Forced Use of the Paretic Leg Induced by a Constraint Force Applied to the Nonparetic Leg in Individuals Poststroke During Walking

If this truly works your doctor should have this implemented in their hospital in the next month. ROFLMAO.  And an email address to get the protocol for this. Your doctor needs to do no thinking at all to accomplish this, thus not needing to tax their two functioning neurons.
http://journals.sagepub.com/doi/abs/10.1177/1545968317740972

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Chao-Jung Hsu, PT, PhD¹

Chao-Jung Hsu

1Shirley Ryan AbilityLab, Chicago, IL, USA
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, Janis Kim, MPT¹

Janis Kim

1Shirley Ryan AbilityLab, Chicago, IL, USA
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, Elliot J. Roth, MD¹²

Elliot J. Roth

1Shirley Ryan AbilityLab, Chicago, IL, USA2Northwestern University, Chicago, IL, USA
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William Z. Rymer, MD, PhD¹²*

William Z. Rymer

1Shirley Ryan AbilityLab, Chicago, IL, USA2Northwestern University, Chicago, IL, USA
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, Ming Wu, PhD¹²

Ming Wu

1Shirley Ryan AbilityLab, Chicago, IL, USA2Northwestern University, Chicago, IL, USA
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...

First Published November 16, 2017 Research Article

https://doi.org/10.1177/1545968317740972

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Article Information

Volume: 31 issue: 12, page(s): 1042-1052

Article first published online: November 16, 2017; Issue published: December 1, 2017

https://doi.org/10.1177/1545968317740972

Chao-Jung Hsu, PT, PhD¹, Janis Kim, MPT¹, Elliot J. Roth, MD^{1, 2}, William Z. Rymer, MD, PhD^{1, 2}*, Ming Wu, PhD^{1, 2}

¹Shirley Ryan AbilityLab, Chicago, IL, USA

²Northwestern University, Chicago, IL, USA

Corresponding Author: Ming Wu, Legs and Walking Lab, Shirley Ryan AbilityLab, 355 East Erie Street, 23rd Floor, Chicago, IL 60611, USA. Email: w-ming@northwestern.edu

*This author is a member of The American Society of Neurorehabilitation.

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Abstract

Background. Individuals with stroke usually show reduced muscle activities of the paretic leg and asymmetrical gait pattern during walking.
Objective. To determine whether applying a resistance force to the nonparetic leg would enhance the muscle activities of the paretic leg and improve the symmetry of spatiotemporal gait parameters in individuals with poststroke hemiparesis.
Methods. Fifteen individuals with chronic poststroke hemiparesis participated in this study. A controlled resistance force was applied to the nonparetic leg using a customized cable-driven robotic system while subjects walked on a treadmill. Subjects completed 2 test sections with the resistance force applied at different phases of gait (ie, early and late swing phases) and different magnitudes (10%, 20%, and 30% of maximum voluntary contraction [MVC] of nonparetic leg hip flexors). Electromyographic (EMG) activity of the muscles of the paretic leg and spatiotemporal gait parameters were collected.
Results. Significant increases in integrated EMG of medial gastrocnemius, medial hamstrings, vastus medialis, and tibialis anterior of the paretic leg were observed when the resistance was applied during the early swing phase of the nonparetic leg, compared with baseline. Additionally, resistance with 30% of MVC induced the greatest level of muscle activity than that with 10% or 20% of MVC. The symmetry index of gait parameters also improved with resistance applied during the early swing phase.
Conclusion. Applying a controlled resistance force to the nonparetic leg during early swing phase may induce forced use on the paretic leg and improve the spatiotemporal symmetry of gait in individuals with poststroke hemiparesis.