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Can prior exposure to repeated non-paretic slips improve reactive responses on novel paretic slips among people with chronic stroke?

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Abstract

This study examined if people with chronic stroke (PwCS) could adapt following non-paretic overground gait-slips and whether such prior exposure to non-paretic slips could improve reactive responses on novel paretic slip. Forty-nine PwCS were randomly assigned to either adaptation group, which received eight unexpected, overground, nonparetic-side gait-slips followed by two paretic-side slips or a control group, which received two paretic-side slips. Slip outcome, recovery strategies, center of mass (CoM) state stability, post-slip stride length and slipping kinematics were analyzed. The adaptation group demonstrated fall-reduction from first to eighth non-paretic slips, along with improved stability, stride length and slipping kinematics (p < 0.05). Within the adaptation group, on comparing novel slips, paretic-side demonstrated comparable pre-slip stability (p > 0.05); however, lower post-slip stability, increased slip velocity and falls was noted (p < 0.05). There was no difference in any variables between the novel paretic slips of adaptation and control group (p > 0.01). However, there was a rapid improvement on the 2nd slip such that adaptation group demonstrated improved performance from the first to second paretic slip compared to that in the control group (p < 0.01). PwCS demonstrated immediate proactive and reactive adaptation with overground, nonparetic-side gait-slips. However, PwCS did not demonstrate any inter-limb performance gain on the paretic-side after prior nonparetic-side adaptation when exposed to a novel paretic-side slip; but they did show significant positive gains with single slip priming on the paretic-side compared to controls without prior adaptation.

Clinical registry number: NCT03205527.

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Data availability

The original data will be made available from the corresponding author on request.

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Acknowledgements

The authors would like to thank Riddhi Panchal, MS PT, Lakshmi Kannan, MS PT and Rachana Gangwani, BPT for assistance with data collection, and Shuaijie Wang, PhD for assistance with data analysis.

Funding

This study was funded by the National Institute of Health (NIH) [1R01HD088543-01A1] awarded to Dr. Tanvi Bhatt.

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Authors and Affiliations

  1. Department of Physical Therapy, College of Applied Health Sciences, University of Illinois, Chicago, IL, 60612, USA

    Shamali Dusane & Tanvi Bhatt

  2. Ph.D. Program in Rehabilitation Sciences, College of Applied Health Sciences, University of Illinois, Chicago, IL, 60612, USA

    Shamali Dusane

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  1. Shamali Dusane
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  2. Tanvi Bhatt
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Contributions

All authors contributed to the study’s conception and design. Material preparation, data collection and analysis were performed by SD. The first draft of the manuscript was written by SD and TB. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Tanvi Bhatt.

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The authors declare no conflict of interest.

Ethical approval

This research was approved by the University of Illinois at Chicago, Human Subject Research Institutional Review Board (IRB) (Protocol #2016-0933).

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Communicated by Francesco Lacquaniti.

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Dusane, S., Bhatt, T. Can prior exposure to repeated non-paretic slips improve reactive responses on novel paretic slips among people with chronic stroke?. Exp Brain Res 240, 1069–1080 (2022). https://doi.org/10.1007/s00221-021-06300-8

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  • DOI: https://doi.org/10.1007/s00221-021-06300-8

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