Delayed Cortical Responses During Reactive Balance After Stroke Associated With Slower Kinetics and Clinical Balance Dysfunction.
Jacqueline A Palmer, Aiden M Payne, Jasmine L Mirdamadi and 2 others
PMID 39328051WHAT IT FOUND
Stroke survivors showed delayed brain responses to balance loss, linked to poorer clinical balance.
When forced to rely on the paretic leg, these delays correlated with slower corrective body movements. Loading the nonparetic leg masked these deficits, allowing normal-speed reactions.
Key findings
01Stroke survivors had delayed cortical N1 responses (219 ms vs 196 ms) and reduced amplitudes compared to controls.
02In stroke survivors, delayed cortical responses correlated with lower balance scores and slower walking, but this link was not significant in controls for balance scores.
03When balance perturbations loaded the paretic leg, stroke survivors had slower corrective kinetic reactions, and this slowness was strongly associated with their delayed cortical responses.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Small sample size (18 stroke, 16 controls) limits generalisability. Eight stroke participants completed a shortened protocol due to fatigue. Perturbation magnitude was reduced for three participants, which may affect kinetics. Baseline standing posture was not standardized, potentially introducing variability. Clinical impairment scores (e.g., Fugl-Meyer) were not fully reported for all participants.
Declared interests
The authors report no competing interests.
The easy way to misread this
Do not conclude that loading the nonparetic leg restores normal neural processing. Stroke survivors showed normal-speed kinetic reactions when relying on the nonparetic leg, but their cortical responses remained delayed. This suggests compensation, not recovery of the underlying neural deficit.