Gluteus Maximus Muscle Activation Characteristics During a Chair-Rise in Adults With Chronic Stroke

Abstract

Background and Purpose: A successful chair-rise is an important indicator of functional independence post-stroke. Lower extremity electromyographic analyses provide a basis for muscle activation from which clinical intervention protocols may be derived. Gluteus maximus activation during the chair-rise has not been thoroughly researched in the chronic stroke population. This study investigated the magnitude and onset of gluteus maximus activation during the chair-rise comparing adults post-stroke with healthy controls. Methods: In this cross-sectional study, adults with chronic stroke (n = 12) and healthy controls (n = 12) completed 4 natural-speed chair-rise trials. Magnitude and onset of bilateral gluteus maximus activation were measured during the movement with secondary comparative data from biceps femoris and vastus lateralis muscles. Kinetic and kinematic measurements were used to quantify chair-rise phases and movement cycle duration. Results: Significant decreases in paretic (P = 0.002), and nonparetic (P = 0.001) gluteus maximus magnitudes were noted post-stroke compared with ipsilateral extremities of healthy adults. Significant gluteus maximus onset delays were noted in paretic extremities compared with nonparetic extremities post-stroke (P = 0.009) that were not apparent in comparative muscles. Similar onset times were noted when comparing the paretic extremity post-stroke to the ipsilateral extremity of healthy controls (P = 0.714) despite prolonged movement cycle durations in those with chronic stroke (P = 0.001). No onset delays were evident in the biceps femoris (P = 0.72) or vastus lateralis (P = 0.338) muscles. Discussion and Conclusions: Despite apparent unilateral muscle weakness post-stroke, bilateral decreases in gluteus maximus activation magnitudes and compounding onset deficits of the paretic extremity were observed during chair-rising. Further research is needed to determine whether interventions maximizing bilateral activation magnitudes and improving temporal activation congruency during chair-rising will carry over to functional gains Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A387).

The effects of combined transcranial brain stimulation and a 4-week visuomotor stepping training on voluntary step initiation in persons with chronic stroke—a pilot study

“…Persons with chronic stroke (PCS) often exhibit reduced body weight bearing (BWB) on the paretic leg, which further limits their ability to shift weight actively during activities of daily living such as standing, rising from sit-to-stand, and walking ( 1 – 4 ). The impaired ability of active weight shifting, coupled with restricted loading onto the paretic leg, leads to postural instability and asymmetrical gait patterns ( 5 – 8 ).…”