title: Clinical factors associated with ankle muscle coactivation during gait in adults after stroke.
abstract: BACKGROUND
  Increased ankle muscle coactivation during gait represents an adaptation strategy to compensate for postural instability in adults after stroke. Although increased ankle muscle coactivation is correlated with gait disorders in adults after stroke, it remains unclear which physical impairments are the most predictive clinical factors explaining ankle muscle coactivation during gait.
  
  
  OBJECTIVE
  To investigate these physical impairments in adults after stroke using stepwise multiple regression analyses.
  
  
  METHODS
  The magnitude of ankle muscle coactivation during gait was quantified with a coactivation index (CoI) for the first and second double support (DS2), and single support (SS) phases in 44 community-dwelling adults after stroke. Paretic motor function, sensory function, spasticity, ankle muscle strength, and balance ability were evaluated.
  
  
  RESULTS
  The regression analysis revealed that the balance ability and paretic ankle plantarflexor muscle strength were significant factors determining the CoI during the SS phase on the paretic side. For the CoI during the DS2 phase on the paretic side, only the balance ability was selected as a significant factor.
  
  
  CONCLUSIONS
  Adults with impaired balance ability and paretic ankle muscle weakness after stroke used a compensation strategy of increased ankle muscle coactivation on the paretic side to enhance postural stability during gait.
authors.affiliation: Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.|Japan Society for the Promotion of Science, Tokyo, Japan.
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Kitatani
authors.affiliation: Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Ohata
authors.affiliation: Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.|Japan Society for the Promotion of Science, Tokyo, Japan.
authors.forename: Yu
authors.initials: Y
authors.lastname: Hashiguchi
authors.affiliation: Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.|Department of Rehabilitation sciences, Kansai University of Welfare Sciences, Osaka, Japan.
authors.forename: Kaoru
authors.initials: K
authors.lastname: Sakuma
authors.affiliation: Fujita Health University Hospital, Aichi, Japan.
authors.forename: Natsuki
authors.initials: N
authors.lastname: Yamakami
authors.affiliation: Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Shigehito
authors.initials: S
authors.lastname: Yamada
mesh_terms: D000222:Adaptation, Physiological / Q000502:physiology; D000328:Adult; D000368:Aged; D000842:Ankle / Q000503:physiopathology*; D000843:Ankle Joint / Q000503:physiopathology; D004576:Electromyography; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000209:etiology / Q000503:physiopathology*; D053580:Muscle Strength / Q000502:physiology; D018908:Muscle Weakness / Q000503:physiopathology; D018482:Muscle, Skeletal / Q000503:physiopathology*; D010291:Paresis / Q000209:etiology / Q000503:physiopathology; D004856:Postural Balance / Q000502:physiology; D012677:Sensation; D020521:Stroke / Q000150:complications / Q000503:physiopathology*
keywords: Co-contraction; electromyography; gait; hemiplegia; stroke