Sympathetic nervous system responses during complex walking tasks and community ambulation post-stroke

Area of Science:

• Rehabilitation Medicine
• Neuroscience
• Biomedical Engineering

Background:

• Stroke survivors often experience increased perceived challenge of walking (PCW) in complex environments, limiting daily mobility.
• PCW is traditionally assessed via subjective questionnaires, with newer methods involving objective quantification of sympathetic nervous system activity.
• The relationship between these PCW measures and actual daily walking activity post-stroke remains unclear.

Purpose of the Study:

• To compare subjective and objective assessments of PCW in predicting home and community ambulation in stroke survivors.
• To determine if electrodermal activity or balance confidence scales better reflect real-world walking behavior.

Main Methods:

• Twenty-nine participants post-stroke were evaluated.
• Subjective PCW was measured using the Activities-specific Balance Confidence (ABC) Scale.
• Objective PCW was assessed via electrodermal activity (skin conductance levels [SCL] and responses [SCR]) during walking tasks.
• Daily steps and location were tracked using accelerometry and GPS devices.

Main Results:

• Participants with high electrodermal activity (high-change SCL) took significantly fewer daily steps (home and community) compared to those with low electrodermal activity.
• Neither the subjective ABC Scale nor electrodermal SCR measures showed significant differences in daily steps between high and low PCW groups.
• Objective PCW measurement via electrodermal sensing demonstrated a stronger correlation with actual daily ambulation.

Conclusions:

• Objective assessment of perceived challenge of walking using electrodermal activity provides a more accurate representation of home and community ambulation in stroke survivors.
• Subjective measures like the ABC Scale and electrodermal SCR may not fully capture the impact of PCW on daily mobility.
• Electrodermal sensing offers a promising objective tool for evaluating mobility limitations and guiding rehabilitation strategies post-stroke.