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Ready to move? The effect of stroke on attention and motor planning of voluntary leg movements.

University of British Columbia

Background: Many movements individuals perform in a given day are voluntary and goal directed, requiring the ability to focus attention and plan movements according to those goals. Altered cognition and motor impairments after stroke limit functional balance and walking performance. Little research has examined the neurophysiology of attention and planning for standing balance and walking after stroke. Examining the mechanisms underlying attention and planning of balance and walking is paramount to understanding the factors that may be important for stroke recovery and functional community living. Methods: The overarching objective of this thesis was to examine planning and attention for leg movements in individuals with stroke. There were two primary objectives: (1) to examine whether planning differs between the paretic and non-paretic legs measured at the muscle and brain, and (2) to determine how attention may alter, or gate, the processing of irrelevant somatosensory information used for planning. Summary of findings: In Chapters 2 and 3, contrary to expectations, no differences in planning were found between stepping with the non-paretic and paretic legs. However, individuals with greater motor impairment showed larger levels of muscle co-contraction during planning (Chapter 2), and greater cognitive effort and longer planning durations (Chapter 3) than individuals with less motor impairment. For attention, irrelevant somatosensory information was gated by attention during planning plantarflexion movements in young adults compared with rest (Chapter 4). In Chapter 5, the main finding was that some irrelevant somatosensory information was not gated by attention after stroke, while other information was gated. This indicates possible dysfunction in pathways connected to the somatosensory cortex after stroke that can be mediated by attention. More importantly, gating levels during early planning explained a significant amount of variability in a measure of community balance and mobility. Conclusions: This dissertation contributes new knowledge toward understanding the effects of stroke on planning and attention of leg movements. The findings suggest planning and attention are important factors in community levels of balance and mobility that require consideration in future development of targeted neurophysiological assessment and treatment of attention and planning after stroke, with potential impact on balance and walking performance.

Text

2017-11-27

Attribution-NonCommercial-NoDerivatives 4.0 International

http://hdl.handle.net/2429/63739

Rehabilitation Sciences

University of British Columbia

UBCV

http://creativecommons.org/licenses/by-nc-nd/4.0/