LAUSR

Background: Targeting enhancing the use of the paretic leg during locomotor practice might improve motor function of the paretic leg. Objective: The purpose of this study was to determine whether application of constraint force to the non-paretic leg in the posterior direction during overground walking would enhance the use of the paretic leg in people with chronic stroke. Methods: Fifteen individuals post-stroke participated in two experimental conditions, i.e., overground walking with a constraint force applied to the non-paretic leg, and overground walking only. Each participant was tested in the following procedures that consisted of overground walking with either constraint force or no constraint force, instrumented split-belt treadmill walking and pressure-sensitive gaitmat walking before and after the overground walking. Results: Overground walking practice with the constraint force resulted in greater enhancement in lateral weight shift toward the paretic side (P<0.01), muscle activity of the paretic hip abductors (P=0.04), and propulsion force of the paretic leg (P=0.05), compared with the results of no constraint condition. Overground walking practice with constraint force tended to induce greater increase in self-selected overground walking speed (P=0.06), compared with the effect of no constraint condition. The increase in propulsion force from the paretic leg was positively correlated with the increase in self-selected walking speed (r=0.6, P=0.03). Conclusion: Overground walking with the constraint force applied to the non-paretic leg during swing phase of gait may enhance use of the paretic leg, improve weight shifting toward the paretic side, propulsion of the paretic leg, and consequently increase walking speed.