This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Buurke, J. H. Articles by Hermens, H. J. Search for Related Content PubMed PubMed Citation Articles by Buurke, J. H. Articles by Hermens, H. J. Social Bookmarking                         What's this?

Recovery of Gait After Stroke: What Changes?

Roessingh Research & Development, Enschede, j.buurke{at}rrd.nl, Roessingh Rehabilitation Centre, Enschede

Anand V. Nene, PhD, MD

Roessingh Research & Development, Enschede, Roessingh Rehabilitation Centre, Enschede

Gert Kwakkel, PhD

Rehabilitation Centre "De Hoogstraat," Rudolf Magnus Institute of Neuroscience, UMC Utrecht, Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam

Victorien Erren-Wolters, PT

Roessingh Research & Development, Enschede

Maarten J. IJzerman, PhD

University of Twente, Enschede The Netherlands

Hermie J. Hermens, PhD

Roessingh Research & Development, Enschede, University of Twente, Enschede The Netherlands

Background. Little is known about whether changes in coordination patterns of muscle activation after stroke are related to functional recovery of walking. Objective . The present study investigated the longitudinal relationship between changes in neuromuscular activation patterns of paretic muscles in hemiplegic gait and improvement in walking ability after stroke. Methods. Thirteen patients diagnosed with a first unilateral ischemic stroke had their recovery of walking measured by the Rivermead Mobility Index, Functional Ambulation Categories, Barthel Index, Trunk Control Test, Motricity Index, and comfortable walking speed. Surface electromyography (SEMG) of the erector spinae, gluteus maximus, gluteus medius, rectus femoris, vastus lateralis, semitendinosus, gastrocnemius, and tibialis anterior muscles of both legs was used to quantify coordination patterns in comfortable walking mode. All clinical and electromyography-related measurements were taken at 3, 6, 9, 12, and 24 weeks poststroke. Timing parameters of the SEMG patterns were calculated, using an objective burst detection algorithm, and analyzed with the measures of functional recovery. Results . All functional measures, except Trunk Control Test, showed statistically significant improvement over time, whereas SEMG patterns did not change significantly over time. Conclusion. The lack of significant change in SEMG patterns over time suggests that functional gait improvements may be more related to compensatory strategies in muscle activation of the unaffected leg and biomechanical changes than by restitution of muscle coordination patterns in the affected leg.

Key Words: Cerebrovascular accident • Walking • EMG • Recovery • Neurorehabilitation.

Neurorehabilitation and Neural Repair, Vol. 22, No. 6, 676-683 (2008)
DOI: 10.1177/1545968308317972


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				D. S. Reisman, R. Wityk, K. Silver, and A. J. Bastian Split-Belt Treadmill Adaptation Transfers to Overground Walking in Persons Poststroke Neurorehabil Neural Repair, September 1, 2009; 23(7): 735 - 744. [Abstract] [PDF]

				B. J. Kollen, S. Lennon, B. Lyons, L. Wheatley-Smith, M. Scheper, J. H. Buurke, J. Halfens, A. C.H. Geurts, and G. Kwakkel The Effectiveness of the Bobath Concept in Stroke Rehabilitation: What is the Evidence? Stroke, April 1, 2009; 40(4): e89 - e97. [Abstract] [Full Text] [PDF]

				B. H. Dobkin Progressive Staging of Pilot Studies to Improve Phase III Trials for Motor Interventions Neurorehabil Neural Repair, March 1, 2009; 23(3): 197 - 206. [Abstract] [PDF]