Symmetry of cortical planning for initiating stepping in sub-acute stroke

This study examined motor planning for stepping when the paretic leg was either stepping or standing (to step with the non-paretic leg), to understand whether difficulty with balance and walking post-stroke could be attributed to poor motor planning.

Individuals with stroke performed self-initiated stepping. Amplitude and duration of the movement-related cortical potential (MRCP) was measured from Cz. Electromyography (EMG) of biceps femoris (BF) and rectus femoris (RF) were collected.

There were no differences between legs in stepping speed, MRCP or EMG parameters. The MRCPs when stepping with the paretic leg and the non-paretic leg were correlated. When the paretic leg was stepping, the MRCP amplitude correlated with MRCP duration, indicating a longer planning time was accompanied by higher cognitive effort. Slow steppers had larger MRCP amplitudes stepping with the paretic leg and longer MRCP durations stepping with the non-paretic leg.

MRCP measures suggest that motor planning for initiating stepping are similar regardless of which limb is stepping. Individuals who stepped slowly had greater MRCP amplitudes and durations for planning.

Individuals who step slowly may require more time and effort to plan a movement, which may compromise their safety in the community.