Recovery of Gait After Stroke: What Changes?

Buurke, Jaap H.; Nene, Anand V.; Kwakkel, Gert; Erren-Wolters, Victorien; IJzerman, Maarten J.; Hermens, Hermie J.

doi:10.1177/1545968308317972

Cited by 137Stroke Rehabilitation and RecoverySpinal Cord Injury ResearchBotulinum Toxin and Related Neurological Disorders

Recovery of Gait After Stroke: What Changes?

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Buurke, Jaap H., Nene, Anand V., Kwakkel, Gert, Erren-Wolters, Victorien, IJzerman, Maarten J., Hermens, Hermie J.·2008·Neurorehabilitation and Neural Repair

DOI 10.1177/1545968308317972

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Abstract

Background. Little is known about whether changes in coordination patterns of muscle activation after stroke are related to functional recovery of walking. Objective . The present study investigated the longitudinal relationship between changes in neuromuscular activation patterns of paretic muscles in hemiplegic gait and improvement in walking ability after stroke. Methods. Thirteen patients diagnosed with a first unilateral ischemic stroke had their recovery of walking measured by the Rivermead Mobility Index, Functional Ambulation Categories, Barthel Index, Trunk Control Test, Motricity Index, and comfortable walking speed. Surface electromyography (SEMG) of the erector spinae, gluteus maximus, gluteus medius, rectus femoris, vastus lateralis, semitendinosus, gastrocnemius, and tibialis anterior muscles of both legs was used to quantify coordination patterns in comfortable walking mode. All clinical and electromyography-related measurements were taken at 3, 6, 9, 12, and 24 weeks poststroke. Timing parameters of the SEMG patterns were calculated, using an objective burst detection algorithm, and analyzed with the measures of functional recovery. Results . All functional measures, except Trunk Control Test, showed statistically significant improvement over time, whereas SEMG patterns did not change significantly over time. Conclusion. The lack of significant change in SEMG patterns over time suggests that functional gait improvements may be more related to compensatory strategies in muscle activation of the unaffected leg and biomechanical changes than by restitution of muscle coordination patterns in the affected leg.

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Improvements in gait speed and walking ability after stroke were not significantly associated with a change in muscle activation of the paretic leg assessed by electromyography.
“a number of recent longitudinally conducted studies showed that improvements in gait speed and walking ability after stroke were not significantly associated with a change in muscle activation of the paretic leg assessed by electromyography.79 -81”
From The Effectiveness of the Bobath Concept in Stroke Rehabilitation: What is the Evidence? (2009) · cites this paper as [80]

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Changes in Muscle Coordination Following Robot-assisted Gait Training in Hemiparetic Stroke
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Authors: Buurke, J. H., Nene, A. V., Kwakkel, G., Erren-Wolters, V., IJzerman, M. J., & Hermens, H. J.
Affiliations: Roessingh Research and Development (NL)
University Medical Center Utrecht (NL)
University of Twente (NL)
Corresponding author: Buurke, Jaap H.
ORCID: Buurke, Jaap H.
Kwakkel, Gert
IJzerman, Maarten J.
Hermens, Hermie J.
Venue: Neurorehabilitation and Neural Repair
Publisher: SAGE Publications
Published: 2008-10-29
Volume: 22
Issue: 6
Pages: 676-683
ISSN: 0888-4390 (ISSN-L)
1545-9683
1552-6844
DOI: 10.1177/1545968308317972
OpenAlex: W2107160767
Cited by: 137
References: 42
Citations by year: 2026: 4 · 2025: 5 · 2024: 5 · 2023: 6 · 2022: 8 · 2021: 11 · 2020: 9 · 2019: 10 · 2018: 12 · 2017: 7 · 2016: 7 · 2015: 7 · 2014: 12 · 2013: 9 · 2012: 4
FWCI: 7.48
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations: Neurorehabilitation and neural repair (publishedVersion)
PubMed (publishedVersion)
Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
VU Research Portal (publishedVersion)
University of Twente Research Information (publishedVersion)
Pure Amsterdam UMC (submittedVersion)
University of Twente Research Information (submittedVersion)
Data Archiving and Networked Services (DANS) (submittedVersion)
Topics: Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
Health Sciences › Medicine › Pathology and Forensic Medicine › Spinal Cord Injury Research
Health Sciences › Medicine › Neurology › Botulinum Toxin and Related Neurological Disorders
Keywords: stroke, gait recovery, hemiplegia, muscle activation patterns, surface electromyography, paretic muscles, compensatory strategies, walking speed, functional recovery, ischemic stroke, muscle coordination
MeSH terms: Stroke Rehabilitation, Adult, Aged, Electromyography, Exercise Therapy, Female, Humans, Leg, Male, Middle Aged, Psychomotor Performance, Time Factors, Range of Motion, Articular, Muscle, Skeletal, Recovery of Function, Gait Disorders, Neurologic, Stroke

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