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

Hancock, Nicola, Shepstone, Lee, Rowe, Philip and Pomeroy, Valerie (2019) Identification of neuromuscular targets for restoration of walking ability after stroke: precursor to precision rehabilitation. Physiotherapy Research International. 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: -To examine whether neuromuscular measures derived during UP might identify targets for walking rehabilitation after stroke -To determine test-retest repeatability and concurrent validity of the measures. Design : Prospective correlational study Setting : Movement science laboratory Participant s : Eighteen adults with stroke (StrS); ten healthy older adults (HOA). Intervention/measurement : StrS and HOA took part in two identical measurement sessions. During UP, EMG and kinematic data were recorded, then processed to derive three measures: (1) reciprocal activity of quadriceps and hamstrings; (2) percentage muscle activity ‘on’ according to crank angle (3) smoothness of movement. Results HOA and StrS demonstrated differences in reciprocal muscle activity (p=0.044) and quadriceps activity according to crank angle (p=0.034), but pedalled similarly smoothly (p=0.367). For muscle activation according to crank angle in StrS, ICCs (95% CI) showing acceptable repeatability were: 0.46 (0.32, 0.58) affected quadriceps; 0.43 (0.28, 0.56) affected hamstrings; 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
Faculty \ School: Faculty of Medicine and Health Sciences > School of Health Sciences
Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: LivePure Connector
Date Deposited: 04 Oct 2019 15:32
Last Modified: 18 Mar 2020 04:20
URI: https://ueaeprints.uea.ac.uk/id/eprint/72488
DOI: 10.1002/pri.1816

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