Standing balance training: effect on balance and locomotion in hemiparetic adults.

The effects of balance retraining on standing balance and locomotor performance were examined in postacute hemiparetic adults. Balance during habitual and instructed-even standing, as well as locomotor performance, were measured before and after a three- to four-week treatment period. Two groups of 21 matched subjects participated in physical therapy. One group received standing balance training with a specially designed feedback device that provided dynamic visual information about relative weight distribution over the paretic and nonparetic limb. Subjects trained with the feedback device showed significantly better static standing symmetry than did subjects who did not receive augmented feedback, p less than .05. Although both groups improved significantly in gait velocity, cadence, stride length, and cycle time, p less than .01, the initially identified asymmetrical locomotor pattern appeared to be only minimally affected by the standing balance training. Results indicated that although standing balance and locomotor control mechanisms may be highly interrelated, a reduction in standing balance asymmetry does not necessarily lead to a concomitant reduction in the asymmetrical limb movement patterns associated with hemiparetic locomotion.

Posterior transfer of tibialis anterior in low-level myelodysplasia.

A clinical and EMG evaluation was performed on six children with myelomeningocele who previously had undergone bilateral transfer of the tibialis anterior to the heel cord. While the operation was effective in eliminating the calcaneovarus foot deformity, the likelihood of producing a significant new deformity was great. Dynamic EMG studies indicated that the transferred muscle usually did not develop the desired phasic contraction during the stance phase of walking. Bracing requirements at the ankle were unaffected by the procedure. The authors conclude that this transfer is undesirable for children with myelomeningocele.

Dynamic EMG findings in varus hindfoot deformity and spastic cerebral palsy.

Dynamic electromyography was used to examine the activity of muscles of 26 children with varus hindfoot deformities as a result of spastic cerebral palsy. Four different patterns of inappropriate muscle activity involving the tibialis anterior, tibialis posterior, gastrocnemius and soleus were seen during walking. Dynamic electromyographic techniques can be very helpful in identifying the specific muscular aberrations which contribute to this deformity.