Neurobiomechanical Characterization of Feedforward Phase of Gait Initiation in Chronic Stroke: A Linear and Non-Linear Approach

Postural control arises from the complex interplay of stability, adaptability, and dynamic adjustments, which are disrupted post-stroke, emphasizing the importance of examining these mechanisms during functional tasks. This study aimed to analyze the complexity and variability of postural control in...

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Main Authors: Marta Freitas, Pedro Fonseca, Leonel Alves, Liliana Pinho, Sandra Silva, Vânia Figueira, José Félix, Francisco Pinho, João Paulo Vilas-Boas, Augusta Silva
Format: Article
Language:English
Published: MDPI AG 2025-04-01
Series:Applied Sciences
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Online Access:https://www.mdpi.com/2076-3417/15/9/4762
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author Marta Freitas
Pedro Fonseca
Leonel Alves
Liliana Pinho
Sandra Silva
Vânia Figueira
José Félix
Francisco Pinho
João Paulo Vilas-Boas
Augusta Silva
author_facet Marta Freitas
Pedro Fonseca
Leonel Alves
Liliana Pinho
Sandra Silva
Vânia Figueira
José Félix
Francisco Pinho
João Paulo Vilas-Boas
Augusta Silva
author_sort Marta Freitas
collection DOAJ
description Postural control arises from the complex interplay of stability, adaptability, and dynamic adjustments, which are disrupted post-stroke, emphasizing the importance of examining these mechanisms during functional tasks. This study aimed to analyze the complexity and variability of postural control in post-stroke individuals during the feedforward phase of gait initiation. A cross-sectional study analyzed 17 post-stroke individuals and 16 matched controls. Participants had a unilateral ischemic stroke in the chronic phase and could walk independently. Exclusions included cognitive impairments, recent surgery, and neurological/orthopedic conditions. Kinematic and kinetic data were collected during 10 self-initiated gait trials to analyze centre of pressure (CoP) dynamics and joint angles (−600 ms to +50 ms). A 12-camera motion capture system (Qualisys, Gothenburg, Sweden) recorded full-body kinematics using 72 reflective markers placed on anatomical landmarks of the lower limbs, pelvis, trunk, and upper limbs. Ground reaction forces were measured via force plates (Bertec, Columbus, OH, USA) to compute CoP variables. Linear (displacement, amplitude, and velocity) and non-linear (Lyapunov exponent—LyE and multiscale entropy—MSE) measures were applied to assess postural control complexity and variability. Mann–Whitney U tests were applied (<i>p</i> < 0.05). The stroke group showed greater CoP displacement (<i>p</i> < 0.05) and reduced velocity (<i>p</i> = 0.021). Non-linear analysis indicated lower LyE values and reduced complexity and adaptability in CoP position and amplitude across scales (<i>p</i> < 0.05). In the sagittal plane, the stroke group had higher displacement and amplitude in the head, trunk, pelvis, and limbs, with reduced LyE and MSE values (<i>p</i> < 0.05). Frontal plane findings showed increased displacement and amplitude in the head, trunk, and ankle, with reduced LyE and MSE (<i>p</i> < 0.05). In the transverse plane, exaggerated rotational patterns were observed with increased displacement and amplitude in the head, trunk, pelvis, and hip, alongside reduced LyE convergence and MSE complexity (<i>p</i> < 0.05). Stroke survivors exhibit increased linear variability, indicating instability, and reduced non-linear complexity, reflecting limited adaptability. These results highlight the need for rehabilitation strategies that address both stability and adaptability across time scales.
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spelling doaj-art-4464482e6c03482ea351885500adbbac2025-08-20T01:49:27ZengMDPI AGApplied Sciences2076-34172025-04-01159476210.3390/app15094762Neurobiomechanical Characterization of Feedforward Phase of Gait Initiation in Chronic Stroke: A Linear and Non-Linear ApproachMarta Freitas0Pedro Fonseca1Leonel Alves2Liliana Pinho3Sandra Silva4Vânia Figueira5José Félix6Francisco Pinho7João Paulo Vilas-Boas8Augusta Silva9School of Health Sciences of Vale do Ave, Polytechnic and University Higher Education Cooperative, Rua José António Vidal, 81, 4760-409 Vila Nova de Famalicão, PortugalPorto Biomechanics Laboratory (LABIOMEP), Faculty of Sports, University of Porto, 4200-450 Porto, PortugalCentre of Research Rehabilitation (CIR), Escola Superior de Saúde, Rua Dr. António Bernardino de Almeida 400, 4200-072 Porto, PortugalSchool of Health Sciences of Vale do Ave, Polytechnic and University Higher Education Cooperative, Rua José António Vidal, 81, 4760-409 Vila Nova de Famalicão, PortugalSchool of Health Sciences of Vale do Ave, Polytechnic and University Higher Education Cooperative, Rua José António Vidal, 81, 4760-409 Vila Nova de Famalicão, PortugalSchool of Health Sciences of Vale do Ave, Polytechnic and University Higher Education Cooperative, Rua José António Vidal, 81, 4760-409 Vila Nova de Famalicão, PortugalSchool of Health Sciences of Vale do Ave, Polytechnic and University Higher Education Cooperative, Rua José António Vidal, 81, 4760-409 Vila Nova de Famalicão, PortugalSchool of Health Sciences of Vale do Ave, Polytechnic and University Higher Education Cooperative, Rua José António Vidal, 81, 4760-409 Vila Nova de Famalicão, PortugalPorto Biomechanics Laboratory (LABIOMEP), Faculty of Sports, University of Porto, 4200-450 Porto, PortugalCentre of Research Rehabilitation (CIR), Escola Superior de Saúde, Rua Dr. António Bernardino de Almeida 400, 4200-072 Porto, PortugalPostural control arises from the complex interplay of stability, adaptability, and dynamic adjustments, which are disrupted post-stroke, emphasizing the importance of examining these mechanisms during functional tasks. This study aimed to analyze the complexity and variability of postural control in post-stroke individuals during the feedforward phase of gait initiation. A cross-sectional study analyzed 17 post-stroke individuals and 16 matched controls. Participants had a unilateral ischemic stroke in the chronic phase and could walk independently. Exclusions included cognitive impairments, recent surgery, and neurological/orthopedic conditions. Kinematic and kinetic data were collected during 10 self-initiated gait trials to analyze centre of pressure (CoP) dynamics and joint angles (−600 ms to +50 ms). A 12-camera motion capture system (Qualisys, Gothenburg, Sweden) recorded full-body kinematics using 72 reflective markers placed on anatomical landmarks of the lower limbs, pelvis, trunk, and upper limbs. Ground reaction forces were measured via force plates (Bertec, Columbus, OH, USA) to compute CoP variables. Linear (displacement, amplitude, and velocity) and non-linear (Lyapunov exponent—LyE and multiscale entropy—MSE) measures were applied to assess postural control complexity and variability. Mann–Whitney U tests were applied (<i>p</i> < 0.05). The stroke group showed greater CoP displacement (<i>p</i> < 0.05) and reduced velocity (<i>p</i> = 0.021). Non-linear analysis indicated lower LyE values and reduced complexity and adaptability in CoP position and amplitude across scales (<i>p</i> < 0.05). In the sagittal plane, the stroke group had higher displacement and amplitude in the head, trunk, pelvis, and limbs, with reduced LyE and MSE values (<i>p</i> < 0.05). Frontal plane findings showed increased displacement and amplitude in the head, trunk, and ankle, with reduced LyE and MSE (<i>p</i> < 0.05). In the transverse plane, exaggerated rotational patterns were observed with increased displacement and amplitude in the head, trunk, pelvis, and hip, alongside reduced LyE convergence and MSE complexity (<i>p</i> < 0.05). Stroke survivors exhibit increased linear variability, indicating instability, and reduced non-linear complexity, reflecting limited adaptability. These results highlight the need for rehabilitation strategies that address both stability and adaptability across time scales.https://www.mdpi.com/2076-3417/15/9/4762postural controlanticipatory adjustmentsstrokemotor variabilitysystem complexitynon-linear analysis
spellingShingle Marta Freitas
Pedro Fonseca
Leonel Alves
Liliana Pinho
Sandra Silva
Vânia Figueira
José Félix
Francisco Pinho
João Paulo Vilas-Boas
Augusta Silva
Neurobiomechanical Characterization of Feedforward Phase of Gait Initiation in Chronic Stroke: A Linear and Non-Linear Approach
Applied Sciences
postural control
anticipatory adjustments
stroke
motor variability
system complexity
non-linear analysis
title Neurobiomechanical Characterization of Feedforward Phase of Gait Initiation in Chronic Stroke: A Linear and Non-Linear Approach
title_full Neurobiomechanical Characterization of Feedforward Phase of Gait Initiation in Chronic Stroke: A Linear and Non-Linear Approach
title_fullStr Neurobiomechanical Characterization of Feedforward Phase of Gait Initiation in Chronic Stroke: A Linear and Non-Linear Approach
title_full_unstemmed Neurobiomechanical Characterization of Feedforward Phase of Gait Initiation in Chronic Stroke: A Linear and Non-Linear Approach
title_short Neurobiomechanical Characterization of Feedforward Phase of Gait Initiation in Chronic Stroke: A Linear and Non-Linear Approach
title_sort neurobiomechanical characterization of feedforward phase of gait initiation in chronic stroke a linear and non linear approach
topic postural control
anticipatory adjustments
stroke
motor variability
system complexity
non-linear analysis
url https://www.mdpi.com/2076-3417/15/9/4762
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