The Fitbit Ultra may be a low-cost alternative to measure the stepping activity in level, predictable environments of people with stroke and TBI who can walk at speeds ≥0.58 m/s.

Background Post-stroke hemiparesis is usually considered a unilateral motor control deficit of the paretic leg, while the non-paretic leg is assumed to compensate for paretic leg impairments and have minimal to no deficits. While the non-paretic leg EMG patterns are clearly altered, how the non-paretic leg acts to compensate remains to be established. Methods Kinesiological data were recorded from sixty individuals with chronic hemiparesis (age: 60.9, S.D. =12.6 years, 21 females, 28 right hemiparetic, time since stroke: 4.5 years, S.D. 3.9 years), divided into three speed-based groups, and twenty similarly aged healthy individuals (age: 65.1, S.D. =10.4 years, 15 females). All walked on an instrumented split-belt treadmill at their self-selected speed and control subjects also walked at slower speeds matching those of the persons with hemiparesis. We determined the differences in magnitude and timing of non-paretic EMG activity relative to healthy control subjects in four pre-defined regions of stance phase of the gait cycle. Findings Integrated EMG activity and EMG timing in the non-paretic leg were different in many muscles. Multiple compensatory patterns identified included: increased EMG output when the muscle was typically active in controls and novel compensatory EMG patterns that appeared to provide greater propulsion or support with little evidence of impaired motor performance. Interpretation Most novel compensations were made possible by altered kinematics of the paretic and non-paretic leg (i.e., early stance plantarflexor activity provided propulsion due to the decreased advancement of the non-paretic foot) while others (late single limb stance knee extensor and late stance hamstring activity) appeared to be available mechanisms for increasing propulsion.

Abstract-Persons with poststroke hemiparesis are characterized by asymmetry in limb loading (LL) and limb unloading (LU), which has been reported in static and quasi-static tasks but has not been quantified during walking. The purpose of this study was to determine the asymmetry in magnitude and duration of LL and LU in individuals with hemiparesis and its relationship with functional walking status and specific kinematic and kinetic variables during walking. Forty-four participants with chronic hemiparesis walked at their self-selected speeds and eighteen nondisabled control subjects of similar ages walked at predetermined matched speeds while three-dimensional ground reaction forces and body-segment kinematics were recorded. Magnitude of paretic LL was reduced, while duration was increased compared with the nonparetic leg and nondisabled controls walking at matched speeds. The paretic LL and LU was significantly correlated with average leg angle, while the nonparetic leg significantly correlated with average knee angle. Three different patterns of LL and LU were identified (concave, convex, and linear). Individuals with hemiparesis make several biomechanical adjustments that minimize LL of the paretic leg. LL deviations were more pronounced with increased lateral placement of the paretic foot and with decreased functional gait speed. Characterization of these deviations may inspire new strategies for rehabilitation.

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