Neuromuscular control of curved walking in people with stroke: Case report

People are required to adapt their basic walking pattern to turn and change directions safely for activities of daily living. This case study describes the changes in neuromuscular control among individuals with stroke on walking paths of different curvatures. Two men with hemiparetic stroke and one control subject walked along a straight, wide curved, and tight curved pathway while muscle activation of the medial and lateral gastrocnemius was recorded, along with the trajectory of the center of pressure (COP) during the single support phase. Balance, sensorimotor control, and functional ambulation were also evaluated. The subject with greater lower-limb sensorimotor impairment displayed a larger difference in the anterior-posterior COP displacement between limbs, which exacerbated as the path curvature increased. In addition, while the control subject demonstrated a lateral shift in the medial-lateral COP position, this person was unable to adapt the COP position on the nonparetic side. The second participant with a stroke demonstrated better balance and lateral shifting of the COP position. Modulation of the COP trajectory is required to safely perform curved walking. Further study is required to confirm the role of stroke-related gait deficits in the ability to adapt to curved walking.