Paretic propulsion changes with handrail Use in individuals post-stroke.

Area of Science:

• Neurology
• Rehabilitation Medicine
• Biomechanics

Background:

• Stroke affects 800,000 annually in the US, with 30% needing walking assistance.
• Treadmill gait training is common post-stroke, often using handrails.
• The impact of handrail use on propulsive force post-stroke is not well understood.

Purpose of the Study:

• To investigate how individuals post-stroke alter their paretic propulsive force when using treadmill handrails.
• To compare handrail use and assistive device use effects on propulsion.

Main Methods:

• Twenty-one individuals post-stroke walked on a treadmill under three conditions: no handrail, light handrail use (<5% body weight), and self-selected handrail use.
• Three multilevel models analyzed handrail force, paretic, and nonparetic propulsion across conditions and assistive device user groups.

Main Results:

• Handrail propulsive impulse was significantly higher during self-selected use compared to light use (p=0.002).
• Assistive device use and handrail condition significantly improved models for paretic propulsive impulse (p=0.01).
• An interaction between assistive device use and handrail condition significantly improved the model for nonparetic propulsive impulse (p<0.001).

Conclusions:

• Handrail use can influence paretic propulsive impulse in individuals post-stroke.
• Encouraging handrail use during treadmill training may optimize paretic propulsion for rehabilitation.