Biomechanical characteristics and neuromuscular action control mechanism of single-dual-task walking-conversion training in stroke patients

Background and purpose This study aimed to explore the biomechanical characteristics of patients with stroke and neuromuscular action control mechanisms in single-dual-task walking-conversion training. Materials and methods Patients with stroke from four centers were enrolled and randomly divided into the cognitive combined treadmill-walking and exercise combined treadmill-walking groups (n = 30 per group). The gait spatiotemporal parameters, walking function, and fall risk of the two experimental groups were compared before and after 4 and 6 weeks of training. Surface electromyography (sEMG) and functional near-infrared spectroscopy (fNIRS) were performed to analyze neuromuscular action control mechanisms in different task phases. Results After 6 weeks of training, the gait spatiotemporal parameters, walking function, integral electromyogram (iEMG) values, and root mean square (RMS) of the affected lower limb muscles of the two experimental groups significantly improved ( P < 0.01), while the fall risk was reduced ( P < 0.01). fNIRS analysis showed that in both the single- and dual-task phases, HbO signal concentrations in the brain functional regions of the two experimental groups significantly increased after training ( P < 0.01). These indicators were not significantly different between the two experimental groups after 6 weeks of training ( P > 0.05). In addition, during the dual-task phase, the blood oxygen signal concentrations and functional connectivity in the functional brain regions of the two experimental groups were lower than those of healthy controls. Conclusion Cognitive or motor tasks combined with treadmill-walking training can promote the recovery of physical function in patients with stroke. Clinical trial registration: This study was registered in the Chinese Clinical Trial Registry (ChiCTR; registration number: ChiCTR2200060864).