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

Nicola J. Hancock, Lee Shepstone, Philip Rowe, Phyo K. Myint, Valerie M. Pomeroy

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

AbstractObjectives To examine whether people who are within 31 days of stroke onset are able to produce controlled lower limb movement, and phasic activity in antagonistic lower limb muscle groups, during Upright Pedalling (UP). Design Observational study. Setting Acute stroke unit within a University Hospital. Participants Eight adults between 3 and 30 days from stroke onset, with unilateral lower limb paresis and unable to walk without assistance. Participants were considered fit to participate as assessed by a physician-led medical team and were able to take part in UP for one, one minute session. Intervention Participants took part in one session of instrumented UP at their comfortable cadence, as part of a feasibility study investigating UP early after stroke. Outcome measures Reciprocal activation of lower limb muscles derived from muscle activity recorded with surface EMG, quantified using Jaccards Coefficient (J); smoothness of pedalling determined from standard deviations of time spent in each of eight 45° wheel position bins (“S-Ped”). Motor behavioural measures: Motricity Index, Trunk Control Test, Functional Ambulatory Categories. Results Participants were all unable to walk (FAC 0) with severe to moderate lower limb paresis (Motricity Index score/100 median 48.5, IQR 32 to 65.5). Smooth pedalling was observed; some participants pedalling similarly smoothly to healthy older adults, with a variety of muscle activation patterns in the affected and unaffected legs. Conclusion 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.
LanguageEnglish
Number of pages7
JournalPhysiotherapy
Early online date15 Nov 2016
DOIs
Publication statusE-pub ahead of print - 15 Nov 2016

Fingerprint

Muscle
Foot
Stroke
Recovery
Lower Extremity
Chemical activation
Paresis
Muscles
Bins
Wheels
Lead
Feasibility Studies
Observational Studies
Leg
Outcome Assessment (Health Care)
Physicians

Keywords

  • stroke
  • rehabilitation
  • lower limb
  • pedalling
  • walking
  • function

Cite this

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title = "Towards Upright Pedalling to drive recovery in people who cannot walk in the first weeks after stroke: movement patterns and measurement",
abstract = "AbstractObjectives To examine whether people who are within 31 days of stroke onset are able to produce controlled lower limb movement, and phasic activity in antagonistic lower limb muscle groups, during Upright Pedalling (UP). Design Observational study. Setting Acute stroke unit within a University Hospital. Participants Eight adults between 3 and 30 days from stroke onset, with unilateral lower limb paresis and unable to walk without assistance. Participants were considered fit to participate as assessed by a physician-led medical team and were able to take part in UP for one, one minute session. Intervention Participants took part in one session of instrumented UP at their comfortable cadence, as part of a feasibility study investigating UP early after stroke. Outcome measures Reciprocal activation of lower limb muscles derived from muscle activity recorded with surface EMG, quantified using Jaccards Coefficient (J); smoothness of pedalling determined from standard deviations of time spent in each of eight 45° wheel position bins (“S-Ped”). Motor behavioural measures: Motricity Index, Trunk Control Test, Functional Ambulatory Categories. Results Participants were all unable to walk (FAC 0) with severe to moderate lower limb paresis (Motricity Index score/100 median 48.5, IQR 32 to 65.5). Smooth pedalling was observed; some participants pedalling similarly smoothly to healthy older adults, with a variety of muscle activation patterns in the affected and unaffected legs. Conclusion 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.",
keywords = "stroke, rehabilitation, lower limb, pedalling, walking, function",
author = "Hancock, {Nicola J.} and Lee Shepstone and Philip Rowe and Myint, {Phyo K.} and Pomeroy, {Valerie M.}",
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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. / Hancock, Nicola J.; Shepstone, Lee; Rowe, Philip; Myint, Phyo K.; Pomeroy, Valerie M.

In: Physiotherapy, 15.11.2016.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Towards Upright Pedalling to drive recovery in people who cannot walk in the first weeks after stroke

T2 - Physiotherapy

AU - Hancock, Nicola J.

AU - Shepstone, Lee

AU - Rowe, Philip

AU - Myint, Phyo K.

AU - Pomeroy, Valerie M.

PY - 2016/11/15

Y1 - 2016/11/15

N2 - AbstractObjectives To examine whether people who are within 31 days of stroke onset are able to produce controlled lower limb movement, and phasic activity in antagonistic lower limb muscle groups, during Upright Pedalling (UP). Design Observational study. Setting Acute stroke unit within a University Hospital. Participants Eight adults between 3 and 30 days from stroke onset, with unilateral lower limb paresis and unable to walk without assistance. Participants were considered fit to participate as assessed by a physician-led medical team and were able to take part in UP for one, one minute session. Intervention Participants took part in one session of instrumented UP at their comfortable cadence, as part of a feasibility study investigating UP early after stroke. Outcome measures Reciprocal activation of lower limb muscles derived from muscle activity recorded with surface EMG, quantified using Jaccards Coefficient (J); smoothness of pedalling determined from standard deviations of time spent in each of eight 45° wheel position bins (“S-Ped”). Motor behavioural measures: Motricity Index, Trunk Control Test, Functional Ambulatory Categories. Results Participants were all unable to walk (FAC 0) with severe to moderate lower limb paresis (Motricity Index score/100 median 48.5, IQR 32 to 65.5). Smooth pedalling was observed; some participants pedalling similarly smoothly to healthy older adults, with a variety of muscle activation patterns in the affected and unaffected legs. Conclusion 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.

AB - AbstractObjectives To examine whether people who are within 31 days of stroke onset are able to produce controlled lower limb movement, and phasic activity in antagonistic lower limb muscle groups, during Upright Pedalling (UP). Design Observational study. Setting Acute stroke unit within a University Hospital. Participants Eight adults between 3 and 30 days from stroke onset, with unilateral lower limb paresis and unable to walk without assistance. Participants were considered fit to participate as assessed by a physician-led medical team and were able to take part in UP for one, one minute session. Intervention Participants took part in one session of instrumented UP at their comfortable cadence, as part of a feasibility study investigating UP early after stroke. Outcome measures Reciprocal activation of lower limb muscles derived from muscle activity recorded with surface EMG, quantified using Jaccards Coefficient (J); smoothness of pedalling determined from standard deviations of time spent in each of eight 45° wheel position bins (“S-Ped”). Motor behavioural measures: Motricity Index, Trunk Control Test, Functional Ambulatory Categories. Results Participants were all unable to walk (FAC 0) with severe to moderate lower limb paresis (Motricity Index score/100 median 48.5, IQR 32 to 65.5). Smooth pedalling was observed; some participants pedalling similarly smoothly to healthy older adults, with a variety of muscle activation patterns in the affected and unaffected legs. Conclusion 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.

KW - stroke

KW - rehabilitation

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