Gait recovery is not associated with changes in the temporal patterning of muscle activity during treadmill walking in patients with post-stroke hemiparesis

Otter, A.; Geurts, Alexander C. H.; Mulder, Theo; Duysens, Jacques

doi:10.1016/j.clinph.2005.08.014

Cited by 142 publications

(121 citation statements)

References 39 publications

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“…While it does not exist in the normal gait, in our delayed treatment stroke patients, TA-GAS coactivation was important at the beginning of the swing phase to maintain dorsiflexion for the initial contact, and to control foot drop [11,12]. This prolonged activation of the posterior and anterior lower leg muscles contributes to inversion of the ankle in our stroke patients, as has been previously reported [2,3,16]. It was observed at the post-physiotherapy stage that BF-RF and TA-GAS muscle co-activation was unchanged.…”

Section: Discussionsupporting

confidence: 53%

“…After almost 60 days of physiotherapy intervention, the patients' spatiotemporal and clinical measures of mobility and ambulatory independence scores increased significantly but aberrant muscle timing patterns persisted. They suggested that normal temporal patterning of lower extremity muscle activity is not a prerequisite for functional gait recovery [2,3]. We found that our patients exhibited some changes in muscle pattern activation after the intervention.…”

Section: Discussionmentioning

confidence: 52%

“…Den Otter [2] compared clinical, spatiotemporal, and electromyographic assessments of post-stroke patients at four time stages during recovery. Although the investigation was performed during early rehabilitation (35 to 90 days after stroke), the results regarding the timing behavior of muscles agreed with ours.…”

Section: Discussionmentioning

confidence: 99%

“…Abnormal electrical activity (EA) findings associated with post-stroke gait show alterations in amplitude of muscle activity, and also in timing of muscle activity during the gait cycle [2,7,11]. Despite large individual differences among patients, some common findings have been reported.…”

Section: Introductionmentioning

confidence: 99%

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Late physiotherapy rehabilitation changes gait patterns in post-stroke patients

Almeida

Cruz

Candeira

et al. 2017

Biomedical Human Kinetics

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SummaryStudy aim: To determine whether a physiotherapy protocol improves the electromyographic activation (EA) during the hemiparetic gait in patients with delayed access to rehabilitation. Material and methods: 40 post-stroke patients underwent clinical evaluation and gait assessment at the time of admission and at the end of treatment. Results: The anterior leg muscles tibialis anterior and rectus femoris had earlier onset (p = 0.0001). Conclusion: Electromyographic findings showed altered patterns during the hemiparetic gait cycle, even in patients with delayed access to treatment.

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Section: Discussionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Late physiotherapy rehabilitation changes gait patterns in post-stroke patients

Almeida

Cruz

Candeira

et al. 2017

Biomedical Human Kinetics

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“…After time-normalisation to 0-100% of stride time, mean and maximum EMG activities were calculated. K-means cluster analysis of peak EMG amplitude was used to determine when each muscle was on or off (Den Otter et al, 2006), with number of clusters set to 5, and the cluster with the lowest activity defined as "off". Because level of co-contraction may be confounded by pathology or pain (Mizner et al, 2005), we decided to use co-contraction time (cf.…”

Section: Calculationsmentioning

confidence: 99%

Determinants of co-contraction during walking before and after arthroplasty for knee osteoarthritis

Fallah-Yakhdani¹,

Bafghi²,

Meijer³

et al. 2012

Clinical Biomechanics

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Background: Knee osteoarthritis patients co-contract in knee-related muscle pairs during walking. The determinants of this co-contraction remain insufficiently clear. Methods: A heterogeneous group of 14 patients was measured before and one year after knee arthroplasty, and compared to 12 healthy peers and 15 young subjects, measured once. Participants walked on a treadmill at several imposed speeds. Bilateral activity of six muscles was registered electromyographically, and cocontraction time was calculated as percentage of stride cycle time. Local dynamic stability and variability of sagittal plane knee movements were determined. The surgeon's assessment of alignment was used. Preoperatively, multivariate regressions on co-contraction time were used to identify determinants of cocontraction. Post-operatively it was assessed if predictor variables had changed in the same direction as co-contraction time. Findings: Patients co-contracted longer than controls, but post-operatively, differences with the healthy peers were no longer significant. Varus alignment predicted co-contraction time. No patient had post-operative varus alignment. The patients' unaffected legs were more unstable, and instability predicted co-contraction time in both legs. Post-operatively, stability normalised. Longer unaffected side co-contraction time was associated with reduced affected side kinematic variability. Post-operatively, kinematic variability had further decreased. Interpretations: Varus alignment and instability are determinants of co-contraction. The benefits of cocontraction in varus alignment require further study. Co-contraction probably increases local dynamic stability, which does not necessarily decrease the risk of falling. Unaffected side co-contraction contributed to decreasing affected side variability, but other mechanisms than co-contraction may also have played a role in decreasing variability.

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Management of Gait Impairments in Chronic Unilateral Upper Motor Neuron Lesions

et al. 2018

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Importance: A variety of neurological disorders can damage the corticospinal tract in the supratentorial region of the brain. Gait impairments are common in patients with chronic supratentorial upper motor neuron lesions, and are a source of great disability. Clinical management aimed at improving the gait pattern in these patients is generally perceived as a challenging task, as many possible abnormalities may interact. Moreover, a multitude of treatment options exist-ranging from assistive devices and muscle stretching to pharmacological and surgical interventions-but evidence is inconclusive for most approaches and there is a lack of clear treatment guidelines. Observations: To improve management, we here show that gait deviations in adults with a chronic supratentorial upper motor neuron lesion can roughly be reduced to three groups of primary deficits: (1) imbalance of muscle strength, length and activity around the ankle and tarsal joints leading to pes equino(varus), (2) calf muscle weakness, and (3) overactivity of proximal leg muscles.

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Gait recovery is not associated with changes in the temporal patterning of muscle activity during treadmill walking in patients with post-stroke hemiparesis

Cited by 142 publications

References 39 publications

Late physiotherapy rehabilitation changes gait patterns in post-stroke patients

Late physiotherapy rehabilitation changes gait patterns in post-stroke patients

Determinants of co-contraction during walking before and after arthroplasty for knee osteoarthritis

Management of Gait Impairments in Chronic Unilateral Upper Motor Neuron Lesions

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