Simulation-Guided Stimulation for Paretic Ankle Muscles During Stroke Gait

Stroke is the leading cause of long-term adult disability in the U.S. Neuronal damage in the brain results in impaired muscle coordination which induces asymmetric and abnormal walking patterns. Muscle-actuated forward dynamic simulation of walking patterns of healthy young adults has elucidated unique and synergistic roles of the uniarticular and biarticular plantarflexors. Neptune and colleagues (2001) reported that soleus delivers energy to the trunk, gastrocnemius accelerates the leg forward, and both contribute significantly to vertical support of the center of mass [1]. In a simulation of post-stroke hemiparetic gait, Higginson et al. (2006) observed that non-paretic muscles mimicked the function of healthy muscles, while paretic ankle plantarflexor function was limited and required supplemental effort by hip and knee extensors [2].