Contribution of muscle activity at different gait phases for improving walking performance in chronic stroke patients with hemiparesis

So what the hell is the protocol for increasing the biceps femoris activity? Without that knowledge this research was a total waste of time.  

Contribution of muscle activity at different gait phases for improving walking performance in chronic stroke patients with hemiparesis

 

Kazuki Fujita, Hideaki Hori, Yasutaka Kobayashi

著者情報

キーワード: Stroke, Gait, Electromyography

ジャーナル フリー

2018 年 30 巻 11 号 p. 1381-1385

DOI https://doi.org/10.1589/jpts.30.1381

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Purpose The aim of this study was to clarify the optimal timing for increasing muscle activity in the paralyzed lower limb of stroke survivors by evaluating the relationship between gait muscle activity patterns and gait parameters.
Participants and Methods Electromyography of the tibialis anterior, soleus, rectus femoris, and biceps femoris on the paralyzed side and spatiotemporal gait parameters were evaluated in 40 chronic post-stroke patients as they walked at a comfortable speed. The normalized average amplitude and asymmetry indexes of each gait phase were calculated. The correlations between gait velocity or asymmetry indexes and the activity amplitudes of various muscles during each gait phase were analyzed. Multiple regression analysis was performed with gait velocity or asymmetry indexes as the response variable and the muscle activity amplitudes in the various gait phases as explanatory variables.
Results The major determinants of gait velocity were the tibialis anterior activity (β=−0.35) and biceps femoris activity (β=0.45) during the swing phase. In addition, the biceps femoris activity during the swing phase was the major determinant of the asymmetry index for the swing phase duration (β=−0.41).
Conclusion For patients with hemiparesis, increasing the biceps femoris activity during the swing phase is considered optimal, which may lead to improvement in walking performance.

Spastic cocontraction of triceps surae increases with the tension applied during swing phase of gait in chronic hemiparesis

In conclusion, I see absolutely nothing here that helps survivors get recovered. You try to decipher the results paragraph. 

Spastic cocontraction of triceps surae increases with the tension applied during swing phase of gait in chronic hemiparesis

EmilieHutin
 MounaGhédira 
ValentinaMardale
 Catherine-MarieLoche 
CarolineGault-Colas 
Jean-MichelGraciesNicolasBayle

Objective

The present study aimed to quantify the impact of the tension applied on triceps surae during the swing phase of gait on its cocontraction in chronic hemiparesis.

Material/patients and methods

Forty-one subjects with chronic hemiparesis (50 ± 15 years; time since lesion, 7 ± 7 years; mean ± SD) completed a kinematic gait analysis, barefoot at comfortable speed (10 opto-electronic cameras, 6 dynamometric force plates, 27 ± 13 cycles analyzed/subject), with electromyography of soleus (so) and gastrocnemius medialis (gm) on the paretic side. The Coefficients of Spastic Cocontraction, CSCso and CSCgm, were calculated over 3 periods of swing phase (T1, [0–33] %; T2, [34–66] %; T3, [67–100] %), by the ratio of the RMS of the electromyogram in the period of interest over the RMS of the electromyogram of the same muscle over 100 ms around the maximal agonist isometric activity (measured on standing position by a maximal effort against resistance). In addition, a coefficient of lengthening of triceps surae, CLts, was computed over each period in the sagittal plane, from the ankle/knee displacements recorded during the period of interest divided by the total range of ankle/knee movements measured across all gait cycles. CSCso, CSCgm and CLts were compared between the 3 periods (ANOVA, significant effect P < 0.05). Exploration of individual correlations were performed with all gait cycles of each patient, using univariate regression analysis with CLts as predictor and coefficients of spastic cocontraction (CSCso and CSCgm) as dependent variables.

Results

Between T2 et T3, CSCso increased by 233 ± 54% (mean ± SEM, P < 1E-5) and CSCgm by 67 ± 10% (P = 0.0017). CLts increased by 23 ± 7% in T2 (P = 0.009) and 52 ± 12% in T3 (P < 1E-5). CLts was positively correlated with CSCso in 63% of cases (n = 25, r = 0.63 ± 0.04, P < 0.1) and with CSCgm in 53% of cases (n = 21, r = 0.60 ± 0.04, P < 0.1).

Discussion – conclusion

In chronic hemiparesis, tension (lengthening) applied on triceps surae is associated with the increase of its spastic cocontraction during swing phase of gait at comfortable speed.