Force-Control vs. Strength Training: The Effect on Gait Variability in Stroke Survivors

Patel, Prakruti; Casamento‐Moran, Agostina; Christou, Evangelos A.; Lodha, Neha

doi:10.3389/fneur.2021.667340

Cited by 11 publications

(9 citation statements)

References 61 publications

(81 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Such differential recovery in gait speed and gait coordination underscores the need to incorporate gait coordination as a critical rehabilitation target for restoring safe ambulation after stroke. Recent studies provide some evidence that force-control and dual-task walking trainings may be effective in reducing gait variability after stroke 30 , 52 . Accordingly, our findings have direct implications on the development of interventions targeting gait variability to improve coordination during walking after stroke.…”

Section: Discussionmentioning

confidence: 99%

“…Prior work suggests that individuals with stroke show an increased risk for falls during activities that require coordination between the lower extremities such as walking, turning, and position transfer 27 – 29 . Recent work from others and our group suggests that gait variability can be improved in people with gait dysfunction 30 , 31 . Thus, identifying potentially modifiable biomechanical factors that contribute to deficits in gait coordination can facilitate the development of effective gait interventions that promote safe mobility after stroke.…”

Section: Introductionmentioning

confidence: 95%

See 1 more Smart Citation

Increased temporal stride variability contributes to impaired gait coordination after stroke

Patel

Enzastiga

Casamento‐Moran

et al. 2022

Sci Rep

Self Cite

View full text Add to dashboard Cite

Heightened motor variability is a prominent impairment after stroke. During walking, stroke survivors show increased spatial and temporal variability; however, the functional implications of increased gait variability are not well understood. Here, we determine the effect of gait variability on the coordination between lower limbs during overground walking in stroke survivors. Ambulatory stroke survivors and controls walked at a preferred pace. We measured stride length and stride time variability, and accuracy and consistency of anti-phase gait coordination with phase coordination index (PCI). Stroke survivors showed increased stride length variability, stride time variability, and PCI compared with controls. Stride time variability but not stride length variability predicted 43% of the variance in PCI in the stroke group. Stride time variability emerged as a significant predictor of error and consistency of phase. Despite impaired spatial and temporal gait variability following stroke, increased temporal variability contributes to disrupted accuracy and consistency of gait coordination. We provide novel evidence that decline in gait coordination after stroke is associated with exacerbated stride time variability, but not stride length variability. Temporal gait variability may be a robust indicator of the decline in locomotor function and an ideal target for motor interventions that promote stable walking after stroke.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 95%

Increased temporal stride variability contributes to impaired gait coordination after stroke

Patel

Enzastiga

Casamento‐Moran

et al. 2022

Sci Rep

Self Cite

View full text Add to dashboard Cite

show abstract

“…Compared with HC, ET DBS subjects exhibited greater stride length variability and sway path length. Greater stride variability may signify a reduced ability to allocate attention to control step rhythmicity [ 30 ] or a reduced coordination between the lower limbs [ 31 ]. Greater postural sway during a quiet standing task could be the result of diminished sensory ability (proprioceptive, vestibular, and visual system) [ 32 ] or increased low-frequency oscillations in the activity of the muscles for postural maintenance [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Suppression of Axial Tremor by Deep Brain Stimulation in Patients with Essential Tremor: Effects on Gait and Balance Measures

Choi

Yacoubi

Casamento‐Moran

et al. 2022

Tremor and Other Hyperkinetic Movements

Self Cite

View full text Add to dashboard Cite

Background: Deep brain stimulation (DBS) of the ventralis intermedius (VIM) nucleus of the thalamus has been successful in mitigating upper limb tremor, but the effect on gait and balance performance is unclear. Here, we aim to examine the effectiveness of VIM DBS on stride length variability, sway path length, and task-relevant tremor of various body segments in essential tremor (ET). Methods:Seventeen ET individuals treated with DBS (ET DBS) and 17 age-and sexmatched healthy controls (HC) performed a postural balance and overground walking task. In separate and consecutive visits, ET DBS performed gait and balance tasks with DBS ON or OFF. The main outcome measures were sway path length, stride length variability, and tremor quantified from upper limb, lower limb, upper and lower trunk (axial) during the gait and balance tasks.Results: With DBS OFF, ET DBS exhibited significantly greater stride length variability, sway path length, and tremor during gait and balance task relative to HC. Relative to DBS OFF, DBS ON reduced stride length variability and sway path length in ET DBS. The DBS-induced reduction in stride length variability was associated with the reduction in both upper trunk tremor and upper limb tremor. The DBS-induced reduction in sway path length was associated with the reduction in upper trunk tremor. Discussion:The findings of this study revealed that VIM DBS was effective in improving gait and balance in ET DBS and that improvements in gait and postural balance were associated with a reduction of axial tremor during the tasks.

show abstract

“…The plantarflexion and dorsiflexion MVCs were assessed at the beginning of each training session to determine the target forces for force-control and strength training. Additional details of the training have been reported in our previous publication ( 14 ).…”

Section: Methodsmentioning

confidence: 99%

Motor Training After Stroke: A Novel Approach for Driving Rehabilitation

et al. 2022

Self Cite

View full text Add to dashboard Cite

BackgroundA key component of safe driving is a well-timed braking performance. Stroke-related decline in motor and cognitive processes slows braking response and puts individuals with stroke at a higher risk for car crashes. Although the impact of cognitive training on driving has been extensively investigated, the influence of motor interventions and their effectiveness in enhancing specific driving-related skills after stroke remains less understood. We compare the effectiveness of two motor interventions (force-control vs. strength training) to facilitate braking, an essential skill for safe driving.MethodsTwenty-two stroke survivors were randomized to force-control training or strength training. Before and after training, participants performed a braking task during car-following in a driving simulator. We quantified the cognitive and motor components of the braking task with cognitive processing time and movement execution time.ResultsThe cognitive processing time did not change for either training group. In contrast, the movement execution became significantly faster (14%) following force-control training but not strength training. In addition, task-specific effects of training were found in each group. The force-control group showed improved accuracy and steadiness of ankle movements, whereas the strength training group showed increased dorsiflexion strength following training.ConclusionMotor intervention that trains ankle force control in stroke survivors improves the speed of movement execution during braking. Driving rehabilitation after stroke might benefit from incorporating force-control training to enhance the movement speed for a well-timed braking response.

show abstract

Force-Control vs. Strength Training: The Effect on Gait Variability in Stroke Survivors

Cited by 11 publications

References 61 publications

Increased temporal stride variability contributes to impaired gait coordination after stroke

Increased temporal stride variability contributes to impaired gait coordination after stroke

Suppression of Axial Tremor by Deep Brain Stimulation in Patients with Essential Tremor: Effects on Gait and Balance Measures

Motor Training After Stroke: A Novel Approach for Driving Rehabilitation

Contact Info

Product

Resources

About