A locomotor adaptability task promotes intense and task-appropriate output from the paretic leg during walking

Publication date: Available online 23 October 2015
Source:Archives of Physical Medicine and Rehabilitation
Author(s): David J. Clark, Richard R. Neptune, Andrea L. Behrman, Steven A. Kautz
ObjectiveTo test the hypothesis that participants with stroke will exhibit appropriate increases in muscle activation of the paretic leg when taking a non-paretic long step compared to steady state walking, with a consequent increase in biomechanical output and symmetry during the stance phase of the modified gait cycle.DesignSingle-session observational studySettingClinical research center in an outpatient hospital setting.ParticipantsFifteen adults with chronic post-stroke hemiparesis.InterventionsParticipants walked on an instrumented treadmill while kinetic, kinematic and electromyographical data were recorded. Participants performed steady state walking and a separate trial of the long step adaptability task in which they were instructed to intermittently take a longer step with the non-paretic leg.Main Outcome Measure(s)Forward progression, propulsive force, and neuromuscular activation during walking.ResultsParticipants performed the adaptability task successfully and demonstrated greater neuromuscular activation in appropriate paretic leg muscles, particularly heightened activity in paretic plantarflexor muscles. Propulsion and forward progression by the paretic leg were also increased.ConclusionsThese findings support the assertion that the non-paretic long step task may be effective for use in post-stroke locomotor rehabilitation in order to engage the paretic leg and promote recovery of walking.



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