The
role of the brain in post-stroke gait is not understood properly,
although the ability to walk becomes impaired in more than 80% of
post-stroke patients. Most, however, regain some ability to walk with
either
limited mobility
or inefficient, asymmetrical or unsafe gait. Conventional intervention
focuses on support of weak muscles or body part by use of foot
orthosis
and walking aids. This review provides an overview of available
evidence of neuro-kinesiology & neurophysiology of normal and
post-stroke gait. The role of the spinal cord has been explored, more in
animals than humans. Mammalian
locomotion is based on a rhythmic, “
pacemaker” activity of the spinal stepping
generators.
Bipedal human locomotion is different from quadripedal animal
locomotion. However, knowledge derived from the spinal cord
investigation of animals, is being applied for management of human gait
dysfunction. The potential role of the brain is now recognized in the
independent activation of muscles during walking. The brain modifies the
gait pattern during the complex demands of daily activities. Though the
exact role of the
motor cortex in control of gait is unclear, available evidence may be applied to gait rehabilitation of post-stroke patients.
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