Single Session of Functional Electrical Stimulation-Assisted Walking Produces Corticomotor Symmetry Changes Related to Changes in Poststroke Walking Mechanics

Palmer, Jacqueline A.; Hsiao, Hao-Yuan; Wright, Tamara; Binder‐Macleod, Stuart A.

doi:10.1093/ptj/pzx008

Cited by 22 publications

(35 citation statements)

References 43 publications

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“…Though mean MEP amplitudes demonstrated increases in corticomotor excitability following PAS, individuals’ overall responses to PAS at all POST testing time points ranged from –17 to +318% increase from baseline. Variability in response to interventions is commonly observed in post-stroke patient populations ( Koski et al, 2004 ; Palmer, Hsiao, Wright, & Binder-Macleod, 2017 ). Participants in the present study showing the greatest magnitude or corticomotor excitability increase may have sufficient neural substrate supporting PAS-induced enhancement of motor skill performance ( Koski, Mernar, & Dobkin, 2004 ; Rushton, 2003 ).…”

Section: Discussionmentioning

confidence: 99%

Paired associative stimulation modulates corticomotor excitability in chronic stroke: A preliminary investigation

Palmer

Wolf

Borich

2018

RNN

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Background:Paired associative stimulation (PAS) combining repeated pairing of electrical stimulation of a peripheral nerve with transcranial magnetic stimulation (TMS) over the primary motor cortex (M1) can induce neuroplastic adaptations in the human brain and enhance motor learning in neurologically-intact individuals. However, the extent to which PAS is an effective technique for inducing associative plasticity and improving motor function in individuals post-stroke is unclear.Objective:The objective of this pilot study was to investigate the effects of a single session of PAS to modulate corticomotor excitability and motor skill performance in individuals post-stroke.Methods:Seven individuals with chronic stroke completed two separate visits separated by at least one week. We assessed general corticomotor excitability, intracortical network activity and behavioral outcomes prior to and at three time points following PAS and compared these outcomes to those following a sham PAS condition (PASSHAM).Results:Following PAS, we found increased general corticomotor excitability but no significant difference in behavioral measures between PAS conditions. There was a relationship between PAS-induced corticomotor excitability increase and enhanced motor skill performance across post-PAS testing time points.Conclusion:These results provide preliminary evidence for the potential of PAS to increase corticomotor excitability that could favorably impact motor skill performance in chronic individuals post-stroke and are an important first step for future studies investigating the clinical application and behavioral relevance of PAS interventions in post stroke patient populations.

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Section: Discussionmentioning

confidence: 99%

Paired associative stimulation modulates corticomotor excitability in chronic stroke: A preliminary investigation

Palmer

Wolf

Borich

2018

RNN

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“…The double-cone coil has been used most frequently (Jayaram & Stinear, 2009; Madhavan, Rogers, & Stinear, 2010; Papegaaij, Baudry, et al, 2016; Papegaaij, Taube, Hogenhout, et al, 2014; Papegaaij, Taube, et al, 2016). Other studies have used the batwing coil (Barthelemy et al, 2011; Needle, Palmer, Kesar, Binder-Macleod, & Swanik, 2013; Palmer, Hsiao, Awad, & Binder-Macleod, 2016; Palmer, Hsiao, Wright, & Binder-Macleod, 2017; Palmer, Needle, Pohlig, & Binder-Macleod, 2016; Palmer, Zarzycki, Morton, Kesar, & Binder-Macleod, 2017) and flat figure of eight coil (Smith et al, 2017). The angulation in the batwing and double cone coils helps to increase the depth of penetration of the induced electric field (Deng et al, 2013; Klooster et al, 2016).…”

Section: The Use Of Tms For Studying Lower Limb Musculature Presents mentioning

confidence: 99%

The use of transcranial magnetic stimulation to evaluate cortical excitability of lower limb musculature: Challenges and opportunities

Kesar

Stinear

Wolf

2018

RNN

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Neuroplasticity is a fundamental yet relatively unexplored process that can impact rehabilitation of lower extremity (LE) movements. Transcranial magnetic stimulation (TMS) has gained widespread application as a non-invasive brain stimulation technique for evaluating neuroplasticity of the corticospinal pathway. However, a majority of TMS studies have been performed on hand muscles, with a paucity of TMS investigations focused on LE muscles. This perspective review paper proposes that there are unique methodological challenges associated with using TMS to evaluate corticospinal excitability of lower limb muscles. The challenges include: (1) the deeper location of the LE motor homunculus; (2) difficulty with targeting individual LE muscles during TMS; and (3) differences in corticospinal circuity controlling upper and lower limb muscles. We encourage future investigations that modify traditional methodological approaches to help address these challenges. Systematic TMS investigations are needed to determine the extent of overlap in corticomotor maps for different LE muscles. A simple, yet informative methodological solution involves simultaneous recordings from multiple LE muscles, which will provide the added benefit of observing how other relevant muscles co-vary in their responses during targeted TMS assessment directed toward a specific muscle. Furthermore, conventionally used TMS methods (e.g., determination of hot spot location and motor threshold) may need to be modified for TMS studies involving LE muscles. Additional investigations are necessary to determine the influence of testing posture as well as activation state of adjacent and distant LE muscles on TMS-elicited responses. An understanding of these challenges and solutions specific to LE TMS will improve the ability of neurorehabilitation clinicians to interpret TMS literature, and forge novel future directions for neuroscience research focused on elucidating neuroplasticity processes underlying locomotion and gait training.

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“…Gait analysis is commonly performed to characterize healthy walking and quantify deviations that may exist due to pathology or injury [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 ]. The gait cycle is defined as the time interval between two successive occurrences of one of the repetitive events of walking [ 10 ], typically beginning from initial contact (IC) of the foot to the successive IC.…”

Section: Introductionmentioning

confidence: 99%

An Evaluation of Three Kinematic Methods for Gait Event Detection Compared to the Kinetic-Based ‘Gold Standard’

Zahradka

Verma

Behboodi

et al. 2020

Sensors

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Video- and sensor-based gait analysis systems are rapidly emerging for use in ‘real world’ scenarios outside of typical instrumented motion analysis laboratories. Unlike laboratory systems, such systems do not use kinetic data from force plates, rather, gait events such as initial contact (IC) and terminal contact (TC) are estimated from video and sensor signals. There are, however, detection errors inherent in kinematic gait event detection methods (GEDM) and comparative study between classic laboratory and video/sensor-based systems is warranted. For this study, three kinematic methods: coordinate based treadmill algorithm (CBTA), shank angular velocity (SK), and foot velocity algorithm (FVA) were compared to ‘gold standard’ force plate methods (GS) for determining IC and TC in adults (n = 6), typically developing children (n = 5) and children with cerebral palsy (n = 6). The root mean square error (RMSE) values for CBTA, SK, and FVA were 27.22, 47.33, and 78.41 ms, respectively. On average, GED was detected earlier in CBTA and SK (CBTA: −9.54 ± 0.66 ms, SK: −33.41 ± 0.86 ms) and delayed in FVA (21.00 ± 1.96 ms). The statistical model demonstrated insensitivity to variations in group, side, and individuals. Out of three kinematic GEDMs, SK GEDM can best be used for sensor-based gait event detection.

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Single Session of Functional Electrical Stimulation-Assisted Walking Produces Corticomotor Symmetry Changes Related to Changes in Poststroke Walking Mechanics

Cited by 22 publications

References 43 publications

Paired associative stimulation modulates corticomotor excitability in chronic stroke: A preliminary investigation

Paired associative stimulation modulates corticomotor excitability in chronic stroke: A preliminary investigation

The use of transcranial magnetic stimulation to evaluate cortical excitability of lower limb musculature: Challenges and opportunities

An Evaluation of Three Kinematic Methods for Gait Event Detection Compared to the Kinetic-Based ‘Gold Standard’

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