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Neuromechanics of Post-Stroke Gait

For many stroke survivors, neuromotor dysfunction impairs walking ability, limiting their capacity to perform daily tasks independently. As a result, rehabilitation efforts for this population frequently prioritize improving walking function. However, the development of new, more effective interventions for gait rehabilitation depends on research that helps to establish links between impairment mitigation and improvements in functional ability. We are particularly interested in understanding how sensorimotor impairments in people post-stroke impact the gait quality, particularly as characterized by measures of metabolic cost, perceived effort, and stability.

Ongoing Projects

Factors Influencing the Energetic Cost of Walking in People Post-Stroke
Hemiparetic gait, which is characterized by weakness on one side of the body, is associated with many walking abnormalities. For example, stroke survivors walk at slower speeds and with a higher metabolic cost than healthy individuals. Also, their gait is asymmetric, with different values of kinematic and kinetic parameters between the paretic and non-paretic sides, such as differences in stance and swing times, double support times, joint power, joint excursions, and step lengths. Typically, the spatiotemporal asymmetries observed during a hemiparetic gait are considered to be impairments or deviations at the level of body function and activity. However, in the absence of complete repair at the neural level, stroke survivors will always have a marked asymmetry in the neural circuits responsible for walking. As a result, it is possible that the symmetric movement patterns observed in healthy individuals may no longer be optimal given the constraints imposed by brain lesions.

Here, we aim to understand whether there are functional benefits to restoring spatiotemporal gait symmetry for stroke survivors to a level considered “normal” for non-impaired individuals. To answer this question, we must first select a set of metrics by which the “quality” of an individual’s walking pattern can be evaluated. We primarily use measures of walking economy, characterized by the metabolic cost of walking at a given speed, measures of dynamic stability, perceived effort, and patient preference to capture how changes in spatiotemporal coordination impact the quality of walking in people post-stroke. We ultimately hope that our work will be used to guide patient-specific interventions for gait rehabilitation. 

Key Lab Personnel

Publications

  1. ​​N Sánchez, N Schweighofer, JM Finley. Different biomechanical variables explain within-subjects versus between-subjects variance in step length asymmetry post-stroke. IEEE Trans Neural Syst Rehabil Eng. 2021;29:1188-1198. doi: 10.1109/TNSRE.2021.3090324.
  2. S Park, C Liu, N Sánchez, JK. Tilson, SJ. Mulroy, and JM. Finley. Using biofeedback to reduce spatiotemporal asymmetry impairs dynamic balance in people post-stroke. Neurorehabil Neural Repair. 2021 Jun 1;:15459683211019346. doi: 10.1177/15459683211019346.
  3. Buurke TJW, Liu C, Park S, den Otter R, Finley JM. (2020). Maintaining sagittal plane balance compromises frontal plane balance during reactive stepping in people post-strokeClinical Biomechanics, 80.
  4. ​Sánchez, Natalia, and James M. Finley. (2018). Individual Differences in Locomotor Function Predict the Capacity to Reduce Asymmetry and Modify the Energetic Cost of Walking Poststroke. Neurorehabilitation and neural repair 32.8 (2018): 701-713.
  5. J.M. Finley and A.J. Bastian. (2017). Associations between Foot Placement Asymmetries and Metabolic Cost of Transport in Hemiparetic GaitNeurorehabilitation and Neural Repair. 31, 168-177. 
  6. J.M. Finley, A. Long, A.J.Bastian, and G. Torres-Oviedo (2015). Spatial and Temporal Control Contribute to Step Length Asymmetry during Split-Belt Adaptation and Hemiparetic Gait. Neurorehabilitation and Neural Repair. 29:786-95.
  7. R. D. Trumbower*, J. M. Finley*, J.Shemmell, C. F. Honeycutt, E. J. Perreault. (2013). Bilateral Impairments in Task-Dependent Modulation of the Long-Latency Stretch Reflex Following Stroke. Clinical Neurophysiology. 124,1373-1380 
  8. J.M. Finley, E.J. Perreault, Y.Y. Dhaher.(2008). Stretch Reflex Coupling Between the Hip and Knee:Implications for Impaired Gait Following Stroke. Experimental Brain Research 131, 305-319

Funding

Toward a Mechanistic Understanding of Optimization Principles Underlying Hemiparetic Gait
1R01HD091184-01A1      
PI: James M. Finley, Ph.D
Dates: 2017-2022

Southern California Clinical and Translational Science Institute Pilot Award
PI: James M. Finley, Ph.D
Dates: 2018-2019

Engineering Career Development Award in Movement and Rehabilitation Sciences ​K12 HD073945
Scholar: James M. Finley, PhD
Dates: 2013-2015

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