Using a Module-Based Analysis Framework for Investigating Muscle Coordination during Walking in Individuals Poststroke: A Literature Review and Synthesis

Table 4

Study findings (prepost experimental designs).

Author, year	Intervention	Changes in module number	Changes in module composition and control	Changes in gait outcomes	Changes in rehabilitation measures
Ferrante et al. 2016 [28]	FES-supported treadmill walking for 30 minutes, 3 times/week for 4 weeks	Both subjects (S1, S2) increased module number from 3 to 4.	S1: initial merging of modules 1 and 4; S2: initial merging of modules 3 and 4	Gait speed (pre/post); S1: 0.43/0.88 m/s; S2: 0.38/0.68 m/s; GRC (change score); S1: +4; S2: +2; Cadence (pre/post); S1: 0.98/1.01 strides/s; S2: 0.81/0.80 strides/s	S1 (pre/post); Mini Best test (17/22); FIM motor (78/78); S2 (pre/post); Mini Best test (21/23); FIM motor (85/85)
Hashiguchi et al. 2016 [30]	1 month of inpatient rehabilitation (gait, balance and task-specific training), 60 min/day, 5 days/week	No significant change in module number ()	Paretic muscle strength index and ankle range of motion correlated with the merging index; Strength β −0.558 (−1.26, −0.17); Range of ankle β −0.481 (−1.16, −0.07); BI correlated with the fractionalization index; β 0.577 (0.15, 4.84)	Gait speed significantly improved postrehabilitation ().	Paretic muscle strength index improved significantly postrehabilitation ().; BI, BBT, and TUG all had significant improvement postrehabilitation.
Routson et al. 2013 [32]	A 12-week, 36 session locomotor training program with body weight support and manual assistance	All subjects attained 4 modules postrehabilitation ()	Individuals with 4 modules pre- and postrehabilitation improved the timing of module 2 to match healthy controls ().; Module 2 composition differences were significantly different from healthy controls in individuals with 3 modules prerehabilitation; ().	Significant improvements in gait speed: (); preswing leg angle: (); Nonsignificant improvements in PP: (); PSR: (); Subjects with 3 modules prerehabilitation had increased step length, propulsion asymmetry, and reduced SS gait speed and preswing leg angle than controls ()	None reported

FES: functional electric stimulation; GRC: global rating change; BBT: Berg Balance Test; BI: barthel index; TUG: timed up and go; PP: paretic propulsion; PSR: paretic step ratio; SS: self-selected; FC: fastest comfortable; Paretic muscle strength index (N·m/kg): sum of hip flexor, knee extensor, knee flexor, ankle dorsiflexor, and ankle plantar flexor.