Towards Upright Pedalling to drive recovery in people who cannot walk in the first weeks after stroke: movement patterns and measurement

Hancock, Nicola; Shepstone, Lee; Rowe, Peter; Myint, Phyo Kyaw; Pomeroy, Valerie M.

doi:10.1016/j.physio.2016.10.392

Cited by 6 publications

(12 citation statements)

References 28 publications

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“…All could contribute to potential errors in interpretation and analysis (Hug & Dorel, ). A strength of the current and previous study (Hancock et al, ) is the use of well‐defined, replicable procedures for the use of sEMG, including the precise determination of muscle activity according to crank angle. Such standardized procedures are increasingly important as EMG technology is becoming increasingly portable and usable for clinical settings, meaning that the potential impact of derived measures is substantial.…”

Section: Discussionmentioning

confidence: 96%

“…Data were processed exactly as described in Hancock et al (). In summary, first, the muscle activity raw signal was rectified using custom written scripts and smoothed using a moving average of 50 ms. Then, to establish muscle activity bursts Baseline (threshold) EMG values were calculated from the processed signal as the mean ± 3 SD during the 30‐s resting period—muscles considered “on” above this threshold and “off” when below it. For each 45° position bin, onset of activity was expressed as a percentage of total “on” time for that specific position.…”

Section: Methodsmentioning

confidence: 99%

“…Earlier, preliminary work with people within 30 days of stroke onset and substantial paresis also found that smooth movement was achievable during UP (Hancock et al, 2017). It is therefore possible that UP might have potential as a rehabilitation tool, as well as providing indicators of change in movement performance and potential targets for therapy.…”

Section: Assessment Of Test-retest Repeatability For Upderived Neurmentioning

confidence: 97%

“…Data were processed exactly as described in Hancock et al (2017). In summary, first, the muscle activity raw signal was rectified using custom written scripts and smoothed using a moving average of 50 ms.…”

Section: Data Processingmentioning

confidence: 99%

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Identification of neuromuscular targets for restoration of walking ability after stroke: Precursor to precision rehabilitation

Hancock

Shepstone

Rowe

et al. 2019

Physiotherapy Res Intl

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Objectives Restoration of walking is a priority for stroke survivors and key target for physical therapies. Upright pedalling (UP) can provide functional walking‐like activity using a variety of muscle synergies; it is unclear which synergies might be most useful for recovery of walking. Objectives here were as follows: to examine whether neuromuscular measures derived during UP might identify targets for walking rehabilitation after stroke and to determine test–retest repeatability and concurrent validity of the measures. Design This was a prospective correlational study. Setting The study was carried out in a movement science laboratory. Participants The participants were 18 adults with stroke (StrS) and 10 healthy older adults (HOA). Intervention/measurement StrS and HOA took part in two identical measurement sessions. During UP, surface electromyography and kinematic data were recorded and then processed to derive three measures: reciprocal activity of quadriceps and hamstrings; percentage muscle activity “on” according to crank angle; and smoothness of movement. Results HOA and StrS demonstrated differences in reciprocal muscle activity (p = .044) and quadriceps activity according to crank angle (p = .034) but pedalled similarly smoothly (p = .367). For muscle activation according to crank angle in StrS, intraclass correlation coefficients (95% confidence interval) showing acceptable repeatability were 0.46 [0.32, 0.58] affected quadriceps; 0.43 [0.28, 0.56] affected hamstrings; and 0.67 [0.56, 0.75] unaffected quadriceps. Conclusion Muscle activation according to crank angle is a promising measure of lower limb impairment during functional activity after stroke; subsequent investigation should determine magnitude of variance between testing sessions. Reciprocal activity of quadriceps and hamstrings muscles and quadriceps activity according to crank angle are both potential targets for physical therapies to improve motor recovery. Further investigations are warranted.

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Section: Discussionmentioning

confidence: 96%

Section: Methodsmentioning

confidence: 99%

Section: Assessment Of Test-retest Repeatability For Upderived Neurmentioning

confidence: 97%

Section: Data Processingmentioning

confidence: 99%

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Identification of neuromuscular targets for restoration of walking ability after stroke: Precursor to precision rehabilitation

Hancock

Shepstone

Rowe

et al. 2019

Physiotherapy Res Intl

Self Cite

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“…These characteristics lead to a major cause of disability, limiting the ability to function in daily activities and affecting quality of life (Hsu et al, 2003). Consequently, improving gait performance is considered to be an important goal in most rehabilitation programs (Hancock, Shepstone, Rowe, Myint, & Pomeroy, 2017;Kumar, Chakrapani, & Kedambadi, 2016;Lee et al, 2001). The majority of therapies address this goal by using physical repetitions, which are thought to improve motor activity by acting as stimulations for the brain to use the circuitry that facilitates voluntary movement (Hancock et al, 2017;Riberio, Silva, Costa, Cavalcanti, & Lindquist, 2017).…”

Section: Introductionmentioning

confidence: 99%

Motor Imagery Training for Gait Rehabilitation of People With Post-Stroke Hemiparesis: Practical Applications and Protocols

Dunsky¹,

Dickstein²

2018

GJHS

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Over the last two decades, the use of motor imagery (MI) for post-stroke rehabilitation has significantly increased. Previous findings support the feasibility of the incorporation of specific MI exercises to improve walking skills in individuals with post-stroke hemiparesis. However, detailed practical applications and specific protocols for the implementation of MI are scarce. The objective of this manuscript is to propose practical applications for a structured MI regimen, including detailed protocols of a six-week intervention targeting gait improvement following stroke. The proposed regimen is based on previous experience with MI rehabilitation programs for gait improvement following stroke, motor learning principles with applications for stroke rehabilitation, and the PETTLEP model. The proposed detailed protocols were found to be adjusted for gait improvement of post-stroke survivors as described in several studies, and may address the targets of different rehabilitation programs. Based on motor learning principles and guidelines, an example of verbal instructions for each treatment session during six weeks of intervention is proposed. The potential of this training program to augment and extend the rehabilitation process was proven in several studies. The variety of possibilities of scenes to image allows the clinician to target specific impaired performance and disabilities. By using the proposed structure and protocols, a large number of therapists may be able to address these targets.

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Trunk training following stroke

Thijs

Voets

Denissen

et al. 2023

Cochrane Database of Systematic Reviews

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Towards Upright Pedalling to drive recovery in people who cannot walk in the first weeks after stroke: movement patterns and measurement

Abstract: These observational data indicate that people with substantial paresis early after stroke and who cannot walk, can produce smooth movement during UP using a variety of muscle activation strategies.

Cited by 6 publications

References 28 publications

Identification of neuromuscular targets for restoration of walking ability after stroke: Precursor to precision rehabilitation

Identification of neuromuscular targets for restoration of walking ability after stroke: Precursor to precision rehabilitation

Motor Imagery Training for Gait Rehabilitation of People With Post-Stroke Hemiparesis: Practical Applications and Protocols

Trunk training following stroke

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