Abnormal lower limb movement patterns and mechanisms of occurrence in hemiplegic patients

  Hemiplegia is the loss of motor system regulation by the higher central nervous system, resulting in the release of primitive, inhibited, and regulated subcortical central motor reflexes, leading to disordered coordination among limb muscle groups, abnormal muscle tone, and movement disorders. The main abnormal movement patterns of lower limbs in hemiplegic patients are joint response, co-movement, tonic reflex, and abnormal muscle tone.  The joint response occurs significantly in patients with hemiplegia in the early stage, but gradually diminishes in the middle and late stages of recovery and remains for a considerable period of time without disappearing. Its presence makes the patient’s muscle spasm generally enhanced, unable to maintain balance, difficult to move, and also hinders the recovery of motor function. le hmann believes that: hemiplegic patients have reduced calf triceps strength, knee instability, and poor ankle mobility, while lower limb muscle spasm and imbalance cause patients to have reduced ability to push off the ground and propel, eventually leading to abnormal walking. sherrington believes that synergistic movement is due to a central nervous system injury resulting in reduced control of primitive responses at the spinal cord level, resulting in abnormal movement patterns. Tonic reflexes can lead to impaired postural changes in patients. Whereas normal individuals are able to shift their body weight quickly to the supporting leg at the onset of normal gait, stroke patients appear hesitant and slow in walking. Their greatest motor deficit is that the disease impairs their ability to shift rapidly from one posture (resting or moving) to another, reducing their drive and braking ability and interfering with normal walking. Patients with hemiplegia have hypotonia during the soft phase and increased muscle tone during the spastic phase, which manifests as pronounced myospasm. In the lower extremities, this is generally manifested as hip extension, inversion and internal rotation, knee extension, plantar flexion and inversion of the foot, and plantar flexion and inversion.