Sympathetic nervous system activity measured by skin conductance quantifies the challenge of walking adaptability tasks after stroke.
David J Clark, Sudeshna A Chatterjee, Theresa E McGuirk and 3 others
PMID 29216598WHAT IT FOUND
Skin conductance rose as walking tasks became harder, linking physiological stress to task difficulty.
Slower walkers showed higher stress responses, but self-reported balance confidence did not predict these changes.
Key findings
01Tasks that elicited higher sympathetic nervous system activity were performed more slowly and received poorer clinical grades.
02Participants with slower walking speeds showed significantly higher sympathetic activity during moderate and high-difficulty tasks compared to faster walkers.
03Self-reported balance confidence did not significantly differ in sympathetic activity levels across any task difficulty category.
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
The clinical grading scale used to estimate task difficulty was created for this study and has not been previously validated. The sample size was small (30 participants), limiting the generalizability of the findings. Skin conductance cannot distinguish between different sources of stress, such as physical exertion versus fear of falling. Self-reported balance confidence did not correlate with physiological stress, suggesting these measures capture different constructs. Stroke may cause abnormal sympathetic nervous system responses, which could introduce variability not accounted for by task difficulty alone.
Declared interests
The authors report no conflicts of interest.
The easy way to misread this
Do not assume that a patient's self-reported balance confidence reflects their physiological stress response during walking tasks. The study found no significant difference in skin conductance between those with high and low confidence, meaning self-report alone may miss the actual challenge a patient faces.