title: Coordination of the non-paretic leg during hemiparetic gait: expected and novel compensatory patterns.
abstract: BACKGROUND
  Post-stroke hemiparesis is usually considered a unilateral motor control deficit of the paretic leg, while the non-paretic leg is assumed to compensate for paretic leg impairments and have minimal to no deficits. While the non-paretic leg electromyography (EMG) patterns are clearly altered, how the non-paretic leg acts to compensate remains to be established.
  
  
  METHODS
  Kinesiological data were recorded from sixty individuals with chronic hemiparesis (age: 60.9, SD=12.6 years, 21 females, 28 right hemiparetic, time since stroke: 4.5 years, SD 3.9 years), divided into three speed-based groups, and twenty similarly aged healthy individuals (age: 65.1, SD=10.4 years, 15 females). All walked on an instrumented split-belt treadmill at their self-selected speed and control subjects also walked at slower speeds matching those of the persons with hemiparesis. We determined the differences in magnitude and timing of non-paretic EMG activity relative to healthy control subjects in four pre-defined regions of stance phase of the gait cycle.
  
  
  RESULTS
  Integrated EMG activity and EMG timing in the non-paretic leg were different in many muscles. Multiple compensatory patterns identified included: increased EMG output when the muscle was typically active in controls and novel compensatory EMG patterns that appeared to provide greater propulsion or support with little evidence of impaired motor performance.
  
  
  CONCLUSIONS
  Most novel compensations were made possible by altered kinematics of the paretic and non-paretic leg (i.e., early stance plantarflexor activity provided propulsion due to the decreased advancement of the non-paretic foot) while others (late single limb stance knee extensor and late stance hamstring activity) appeared to be available mechanisms for increasing propulsion.
authors.affiliation: Rehabilitation Science Doctoral Program, University of Florida, Gainesville, FL, USA.
authors.forename: Bhavana
authors.initials: B
authors.lastname: Raja
authors.forename: Richard R
authors.initials: RR
authors.lastname: Neptune
authors.forename: Steven A
authors.initials: SA
authors.lastname: Kautz
mesh_terms: D000368:Aged; D001696:Biomechanical Phenomena; D016022:Case-Control Studies; D004576:Electromyography; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000503:physiopathology* / Q000534:rehabilitation; D006801:Humans; D007866:Leg / Q000502:physiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000502:physiology / Q000503:physiopathology; D010291:Paresis / Q000209:etiology / Q000503:physiopathology* / Q000534:rehabilitation; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation; D016138:Walking / Q000502:physiology*