Paretic propulsion as a measure of walking performance and functional motor recovery post-stroke: A review.
Sarah A Roelker, Mark G Bowden, Steven A Kautz and 1 others
PMID 30408710WHAT IT FOUND
Walking speed alone can hide persistent weakness in the affected leg.
Measuring how much of the forward push comes from the paretic side reveals true recovery. Therapies targeting this propulsion, not just speed, may better restore function.
Key findings
01Improved walking speed does not always indicate recovery of paretic leg function, as patients often compensate with the non-paretic limb.
02Paretic propulsion (Pp) measures the percentage of forward propulsion generated by the affected leg and correlates with motor recovery stages, unlike walking speed.
03Interventions like Fast-FES and biofeedback can improve paretic propulsion, but patients with severe baseline deficits benefit least from current techniques.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
This is a narrative review, not a systematic review or meta-analysis, so the selection of studies may introduce bias. The review notes that Pp measurement requires specialized equipment (force plates or instrumented treadmills) not commonly available in standard clinical settings. The authors state that the threshold of plantarflexor function needed to benefit from therapy is not yet defined.
Declared interests
The authors have no conflicts of interest to declare.
The easy way to misread this
Do not assume a patient has recovered paretic leg function simply because their walking speed has improved. They may be using compensatory strategies from the healthy limb, masking persistent weakness in the affected side.