[Purpose] Gait training that increases non-paretic step length in stroke patients increases the propulsive force of the paretic leg. However, it limits knee flexion during the swing phase of gait, and this may cause gait disturbances such as worsening of gait pattern and increased risk of falling. Therefore, this study aimed to investigate the effects of increasing non-paretic step length on the joint movement and muscle activity of a paretic lower limb during hemiparetic gait. [Participants and Methods] A total of 15 hemiparetic patients with chronic stroke were enrolled in this study. Spatiotemporal parameters, along with kinematic and electromyography data of their paretic lower limbs, were measured during a 10-m distance overground walking. Two walking conditions were assessed: normal (comfortable gait) and non-paretic-long (gait with increased non-paretic step length) conditions. [Results] Under the non-paretic-long condition, the trailing limb angle was larger than under the normal condition. However, no significant difference was observed in the knee flexion angle during the swing phase. [Conclusion] Increasing non-paretic step length during gait is unlikely to limit knee flexion during the swing phase and can safely improve the propulsive force of a paretic leg.

Gait training to intentionally lengthen the nonparetic step length can increase the propulsive force of the paretic leg but may also induce overactivity of the knee extensor muscles that might limit knee flexion during the swing phase. Herein, we investigated the effects of lengthening the nonparetic step length during gait on the joint motion and muscle activity of the paretic lower limb. Fifteen chronic stroke patients (stroke group) and 15 healthy participants (control group) were evaluated for lower limb joint movements, electromyography, and spatiotemporal gait parameters during walking. Walking conditions were Normal (comfortable walking) and NP-Long/Contralateral-Long (walking with a lengthened step length of the nonmeasured limb). The trailing limb angle, a surrogate for propulsive forces, was increased in both groups by changing the step length, with no significant change in the peak knee flexion angle during the swing phase. However, the stroke group did not increase ankle plantar flexor activity in the stance phase or ankle dorsiflexion angle in the swing phase. Intentionally lengthening the nonparetic step length did not limit knee flexion. However, the effect of increased propulsive force during the stance phase was insufficient, with the possibility of decreased foot clearance.

Purpose] This study investigated the influence of pelvic angles on back muscle activity during upper limb elevation. [Subjects] Ten healthy males participated in this study. [Methods] We measured back muscle activities at 5˚ anterior pelvic tilt, and 5 and 15˚ of posterior pelvic tilt while sitting with upper limb elevation of 90°. Surface electromyography of the activities of the right trapezius upper fibers, middle fibers, lower fibers, lumbar erector spinae and lumbar multifidus were recorded. [Results] Posterior tilt of the pelvis decreased the lumbar multifidus activity, but increased trapezius muscle activity. [Conclusion] The results suggest that exercise of the back muscles with 5˚ anterior pelvic while sitting would effectively activate the lumbar multifidus.

〔目的〕脳卒中片麻痺患者の足関節底屈筋に対するボツリヌス療法と集中的理学療法の併用効果を検討すること．〔対象と方法〕脳梗塞発症後7ヵ月経過した60歳代男性．〔方法〕ボツリヌス療法後に足関節底屈筋のストレッチ，膝関節伸展筋の筋力トレーニング，歩行練習を4週間行った．介入前後で足関節底屈筋の痙縮の程度，足関節可動域，下肢Motricity Index，歩行時の麻痺側下肢筋電図および時間・距離因子を比較した．〔結果〕足関節底屈筋の痙縮軽減，下肢筋力の増加，単脚支持期の大腿直筋活動の増加，歩行速度の改善が得られた．〔結語〕ボツリヌス療法と集中的理学療法の併用が歩行速度などの能動的機能の改善に寄与する可能性がある．