Forced use of paretic leg induced by constraining the non-paretic leg leads to motor learning in individuals post-stroke

  • Ming WuEmail author
  • Chao-Jung Hsu
  • Janis Kim
Research Article


The purpose of this study was to determine whether applying repetitive constraint forces to the non-paretic leg during walking would induce motor learning of enhanced use of the paretic leg in individuals post-stroke. Sixteen individuals post chronic (> 6 months) stroke were recruited in this study. Each subject was tested in two conditions, i.e., applying a constraint force to the non-paretic leg during treadmill walking and treadmill walking only. For the constraint condition, subjects walked on a treadmill with no force for 1 min (baseline), with force for 7 min (adaptation), and then without force for 1 min (post-adaptation). For the treadmill only condition, a similar protocol was used but no force was applied. EMGs from muscles of the paretic leg and ankle kinematic data were recorded. Spatial–temporal gait parameters during overground walking pre and post treadmill walking were also collected. Integrated EMGs of ankle plantarflexors and hip extensors during stance phase significantly increased during the early adaptation period, and partially retained (15–21% increase) during the post-adaptation period for the constraint force condition, which were significantly greater than that for the treadmill only (3–5%) condition. The symmetry of step length during overground walking significantly improved (p = 0.04) after treadmill walking with the constraint condition, but had no significant change after treadmill walking only. Repetitively applying constraint force to the non-paretic leg during treadmill walking may lead to a motor learning of enhanced use of the paretic leg in individuals post-stroke, which may transfer to overground walking.


EMG Stroke Locomotion Forced use Constraint force 



This study was supported by NIH/NICHD, R01HD082216. We thank Dr. Rongnian Tang’s assistance for data collection.

Compliance with ethical standards

Conflict of interest

None of the authors have potential conflicts of interest to be disclosed.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Legs and Walking LabShirley Ryan AbilityLabChicagoUSA
  2. 2.Department of BioengineeringUniversity of Illinois at ChicagoChicagoUSA
  3. 3.Department of Physical Medicine and RehabilitationNorthwestern UniversityChicagoUSA

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