The influence of walking-aids on the plasticity of spinal interneuronal networks, central-pattern-generators and the recovery of gait post-stroke. A literature review and scholarly discussion

Clare C. Maguire*, Judith M. Sieben, Robert A. de Bie

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

7 Citations (Web of Science)
269 Downloads (Pure)

Abstract

Background: Many aspects of post-stroke gait-rehabilitation are based on low-level evidence or expert opinion. Neuroscientific principles are often not considered when evaluating the impact of interventions. The use of walking-aids including canes and rollators, although widely used for long periods, has primarily been investigated to assess the immediate kinetic, kinematic or physiological effects. The long-term impact on neural structures und functions remains unclear.

Methods: A literature review of the function of and factors affecting plasticity of spinal interneuronal-networks and central-pattern-generators (CPG) in healthy and post-stroke patients. The relevance of these mechanisms for gait recovery and the potential impact of walking-aids is discussed.

Results: Afferent-input to spinal-networks influences motor-output and spinal and cortical plasticity. Disrupted input may adversely affect post-stroke plasticity and functional recovery. Joint and muscle unloading and decoupling from four-limb CPG control may be particularly relevant.

Conclusions: Canes and rollators disrupt afferent-input and may negatively affect the recovery of gait. (C) 2016 Elsevier Ltd. All rights reserved.

Original languageEnglish
Pages (from-to)422-434
Number of pages13
JournalJournal of Bodywork and Movement Therapies
Volume21
Issue number2
DOIs
Publication statusPublished - Apr 2017

Keywords

  • Cerebrovascular stroke
  • Walking
  • Assistive devices
  • Central pattern generators
  • Neuronal plasticity
  • CORD-INJURY
  • INTERLIMB COORDINATION
  • LOCOMOTOR CIRCUITS
  • SENSORY FEEDBACK
  • MUSCLE-ACTIVITY
  • LOAD RECEPTORS
  • MOTOR CORTEX
  • HUMANS
  • REHABILITATION
  • REFLEX

Cite this