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Patten, C.

Publications and source records attributed to Patten, C..

3 recordsLinked to original sources

Inter-joint and temporal coordination change in very slow walking

PurposeVery slow walking has been suggested to be a distinctively different motor behavior than walking at comfortable gait speeds. While kinematic and spatiotemporal gait parameters are known to scale with gait speed, inter-joint coordination during swing remains consistent, at least across comfortable speeds. The purpose of this study was to determine whether coordination patterns serving limb clearance and shortening differ with very slow walking, providing additional support for the premise that very slow walking represents a unique motor behavior.\n\nMethodsWe assessed nine healthy adults walking overground at their self-selected speed and two-to-three progressively slower speeds. We collected lower extremity kinematics with 3D motion analysis and quantified joint motion contributions to limb clearance and shortening. We investigated changes in coordination using linear mixed models to determine magnitude and timing differences of joint influence across walking speeds.\n\nResultsHip and knee influences serving limb clearance reduced considerably with slower walking speeds. Similarly, knee influence on limb shortening reduced with very slow walking. Importantly, ankle influence remained unchanged across gait speeds for limb shortening and reduced subtly for limb clearance. Temporally, joint influences on limb clearance varied across walking speeds. Specifically, the temporal order of peak hip and knee influences reversed between comfortable and very slow walking. For limb shortening the timing of ankle influence remained unchanged while the timing of knee influence occurred later in the gait cycle for slower walking speeds.\n\nConclusionsOur results demonstrate temporal coordination and the relative joint contributions serving limb clearance and shortening differ with very slow walking providing additional evidence that slow walking may be a behavior distinct from walking at comfortable speeds.

neuroscience

Direction of gait asymmetry following stroke determines acute response to locomotor task

BackgroundGiven the prevalence of gait dysfunction following stroke, walking recovery is a primary goal of rehabilitation. However, current gait rehabilitation approaches fail to demonstrate consistent benefits. Furthermore, asymmetry is a prominent feature of gait dysfunction following stroke. Differential patterns of gait asymmetry may respond differently to gait training parameters.\n\nObjectiveThe purpose of this study was to determine whether differential responses to locomotor task condition occur on the basis of direction of step length asymmetry (Symmetrical, NPshort, Pshort) observed during overground walking.\n\nMethodsParticipants first walked overground at their self-selected walking speed. Overground data were compared against three task conditions all tested during treadmill walking: self-selected speed with 0% body weight support (TM); self-selected speed with 30% body weight support (BWS); and fastest comfortable speed with 30% body weight support and nonparetic leg guidance (GuidanceNP). Our primary outcomes were: step length, single limb support duration, and stride length.\n\nResultsWe identified differences in the response to locomotor task conditions for each step length asymmetry subgroup. GuidanceNP induced an acute spatial symmetry only in the NPshort group and temporal symmetry in the Symmetrical group.\n\nConclusionsTask conditions consistent with locomotor training do not produce uniform effects across subpatterns of gait asymmetry. We identified differential responses to locomotor task conditions between groups with distinct asymmetry patterns, suggesting these subgroups may require unique intervention strategies. Despite group differences in asymmetry characteristics, improvements in symmetry noted in the Symmetrical and NPshort groups were driven by changes in both the paretic and nonparetic limbs.

neuroscience

Lower Extremity Long-Latency Reflexes Differentiate Walking Function After Stroke

The neural mechanisms of walking impairment after stroke are not well characterized. There is a need for a neurophysiologic marker that can unambiguously differentiate functional status and potential for walking recovery. The long-latency reflex (LLR) is a supraspinally-mediated response that integrates sensorimotor information during movement. It is hypothesized that lower extremity LLRs contribute to regulation of motor output during walking in healthy individuals. The goal of the present study was to assess the relationship between lower extremity LLRs, measures of supraspinal drive, and walking function. Thirteen individuals with chronic post-stroke hemiparesis and thirteen healthy controls performed both isometric and dynamic plantarflexion. Transcranial magnetic stimulation (TMS) assessed supraspinal drive to the tibialis anterior. LLR activity was assessed during dynamic voluntary plantarflexion and individuals post-stroke were classified as either LLR present (LLR+) or absent (LLR-). All healthy controls and nine individuals post-stroke exhibited LLRs, while four did not. LLR+ individuals revealed higher clinical scores, walking speeds, and greater ankle plantarflexor power during walking compared to LLR- individuals. LLR- individuals exhibited exaggerated responses to TMS during dynamic plantarflexion relative to healthy controls. This LLR- subset revealed dysfunctional modulation of stretch responses and antagonist supraspinal drive relative to healthy controls and the higher functioning LLR+ individuals post-stroke. These abnormal responses allow for unambiguous differentiation between individuals post-stroke and are associated with multiple measures of motor function. These findings provide an opportunity to distinguish among the heterogeneity of lower extremity motor impairments present following stroke by associating them with responses at the nervous system level.

neuroscience