title: Locomotor Adaptability Task Promotes Intense and Task-Appropriate Output From the Paretic Leg During Walking.
abstract: OBJECTIVE
  To test the hypothesis that participants with stroke will exhibit appropriate increase in muscle activation of the paretic leg when taking a long step with the nonparetic leg compared to during steady-state walking, with a consequent increase in biomechanical output and symmetry during the stance phase of the modified gait cycle.
  
  
  METHODS
  Single-session observational study.
  
  
  METHODS
  Clinical research center in an outpatient hospital setting.
  
  
  METHODS
  Adults with chronic poststroke hemiparesis (N=15).
  
  
  METHODS
  Participants walked on an instrumented treadmill while kinetic, kinematic, and electromyogram data were recorded. Participants performed steady-state walking and a separate trial of the long-step adaptability task in which they were instructed to intermittently take a longer step with the nonparetic leg.
  
  
  METHODS
  Forward progression, propulsive force, and neuromuscular activation during walking.
  
  
  RESULTS
  Participants performed the adaptability task successfully and demonstrated greater neuromuscular activation in appropriate paretic leg muscles, particularly increased activity in paretic plantarflexor muscles. Propulsion and forward progression by the paretic leg were also increased.
  
  
  CONCLUSIONS
  These findings support the assertion that the nonparetic long-step task may be effective for use in poststroke locomotor rehabilitation to engage the paretic leg and promote recovery of walking.
authors.affiliation: Brain Rehabilitation Research Center, Malcom Randall Veterans Affairs Medical Center, Gainesville, FL; Department of Aging and Geriatric Research, University of Florida, Gainesville, FL. Electronic address: davidclark@ufl.edu.
authors.forename: David J
authors.initials: DJ
authors.lastname: Clark
authors.affiliation: Department of Mechanical Engineering, The University of Texas at Austin, Austin, TX.
authors.forename: Richard R
authors.initials: RR
authors.lastname: Neptune
authors.affiliation: Department of Neurological Surgery, University of Louisville, Louisville, KY.
authors.forename: Andrea L
authors.initials: AL
authors.lastname: Behrman
authors.affiliation: Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC; Department of Health Sciences and Research, Medical University of South Carolina, Charleston, SC; Division of Physical Therapy, Department of Health Professions, Medical University of South Carolina, Charleston, SC.
authors.forename: Steven A
authors.initials: SA
authors.lastname: Kautz
mesh_terms: D004576:Electromyography; D005260:Female; D006801:Humans; D007866:Leg / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000503:physiopathology* / Q000534:rehabilitation*; D020521:Stroke / Q000503:physiopathology*; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology*
keywords: Electromyography; Rehabilitation; Stroke; Walking