Document Type
Article
Publication Date
12-4-2025
Abstract
Background:
Clinical practice guidelines for walking recovery post-stroke recommend high aerobic intensity training, which usually involves walking at fast speeds. However, the acute effect of fast speeds on the neuromuscular control of walking is unclear.
Objectives:
(1) Assess the criterion validity of the Dynamic Motor Control Index (WalkDMC) as a measure of coactivation post-stroke. (2) Assess acute speed-dependent coactivation post-stroke. (3) Assess how clinical characteristics shape the speed-dependent coactivation response. (4) Assess the relationship between heart rate and coactivation post-stroke. We hypothesized that WalkDMC is correlated with function and impairment measures. We also hypothesize that coactivation measured via the WalkDMC increases for speeds above or below self-selected speeds (SSS).
Methods:
32 chronic stroke survivors and 17 age and sex-matched controls walked at SSS, fast, and slow speeds. EMGs were measured bilaterally on 7 lower extremity muscles. We used non-negative matrix factorization to calculate WalkDMC. We used regression to assess the relationship between WalkDMC, speed, heart rate, and clinical outcomes.
Results:
WalkDMC was correlated with clinical outcomes, supporting its criterion validity. We observed a quadratic relationship between speed and coactivation: for the paretic extremity, the predicted speed that would lead to the lowest coactivation was ~120% higher than SSS. Slow speeds consistently increased coactivation in controls and participants post-stroke. Coactivation in the paretic extremity was significantly predicted by speed, balance, and impairment.
Conclusions:
Our results suggest that increased speeds lead to differential improvements in coactivation in the paretic and non-paretic extremities. These results may inform speed prescriptions for HIT interventions.
Recommended Citation
Sánchez N, Kuch A, Jeffcoat SN, et al. The Differential Effects of Fast Walking Speed on Muscle Coactivation in the Paretic and Non-Paretic Extremities Post-Stroke. Neurorehabilitation and Neural Repair. 2025;0(0). https://doi.org/10.1177/15459683251387093
Peer Reviewed
1
Copyright
The authors
Comments
This is a pre-copy-editing, author-produced PDF of an article accepted for publication in Neurorehabilitation and Neural Repair in 2025 following peer review. This article may not exactly replicate the final published version. The definitive publisher-authenticated version is available online at https://doi.org/10.1177/15459683251387093.