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Motor Planning for Loading During Gait in Subacute Stroke.
Sue Peters1, S Jayne Garland1, Kimberly J Miller2
1Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada.
Archives of Physical Medicine and Rehabilitation
|December 4, 2015
Summary
Individuals poststroke exhibit symmetrical thigh muscle timing and amplitude during gait. However, increased knee co-contraction is linked to poorer balance and mobility, suggesting a compensatory mechanism for motor impairment.
Area of Science:
- Neuroscience
- Biomechanics
- Rehabilitation Science
Background:
- Stroke frequently impairs motor control, affecting gait and balance.
- Understanding muscle activation patterns is crucial for optimizing rehabilitation strategies poststroke.
Purpose of the Study:
- To characterize thigh muscle (biceps femoris and rectus femoris) timing, amplitude, and co-contraction during gait in individuals poststroke.
- To investigate the relationship between thigh muscle co-contraction levels and functional balance/mobility outcomes.
Main Methods:
- An observational study involving 27 individuals in the subacute phase poststroke and 8 healthy controls.
- Electromyography measured the timing and amplitude of biceps femoris (BF) and rectus femoris (RF) muscles during gait.
- A co-contraction index (CCI) was calculated, and participants were categorized into low and high CCI groups based on comparison with healthy controls. Functional balance and mobility were assessed using the Community Balance and Mobility Scale (CB&M).
Main Results:
- Individuals poststroke demonstrated symmetrical timing and amplitude of BF and RF muscle activity between paretic and nonparetic limbs.
- The high CCI group exhibited significantly lower CB&M scores, indicating poorer balance and mobility.
- Higher levels of BF and RF muscle activity were observed in the high CCI group compared to healthy controls.
Conclusions:
- Gait motor control post-subacute stroke is characterized by symmetrical knee muscle recruitment timing and amplitude.
- Elevated knee co-contraction is associated with diminished functional balance and mobility.
- Increased co-contraction may represent a compensatory strategy in individuals with greater motor impairment, despite maintaining biomechanical symmetry between limbs.
