Skip Navigation LinksHome > January/March 2010 - Volume 33 - Issue 1 > Bridging Performance of Adults With Hemiparesis: Sliding of...
Journal of Geriatric Physical Therapy:
doi: 10.1097/JPT.0b013e3181d0748e
Research Reports

Bridging Performance of Adults With Hemiparesis: Sliding of the Paretic Limb

Kozol, Menachem Z. PhD, PT1; Filer, Maya PT2; Ring, Haim MD2,†

Collapse Box

Abstract

Background: Individuals with hemiparesis resulting from cerebrovascular accident often demonstrate uncontrollable sliding of the paretic lower extremity when attempting to lift their pelvis from a hook-lying position (bridging), during bed mobility. This disorder is often attributed to hypertonicity of the knee extensors, though this assumption has not been confirmed experimentally.

Purpose: To determine the interaction of limb sliding during bridging with impairments of motor control, knee moments, and spasticity.

Methods: Twenty-seven adults with hemiparesis were assigned to 2 groups on the basis of their ability to perform bridging on a smooth surface. The association of the dichotomous parameter of bridging performance (success/failure) with the other parameters was determined by point biserial correlation, and the predictability of limb sliding was estimated from binary logistic regression. A 2-way repeated-measures analysis of variance was used to determine the differences between knee moments.

Results: The group that could perform bridging without sliding had higher moments of the paretic knee flexors and a higher level of motor control than the other group (P = .001). The moments of the paretic flexors and the level of motor control were also correlated with limb-sliding occurrence (r = 0.61 and 0.74, respectively) and served as the best predictors of bridging performance. The paretic knee's flexion moment was found to be more affected than the extension moment (P = .04).

Conclusion: Low level of motor control and reduced strength of the knee flexors are 2 major deterrents of successful bridging in persons with hemiparesis. The predominant decline of the flexors' moment may reflect a more severe disruption of the flexors' cortical innervation or superior recovery of the extensors.

Copyright © 2010 the Section on Geriatrics of the American Physical Therapy Association

You currently do not have access to this article.

You may need to:

Note: If your society membership provides for full-access to this article, you may need to login on your society’s web site first.

Login

Article Tools

Share

Article Level Metrics

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.