Stroke survivors exhibit stronger lower extremity synergies in more challenging walking conditions

Exp Brain Res. 2019 Aug;237(8):1919-1930. doi: 10.1007/s00221-019-05560-9. Epub 2019 May 20.


The aim of this study was to examine how kinematic synergies are utilised as compensatory movements to stabilise foot positions under different walking task constraints in people with stroke. Ten (Males = 6, Females = 4) hemiplegic chronic stroke survivors volunteered to participate in this study, recruited from a rehabilitation centre. They completed a consent form and participated in treadmill walking tasks; flat, uphill, and crossing over a moving obstacle. The uncontrolled manifold method was used to quantify kinematic synergies in the paretic and non-paretic legs during their swing phase. The results of this study showed the strength of synergies was significantly greater in the obstacle task than in the uphill walking tasks at mid and terminal swing phases. In conclusion, the results suggest that walking in the challenging situations caused people with stroke to control step stability with greater compensation between lower extremity joints. Participants adapted to the increased challenge by increasing the amount of 'good variability', which could be a strategy to reduce the risks of falling.

Keywords: Gait; Stroke; Synergies; Uncontrolled manifold.

MeSH terms

  • Adult
  • Aged
  • Exercise Test / instrumentation
  • Exercise Test / methods
  • Female
  • Gait / physiology
  • Humans
  • Lower Extremity / physiology*
  • Male
  • Middle Aged
  • Stroke / diagnosis
  • Stroke / physiopathology*
  • Stroke / therapy
  • Stroke Rehabilitation / instrumentation
  • Stroke Rehabilitation / methods*
  • Survivors*
  • Walking / physiology*