Neuromechanical interlimb interactions and rehabilitation of walking after stroke

Abstract

Bipedal humans operate using elements of quadrupedal neuronal limb control during locomotion. This has significant implications for supporting transfer of the huge body of quadrupedal animal literature to human rehabilitation. In particular, this has translational applications for neurological rehabilitation after stroke where interlimb coordination is compromised. The data supports including arm activity in addition to leg activity as a component of gait retraining after stroke. An additional component is to consider strength training of the less affected limb to improve motor output of the more affected limb when that limb is too weak to be initially incorporated in functional rehabilitation. The major concept is to use activity related to the less affected limbs to modulate output of the more affected limbs after stroke. A key example is to incorporate arm activity into rehabilitation of leg motion in stepping after stroke.