Deficiencies in standing weight shifts by ambulant hemiplegic subjects

Objective: To compare weight shifts of hemiplegic subjects with controls in parallel and diagonal stance. Design: Case-control study. Setting: All subjects were functionally independent in the general community. Hemiplegic subjects had qualified for and had received rehabilitation. Participants: Independently ambulant hemiplegic subjects, who exhibited an asymmetrical gait pattern, were compared with age- and sex-matched controls recruited from the same community. Interventions: Subjects maintained a series of weight shift postures, each for a duration of 10sec, while standing on a transduced platform with feet both parallel and placed diagonally, the latter position designed to mimic the double support phases of the gait cycle. Main Outcome Measures: Locations of center of pressure (CP) were measured in relation to each subject's center of base of support and, ranges of weight shift in each direction were calculated. Results: With feet parallel, the hemiplegic sample was deficient in shifting weight towards the hemiplegic leg and posteriorly (p < .05). The diagonal tests revealed deficiencies in shifting weight posterolaterally over both lower limbs (p < .05) but particularly over the affected leg. The ranges over which weight could be shifted were significantly below the values for the normal sample in both cardinal plane and diagonal directions (p < .05). Conclusions: Even functionally ambulant hemiplegic subjects demonstrate marked limitations in the capacity to shift weight and possess a reduced range of weight shift. The diagonal tests emphasized deficiencies in shifting weight posteriorly over both limbs and toward the affected side, specific rehabilitation of which may improve gait. (C) 1996 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation