The Impact Of Different Foot Positions On The Sit-to-stand Stability And Lower Limb Loading In Hemiplegic Stroke Patients

ObjectiveTo explore the effects of different foot positions on sit-to-stand stability and loading oflower limbs in hemiplegic stroke patients.Methods36hemiplegic patients with stroke (experimental group) and36healthy people (controlgroup) were recruited, two groups of subjects were required to complete the sit-to-standmovement with3different foot positions.(1) both feet (BF) placed at10°of ankledorsiflexion.(2) The paretic foot placed posterior (PFP) for the hemiparetic subjects orthe undominant foot placed posterior (UDFP) for the healthy subjects.(3)Thenon-paretic foot placed posterior (NPFP) for the hemiparetic subjects or the dominantfoot placed posterior (DFP) for the healthy subjects. Gait and balance function trainingand assessment system(model AL-080) was used for collecting the time for completingsit-to-stand, the average load differences between left and right (ALD) and the center ofgravity in mediolateral direction sway (COGX), and the differences between them wereinvestigated.Results1. When BF ankle dorsiflexion is10°, in addition to time required for sit-to-standmovement, the differences were statistically significant (P <0.05) for the averageloading of the non-paretic foot[(59.12±2.71)%], the paretic foot[(40.88±2.71)%],ALD [(18.24±5.41)%] and COGX [(3.58±0.76) cm] compared with the PFP.2. For NPFP, when compared with all of the above indicators of PFP, the differenceswere statistically significant (P <0.05), compared with the indicators10°of BF ankle dorsiflexion, except for the time required for sit-to-stand movement, theremaining indicators and their differences were statistically significant (P <0.05).3. When compared with the control group as for UFDP, all indicators were increasedor decreased to varying degrees(P <0.05) as10°of BF ankle dorsiflexion, whileDFP, except for the time required for sit-to-stand movement, the difference for theremaining indicators compared with UDFP were statistically significant (P <0.05).All indicators for all three kinds of foot position in the control group, werestatistically significant different (P <0.05) compared with the experimental group.4. In the experimental group when PFP(r=0.753, p=0.00),10°of BF ankledorsiflexion(r=0.798, p=0.00), and NPFP(r=0.814, p=0.00), ALD and COGXshowed a high positive correlation. While in the control group, UPFP (r=0.764, p=0.00),10°of BF ankle dorsiflexion(r=0.824, p=0.00) and DFP(r=0.838, p=0.00), there also existed a high positive correlation between the ALD and COGX.Conclusions5.1The different foot placements had a major influence on loading of lower limbs andstability of sit-to-stand in hemiplegic stroke patients.5.2Placing non-paretic foot posterior was favorable for improving the stability ofsit-to-stand in stroke patients with hemiplegia.5.3Placing paretic foot posterior is presented as a potential therapeutic way ofimproving the paretic limb function.5.4The higher the loading of lower limbs was, the better the postural stability would be.