Grant: Travel Awards - Institute Community Support

With the advance of technology, the ability to record brain activity while an individual completes large movements, such as walking, has become increasingly achievable. Recent systematic reviews on this topic (Hamacher et al 2015; Vitorio et al 2017) non-specifically grouped neurological populations together. As neurostimulation and individualized interventions are receiving increasing attention to improve walking in the post-stroke population, it is important to identify areas of activation during walking specific to the post-stroke brain. METHODS: Two independent reviewers assessed search results from 6 databases and relevant references. Search categories included terms for stroke, ambulation/stepping, brain activation, and specific techniques to record brain activity. Studies that did not measure or report activation during actual upright walking or stepping (e.g. simulated walking or seated stepping) were excluded. RESULTS: From the 937 papers identified, 12 studies were included for review. Real-time walking tasks varied: initiation of walking or stepping, overground walking, treadmill walking, body weight-supported walking, or robotic-assisted walking. The majority of fNIRS studies did not utilize techniques for precise localization of probes, nor account for individualized brain anatomy, or task-related systemic changes. Further, recordings were often over a limited area, and were not compared to an age-matched healthy group. Significant heterogeneity in task and analysis techniques also resulted in varied findings showing increases, decreases, or no difference between activation areas, tasks, or groups. CONCLUSIONS: While the ability to record brain activity during walking has become increasingly feasible, numerous limitations hinder the interpretation of current results. Although some patterns are beginning to emerge, future work would benefit from more rigorous methods suggested within this presentation.