Relationships between mediolateral step modulation and clinical balance measures in people with chronic stroke.

Background: Many people with chronic stroke (PwCS) exhibit walking balance deficits linked to increased fall risk and decreased balance confidence. One potential contributor to these balance deficits is a decreased ability to modulate mediolateral stepping behavior based on pelvis motion. This behavior, hereby termed mediolateral step modulation, is thought to be an important balance strategy but can be disrupted in PwCS.

Post-stroke deficits in mediolateral foot placement accuracy depend on the prescribed walking task.

People with chronic stroke (PwCS) are susceptible to mediolateral losses of balance while walking, possibly due in part to inaccurate control of mediolateral paretic foot placement. We hypothesized that mediolateral foot placement errors when stepping to stationary or shifting visual targets would be larger for paretic steps than for steps taken by neurologically-intact individuals, hereby referred to as controls. Secondarily, we hypothesized that paretic foot placement errors would be correlated with previously identified deficits in isolated paretic hip abduction accuracy.

Paired inhibitory stimulation and gait training modulates supplemental motor area connectivity in freezing of gait.

Introduction: Freezing of gait (FOG) is a debilitating feature of Parkinson's disease (PD). Evidence suggests patients with FOG have increased cortical control of gait. The supplementary motor area (SMA) may be a key structure due to its connectivity with locomotor and cognitive networks.

Transcranial Direct Current Stimulation Electrode Montages May Differentially Impact Variables of Walking Performance in Individuals Poststroke: A Preliminary Study.

Purpose: Transcranial direct current stimulation (tDCS) has mixed effects on walking performance in individuals poststroke. This is likely the result of variations in tDCS electrode montages and individualized responses. The purpose of this study was to quantify the effects of a single session of tDCS using various electrode montages on poststroke walking performance.

Post-stroke deficits in the step-by-step control of paretic step width.

Background: Humans partially maintain gait stability by actively controlling step width based on the dynamic state of the pelvis - hereby defined as the "dynamics-dependent control of step width". Following a stroke, deficits in the accurate control of paretic leg motion may prevent use of this stabilization strategy.

Research Question: Do chronic stroke survivors exhibit paretic-side deficits in the dynamics-dependent control of step width?

Methods: Twenty chronic stroke survivors participated in this cross-sectional study, walking on a treadmill at their self-selected (0.

FES-assisted Cycling Improves Aerobic Capacity and Locomotor Function Postcerebrovascular Accident.

Purpose: After a cerebrovascular accident (CVA) aerobic deconditioning contributes to diminished physical function. Functional electrical stimulation (FES)-assisted cycling is a promising exercise paradigm designed to target both aerobic capacity and locomotor function. This pilot study aimed to evaluate the effects of an FES-assisted cycling intervention on aerobic capacity and locomotor function in individuals post-CVA.

Combining therapeutic approaches: rTMS and aerobic exercise in post-stroke depression: a case series.

Objective and importance Residual effects of stroke include well-documented functional limitations and high prevalence of depression. Repetitive transcranial magnetic stimulation (rTMS) and aerobic exercise (AEx) are established techniques that improve depressive symptoms, but a combination of the two has yet to be reported. The purpose of this case series is to examine the safety, feasibility, and impact of combined rTMS and AEx on post-stroke depression and functional mobility.

POWER training in chronic stroke individuals: differences between responders and nonresponders.

Background: Lower extremity muscle weakness is a primary contributor to post-stroke dysfunction. Resistance training is an effective treatment for hemiparetic weakness and improves walking performance. Post-stroke subject characteristics that do or do not improve walking speed following resistance training are unknown.

Effects of hip abduction and adduction accuracy on post-stroke gait.

Background: Gait instability often limits post-stroke function, although the mechanisms underlying this instability are not entirely clear. Our recent work has suggested that one possible factor contributing to post-stroke gait instability is a reduced ability to accurately control foot placement. The purpose of the present experiments was to investigate whether post-stroke gait function is related to the ability to accurately abduct and adduct the hip, as required for accurate foot placement.

The Effects of POWER Training in Young and Older Adults after Stroke.

Background. Approximately 35,000 strokes occur annually in adults below the age of 40, and there is disappointingly little data describing their responses to rehabilitation. The purpose of this analysis was to determine the effects of Poststroke Optimization of Walking using Explosive Resistance (POWER) training in young (<40 years) and older (>60 years) adults and to describe relationships between training-induced improvements in muscular and locomotor function.

Lower Extremity Strength Is Correlated with Walking Function After Incomplete SCI.

Background: Lower extremity strength has been reported to relate to walking ability, however, the relationship between voluntary lower extremity muscle function as measured by isokinetic dynamometry and walking have not been thoroughly examined in individuals with incomplete spinal cord injury (iSCI).

Objective: To determine the extent to which measures of maximal voluntary isometric contraction (MVIC) and rate of torque development (RTD) in the knee extensor (KE) and plantar flexor (PF) muscle groups correlate with self-selected overground walking speed and spatiotemporal characteristics of walking.

Methods: Twenty-two subjects with chronic (>6 months) iSCI participated in a cross-sectional study.

Rehabilitation of walking after stroke.

Rehabilitation of walking after stroke has been investigated with a variety of interventions, which will be outlined in this review. To date, the majority of interventions have demonstrated a positive, but similar effect in the primary clinical outcome of self-selected walking speed. Consistent among the most successful interventions is a focus on the intensity of the intervention and the ability to progress rehabilitation in a structured fashion.

Physical therapy adjuvants to promote optimization of walking recovery after stroke.

Stroke commonly results in substantial and persistent deficits in locomotor function. The majority of scientific inquiries have focused on singular intervention approaches, with recent attention given to task specific therapies. We propose that measurement should indicate the most critical limiting factor(s) to be addressed and that a combination of adjuvant treatments individualized to target accompanying impairment(s) will result in the greatest improvements in locomotor function.