Lower Extremity Constraint-Induced Movement Therapy Increase Variability in the Intra-Limb Coordination during Walking in Chronic Post-Stroke

This study aimed to assess the effect of the Lower Extremity Constraint-Induced Movement Therapy (LE-CIMT) intervention on the intra-limb hip-knee coordination and its variability in walking in chronic post-stroke individuals considering the lenses of the dynamic systems approach to motor behavior. Twelve chronic post-stroke individuals received the LE-CIMT intervention for 10 days following all protocol’s recommendations and designed according to individuals’ needs. Before, three days, and 30 days after the intervention, angular kinematics in the sagittal plane of the trunk, hip and knee of both extremities were analyzed. We analyzed joint angles for swing and stance phases of walking, and the intra-limb coordination of hip-knee joints through the vector coding technique. For separate joint angular kinematics, we found differences between affected extremities but no effects of the intervention. However, we observed changes in intra-limb coordination pattern as a function of increased variability after intervention and increased stability at follow-up. These changes follow the predicted pattern from the dynamic systems approach to motor behavior. The immediate decreased stability of the initial pattern could be due to the active exploration of space solution offered by the LE-CIMT and, posteriorly, the stability increased after finding new movement solutions in the real-life environment.