title: Baseline predictors of treatment gains in peak propulsive force in individuals poststroke.
abstract: BACKGROUND
  Current rehabilitation for individuals poststroke focuses on increasing walking speed because it is an indicator of community walking ability and quality of life. Propulsive force generated from the paretic limb is critical to walking speed and may reflect actual neural recovery that restores the affected neural systems. A wide variation across individuals in the improvements in paretic propulsive force was observed following an intervention that targeted paretic propulsive force. This study aimed to determine if specific baseline characteristics can be used to predict patients who would respond to the intervention.
  
  
  METHODS
  Participants (N = 19) with chronic poststroke hemiparesis walked at their self-selected and maximal walking speeds on a treadmill before and after a 12-week gait training program. Propulsive forces from the paretic limb were analyzed. Pearson correlation coefficient was used to determine the relationships between (1) treatment gains in walking speed and propulsive force following intervention, and (2) treatment gains in propulsive force and baseline propulsive forces.
  
  
  RESULTS
  Treatment gains in self-selected walking speed were correlated to treatment gains in paretic propulsive force following intervention. In addition, changes in paretic propulsive force between self-selected and maximal walking speeds at baseline were strongly correlated to treatment gains in paretic propulsive force.
  
  
  CONCLUSIONS
  The capacity to modulate paretic propulsive force, rather than the absolute propulsive force during self-selected or maximal walking speed, predicted treatment gains in propulsive force following the intervention. Findings from this research could help to inform clinicians and researchers to target the appropriate patient population for rehabilitation interventions.
authors.affiliation: Biomechanics and Movement Science Program, University of Delaware, Newark, DE, 19716, USA. haoyuan@udel.edu.|, 540 S. College Avenue, Suite 201F, Newark, DE, 19716, USA. haoyuan@udel.edu.
authors.forename: HaoYuan
authors.initials: H
authors.lastname: Hsiao
authors.affiliation: Department of Mechanical Engineering, University of Delaware, Newark, DE, 19716, USA. higginson@udel.edu.
authors.forename: Jill S
authors.initials: JS
authors.lastname: Higginson
authors.affiliation: Department of Physical Therapy, University of Delaware, Newark, DE, 19716, USA. sbinder@udel.edu.
authors.forename: Stuart A
authors.initials: SA
authors.lastname: Binder-Macleod
mesh_terms: D000368:Aged; D005081:Exercise Therapy; D005260:Female; D005684:Gait; D006801:Humans; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000534:rehabilitation; D011237:Predictive Value of Tests; D011788:Quality of Life; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D016138:Walking