Impaired Interlimb Coordination of Voluntary Leg Movements in Poststroke Hemiparesis

Appropriate interlimb coordination of the lower extremities is particularly important for a variety of functional human motor behaviors such as jumping, kicking a ball, or simply walking. Specific interlimb coordination patterns may be especially impaired after a lesion to the motor system such as stroke, yet this has not been thoroughly examined to date. The purpose of this study was to investigate the motor deficits in individuals with chronic stroke and hemiparesis when performing unilateral versus bilateral inphase versus bilateral antiphase voluntary cyclic ankle movements. We recorded ankle angular trajectories and muscle activity from the dorsiflexors and plantarflexors and compared these between subjects with stroke and a group of healthy age-matched control subjects. Results showed clear abnormalities in both the kinematics and EMG of the stroke subjects, with significant movement degradation during the antiphase task compared with either the unilateral or the inphase task. The abnormalities included prolonged cycle durations, reduced ankle excursions, decreased agonist EMG bursts, and reduced EMG modulation across movement phases. By comparison, the control group showed nearly identical performance across all task conditions. These findings suggest that stroke involving the corticospinal system projection to the leg specifically impairs one or more components of the neural circuitry involved in lower extremity interlimb coordination. The express susceptibility of the antiphase pattern to exaggerated motor deficits could contribute to functional deficits in a number of antiphase leg movement tasks, including walking.