@article{ref1,
title="Posterior fall-recovery training applied to individuals with chronic stroke: a single-group intervention study",
journal="Clinical biomechanics",
year="2020",
author="Crenshaw, Jeremy R. and Christensen, Michael S. and Petersen, Drew A. and Conner, Benjamin C. and Wright, Tamara R. and Jeka, John J. and Pohlig, Ryan T. and Pigman, Jamie and Reisman, Darcy S.",
volume="82",
number="",
pages="e105249-e105249",
abstract="BACKGROUND: To assess the effects of the initial stepping limb on posterior fall recovery in individuals with chronic stroke, as well as to determine the benefits of  fall-recovery training on these outcomes. <br><br>METHODS: This was a single-group  intervention study of 13 individuals with chronic stroke. Participants performed up  to six training sessions, each including progressively challenging,  treadmill-induced perturbations from a standing position. Progressions focused on  initial steps with the paretic or non-paretic limb. The highest perturbation level  achieved, the proportion of successful recoveries, step and trunk kinematics, as  well as stance-limb muscle activation about the ankle were compared between the  initial stepping limbs in the first session. Limb-specific outcomes were also  compared between the first and last training sessions. <br><br>FINDINGS: In the first  session, initial steps with the non-paretic limb were associated with a higher  proportion of success and larger perturbations than steps with the paretic limb  (p = 0.02, Cohen's d = 0.8). Paretic-limb steps were wider relative to the center of  mass (CoM; p = 0.01, d = 1.3), likely due to an initial standing position with the  CoM closer to the non-paretic limb (p = 0.01, d = 1.4). In the last training  session, participants recovered from a higher proportion of perturbations and  advanced to larger perturbations (p < 0.05, d > 0.6). There were no notable changes  in kinematic or electromyography variables with training (p > 0.07, d < 0.5). <br><br>INTERPRETATION: The skill of posterior stepping in response to a perturbation can be  improved with practice in those with chronic stroke, we were not able to identify  consistent underlying kinematic mechanisms behind this adaptation.<p /> <p>Language: en</p>",
language="en",
issn="0268-0033",
doi="10.1016/j.clinbiomech.2020.105249",
url="http://dx.doi.org/10.1016/j.clinbiomech.2020.105249"
}