Grant: Doctoral Award - Frederick Banting and Charles Best Canada Graduate Scholarships

Walking independently is the most common goal reported by individuals after stroke and maintaining balance while walking is essential to this goal. It has been reported that as many as 88% of individuals post-stroke will regain the ability to walk, yet 73% of these individuals will experience a fall while walking after returning home from in-hospital rehabilitation. For optimal balance, the brain must coordinate the activity of many muscles to keep the body steady as it moves. Little is known as to how muscles are coordinated to maintain dynamic balance. We have recently shown that treatment directed towards increased speed of a stepping reaction (necessary to regain balance) during a simulated loss of balance significantly improves dynamic balance post-stroke. This resulted in an increased ability to perform high level walking challenges associated with independent community mobility. Our proposed research aims to study this treatment approach more extensively by encompassing two overarching, yet interconnected themes: 1) examination of motor control strategies during dynamic balance tasks requiring stepping to regain balance in individuals post-stroke, and 2) evaluation of this innovative treatment aimed at optimizing dynamic balance. We will use electromyography (EMG) to monitor muscle activity during the movements and measure the whole body motion using special cameras. EMG recordings from leg muscles will be taken at the same time as a camera-based evaluation of movement of the whole body. Combining these laboratory-based measures with clinical outcomes will provide a complete picture of how people coordinate muscles and movement after stroke. We believe that improved balance will make walking easier and improve the ability of individuals post-stroke to walk independently in the community, decreasing their risk of falling, and improving their quality of life.