1. This article and any supplementary material should be cited as follows: Raja B, Neptune RR, Kautz SA. Quantifiable patterns of limb loading and unloading during hemiparetic gait: Relation to kinetic and kinematic parameters. J Rehabil Res Dev. 2012;49(9):1293–1304. http://dx.doi.org/10.1682/JRRD.2011.02.0018 Slideshow Project DOI:10.1682/JRRD.2011.02.0018JSP Quantifiable patterns of limb loading and unloading during hemiparetic gait: Relation to kinetic and kinematic parameters Bhavana Raja, PT, PhD; Richard R. Neptune, PhD; Steven A. Kautz, PhD

2. This article and any supplementary material should be cited as follows: Raja B, Neptune RR, Kautz SA. Quantifiable patterns of limb loading and unloading during hemiparetic gait: Relation to kinetic and kinematic parameters. J Rehabil Res Dev. 2012;49(9):1293–1304. http://dx.doi.org/10.1682/JRRD.2011.02.0018 Slideshow Project DOI:10.1682/JRRD.2011.02.0018JSP Aim – Determine magnitude and duration of asymmetry in limb loading (LL) and limb unloading (LU) in hemiparesis. – Determine relationship with functional walking status and specific kinematic and kinetic variables during walking. Relevance – Understanding LL and LU asymmetry will provide insight into changes in poststroke individuals’ locomotion and inspire new walking rehabilitation strategies.

3. This article and any supplementary material should be cited as follows: Raja B, Neptune RR, Kautz SA. Quantifiable patterns of limb loading and unloading during hemiparetic gait: Relation to kinetic and kinematic parameters. J Rehabil Res Dev. 2012;49(9):1293–1304. http://dx.doi.org/10.1682/JRRD.2011.02.0018 Slideshow Project DOI:10.1682/JRRD.2011.02.0018JSP Method Participants: – 44 people with chronic hemiparesis and 18 nondisabled controls. Protocol – Participants walked on instrumented split-belt treadmill without assistive device or ankle foot orthosis for 3 walking trials at self-selected speed. Controls walked at self-selected speed, 0.3 m/s, and 0.6 m/s. – 12-camera motion analysis system collected data as subjects walked. – Variables calculated during double-limb support phases of gait (when LL and LU occur).

4. This article and any supplementary material should be cited as follows: Raja B, Neptune RR, Kautz SA. Quantifiable patterns of limb loading and unloading during hemiparetic gait: Relation to kinetic and kinematic parameters. J Rehabil Res Dev. 2012;49(9):1293–1304. http://dx.doi.org/10.1682/JRRD.2011.02.0018 Slideshow Project DOI:10.1682/JRRD.2011.02.0018JSP Results LL Magnitude – At self-selected speeds: Magnitude less in paretic vs nonparetic leg and controls. – At matched speeds: No significant difference between paretic leg and controls when considering subjects with hemiparesis as single group. When considered separately, reduced paretic leg LL was related to functional walking status in hemiparesis group. Slower individuals had significant differences in LL vs controls. Community ambulators not significantly different.

5. This article and any supplementary material should be cited as follows: Raja B, Neptune RR, Kautz SA. Quantifiable patterns of limb loading and unloading during hemiparetic gait: Relation to kinetic and kinematic parameters. J Rehabil Res Dev. 2012;49(9):1293–1304. http://dx.doi.org/10.1682/JRRD.2011.02.0018 Slideshow Project DOI:10.1682/JRRD.2011.02.0018JSP Results (cont’d.) LU Magnitude – At self-selected and matched speeds: For household and limited community ambulators, significantly lower in paretic vs nonparetic leg and controls No significant difference between community ambulators and nonparetic leg and controls. LL/LU Timing & Pattern – Household ambulators LL time of nonparetic leg significantly less than limited community ambulators and community ambulators. LU time greater than limited community ambulators and community ambulators.

6. This article and any supplementary material should be cited as follows: Raja B, Neptune RR, Kautz SA. Quantifiable patterns of limb loading and unloading during hemiparetic gait: Relation to kinetic and kinematic parameters. J Rehabil Res Dev. 2012;49(9):1293–1304. http://dx.doi.org/10.1682/JRRD.2011.02.0018 Slideshow Project DOI:10.1682/JRRD.2011.02.0018JSP Results (cont’d.) Mediolateral (M-L) GRF and LL/LU – No significant correlation. Knee Angle and LL/LU – No significant correlation. M-L Leg Angle and LL/LU – Subjects with reduced paretic leg LL placed paretic leg further lateral relative to pelvis center of mass. – LL negatively associated with leg angle of paretic side in M-L direction during 1 st double-support phase. – Paretic leg M-L angle significantly greater than nonparetic leg and controls at matched speeds.

7. This article and any supplementary material should be cited as follows: Raja B, Neptune RR, Kautz SA. Quantifiable patterns of limb loading and unloading during hemiparetic gait: Relation to kinetic and kinematic parameters. J Rehabil Res Dev. 2012;49(9):1293–1304. http://dx.doi.org/10.1682/JRRD.2011.02.0018 Slideshow Project DOI:10.1682/JRRD.2011.02.0018JSP Conclusion Paretic LL magnitude was reduced, while duration was increased vs nonparetic leg and controls walking at matched speeds. 3 LL/LU patterns were identified: concave, convex, and linear. Results indicate that people with hemiparesis make biomechanical adjustments to maintain a steady walking state. – Characterization of these deviations may inspire new strategies for rehabilitation.