title: Evidence of impaired neuromuscular responses in the support leg to a destabilizing swing phase perturbation in hemiparetic gait.
abstract: The neuromuscular mechanisms that underlie post-stroke impairment in reactive balance control during gait are not fully understood. Previous research has described altered muscle activations in the paretic leg in response to postural perturbations from static positions. Additionally, attenuation of interlimb reflexes after stroke has been reported. Our goal was to characterize post-stroke changes to neuromuscular responses in the stance leg following a swing phase perturbation during gait. We hypothesized that, following a trip, altered timing, sequence, and magnitudes of perturbation-induced activations would emerge in the paretic and nonparetic support legs of stroke survivors compared to healthy control subjects. The swing foot was interrupted, while subjects walked on a treadmill. In healthy subjects, a sequence of perturbation-induced activations emerged in the contralateral stance leg with mean onset latencies of 87-147 ms. The earliest latencies occurred in the hamstrings and hip abductor and adductors. The hamstrings, the adductor magnus, and the gastrocnemius dominated the relative balance of perturbation-induced activations. The sequence and balance of activations were largely preserved after stroke. However, onset latencies were significantly delayed across most muscles in both paretic and nonparetic stance legs. The shortest latencies observed suggest the involvement of interlimb reflexes with supraspinal pathways. The preservation of the sequence and balance of activations may point to a centrally programmed postural response that is preserved after stroke, while post-stroke delays may suggest longer transmission times for interlimb reflexes.
authors: Liberty Mutual Research Institute for Safety, 71 Frankland Road, Hopkinton, MA, 01748, USA. bahar.sharafi@libertymutual.com.|Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL, USA. bahar.sharafi@libertymutual.com.|Sensory Motor Performance Program, Rehabilitation Institute of Chicago, Chicago, IL, USA. bahar.sharafi@libertymutual.com.
authors: Bahar
authors: B
authors: Sharafi
authors: Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL, USA.|Sensory Motor Performance Program, Rehabilitation Institute of Chicago, Chicago, IL, USA.
authors: Gilles
authors: G
authors: Hoffmann
authors: Sensory Motor Performance Program, Rehabilitation Institute of Chicago, Chicago, IL, USA.|Northwestern University Interdepartmental Neuroscience, Northwestern University, Chicago, IL, USA.
authors: Andrew Q
authors: AQ
authors: Tan
authors: Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL, USA.|Sensory Motor Performance Program, Rehabilitation Institute of Chicago, Chicago, IL, USA.|Northwestern University Interdepartmental Neuroscience, Northwestern University, Chicago, IL, USA.|Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA.
authors: Yasin
authors: Y
authors: Y Dhaher
mesh_terms: D000328:Adult; D000368:Aged; D001696:Biomechanical Phenomena; D004576:Electromyography; D005080:Exercise Test; D005260:Female; D007839:Functional Laterality / Q000502:physiology*; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000534:rehabilitation*; D006801:Humans; D007866:Leg / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000503:physiopathology; D009468:Neuromuscular Diseases / Q000209:etiology*; D020521:Stroke / Q000150:complications
keywords: Bilateral impairment; Hemiparetic gait; Interlimb reflex; Long-latency reflex; Reactive balance control