Ep 08: Propulsion Asymmetry Post-Stroke
In Episode 8, Michael Lewek, PT, PhD expands on previous talks on gait rehabilitation (https://www.youtube.com/watch?v=tHY3E…) and paretic propulsion (https://www.youtube.com/watch?v=xQHJa…), to provide a deeper look at the significance of propulsion asymmetry after stroke, and the impact this has on patients’ walking speed and metabolic efficiency.
Mike also highlights recent research which explores the concept of a propulsive reserve – suggesting that individuals post-stroke have the capacity to improve their paretic contribution to propulsion, and can be trained to access this reserve and thus improve their propulsion symmetry and overall walking efficiency. For more information on ReWalk Robotics or this web series, please visit: https://rewalk.com/contact/ In case you missed last week’s episode, click here to watch Topics in Neuro Rehab Ep 07: https://www.youtube.com/watch?v=E68yK… To learn more about Mike’s work or any of the research he referenced in his talk, please visit the following links: Research Labs: UNC at Chapel Hill: https://www.med.unc.edu/ahs/physical/… CLEAR Engineering Group: https://www.clear-ncsu-unc.com/ https://www.youtube.com/watch?v=QpSLl… Additional References: Goldberg, Evan J., Steven A. Kautz, and Richard R. Neptune. “Can treadmill walking be used to assess propulsion generation?.” Journal of biomechanics 41.8 (2008): 1805-1808. https://doi.org/10.1016/j.jbiomech.20… Lewek, Michael D. “The influence of body weight support on ankle mechanics during treadmill walking.” Journal of biomechanics 44.1 (2011): 128-133. https://doi.org/10.1016/j.jbiomech.20… Palmer, Jacqueline A., et al. “Symmetry of corticomotor input to plantarflexors influences the propulsive strategy used to increase walking speed post-stroke.” Clinical Neurophysiology 127.3 (2016): 1837-1844. https://doi.org/10.1016/j.clinph.2015… Reisman, Darcy S., et al. “Locomotor adaptation on a split-belt treadmill can improve walking symmetry post-stroke.” Brain 130.7 (2007): 1861-1872. https://doi.org/10.1093/brain/awm035 Lewek, Michael D., Cristina Raiti, and Amanda Doty. “The presence of a paretic propulsion reserve during gait in individuals following stroke.” Neurorehabilitation and neural repair 32.12 (2018): 1011-1019. https://journals.sagepub.com/doi/pdf/… Farris, Dominic James, et al. “Revisiting the mechanics and energetics of walking in individuals with chronic hemiparesis following stroke: from individual limbs to lower limb joints.” Journal of neuroengineering and rehabilitation 12.1 (2015): 24. https://link.springer.com/article/10…. Penke, Kelly, et al. “Propulsive forces applied to the body’s center of mass affect metabolic energetics poststroke.” Archives of physical medicine and rehabilitation 100.6 (2019): 1068-1075. https://doi.org/10.1016/j.apmr.2018.1… Lewek, Michael D., and Gregory S. Sawicki. “Trailing limb angle is a surrogate for propulsive limb forces during walking post-stroke.” Clinical Biomechanics 67 (2019): 115-118. https://doi.org/10.1016/j.clinbiomech… Franz, Jason R., Michela Maletis, and Rodger Kram. “Real-time feedback enhances forward propulsion during walking in old adults.” Clinical biomechanics 29.1 (2014): 68-74. https://doi.org/10.1016/j.clinbiomech… Schenck, Christopher, and Trisha M. Kesar. “Effects of unilateral real-time biofeedback on propulsive forces during gait.” Journal of neuroengineering and rehabilitation 14.1 (2017): 52. https://link.springer.com/article/10…. McGinley, Jennifer L., et al. “Accuracy and reliability of observational gait analysis data: judgments of push-off in gait after stroke.” Physical Therapy 83.2 (2003): 146-160. https://doi.org/10.1093/ptj/83.2.146
JNPT Webinar – ReStoring Paretic PropulsionClinician's Corner | Kathleen O'Donnell | December 13, 2020