Symmetry of cortical planning for initiating stepping in sub-acute stroke

Sue Peters; Tanya D Ivanova; Bimal Lakhani; Lara A Boyd; W Richard Staines; Todd C Handy; S Jayne Garland

doi:10.1016/j.clinph.2018.01.018

Symmetry of cortical planning for initiating stepping in sub-acute stroke

Clin Neurophysiol. 2018 Apr;129(4):787-796. doi: 10.1016/j.clinph.2018.01.018. Epub 2018 Feb 1.

Authors

Sue Peters¹, Tanya D Ivanova², Bimal Lakhani³, Lara A Boyd⁴, W Richard Staines⁵, Todd C Handy⁶, S Jayne Garland⁷

Affiliations

¹ Graduate Programs in Rehabilitation Sciences, Faculty of Medicine, University of British Columbia, 212 - 2177 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada.
² Faculty of Health Sciences, Western University, Arthur and Sonia Labatt Health Sciences Building, Room 200, London, Ontario N6A 5B9, Canada; Department of Physical Therapy, Faculty of Medicine, University of British Columbia, 212 - 2177 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada.
³ Department of Physical Therapy, Faculty of Medicine, University of British Columbia, 212 - 2177 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada.
⁴ Department of Physical Therapy, Faculty of Medicine, University of British Columbia, 212 - 2177 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2215 Wesbrook Mall, Vancouver, BC V6T IZ3, Canada.
⁵ Department of Kinesiology, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada.
⁶ Department of Psychology, Faculty of Arts, University of British Columbia, 2136 West Mall, Vancouver, BC V6T 1Z4, Canada.
⁷ Faculty of Health Sciences, Western University, Arthur and Sonia Labatt Health Sciences Building, Room 200, London, Ontario N6A 5B9, Canada; Department of Physical Therapy, Faculty of Medicine, University of British Columbia, 212 - 2177 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada. Electronic address: jgarland@uwo.ca.

PMID: 29453170
DOI: 10.1016/j.clinph.2018.01.018

Abstract

Objective: This study examined motor planning for stepping when the paretic leg was either stepping or standing (to step with the non-paretic leg), to understand whether difficulty with balance and walking post-stroke could be attributed to poor motor planning.

Methods: Individuals with stroke performed self-initiated stepping. Amplitude and duration of the movement-related cortical potential (MRCP) was measured from Cz. Electromyography (EMG) of biceps femoris (BF) and rectus femoris (RF) were collected.

Results: There were no differences between legs in stepping speed, MRCP or EMG parameters. The MRCPs when stepping with the paretic leg and the non-paretic leg were correlated. When the paretic leg was stepping, the MRCP amplitude correlated with MRCP duration, indicating a longer planning time was accompanied by higher cognitive effort. Slow steppers had larger MRCP amplitudes stepping with the paretic leg and longer MRCP durations stepping with the non-paretic leg.

Conclusions: MRCP measures suggest that motor planning for initiating stepping are similar regardless of which limb is stepping. Individuals who stepped slowly had greater MRCP amplitudes and durations for planning.

Significance: Individuals who step slowly may require more time and effort to plan a movement, which may compromise their safety in the community.

Keywords: Electroencephalogram; Electromyogram; Movement related cortical potential; Postural control; Preparation; Stroke.

Publication types

Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Aged, 80 and over
Cerebral Cortex
Electroencephalography / methods
Electromyography / methods*
Female
Humans
Intention*
Male
Middle Aged
Motor Cortex / physiology*
Movement / physiology*
Postural Balance / physiology
Stroke / diagnosis
Stroke / physiopathology*
Walking / physiology*
Walking / psychology

Grants and funding

CIHR/Canada