title: Partial body weight support treadmill training speed influences paretic and non-paretic leg muscle activation, stride characteristics, and ratings of perceived exertion during acute stroke rehabilitation.
abstract: BACKGROUND
  Intensive task-specific training is promoted as one approach for facilitating neural plastic brain changes and associated motor behavior gains following neurologic injury. Partial body weight support treadmill training (PBWSTT), is one task-specific approach frequently used to improve walking during the acute period of stroke recovery (<1month post infarct). However, only limited data have been published regarding the relationship between training parameters and physiologic demands during this early recovery phase.
  
  
  OBJECTIVE
  To examine the impact of four walking speeds on stride characteristics, lower extremity muscle demands (both paretic and non-paretic), Borg ratings of perceived exertion (RPE), and blood pressure.
  
  
  METHODS
  A prospective, repeated measures design was used.
  
  
  METHODS
  Ten inpatients post unilateral stroke participated. Following three familiarization sessions, participants engaged in PBWSTT at four predetermined speeds (0.5, 1.0, 1.5 and 2.0mph) while bilateral electromyographic and stride characteristic data were recorded. RPE was evaluated immediately following each trial.
  
  
  RESULTS
  Stride length, cadence, and paretic single limb support increased with faster walking speeds (p⩽0.001), while non-paretic single limb support remained nearly constant. Faster walking resulted in greater peak and mean muscle activation in the paretic medial hamstrings, vastus lateralis and medial gastrocnemius, and non-paretic medial gastrocnemius (p⩽0.001). RPE also was greatest at the fastest compared to two slowest speeds (p<0.05).
  
  
  CONCLUSIONS
  During the acute phase of stroke recovery, PBWSTT at the fastest speed (2.0mph) promoted practice of a more optimal gait pattern with greater intensity of effort as evidenced by the longer stride length, increased between-limb symmetry, greater muscle activation, and higher RPE compared to training at the slowest speeds.
authors: Movement and Neurosciences Center, Institute for Rehabilitation Science and Engineering, Madonna Rehabilitation Hospital, Lincoln, NE, United States. Electronic address: Jburnfield@madonna.org.
authors: Judith M
authors: JM
authors: Burnfield
authors: Movement and Neurosciences Center, Institute for Rehabilitation Science and Engineering, Madonna Rehabilitation Hospital, Lincoln, NE, United States.
authors: Thad W
authors: TW
authors: Buster
authors: Movement and Neurosciences Center, Institute for Rehabilitation Science and Engineering, Madonna Rehabilitation Hospital, Lincoln, NE, United States.
authors: Amy J
authors: AJ
authors: Goldman
authors: Movement and Neurosciences Center, Institute for Rehabilitation Science and Engineering, Madonna Rehabilitation Hospital, Lincoln, NE, United States.
authors: Laura M
authors: LM
authors: Corbridge
authors: Department of Applied Medicine & Rehabilitation, Sycamore Center for Wellness & Applied Medicine, Indiana State University, Terre Haute, IN, United States.
authors: Kellee
authors: K
authors: Harper-Hanigan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001835:Body Weight; D005080:Exercise Test; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005684:Gait / Q000502:physiology; D006801:Humans; D007866:Leg / Q000502:physiology; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000502:physiology*; D005082:Physical Exertion; D011446:Prospective Studies; D020521:Stroke / Q000503:physiopathology*; D000071939:Stroke Rehabilitation / Q000379:methods*; D016138:Walking / Q000502:physiology
keywords: Electrophysiology; Gait; Neurological disorders & brain damage; Rehabilitation