R4. Acquisition of Locomotor Capability Post-Stroke

A primary goal of stroke rehabilitation is to improve lower limb function so that patients can stand and ambulate more effectively with less risk of falling. To achieve these goals, the patient must acquire the ability to generate appropriate force output in the plegic limb, bear weight safely onto the plegic limb, propel the plegic limb forward while lifting the foot over the walking surface, and maintain a stable, upright body posture. Ultimately, these sub-tasks must be integrated into the whole pattern of locomotion so that the patient is able to ambulate safely within their environment.

We have developed an evaluation tool designed to measure the sub-tasks associated with successful ambulation (e.g. lower limb force generation, weight-support, limb progression, and lateral postural stability) in persons with post-stroke hemiplegia that are, as yet, unable to ambulate without assistance. Since even non-ambulatory patients are able to generate purposeful locomotor patterns, the evaluation tool utilizes a modified bicycle ergometer to measure kinetic and kinematic variables that are relevant to functional ambulation. The specific aims for this project are: 1) to investigate the rate of acquisition of critical sub-tasks involved in safe and effective ambulation in the acute phase of post-stroke recovery; 2) to develop a predictive model for the recovery of functional ambulation based upon the ability to perform critical locomotor sub-tasks during the non-seated pedaling evaluation performed within 1 month post-stroke; and 3) to conduct a clinical intervention trial in which the nonseated pedaling paradigm will be used as an exercise intervention to assist in accelerating the rate of acquisition of these locomotor sub-tasks.

This research is supported by the U.S. Department of Education, National Institute on Disability and Rehabilitation Research, Grant Number H133B980021

©2002 Rehabilitation Research and Training Center