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dc.contributor.authorPalmer, J.A.
dc.contributor.authorHsiao, H.Y.
dc.contributor.authorWright, T.
dc.date.accessioned2019-10-08T19:43:54Z
dc.date.available2019-10-08T19:43:54Z
dc.date.issued2017
dc.identifier.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85022189938&doi=10.1093%2fptj%2fpzx008&partnerID=40&md5=eab665ffe45890050f154a62da1f3b4f
dc.identifier.urihttp://hdl.handle.net/10713/11145
dc.description.abstractBackground. Recent research demonstrated that the symmetry of corticomotor drive with the paretic and nonparetic plantarflexor muscles was related to the biomechanical ankle moment strategy that people with chronic stroke used to achieve their greatest walking speeds. Rehabilitation strategies that promote corticomotor balance might improve poststroke walking mechanics and enhance functional ambulation. Objective. The study objectives were to test the effectiveness of a single session of gait training using functional electrical stimulation (FES) to improve plantarflexor corticomotor symmetry and plantarflexion ankle moment symmetry and to determine whether changes in corticomotor symmetry were related to changes in ankle moment symmetry within the session. Design. This was a repeated-measures crossover study. Methods. On separate days, 20 people with chronic stroke completed a session of treadmill walking either with or without the use of FES of their ankle dorsi- and plantarflexor muscles. We calculated plantarflexor corticomotor symmetry using transcranial magnetic stimulation and plantarflexion ankle moment symmetry during walking between the paretic and the nonparetic limbs before and after each session. We compared changes and tested relationships between corticomotor symmetry and ankle moment symmetry following each session. Results. Following the session with FES, there was an increase in plantarflexor corticomotor symmetry that was related to the observed increase in ankle moment symmetry. In contrast, following the session without FES, there were no changes in corticomotor symmetry or ankle moment symmetry. Limitations. No stratification was made on the basis of lesion size, location, or clinical severity. Conclusions. These findings demonstrate, for the first time (to our knowledge), the ability of a single session of gait training with FES to induce positive corticomotor plasticity in people in the chronic stage of stroke recovery. They also provide insight into the neurophysiologic mechanisms underlying improvements in biomechanical walking function.en_US
dc.description.sponsorshipThis work was supported, in part, by the Delaware Health Sciences Alliance (pilot grant), a grant from the National Institute of Neurological Disorders and Stroke (R01NR010786), and a Promotion of Doctoral Studies Level II Scholarship from the Foundation for Physical Therapy.en_US
dc.description.urihttps://doi.org/10.1093/ptj/pzx008en_US
dc.language.isoen_USen_US
dc.publisherAmerican Physical Therapy Associationen_US
dc.relation.ispartofPhysical Therapy
dc.subject.meshElectric Stimulation Therapy--methodsen_US
dc.subject.meshGait Disorders, Neurologic--rehabilitationen_US
dc.subject.meshMotor Cortex--physiologyen_US
dc.subject.meshParesis--rehabilitationen_US
dc.subject.meshStroke Rehabilitation--methodsen_US
dc.titleSingle session of functional electrical stimulation-assisted walking produces corticomotor symmetry changes related to changes in poststroke walking mechanicsen_US
dc.typeArticleen_US
dc.identifier.doi10.1093/ptj/pzx008
dc.identifier.pmid28339828


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