Deans' stroke musings: Trading Symmetry for Energy Cost During Walking in Healthy Adults and Persons Poststroke

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Tuesday, June 25, 2019

Trading Symmetry for Energy Cost During Walking in Healthy Adults and Persons Poststroke

If you really wanted to reduce my energy cost of walking you would cure my leg spasticity.

Trading Symmetry for Energy Cost During Walking in Healthy Adults and Persons Poststroke

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Ryan T. Roemmich, PhD

, Kristan A. Leech, PhD, DPT, Anthony J. Gonzalez, ...

First Published June 18, 2019 Research Article

Abstract

Background. Humans typically walk in ways that minimize energy cost. Recent work has found that healthy adults will even adopt new ways of walking when a new pattern costs less energy. This suggests potential for rehabilitation to drive changes in walking by altering the energy costs of walking patterns so that the desired pattern becomes energetically optimal (ie, costs least energy of all available patterns).
Objective. We aimed to change gait symmetry in healthy adults and persons poststroke by creating environments where changing symmetry allowed the participants to save energy.
Methods. Across 3 experiments, we tested healthy adults (n = 12 in experiment 1, n = 20 in experiment 2) and persons poststroke (n = 7 in experiment 3) in a novel treadmill environment that linked asymmetric stepping and gait speed—2 factors that influence energy cost—to create situations where walking with one’s preferred gait symmetry (or asymmetry, in the case of the persons poststroke) was no longer the least energetically costly way to walk.
Results. Across the 3 experiments, we found that most participants changed their gait when experiencing the new energy landscape. Healthy adults often adopted an asymmetric gait if it saved energy, and persons poststroke often began to step more symmetrically than they prefer to walk in daily life.
Conclusions. We used a novel treadmill environment to show that people with and without stroke change clinically relevant features of walking to save energy. These findings suggest that rehabilitation approaches aimed at making symmetric walking energetically “easier” may promote gait symmetry after stroke.

Keywords gait, stroke, feedback, locomotion, cost, rehabilitation