dyer, Daniel Bourbonnais and Robert Forget
were supported by the Fonds de la recherche en santé du
Québec.
Ethics approval: The study was approved by the Research
Ethics Committee of the CRIR institutions in Montreal.
Research Report Poster Display
Number: RR-PO-208-2-Tue Tuesday 21 June 12:00
RAI: Exhibit Halls2&3
FOOT POSTURE VARIATIONS AFTER STROKE:
FREQUENCY, NATURE AND CLINICAL
SIGNIFICANCE
Forghany S. 1,2 , Tyson S. 2 , Nester C. 2 , Jones R. 2 , Preece S. 2
1Isfahan University of Medical Sciences, School of Rehabilitation
Sciences, Isfahan, Iran, 2The University of Salford,
Centre for Health, Sport and Rehabilitation Sciences
Research, Salford, United Kingdom
Purpose: Clinical convention suggests that foot abnormalities
are common after stroke and cause walking difficulties.
However, there is little objective data to support or refute
these beliefs. The aim of this paper was therefore to undertake
the first detailed survey of foot problems after stroke. Specifically
we aimed to (i) establish the frequency and nature of
foot deformities and (ii) explore the relationships between
foot abnormalities, stroke-related impairments and mobility
activity limitations.
Relevance: Given the lack of previous work in this field
we sought to investigate five beliefs that underpin clinical
reasoning and decision-making by health care professionals
when prescribing and fitting foot orthotics for people with
stroke: 1. Foot abnormalities are common; 2. Equinovarus
(supinated/inverted foot) is the predominant abnormality;
3. Foot posture is asymmetrical; 4. Foot posture is related
to stroke impairments; Stroke survivors with more severe
impairments will have more frequent and severe foot abnormalities;
5. Foot posture is related to walking ability – stroke
survivors with more severe abnormalities will have more
limited walking ability.
Participants: Seventy-two stroke subjects were recruited
with a mean age of 68.3 (±12.6) years. There were 34 men
and 38 women, 64 suffered an ischemic and 8 a hemorrhagic
stroke, the right side was affected for 28 subjects and the left
side for 44.
Methods: Foot posture was measured using the Foot Posture
Index which defines foot position as normal, supinated or
pronated. To investigate the relationship between foot posture
and stroke related impairments; lower limb weakness
and spasticity on the affected side were also measured. The
Motricity Index (MI) measured lower limb weakness and the
Modified Ashworth Scale (MAS) graded ankle plantarflexor
spasticity. To explore the relationships between foot posture
and function, walking ability was assessed using the Walking
Handicap Scale which classified participants as household or
community walkers according to their self-reported everyday
activity.
Analysis: Descriptive statistics established the frequency,
nature and symmetry of foot posture abnormalities. Multiple
linear regression determined the factors that influenced
foot posture. Finally, binary logistic regression was used to
explore the contribution of foot abnormalities to walking.