Quadriceps Muscle Activity and Gait Kinematics in Patients With Post-Stroke Stiff-Knee Gait Compared With Healthy Controls
Trial statusRecruiting
Trial phaseNot listed
Trial typeObservational
Biological sexAll
Age18+
SponsorFrédéric Chantraine
About this trial
Stiff-knee gait (SKG) is a frequent gait abnormality in people with post-stroke hemiparesis and is characterized by insufficient knee flexion during the swing phase of walking. One potential mechanism is inappropriate activation of one or more heads of the quadriceps during pre-swing and early swing.
This observational study will compare quadriceps electromyographic activity and gait kinematics between adults with chronic post-stroke hemiparesis with SKG and healthy adult controls.
The study will include 30 participants with post-stroke SKG and 24 healthy controls. Quantitative gait analysis will be performed using three-dimensional motion analysis together with electromyography (EMG). Ultrasound-guided fine-wire electrodes will record the activity of all four heads of the quadriceps: rectus femoris, vastus intermedius, vastus medialis, and vastus lateralis.
Healthy controls will be assessed while walking at a slow speed selected to provide a reference condition that is comparable with the walking speeds typically observed in participants with post-stroke hemiparesis.
The primary outcome is the difference in fine-wire EMG activation patterns of the four quadriceps heads between participants with post-stroke SKG and healthy controls, with particular attention to pre-swing and early swing.
Secondary outcomes will assess differences in gait kinematics between groups, including peak knee flexion during the swing phase and knee flexion-extension patterns throughout the gait cycle.
The study aims to improve understanding of the muscular mechanisms underlying post-stroke SKG and to establish relevant fine-wire EMG reference patterns for all four quadriceps heads in healthy individuals walking at a speed comparable with patients with hemiparesis.
Eligibility criteria
This trial accepts healthy volunteersQualifiers
Clinical diagnosis of cerebral stroke with hemiparesis.
Age greater than 18 years.
Right- or left-sided hemiparesis following stroke.
Stroke occurred at least 6 months before assessment.
Disqualifiers
Other disease or history of disease likely to influence gait, including peripheral neurological, cerebellar, vestibular, rheumatological, orthopedic, or metabolic disorders.
Visual or hearing impairment.
Medication likely to affect gait.
Botulinum toxin injection into the lower-limb muscles within the preceding 6 months
Trial population
The study population consists of adults with chronic post-stroke hemiparesis and stiff-knee gait receiving care at the Rehazenter and healthy adult volunteers. Patients with SKG are selected from individuals attending the Rehazenter who meet the study eligibility criteria. Healthy controls are recruited on a voluntary basis, including through invitations to Rehazenter personnel and family members of patients attending consultations.
Trial design
Design model
Case-control
Time perspective
Cross-sectional
Treatments tested in this trial
Not listed
Trial groups
50 Participants
are grouped into 2 trial groupsGroup A: Post-Stroke Stiff-Knee Gait
Group B: Healthy Controls
Trial outcomes
Primary outcomes
1
On-Off Quadriceps Electromyographic Activity During the Gait Cycle
Difference in Fine-Wire Electromyographic Activity of the Four Quadriceps Heads Between Participants With Post-Stroke Stiff-Knee Gait and Healthy Controls. Fine-wire electromyographic activity will be recorded with a telemetric electromyograph equipment from the rectus femoris, vastus intermedius, vastus medialis, and vastus lateralis during walking. For each muscle, the EMG envelope will be calculated from the raw EMG signal using root mean square processing and expressed over the time-normalized gait cycle. The primary analysis will compare quadriceps activation patterns (On-Off) between participants with post-stroke stiff-knee gait and healthy controls assessed at a slow walking speed, with particular attention to the pre-swing and early-swing phases of gait. On-Off activation patterns will be expressed as period(s) during the gait cycle (%). The four quadriceps heads will be evaluated individually to identify muscle-specific differences in activation between groups.
Time frame
BaselineSecondary outcomes
1
Peak Knee Flexion During the Swing Phase of Gait
Difference in Peak Knee Flexion During the Swing Phase Between Participants With Post-Stroke Stiff-Knee Gait and Healthy Controls. Peak knee-flexion angle (expressed in degrees) during the swing phase will be measured using a 10-cameras optoelectronic system and compared between participants with post-stroke stiff-knee gait and healthy controls.
Time frame
Baseline2
Knee Kinematic Profile During the Gait Cycle
Difference in Sagittal-Plane Knee Kinematics Between Participants With Post-Stroke Stiff-Knee Gait and Healthy Controls. The knee flexion-extension angle (expressed in degrees) will be evaluated throughout the time-normalized gait cycle using a 10-cameras optoelectronic system and compared between the two groups.
Time frame
Baseline3
Lower-Limb Kinematics
Differences in Hip, Knee, and Ankle Kinematics Between Participants With Post-Stroke Stiff-Knee Gait and Healthy Controls. Three-dimensional kinematic angle measurements (expressed in degrees) of the hips, knees, and ankles collected with a 10-cameras optoelectronic system will be evaluated to characterize differences in gait patterns between the two groups.
Time frame
BaselineSponsors and contacts
Click on the lead sponsor to view all of their trials.
Frédéric Chantraine
Lead sponsor
Centre National de Rééducation Fonctionnelle et de Réadaptation
Sponsor institution
Source ClinicalTrials.gov