The effect of walking aids on muscle activation patterns during walking in stroke patients

The purpose of this study was to investigate changes in muscle activation patterns with respect to timing and amplitude that occur when subjects with stroke walk with and without a walking aid. This knowledge could help therapists in deciding whether or not patients should use a cane or quad stick while walking. Thirteen patients suffering from a first unilateral ischemic stroke participated in the study. Surface electromyography (SEMG) of the erector spinae, gluteus maximus, gluteus medius, vastus lateralis, semitendinosus, gastrocnemius and tibialis anterior of the affected side were measured during three different conditions: (1) walking without a walking aid, (2) walking with a cane and (3) walking with a quad stick. Timing and amplitude parameters of the activation patterns were quantified using an objective burst detection algorithm and statistically evaluated. Results showed a statistically significant and clinically relevant decrease in burst duration of both erector spinae and tibialis anterior when walking with a cane. The amplitude of the vastus lateralis and tibialis anterior dropped when patients walked with a cane and quad stick. The use of a cane should be considered when therapy is given to stroke patients to achieve normal muscle activation patterns.