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Associations between muscle strength asymmetry and impairments in gait and posture in young brain-injured patients

(2015) JOURNAL OF NEUROTRAUMA. 32(17). p.1324-1332
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Abstract
Traumatic brain injury (TBI) can lead to deficits in gait and posture, which are often asymmetric. A possible factor mediating these deficits may be asymmetry in strength of the leg muscles. However, muscle strength in the lower extremities has rarely been investigated in (young) TBI patients. Here, we investigated associations between lower-extremity muscle weakness, strength asymmetry, and impairments in gait and posture in young TBI patients. A group of young patients with moderate-to-severe TBI (n=19; age, 14 years 11 months +/- 2 years) and a group of typically developing subjects (n=31; age, 14 years 1 month +/- 3 years) participated in this study. A force platform was used to measure postural sway to quantify balance control during normal standing and during conditions of compromised visual and/or somatosensory feedback. Spatiotemporal gait parameters were assessed during comfortable and fast-speed walking, using an electronic walkway. Muscle strength in four lower-extremity muscle groups was measured bilaterally using a handheld dynamometer. Findings revealed that TBI patients had poorer postural balance scores across all sensory conditions, as compared to typically developing subjects. During comfortable and fast gait, TBI patients demonstrated a lower gait velocity, longer double-support phase, and increased step-length asymmetry. Further, TBI patients had a reduced strength of leg muscles and an increased strength asymmetry. Correlation analyses revealed that asymmetry in muscle strength was predictive of a poorer balance control and a more variable and asymmetric gait. To the best of our knowledge, this is the first study to measure strength asymmetry in leg muscles of a sample of TBI patients and illustrate the importance of muscular asymmetry as a potential marker and possible risk factor of impairments in control of posture and gait.
Keywords
balance control, traumatc brain injury, muscle strength, posture, gait, HAND-HELD DYNAMOMETRY, MILD HEAD-INJURY, CEREBRAL-PALSY, BALANCE PERFORMANCE, HEMIPLEGIC GAIT, CHILDREN, WALKING, STROKE, VARIABILITY, DISABILITY

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Citation

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MLA
Drijkoningen, David et al. “Associations Between Muscle Strength Asymmetry and Impairments in Gait and Posture in Young Brain-injured Patients.” JOURNAL OF NEUROTRAUMA 32.17 (2015): 1324–1332. Print.
APA
Drijkoningen, D., Caeyenberghs, K., Vander Linden, C., Van Herpe, K., Duysens, J., & Swinnen, S. P. (2015). Associations between muscle strength asymmetry and impairments in gait and posture in young brain-injured patients. JOURNAL OF NEUROTRAUMA, 32(17), 1324–1332.
Chicago author-date
Drijkoningen, David, Karen Caeyenberghs, Catharine Vander Linden, Katrin Van Herpe, Jacques Duysens, and Stephan P Swinnen. 2015. “Associations Between Muscle Strength Asymmetry and Impairments in Gait and Posture in Young Brain-injured Patients.” Journal of Neurotrauma 32 (17): 1324–1332.
Chicago author-date (all authors)
Drijkoningen, David, Karen Caeyenberghs, Catharine Vander Linden, Katrin Van Herpe, Jacques Duysens, and Stephan P Swinnen. 2015. “Associations Between Muscle Strength Asymmetry and Impairments in Gait and Posture in Young Brain-injured Patients.” Journal of Neurotrauma 32 (17): 1324–1332.
Vancouver
1.
Drijkoningen D, Caeyenberghs K, Vander Linden C, Van Herpe K, Duysens J, Swinnen SP. Associations between muscle strength asymmetry and impairments in gait and posture in young brain-injured patients. JOURNAL OF NEUROTRAUMA. 2015;32(17):1324–32.
IEEE
[1]
D. Drijkoningen, K. Caeyenberghs, C. Vander Linden, K. Van Herpe, J. Duysens, and S. P. Swinnen, “Associations between muscle strength asymmetry and impairments in gait and posture in young brain-injured patients,” JOURNAL OF NEUROTRAUMA, vol. 32, no. 17, pp. 1324–1332, 2015.
@article{8579837,
  abstract     = {Traumatic brain injury (TBI) can lead to deficits in gait and posture, which are often asymmetric. A possible factor mediating these deficits may be asymmetry in strength of the leg muscles. However, muscle strength in the lower extremities has rarely been investigated in (young) TBI patients. Here, we investigated associations between lower-extremity muscle weakness, strength asymmetry, and impairments in gait and posture in young TBI patients. A group of young patients with moderate-to-severe TBI (n=19; age, 14 years 11 months +/- 2 years) and a group of typically developing subjects (n=31; age, 14 years 1 month +/- 3 years) participated in this study. A force platform was used to measure postural sway to quantify balance control during normal standing and during conditions of compromised visual and/or somatosensory feedback. Spatiotemporal gait parameters were assessed during comfortable and fast-speed walking, using an electronic walkway. Muscle strength in four lower-extremity muscle groups was measured bilaterally using a handheld dynamometer. Findings revealed that TBI patients had poorer postural balance scores across all sensory conditions, as compared to typically developing subjects. During comfortable and fast gait, TBI patients demonstrated a lower gait velocity, longer double-support phase, and increased step-length asymmetry. Further, TBI patients had a reduced strength of leg muscles and an increased strength asymmetry. Correlation analyses revealed that asymmetry in muscle strength was predictive of a poorer balance control and a more variable and asymmetric gait. To the best of our knowledge, this is the first study to measure strength asymmetry in leg muscles of a sample of TBI patients and illustrate the importance of muscular asymmetry as a potential marker and possible risk factor of impairments in control of posture and gait.},
  author       = {Drijkoningen, David and Caeyenberghs, Karen and Vander Linden, Catharine and Van Herpe, Katrin and Duysens, Jacques and Swinnen, Stephan P},
  issn         = {0897-7151},
  journal      = {JOURNAL OF NEUROTRAUMA},
  keywords     = {balance control,traumatc brain injury,muscle strength,posture,gait,HAND-HELD DYNAMOMETRY,MILD HEAD-INJURY,CEREBRAL-PALSY,BALANCE PERFORMANCE,HEMIPLEGIC GAIT,CHILDREN,WALKING,STROKE,VARIABILITY,DISABILITY},
  language     = {eng},
  number       = {17},
  pages        = {1324--1332},
  title        = {Associations between muscle strength asymmetry and impairments in gait and posture in young brain-injured patients},
  url          = {http://dx.doi.org/10.1089/neu.2014.3787},
  volume       = {32},
  year         = {2015},
}

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