Contribution of paretic and nonparetic limb peak propulsive forces to changes in walking speed in individuals poststroke

Haoyuan Hsiao, Louis N. Awad, Jacqueline A. Palmer, Jill S. Higginson, Stuart A. Binder-Macleod

Research output: Contribution to journalArticlepeer-review

54 Scopus citations

Abstract

Background. Recent rehabilitation efforts after stroke often focus on increasing walking speed because it is associated with quality of life. For individuals poststroke, propulsive force generated from the paretic limb has been shown to be correlated to walking speed. However, little is known about the relative contribution of the paretic versus the nonparetic propulsive forces to changes in walking speed. Objective. The primary purpose of this study was to determine the contribution of propulsive force generated from each limb to changes in walking speed during speed modulation within a session and as a result of a 12-week training program. Methods. Gait analysis was performed as participants (N = 38) with chronic poststroke hemiparesis walked at their self-selected and faster walking speeds on a treadmill before and after a 12-week gait retraining program. Results. Prior to training, stroke survivors increased nonparetic propulsive forces as the primary mechanism to change walking speed during speed modulation within a session. Following gait training, the paretic limb played a larger role during speed modulation within a session. In addition, the increases in paretic propulsive forces observed following gait training contributed to the increases in the self-selected walking speeds seen following training. Conclusions. Gait retraining in the chronic phase of stroke recovery facilitates paretic limb neuromotor recovery and reduces the reliance on the nonparetic limb's generation of propulsive force to increase walking speed. These findings support gait rehabilitation efforts directed toward improving the paretic limb's ability to generate propulsive force.

Original languageEnglish (US)
Pages (from-to)743-752
Number of pages10
JournalNeurorehabilitation and Neural Repair
Volume30
Issue number8
DOIs
StatePublished - Sep 1 2016
Externally publishedYes

Bibliographical note

Publisher Copyright:
© American Society of Neurorehabilitation.

Keywords

  • gait
  • ground reaction force
  • propulsion
  • stroke
  • walking speed

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