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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Aged, Ankle Joint, Female, Humans, Male, Middle Aged, Motor Cortex, Muscle, Skeletal, Paresis, Stroke, Transcranial Magnetic Stimulation, Walking.
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Does symmetry of corticomotor input to plantarflexors influence the propulsive strategy used to increase walking speed post-stroke? Context: A deficit in paretic limb propulsion has been identified as a major biomechanical factor limiting walking speed after stroke. The purpose of this study was to determine the influence of corticomotor symmetry between paretic and nonparetic plantarflexors on the propulsive strategy used to increase walking speed. Twenty-three participants with post-stroke hemiparesis underwent transcranial magnetic stimulation and biomechanical testing at their self-selected and fastest walking speeds. Plantarflexor corticomotor symmetry (CS(PF)) was calculated as a ratio of the average paretic versus nonparetic soleus motor evoked potential amplitude. The ratio of the paretic and nonparetic peak ankle plantarflexion moments (PF(sym)) was calculated at each speed. CS(PF) predicted the ΔPF(sym) from self-selected and fastest speeds (R(2)=.629, F(1,21)=35.56, p<.001). An interaction between CS(PF) and ΔPF(sym) (β=.596, p=.04) was observed when predicting Δspeed ((adj)R(2)=.772, F(3,19)=20.48, p<.001). Specifically, the ΔPF(sym) with speed modulation was positively related to the Δspeed (p=.03) in those with greater CS(PF), but was not related in those with poor CS(PF) (p=.30).
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Symmetry of the corticomotor input to the plantarflexors influences the propulsive strategy used to increase post-stroke walking speed. Final Decision: yes