Neuromechanical differences between successful and failed sit-to-stand movements and response to rehabilitation early after stroke

Andy Kerr, Allan Clark, Valerie M. Pomeroy

Research output: Contribution to journalArticle

Abstract

Background. Recovery of the sit-to-stand (StS) movement early after stroke could be improved by targeting physical therapy at the underlying movement deficits in those people likely to respond. Aim. To compare the movement characteristics of successful and failed StS movements in people early after stroke and identify which characteristics change in people recovering their ability to perform this movement independently following rehabilitation. Methods. Muscle activity and kinematic (including center of mass, CoM) data were recorded from 91 participants (mean 35 days after stroke) performing the StS movement before (baseline), immediately after (outcome), and 3 months after (follow-up) rehabilitation. Three subgroups (never-able [n = 19], always-able [n = 51], and able-after-baseline [n = 21]) were compared at baseline with the able-after-baseline subgroup compared before and after rehabilitation. Results. The subgroups differed at baseline for quadriceps onset time (P = .009) and forward body position when quadriceps peaked (P = .038). Following rehabilitation, the able-after-baseline subgroup increased their forward position (P < .001), decreased the time difference between bilateral quadriceps peaks (P < .001) and between quadriceps and hamstrings peaks on the nonhemiplegic side (P = .007). An improved performance in the always-able subgroup was associated with a number of baseline factors, including forward positioning (P = .002) and time difference between peak activity of bilateral quadriceps (P = .001). Conclusions. This neuromechanical study of StS before and after rehabilitation in a sample of people early after stroke identified the importance of temporal coupling between forward trunk movement and quadriceps and hamstrings’ activity. These findings advance the science of stroke rehabilitation by providing evidence-based therapy targets to promote recovery of the StS movement.
LanguageEnglish
Pages395-403
Number of pages9
JournalNeurorehabilitation and Neural Repair
Volume33
Issue number5
Early online date3 May 2019
DOIs
Publication statusPublished - 31 May 2019

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Patient rehabilitation
Rehabilitation
Stroke
Physical therapy
Recovery
Biomechanical Phenomena
Muscle
Kinematics
Muscles
Therapeutics

Keywords

  • stroke rehabilitation
  • physical therapy
  • sit-to-stand
  • kinematics
  • EMG
  • therapy targets

Cite this

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title = "Neuromechanical differences between successful and failed sit-to-stand movements and response to rehabilitation early after stroke",
abstract = "Background. Recovery of the sit-to-stand (StS) movement early after stroke could be improved by targeting physical therapy at the underlying movement deficits in those people likely to respond. Aim. To compare the movement characteristics of successful and failed StS movements in people early after stroke and identify which characteristics change in people recovering their ability to perform this movement independently following rehabilitation. Methods. Muscle activity and kinematic (including center of mass, CoM) data were recorded from 91 participants (mean 35 days after stroke) performing the StS movement before (baseline), immediately after (outcome), and 3 months after (follow-up) rehabilitation. Three subgroups (never-able [n = 19], always-able [n = 51], and able-after-baseline [n = 21]) were compared at baseline with the able-after-baseline subgroup compared before and after rehabilitation. Results. The subgroups differed at baseline for quadriceps onset time (P = .009) and forward body position when quadriceps peaked (P = .038). Following rehabilitation, the able-after-baseline subgroup increased their forward position (P < .001), decreased the time difference between bilateral quadriceps peaks (P < .001) and between quadriceps and hamstrings peaks on the nonhemiplegic side (P = .007). An improved performance in the always-able subgroup was associated with a number of baseline factors, including forward positioning (P = .002) and time difference between peak activity of bilateral quadriceps (P = .001). Conclusions. This neuromechanical study of StS before and after rehabilitation in a sample of people early after stroke identified the importance of temporal coupling between forward trunk movement and quadriceps and hamstrings’ activity. These findings advance the science of stroke rehabilitation by providing evidence-based therapy targets to promote recovery of the StS movement.",
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Neuromechanical differences between successful and failed sit-to-stand movements and response to rehabilitation early after stroke. / Kerr, Andy; Clark, Allan; Pomeroy, Valerie M.

In: Neurorehabilitation and Neural Repair , Vol. 33, No. 5, 31.05.2019, p. 395-403.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Neuromechanical differences between successful and failed sit-to-stand movements and response to rehabilitation early after stroke

AU - Kerr, Andy

AU - Clark, Allan

AU - Pomeroy, Valerie M.

PY - 2019/5/31

Y1 - 2019/5/31

N2 - Background. Recovery of the sit-to-stand (StS) movement early after stroke could be improved by targeting physical therapy at the underlying movement deficits in those people likely to respond. Aim. To compare the movement characteristics of successful and failed StS movements in people early after stroke and identify which characteristics change in people recovering their ability to perform this movement independently following rehabilitation. Methods. Muscle activity and kinematic (including center of mass, CoM) data were recorded from 91 participants (mean 35 days after stroke) performing the StS movement before (baseline), immediately after (outcome), and 3 months after (follow-up) rehabilitation. Three subgroups (never-able [n = 19], always-able [n = 51], and able-after-baseline [n = 21]) were compared at baseline with the able-after-baseline subgroup compared before and after rehabilitation. Results. The subgroups differed at baseline for quadriceps onset time (P = .009) and forward body position when quadriceps peaked (P = .038). Following rehabilitation, the able-after-baseline subgroup increased their forward position (P < .001), decreased the time difference between bilateral quadriceps peaks (P < .001) and between quadriceps and hamstrings peaks on the nonhemiplegic side (P = .007). An improved performance in the always-able subgroup was associated with a number of baseline factors, including forward positioning (P = .002) and time difference between peak activity of bilateral quadriceps (P = .001). Conclusions. This neuromechanical study of StS before and after rehabilitation in a sample of people early after stroke identified the importance of temporal coupling between forward trunk movement and quadriceps and hamstrings’ activity. These findings advance the science of stroke rehabilitation by providing evidence-based therapy targets to promote recovery of the StS movement.

AB - Background. Recovery of the sit-to-stand (StS) movement early after stroke could be improved by targeting physical therapy at the underlying movement deficits in those people likely to respond. Aim. To compare the movement characteristics of successful and failed StS movements in people early after stroke and identify which characteristics change in people recovering their ability to perform this movement independently following rehabilitation. Methods. Muscle activity and kinematic (including center of mass, CoM) data were recorded from 91 participants (mean 35 days after stroke) performing the StS movement before (baseline), immediately after (outcome), and 3 months after (follow-up) rehabilitation. Three subgroups (never-able [n = 19], always-able [n = 51], and able-after-baseline [n = 21]) were compared at baseline with the able-after-baseline subgroup compared before and after rehabilitation. Results. The subgroups differed at baseline for quadriceps onset time (P = .009) and forward body position when quadriceps peaked (P = .038). Following rehabilitation, the able-after-baseline subgroup increased their forward position (P < .001), decreased the time difference between bilateral quadriceps peaks (P < .001) and between quadriceps and hamstrings peaks on the nonhemiplegic side (P = .007). An improved performance in the always-able subgroup was associated with a number of baseline factors, including forward positioning (P = .002) and time difference between peak activity of bilateral quadriceps (P = .001). Conclusions. This neuromechanical study of StS before and after rehabilitation in a sample of people early after stroke identified the importance of temporal coupling between forward trunk movement and quadriceps and hamstrings’ activity. These findings advance the science of stroke rehabilitation by providing evidence-based therapy targets to promote recovery of the StS movement.

KW - stroke rehabilitation

KW - physical therapy

KW - sit-to-stand

KW - kinematics

KW - EMG

KW - therapy targets

U2 - 10.1177/1545968319846119

DO - 10.1177/1545968319846119

M3 - Article

VL - 33

SP - 395

EP - 403

JO - Neurorehabilitation and Neural Repair

T2 - Neurorehabilitation and Neural Repair

JF - Neurorehabilitation and Neural Repair

SN - 1545-9683

IS - 5

ER -