Abstract
Post-stroke locomotion is usually characterized by asymmetrical gait patterns, compensatory movements of trunk and nonparetic limb, altered motor coordination, and wide inter-stride variability. This pilot study was designed to test a twofold hypothesis: post-stroke survivors can exploit the redundancy of the segmental angles to stabilize the 3D footpath trajectory during the swing phase, in accordance with the Uncontrolled Manifold (UCM) theory; an intense rehabilitative treatment improves both motor performance and outcomes of the UCM analysis. Ten stroke survivors underwent two evaluation sessions, before and after a conventional multidisciplinary intensive rehabilitation program, encompassing clinical tests and gait analysis, both overground and on treadmill. In addition, the UCM analysis was implemented to investigate whether variance of segmental angles is structured to minimize the inter-stride variability of the 3D footpath during the swing phase of treadmill locomotion. Both clinical and spatio-temporal parameters improved after the treatment, even if the statistical significance was reached for a limited set of them. The UCM analysis suggested that post-stroke survivors exploit the redundancy of lower limbs segmental angles mainly during the late swing, without significant differences between affected and unaffected sides. Thereafter, the main significant effects of the rehabilitative treatment consisted in strengthening the synergistic organization of the redundant segmental angles involving a more accurate control of the 3D footpath. Concluding, the UCM theory can be a promising tool to appraise the effects of a specific rehabilitative protocol on motor coordination in post-stroke survivors.
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Data availability
The datasets recorded during and/or analysed during the current study are available from the corresponding author on reasonable request.
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Acknowledgements
The authors wish to thank all the participants enrolled in this study for their time and valuable contribution and express a special thanks to Elda Judica, MD, neurologist at CCP, for her precious help in patients’ enrolment.
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The study protocol was in accordance with the Declaration of Helsinki and was approved by Local Ethical Committee: Milano Area B (approval number: 827_2018bis).
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Communicated by Francesco Lacquaniti.
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Lofrumento, M., Tropea, P., Picardi, M. et al. Effects of gait rehabilitation on motor coordination in stroke survivors: an UCM-based approach. Exp Brain Res 239, 2107–2118 (2021). https://doi.org/10.1007/s00221-021-06117-5
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DOI: https://doi.org/10.1007/s00221-021-06117-5