Abstract
Abnormal gait, particularly in patients with stroke, causes neuromuscular fatigue. We aimed to clarify temporal changes in gait performance and lower limb muscle activity during extended walking in people with stroke hemiplegia. Twelve adults with stroke and eleven healthy controls performed an extended trial involving 20-min continuous walk at a comfortable speed. The primary outcome was electromyography amplitude during the trial and secondary outcomes were walking performance and the instantaneous mean frequency of electromyography during the trial. Data at 1, 6, 12, and 18 min after initiating walking were compared. Performance during extended walking in people with stroke was maintained over time. The electromyography amplitude decreased in the tibialis anterior during the pre-swing phase and increased in the rectus femoris during the single-support phase over time; these changes were similar on the paretic and nonparetic sides. Instantaneous mean frequency decreased over time on the nonparetic side in the tibialis anterior and on the paretic side in the rectus femoris. Healthy subjects did not show any changes over time. The changes in muscle activity in patients with stroke differed between the paretic and nonparetic sides, muscle type, and gait phase; walking performance was maintained despite being affected by neuromuscular fatigue.
Highlights
Stroke mortality has declined rapidly worldwide [1]; stroke is the third leading cause of disability [2]
Control data were collected from eleven healthy subjects whose age, height, and weight were within the range of mean plus twice the standard deviation in patients with stroke (Table 1)
All subjects completed 20 min of continuous walking without reaching the discontinuation criteria for HR and rating of perceived exertion (RPE) during the extended walking test
Summary
Stroke mortality has declined rapidly worldwide [1]; stroke is the third leading cause of disability [2]. Age-adjusted stroke mortality has declined in Japan as well, stroke remains one of the leading causes of death and disability [3]. Of the various disorders that occur after a stroke, fatigue is a common sequela and affects up to 72% of patients [4,5,6]. There are many patients with stroke for whom fatigue is a problem, and it is important to improve poststroke fatigue and walking problems for better participation in society and improved quality of life. No studies have investigated lower limb fatigue associated with extended walking in patients with stroke
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