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Mobility Function and Recovery After Stroke: Preliminary Insights From Sympathetic Nervous System Activity
Journal article   Peer reviewed

Mobility Function and Recovery After Stroke: Preliminary Insights From Sympathetic Nervous System Activity

Sudeshna A. Chatterjee, Janis J. Daly, Eric C. Porges, Emily J. Fox, Dorian K. Rose, Theresa E. McGuirk, Dana M. Otzel, Katie A. Butera and David J. Clark
Journal of neurologic physical therapy, v 42(4), pp 224-232
01 Oct 2018
DOI: https://doi.org/10.1097/NPT.0000000000000238
PMID: 30138228
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1097/NPT.0000000000000238View
Published, Version of Record (VoR) Restricted

Abstract

Clinical Neurology Life Sciences & Biomedicine Neurosciences & Neurology Rehabilitation Science & Technology
Background and Purpose: Poststroke hemiparesis increases the perceived challenge of walking. Perceived challenge is commonly measured by self-report, which is susceptible to measurement bias. A promising approach to objectively assess perceived challenge is measuring sympathetic nervous system (SNS) activity with skin conductance to detect the physiological stress response. We investigated the feasibility of using skin conductance measurements to detect task-related differences in the challenge posed by complex walking tasks in adults poststroke. Methods: Adults poststroke (n = 31) and healthy young adults (n = 8) performed walking tasks including typical walking, walking in dim lighting, walking over obstacles, and dual-task walking. Measures of skin conductance and spatiotemporal gait parameters were recorded. Continuous decomposition analysis was conducted to assess changes in skin conductance level (SCL) and skin conductance response (SCR). A subset of participants poststroke also underwent a 12-week rehabilitation intervention. Results: SNS activity measured by skin conductance (both SCL and SCR) was significantly greater for the obstacles task and dual-task walking than for typical walking in the stroke group. Participants also exhibited cautious gait behaviors of slower speed, shorter step length, and wider step width during the challenging tasks. Following the rehabilitation intervention, SNS activity decreased significantly for the obstacles task and dual-task walking. Discussion and Conclusions: SNS activity measured by skin conductance is a feasible approach for quantifying task-related differences in the perceived challenge of walking tasks in people poststroke. Furthermore, reduced SNS activity during walking following a rehabilitation intervention suggests a beneficial reduction in the physiological stress response evoked by complex walking tasks.

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Web of Science research areas
Clinical Neurology
Rehabilitation
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