Neuromechanical Interlimb Interactions and Rehabilitation of Walking after Stroke

Abstract

Abstract. Bipedal humans operate using elements of quadrupedal neuronal limb control during locomotion. This has significant implications for supporting transfer of the huge body of quadrupedal animal literature to human rehabilitation. In particular, this has translational applications for neurological rehabilitation after stroke where interlimb coordination is compromised. The data supports including arm activity in addition to leg activity as a component of gait retraining after stroke. An additional component is to consider strength training of the less affected limb to improve motor output of the more affected limb when that limb is too weak to be initially incorporated in functional rehabilitation. The major concept is to use activity related to the less affected limbs to modulate output of the more affected limbs after stroke. A key example is to incorporate arm activity into rehabilitation of leg motion in stepping after stroke.

Soleus responses to Achilles tendon stimuli are suppressed by heel and enhanced by metatarsal cutaneous stimuli during standing

“…a cutaneous reflex), but likely above the threshold to activate γ -motoneurons, did not evoke a change in time-dependent coherence. [Colour figure can be viewed at wileyonlinelibrary.com] cord circuitry for the control of movement and balance as proposed by van Wezel et al (1997van Wezel et al ( , 2000 and Zehr et al (1997Zehr et al ( , 2012Zehr et al ( , 2014. In a backward leaning posture, it would be advantageous for cutaneous feedback from the heels to suppress the soleus stretch response that would increase the risk of falling backward.…”

“…Muscle responses evoked by cutaneous stimuli are also modulated in a task-dependent manner. Cutaneous reflex gain is lower during standing relative to sitting (Aniss et al, 1992) and reflex polarity can reverse during different phases of the gait cycle (Zehr et al, 1997(Zehr et al, , 2012(Zehr et al, , 2014. Low threshold (i.e.…”