Understanding compensatory strategies for muscle weakness during gait by simulating activation deficits seen post-stroke

Brian A. Knarr, Darcy S. Reisman, Stuart A. Binder-Macleod, Jill S. Higginson

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Musculoskeletal simulations have been used to explore compensatory strategies, but have focused on responses to simulated atrophy in a single muscle or muscle group. In a population such as stroke, however, impairments are seen in muscle activation across multiple muscle groups. The objective of this study was to identify available compensatory strategies for muscle weakness during gait by simulating activation deficits in multiple muscle groups. Three dimensional dynamics simulations were created from 10 healthy subjects (48.8 ± 13.3 years, self-selected speed 1.28 ± 0.17. m/s) and constraints were set on the activation capacity of the plantar flexor, dorsiflexor, and hamstrings muscle groups to simulate activation impairments seen post-stroke. When the muscle groups are impaired individually, the model requires that the plantar flexor, dorsiflexor, and hamstrings muscle groups are activated to at least 55%, 64%, and 18%, respectively, to recreate the subjects' normal gait pattern. The models were unable to recreate the normal gait pattern with simultaneous impairment of all three muscle groups. Other muscle groups are unable to assist the dorsiflexor muscles during early swing, which suggests that rehabilitation or assistive devices may be required to correct foot drop. By identifying how muscles can interact, clinicians may be able to develop specific strategies for using gait retraining and orthotic assistance to best address an individual's needs.

Original languageEnglish (US)
Pages (from-to)270-275
Number of pages6
JournalGait and Posture
Volume38
Issue number2
DOIs
StatePublished - Jun 1 2013

Fingerprint

Muscle Weakness
Gait
Stroke
Muscles
Self-Help Devices
Atrophy
Foot
Healthy Volunteers
Rehabilitation

Keywords

  • Gait
  • Muscle function
  • Musculoskeletal Simulation
  • Stroke

ASJC Scopus subject areas

  • Biophysics
  • Orthopedics and Sports Medicine
  • Rehabilitation

Cite this

Understanding compensatory strategies for muscle weakness during gait by simulating activation deficits seen post-stroke. / Knarr, Brian A.; Reisman, Darcy S.; Binder-Macleod, Stuart A.; Higginson, Jill S.

In: Gait and Posture, Vol. 38, No. 2, 01.06.2013, p. 270-275.

Research output: Contribution to journalArticle

Knarr, Brian A. ; Reisman, Darcy S. ; Binder-Macleod, Stuart A. ; Higginson, Jill S. / Understanding compensatory strategies for muscle weakness during gait by simulating activation deficits seen post-stroke. In: Gait and Posture. 2013 ; Vol. 38, No. 2. pp. 270-275.
@article{99fb8c98cede4ff883b715cecda799d3,
title = "Understanding compensatory strategies for muscle weakness during gait by simulating activation deficits seen post-stroke",
abstract = "Musculoskeletal simulations have been used to explore compensatory strategies, but have focused on responses to simulated atrophy in a single muscle or muscle group. In a population such as stroke, however, impairments are seen in muscle activation across multiple muscle groups. The objective of this study was to identify available compensatory strategies for muscle weakness during gait by simulating activation deficits in multiple muscle groups. Three dimensional dynamics simulations were created from 10 healthy subjects (48.8 ± 13.3 years, self-selected speed 1.28 ± 0.17. m/s) and constraints were set on the activation capacity of the plantar flexor, dorsiflexor, and hamstrings muscle groups to simulate activation impairments seen post-stroke. When the muscle groups are impaired individually, the model requires that the plantar flexor, dorsiflexor, and hamstrings muscle groups are activated to at least 55{\%}, 64{\%}, and 18{\%}, respectively, to recreate the subjects' normal gait pattern. The models were unable to recreate the normal gait pattern with simultaneous impairment of all three muscle groups. Other muscle groups are unable to assist the dorsiflexor muscles during early swing, which suggests that rehabilitation or assistive devices may be required to correct foot drop. By identifying how muscles can interact, clinicians may be able to develop specific strategies for using gait retraining and orthotic assistance to best address an individual's needs.",
keywords = "Gait, Muscle function, Musculoskeletal Simulation, Stroke",
author = "Knarr, {Brian A.} and Reisman, {Darcy S.} and Binder-Macleod, {Stuart A.} and Higginson, {Jill S.}",
year = "2013",
month = "6",
day = "1",
doi = "10.1016/j.gaitpost.2012.11.027",
language = "English (US)",
volume = "38",
pages = "270--275",
journal = "Gait and Posture",
issn = "0966-6362",
publisher = "Elsevier",
number = "2",

}

TY - JOUR

T1 - Understanding compensatory strategies for muscle weakness during gait by simulating activation deficits seen post-stroke

AU - Knarr, Brian A.

AU - Reisman, Darcy S.

AU - Binder-Macleod, Stuart A.

AU - Higginson, Jill S.

PY - 2013/6/1

Y1 - 2013/6/1

N2 - Musculoskeletal simulations have been used to explore compensatory strategies, but have focused on responses to simulated atrophy in a single muscle or muscle group. In a population such as stroke, however, impairments are seen in muscle activation across multiple muscle groups. The objective of this study was to identify available compensatory strategies for muscle weakness during gait by simulating activation deficits in multiple muscle groups. Three dimensional dynamics simulations were created from 10 healthy subjects (48.8 ± 13.3 years, self-selected speed 1.28 ± 0.17. m/s) and constraints were set on the activation capacity of the plantar flexor, dorsiflexor, and hamstrings muscle groups to simulate activation impairments seen post-stroke. When the muscle groups are impaired individually, the model requires that the plantar flexor, dorsiflexor, and hamstrings muscle groups are activated to at least 55%, 64%, and 18%, respectively, to recreate the subjects' normal gait pattern. The models were unable to recreate the normal gait pattern with simultaneous impairment of all three muscle groups. Other muscle groups are unable to assist the dorsiflexor muscles during early swing, which suggests that rehabilitation or assistive devices may be required to correct foot drop. By identifying how muscles can interact, clinicians may be able to develop specific strategies for using gait retraining and orthotic assistance to best address an individual's needs.

AB - Musculoskeletal simulations have been used to explore compensatory strategies, but have focused on responses to simulated atrophy in a single muscle or muscle group. In a population such as stroke, however, impairments are seen in muscle activation across multiple muscle groups. The objective of this study was to identify available compensatory strategies for muscle weakness during gait by simulating activation deficits in multiple muscle groups. Three dimensional dynamics simulations were created from 10 healthy subjects (48.8 ± 13.3 years, self-selected speed 1.28 ± 0.17. m/s) and constraints were set on the activation capacity of the plantar flexor, dorsiflexor, and hamstrings muscle groups to simulate activation impairments seen post-stroke. When the muscle groups are impaired individually, the model requires that the plantar flexor, dorsiflexor, and hamstrings muscle groups are activated to at least 55%, 64%, and 18%, respectively, to recreate the subjects' normal gait pattern. The models were unable to recreate the normal gait pattern with simultaneous impairment of all three muscle groups. Other muscle groups are unable to assist the dorsiflexor muscles during early swing, which suggests that rehabilitation or assistive devices may be required to correct foot drop. By identifying how muscles can interact, clinicians may be able to develop specific strategies for using gait retraining and orthotic assistance to best address an individual's needs.

KW - Gait

KW - Muscle function

KW - Musculoskeletal Simulation

KW - Stroke

UR - http://www.scopus.com/inward/record.url?scp=84880042419&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84880042419&partnerID=8YFLogxK

U2 - 10.1016/j.gaitpost.2012.11.027

DO - 10.1016/j.gaitpost.2012.11.027

M3 - Article

C2 - 23273489

AN - SCOPUS:84880042419

VL - 38

SP - 270

EP - 275

JO - Gait and Posture

JF - Gait and Posture

SN - 0966-6362

IS - 2

ER -