Knee hyperextension in chronic stroke: Associated biomechanical and neuromuscular factors

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2025-07-17 DOI:10.1016/j.clinbiomech.2025.106617

Süleyman Korkusuz , Büşra Seçkinoğulları Korkusuz , Nihat Özgören , Serdar Arıtan , Ali Naim Ceren , Mehmet Akif Topçuoğlu , Ayla Fil Balkan

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引用次数: 0

Abstract

Background

This study aimed to determine the gait phase in which knee hyperextension occurs in stroke patients and to investigate the factors associated with knee hyperextension.

Methods

This study included 30 stroke patients aged between 40 and 70 years with maximum knee hyperextension during the stance phase of gait. Muscle strength was evaluated with manual muscle test, and muscle tone was assessed with the Modified Ashworth Scale. Kinematic evaluation of the patients was made using the motion analysis system. Additionally, categorisation was made according to the stance phase of gait, where knee hyperextension was at its highest.

Findings

A weak relationship was found between maximum knee hyperextension angle and gastrocnemius spasticity, a moderate relationship between knee flexor muscle strength, and a moderate relationship between ankle dorsiflexor muscle strength. In addition, a weak relationship was found between the maximum knee hyperextension and pelvic retraction angles. According to this clustering, it was observed that 66.67 % of the participants (20 people) showed maximum knee hyperextension in the single support phase. It was observed that the participants who had maximum knee hyperextension, especially after the mid-stance phase, had higher mean gastrocnemius spasticity. It was also observed that participants in Cluster 4, with a greater amount of maximum knee hyperextension, had the worst clinical parameters.

Interpretation

Our study observed that the degree of maximum knee hyperextension was related to knee flexor and ankle dorsiflexor muscle strengths, gastrocnemius spasticity and pelvic retraction. As clinical parameters worsened, maximum knee hyperextension was thought to occur late in the stance phase.

Clinical Trial code: NCT05679700

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慢性中风的膝关节过伸：相关的生物力学和神经肌肉因素

本研究旨在确定卒中患者发生膝关节过伸的步态阶段，并探讨与膝关节过伸相关的因素。方法本研究纳入30例年龄在40 ~ 70岁的卒中患者，这些患者在站立步态阶段膝关节过伸程度最大。采用手肌试验评估肌力，采用改良Ashworth量表评估肌张力。使用运动分析系统对患者进行运动学评估。此外，根据步态的站立阶段进行分类，其中膝关节过伸程度最高。发现最大膝关节过伸角与腓肠肌痉挛之间存在微弱的关系，膝关节屈肌力量与踝关节背屈肌力量之间存在中等的关系。此外，在最大膝关节过伸和骨盆内收角之间发现了微弱的关系。根据这一聚类，我们观察到66.67%的参与者（20人）在单支撑阶段表现出最大的膝关节过伸。我们观察到，膝关节过伸程度最大的参与者，特别是在中位期之后，有更高的平均腓肠肌痉挛。还观察到，第4组的参与者，最大膝关节过伸量较大，其临床参数最差。我们的研究发现，膝关节最大过伸程度与膝关节屈肌和踝关节背屈肌力量、腓肠肌痉挛和盆腔内缩回有关。随着临床参数的恶化，最大的膝关节过伸被认为发生在站立期的后期。临床试验代码：NCT05679700

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来源期刊

Clinical Biomechanics 医学-工程：生物医学

CiteScore

3.30

自引率

5.60%

发文量

189

审稿时长

12.3 weeks

期刊介绍： Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.