title: Effects of Treadmill Incline and Speed on Ankle Muscle Activity in Subjects After a Stroke.
abstract: OBJECTIVE
  To examine the effects of walking on a treadmill at varying gradients and speeds on ankle muscle activation in stroke survivors, and to compare the effect of increasing speed on plantarflexor muscle activity in participants grouped according to spasticity severity.
  
  
  METHODS
  Within-subject and cross-sectional design. Participants walked on a standard treadmill at 3 different inclines (0°, 3°, 6°) and speeds (self-selected, self-selected+20%, self selected+40%).
  
  
  METHODS
  University laboratory.
  
  
  METHODS
  A convenience sample of stroke survivors (N=19; 13 men, 6 women) available in university clinics.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Electromyographic activity of medial gastrocnemius (MG) and tibialis anterior (TA) muscles at push-off phase of the gait.
  
  
  RESULTS
  Paretic MG muscle activity increased (but TA did not change) at faster speeds irrespective of the incline (P<.05). In contrast, MG muscle activity increased at a higher incline in the nonparetic side (P<.05), but not in the paretic side (P>.05). In the high-spasticity subgroup (Tardieu Scale ≥ 2), paretic MG activity increased as walking speed increased (P=.004).
  
  
  CONCLUSIONS
  Stroke survivors appear to use distinct muscle activation strategies on the paretic and nonparetic sides in response to different walking speeds and inclines. Our data indicates that individuals with stroke can be safely trained on a treadmill to walk 20% to 40% above the self-selected pace to improve MG output without adversely affecting TA output. The speed-dependent characteristic of spasticity may help generate greater MG activity during push-off.
authors.affiliation: Physical Therapy Department, Rehabilitation Faculty, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Roghayeh
authors.initials: R
authors.lastname: Mohammadi
authors.affiliation: Physical Therapy Department, Rehabilitation Faculty, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Saeed
authors.initials: S
authors.lastname: Talebian
authors.affiliation: Spasticity Research Program, West Park Healthcare Centre, York, Ontario, Canada; Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada; Faculty of Health, York University, Toronto, Ontario, Canada.
authors.forename: Chetan P
authors.initials: CP
authors.lastname: Phadke
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mir Saeed
authors.initials: MS
authors.lastname: Yekaninejad
authors.affiliation: Physical Therapy Department, Rehabilitation Faculty, Tehran University of Medical Sciences, Tehran, Iran; Faculty of Rehabilitation, Brain and Spinal Injury Research Center, Imam Hospital, Tehran University of Medical Sciences, International Campus, Tehran, Iran. Electronic address: hadianrs@sina.tums.ac.ir.
authors.forename: Mohammad-Reza
authors.initials: MR
authors.lastname: Hadian
mesh_terms: D004185:Disability Evaluation; D004576:Electromyography; D005080:Exercise Test / Q000295:instrumentation*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D020233:Gait Disorders, Neurologic / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome
keywords: Electromyography; Exercise test, treadmill test; Gait; Mobility limitation; Rehabilitation; Stroke