[A baropodometric parameter to analyze the gait of hemiparetic patients: the path of center of pressure]. / Un paramètre baropodométrique pour l'analyse de la marche du patient hémiplégique: le trajet du centre de pression.

PURPOSE: Hemiparetic gait has been previously evaluated by several biomechanical methods, but plantar pressure distribution has been much less studied. Our purpose was to analyze the changes in the path of the center of pressure (COP) following the occurrence of hemiparesis using an F-Scan in-shoe transducer. MATERIALS AND METHODS: Twenty patients, mean age 50 years [26-67] with hemiparesis due to vascular causes underwent gait analysis (by the F-Scan system). All patients had steady neurological status and were self-sufficient for gait. Podo-orthoses were removed during the test. Five to six cycles of gait, about 8 m, were recorded. Comparison of the COP path was performed between hemiparetic and healthy foot. The group control consisted of 9 healthy volunteer subjects. RESULTS: Differences in the COP path were found in the hemiparetic foot of patients: a significant decrease for the anteroposterior displacement (P=0.002) and the lateral displacement (P=0.04) and a significant anterior displacement of the more posterior contact COP (P=0.005). The "gait line" was irregular, with slowing down going forward and, for some, going back. These results are likely consistent with the equine of the foot. No change was observed in the control group. CONCLUSION: The use of an F-Scan in the shoe transducer allows for revealing the importance of the COP path in analyzing hemiparetic gait; this noninvasive investigation would be helpful for evaluating the best therapy to propose to and to follow-up patients with hemiparesis.

[Incidence of constipation after recent vascular hemiplegia: a prospective cohort of 152 patients]. / Incidence de la constipation dans une population de patients atteints d'hémiplégie vasculaire récente: étude prospective de 152 cas.

Constipation is a major problem for institutionalized patients. This prospective study was performed on a population of 152 in-patients of a stroke rehabilitation center. Constipation was defined as less than three stools weekly or the use of laxative medication. Constipation occurred in sixty percent of the patients. The incidence of constipation was not related to age or sex but was strongly related to functional status of patients assessed by Barthel Index (p<0.003). The influence of both brain lesion or reduce activity is evaluated.

Responses of motor cortical cells to short trains of vibration.

The response discharges of precentral motor cortical cells to brief trains of vibration applied to the tendon of biceps brachii were analyzed in two alert but passive monkeys. The activity of 20 phasic-tonic and 6 tonic cells was analyzed. All had functional linkages with flexor muscles during a preceding flexion task and responded to passive movement of the elbow. Taking as a reference the stereotyped reflex response in the stretched muscle, the effect of changes in the amplitude of a constant frequency vibration (4 vibrations at 58 Hz) was quantified statistically in peristimulus histograms of the cortical cell discharges. All cells were transiently influenced by low vibration amplitudes. Most responses (71%) were excitatory and occurred at a mean latency of 24 ms, which is consistent with cells activated by input from stretch receptors. Excitatory, reproducible responses to the lowest vibration amplitudes were more frequent in phasic-tonic than in pure tonic cells. Large-amplitude vibrations always excited the motor cortical cells. The sign of the responses to vibration matched that to passive elbow movements for most cells. These findings show that elbow-related motor cortical cells are very sensitive to proprioceptive input from primary spindle afferents.