Identification of neuromuscular targets for restoration of walking ability after stroke: precursor to precision rehabilitation

Hancock, Nicola ORCID: https://orcid.org/0000-0003-4850-3152, Shepstone, Lee, Rowe, Philip and Pomeroy, Valerie ORCID: https://orcid.org/0000-0003-4487-823X (2020) Identification of neuromuscular targets for restoration of walking ability after stroke: precursor to precision rehabilitation. Physiotherapy Research International, 25 (2). ISSN 1358-2267

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Abstract

Objectives: Restoration of walking is a priority for stroke survivors and key target for physical therapies. Upright pedalling (UP) can provide functional walking-like activity using a variety of muscle synergies; it is unclear which synergies might be most useful for recovery of walking. Objectives here were as follows: to examine whether neuromuscular measures derived during UP might identify targets for walking rehabilitation after stroke and to determine test–retest repeatability and concurrent validity of the measures. Design: This was a prospective correlational study. Setting: The study was carried out in a movement science laboratory. Participants: The participants were 18 adults with stroke (StrS) and 10 healthy older adults (HOA). Intervention/measurement: StrS and HOA took part in two identical measurement sessions. During UP, surface electromyography and kinematic data were recorded and then processed to derive three measures: reciprocal activity of quadriceps and hamstrings; percentage muscle activity “on” according to crank angle; and smoothness of movement. Results: HOA and StrS demonstrated differences in reciprocal muscle activity (p =.044) and quadriceps activity according to crank angle (p =.034) but pedalled similarly smoothly (p =.367). For muscle activation according to crank angle in StrS, intraclass correlation coefficients (95% confidence interval) showing acceptable repeatability were 0.46 [0.32, 0.58] affected quadriceps; 0.43 [0.28, 0.56] affected hamstrings; and 0.67 [0.56, 0.75] unaffected quadriceps. Conclusion: Muscle activation according to crank angle is a promising measure of lower limb impairment during functional activity after stroke; subsequent investigation should determine magnitude of variance between testing sessions. Reciprocal activity of quadriceps and hamstrings muscles and quadriceps activity according to crank angle are both potential targets for physical therapies to improve motor recovery. Further investigations are warranted.

Item Type: Article
Uncontrolled Keywords: patterns,recovery,reliability,lower extremity,rehabilitation,stroke,walking
Faculty \ School: Faculty of Medicine and Health Sciences > School of Health Sciences
Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Groups > Rehabilitation
Faculty of Medicine and Health Sciences > Research Groups > Public Health and Health Services Research (former - to 2023)
Faculty of Medicine and Health Sciences > Research Groups > Health Services and Primary Care
Faculty of Medicine and Health Sciences > Research Groups > Epidemiology and Public Health
Faculty of Medicine and Health Sciences > Research Groups > Norwich Clinical Trials Unit
Faculty of Medicine and Health Sciences > Research Centres > Norwich Institute for Healthy Aging
Faculty of Science > Research Groups > Norwich Epidemiology Centre
Faculty of Medicine and Health Sciences > Research Groups > Norwich Epidemiology Centre
Faculty of Medicine and Health Sciences > Research Centres > Population Health
Faculty of Medicine and Health Sciences > Research Centres > Lifespan Health
Related URLs:
Depositing User: LivePure Connector
Date Deposited: 04 Oct 2019 15:32
Last Modified: 19 Oct 2023 02:33
URI: https://ueaeprints.uea.ac.uk/id/eprint/72488
DOI: 10.1002/pri.1816

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