Abstract
Which Factors Contribute to Upper Limb Associated Reactions During Walking in People with Acquired Brain Injury?
Brain Injury, Vol.36(Supplemental 1), pp.7-8
Virtual World Congress on Brain Injury, 2021 (Online, 28-Jul-2021)
2022
Abstract
Aim: To determine which potential contributing factors are associated with expression of upper-limb associated reactions during walking.
Design: Cross-sectional observational study.
Method: Forty-two participants with a brain injury and upper-limb associated reaction during walking underwent three-dimensional motion analysis. A composite score outcome measure quantified upper limb kinematic deviation compared to healthy controls. Clinical assessment included: upper and lower limb hypertonicity, spasticity and strength, balance, dynamic walking stability, arm and leg function, anxiety, arm pain/discomfort, and fear of falling. Pearson correlation coefficients (r) were calculated to quantify the extent of associations between these outcomes. For those that were not normally distributed, Spearman correlation coefficients (ρ) were used. For impairments where there was the ability to dichotomize the group into two independent samples. Further analyses were performed to determine if the feature had an impact on AR presentation with t-test calculations and Cohen’s ‘d’ effect size (ES) quantifying the statistical difference and magnitude difference in associated reaction between the two groups. Additionally, Chi-squared analyses explored the relationship between hypertonicity and spasticity of each of the upper limb muscles and the AR at the corresponding upper limb joint axis.
Results: Significant, moderate-to-strong correlations (r = 0.42–0.74, p < 0.05) existed between upper limb associated reactions and hypertonicity and spasticity of the upper limb muscles and the knee extensors. Significant, moderate correlations (r = 0.42–0.59, p < 0.05) existed for balance, dynamic stability, upper limb strength, and arm function. Participants who had shoulder internal rotator, elbow, forearm, and finger flexor hypertonicity; elbow and finger flexor spasticity; knee extensor spasticity; and, reduced dynamic stability had a more severe AR (p < 0.05; effect sizes ≥ 0.80). Associated reactions were also present without these features. For example, an elbow joint axis AR was present in 21% of participants without elbow flexor hypertonicity and 33% without elbow flexor spasticity.
Conclusion: Associated reactions are complex and multi-factorial. Upper limb muscle hypertonicity and spasticity were prevalent and should be prioritized for assessment however, associated reactions were present in the absence of these features. Hypertonicity and spasticity should be differentiated in their relationships to associated reactions. Knee extensor hypertonicity and spasticity, postural stability, upper limb strength, and arm function may also be important factors to consider for associated reactions during walking.
Details
- Title
- Which Factors Contribute to Upper Limb Associated Reactions During Walking in People with Acquired Brain Injury?
- Authors
- Michelle Kahn (Author) - University of the Sunshine Coast, Queensland, School of Health and Behavioural Sciences - LegacyRoss Allan Clark (Author) - University of the Sunshine Coast, Queensland, School of Health and Behavioural Sciences - LegacyBenjamin F Mentiplay (Author) - La Trobe UniversityKelly Bower (Author) - University of MelbourneJohn Olver (Author) - Epworth HospitalGavin P Williams (Author) - Epworth Hospital
- Publication details
- Brain Injury, Vol.36(Supplemental 1), pp.7-8
- Conference details
- Virtual World Congress on Brain Injury, 2021 (Online, 28-Jul-2021)
- Publisher
- Taylor & Francis
- DOI
- 10.1080/02699052.2021.2023296
- ISSN
- 1362-301X
- Organisation Unit
- School of Health and Sport Sciences - Legacy; School of Health and Behavioural Sciences - Legacy; University of the Sunshine Coast, Queensland; School of Health - Public Health
- Language
- English
- Record Identifier
- 99622937302621
- Output Type
- Abstract
Metrics
14 Record Views