Forced Use of the Paretic Leg Induced by a Constraint Force Applied to the Nonparetic Leg in Individuals Poststroke During Walking.
Chao-Jung Hsu, Janis Kim, Elliot J Roth and 2 others
PMID 29145773WHAT IT FOUND
Applying a resistance force to the nonparetic leg during early swing increased paretic leg muscle activity and the time spent on the paretic leg alone during treadmill walking.
It did not test whether this improves walking function.
Key findings
01During early swing, resistance on the nonparetic leg increased paretic medial hamstring and medial gastrocnemius muscle activity by 33.6% and 18.5% compared with baseline.
02Early swing resistance produced a higher stance time symmetry index than baseline and late swing resistance.
03At 30% of maximum voluntary contraction, early swing resistance increased paretic medial hamstring activity by 58.0% and medial gastrocnemius activity by 70.0% compared with baseline.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 15 subjects were enrolled, and muscle data from 1 subject were excluded because of artifact. The resistance was applied for short treadmill bouts, not as a training program, so long-term walking function was not tested. All subjects held the front handrail during testing, so hand forces may have affected the results. A 4-N pretension force was kept on the cable to prevent slack, which may influence walking patterns. Baseline temporal asymmetry was less than 5%, and the study did not test whether the timing changes were clinically important. Four subjects had longer temporal measures on the paretic leg at baseline, and those subjects had greater temporal asymmetry during resistance. Subjects were limited community ambulators, so the findings may not apply to people with much lower walking ability. The study tested immediate responses to different forces in the same people, not a treatment group compared with another treatment group.
Declared interests
The authors declared no potential conflicts of interest.
The easy way to misread this
Do not conclude that this improves walking after stroke. The study measured brief treadmill responses in 15 people and did not test long-term walking function.