Uploaded July 2020 | Updated September 2026, 3 weeks ago
Topics in NeuroRehabilitation: Episode 8. Michael Lewek, PT, PhD expands on previous talks on gait rehabilitation (youtube.com/watch?v=tHY3EkxwVDM) and paretic propulsion (youtube.com/watch?v=xQHJaiSs59k), to provide a deeper look at the significance of propulsion asymmetry after stroke, and the impact this has on patients' walking speed and metabolic efficiency. Mike also highlights recent research which explores the concept of a propulsive reserve - suggesting that individuals post-stroke have the capacity to improve their paretic contribution to propulsion, and can be trained to access this reserve and thus improve their propulsion symmetry and overall walking efficiency.
For more information on ReWalk Robotics or this web series, please visit: rewalk.com/contact
In case you missed last week's episode, click here to watch Topics in Neuro Rehab Ep 07: youtube.com/watch?v=E68yKB9OxLw
To learn more about Mike's work or any of the research he referenced in his talk, please visit the following links:
Research Labs:
UNC at Chapel Hill: https://www.med.unc.edu/ahs/physical/research/interdisciplinary-human-movement-research-lab/michael-lewek-research/
CLEAR Engineering Group: clear-ncsu-unc.com
youtube.com/watch?v=QpSLl2CQj3E
Additional References:
Goldberg, Evan J., Steven A. Kautz, and Richard R. Neptune. "Can treadmill walking be used to assess propulsion generation?." Journal of biomechanics 41.8 (2008): 1805-1808.
doi.org/10.1016/j.jbiomech.2008.03.009
Lewek, Michael D. "The influence of body weight support on ankle mechanics during treadmill walking." Journal of biomechanics 44.1 (2011): 128-133.
doi.org/10.1016/j.jbiomech.2010.08.037
Palmer, Jacqueline A., et al. "Symmetry of corticomotor input to plantarflexors influences the propulsive strategy used to increase walking speed post-stroke." Clinical Neurophysiology 127.3 (2016): 1837-1844.
doi.org/10.1016/j.clinph.2015.12.003
Reisman, Darcy S., et al. "Locomotor adaptation on a split-belt treadmill can improve walking symmetry post-stroke." Brain 130.7 (2007): 1861-1872.
doi.org/10.1093/brain/awm035
Lewek, Michael D., Cristina Raiti, and Amanda Doty. "The presence of a paretic propulsion reserve during gait in individuals following stroke." Neurorehabilitation and neural repair 32.12 (2018): 1011-1019.
journals.sagepub.com/doi/pdf/10.1177/1545968318809920
Farris, Dominic James, et al. "Revisiting the mechanics and energetics of walking in individuals with chronic hemiparesis following stroke: from individual limbs to lower limb joints." Journal of neuroengineering and rehabilitation 12.1 (2015): 24.
link.springer.com/article/10.1186/s12984-015-0012-x
Penke, Kelly, et al. "Propulsive forces applied to the body’s center of mass affect metabolic energetics poststroke." Archives of physical medicine and rehabilitation 100.6 (2019): 1068-1075.
doi.org/10.1016/j.apmr.2018.10.010
Lewek, Michael D., and Gregory S. Sawicki. "Trailing limb angle is a surrogate for propulsive limb forces during walking post-stroke." Clinical Biomechanics 67 (2019): 115-118.
doi.org/10.1016/j.clinbiomech.2019.05.011
Franz, Jason R., Michela Maletis, and Rodger Kram. "Real-time feedback enhances forward propulsion during walking in old adults." Clinical biomechanics 29.1 (2014): 68-74.
doi.org/10.1016/j.clinbiomech.2013.10.018
Schenck, Christopher, and Trisha M. Kesar. "Effects of unilateral real-time biofeedback on propulsive forces during gait." Journal of neuroengineering and rehabilitation 14.1 (2017): 52.
link.springer.com/article/10.1186/s12984-017-0252-z
McGinley, Jennifer L., et al. "Accuracy and reliability of observational gait analysis data: judgments of push-off in gait after stroke." Physical Therapy 83.2 (2003): 146-160.
doi.org/10.1093/ptj/83.2.146
Topics in NeuroRehabilitation: Episode 8. Michael Lewek, PT, PhD expands on previous talks on gait rehabilitation (youtube.com/watch?v=tHY3EkxwVDM) and paretic propulsion (youtube.com/watch?v=xQHJaiSs59k), to provide a deeper look at the significance of propulsion asymmetry after stroke, and the impact this has on patients' walking speed and metabolic efficiency. Mike also highlights recent research which explores the concept of a propulsive reserve - suggesting that individuals post-stroke have the capacity to improve their paretic contribution to propulsion, and can be trained to access this reserve and thus improve their propulsion symmetry and overall walking efficiency.
For more information on ReWalk Robotics or this web series, please visit: rewalk.com/contact
In case you missed last week's episode, click here to watch Topics in Neuro Rehab Ep 07: youtube.com/watch?v=E68yKB9OxLw
To learn more about Mike's work or any of the research he referenced in his talk, please visit the following links:
Research Labs:
UNC at Chapel Hill: https://www.med.unc.edu/ahs/physical/research/interdisciplinary-human-movement-research-lab/michael-lewek-research/
CLEAR Engineering Group: clear-ncsu-unc.com
youtube.com/watch?v=QpSLl2CQj3E
Additional References:
Goldberg, Evan J., Steven A. Kautz, and Richard R. Neptune. "Can treadmill walking be used to assess propulsion generation?." Journal of biomechanics 41.8 (2008): 1805-1808.
doi.org/10.1016/j.jbiomech.2008.03.009
Lewek, Michael D. "The influence of body weight support on ankle mechanics during treadmill walking." Journal of biomechanics 44.1 (2011): 128-133.
doi.org/10.1016/j.jbiomech.2010.08.037
Palmer, Jacqueline A., et al. "Symmetry of corticomotor input to plantarflexors influences the propulsive strategy used to increase walking speed post-stroke." Clinical Neurophysiology 127.3 (2016): 1837-1844.
doi.org/10.1016/j.clinph.2015.12.003
Reisman, Darcy S., et al. "Locomotor adaptation on a split-belt treadmill can improve walking symmetry post-stroke." Brain 130.7 (2007): 1861-1872.
doi.org/10.1093/brain/awm035
Lewek, Michael D., Cristina Raiti, and Amanda Doty. "The presence of a paretic propulsion reserve during gait in individuals following stroke." Neurorehabilitation and neural repair 32.12 (2018): 1011-1019.
journals.sagepub.com/doi/pdf/10.1177/1545968318809920
Farris, Dominic James, et al. "Revisiting the mechanics and energetics of walking in individuals with chronic hemiparesis following stroke: from individual limbs to lower limb joints." Journal of neuroengineering and rehabilitation 12.1 (2015): 24.
link.springer.com/article/10.1186/s12984-015-0012-x
Penke, Kelly, et al. "Propulsive forces applied to the body’s center of mass affect metabolic energetics poststroke." Archives of physical medicine and rehabilitation 100.6 (2019): 1068-1075.
doi.org/10.1016/j.apmr.2018.10.010
Lewek, Michael D., and Gregory S. Sawicki. "Trailing limb angle is a surrogate for propulsive limb forces during walking post-stroke." Clinical Biomechanics 67 (2019): 115-118.
doi.org/10.1016/j.clinbiomech.2019.05.011
Franz, Jason R., Michela Maletis, and Rodger Kram. "Real-time feedback enhances forward propulsion during walking in old adults." Clinical biomechanics 29.1 (2014): 68-74.
doi.org/10.1016/j.clinbiomech.2013.10.018
Schenck, Christopher, and Trisha M. Kesar. "Effects of unilateral real-time biofeedback on propulsive forces during gait." Journal of neuroengineering and rehabilitation 14.1 (2017): 52.
link.springer.com/article/10.1186/s12984-017-0252-z
McGinley, Jennifer L., et al. "Accuracy and reliability of observational gait analysis data: judgments of push-off in gait after stroke." Physical Therapy 83.2 (2003): 146-160.
doi.org/10.1093/ptj/83.2.146
