Paretic Propulsion and Trailing Limb Angle Are Key Determinants of Long-Distance Walking Function After Stroke
The latest:Contribution of Paretic and Nonparetic Limb Peak Propulsive Forces to Changes in Walking Speed in Individuals Poststroke
- HaoYuan Hsiao, MS1⇑
- Louis N. Awad, DPT, PhD2
- Jacqueline A. Palmer, DPT1
- Jill S. Higginson, PhD1
- Stuart A. Binder-Macleod, PhD1
- HaoYuan Hsiao, MS, Biomechanics and Movement Science Program, University of Delaware, 540 S College Avenue, Suite 201F, Newark, DE 19716, USA. Email: haoyuan@udel.edu
Abstract
Background. Recent rehabilitation
efforts after stroke often focus on increasing walking speed because it
is associated with quality
of life. For individuals poststroke, propulsive
force generated from the paretic limb has been shown to be correlated to
walking
speed. However, little is known about the relative
contribution of the paretic versus the nonparetic propulsive forces to
changes in walking speed.
Objective. The primary purpose of this study was to determine the contribution of propulsive force generated from each limb to changes
in walking speed during speed modulation within a session and as a result of a 12-week training program. Methods. Gait analysis was performed as participants (N = 38) with chronic poststroke hemiparesis walked at their self-selected and
faster walking speeds on a treadmill before and after a 12-week gait retraining program.
Results.
Prior to training, stroke survivors increased nonparetic propulsive
forces as the primary mechanism to change walking speed
during speed modulation within a session. Following
gait training, the paretic limb played a larger role during speed
modulation
within a session. In addition, the increases in
paretic propulsive forces observed following gait training contributed
to
the increases in the self-selected walking speeds
seen following training.
Conclusions. Gait retraining in the
chronic phase of stroke recovery facilitates paretic limb neuromotor
recovery and reduces the reliance
on the nonparetic limb’s generation of propulsive
force to increase walking speed. These findings support gait
rehabilitation
efforts directed toward improving the paretic
limb’s ability to generate propulsive force.
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