POST-STROKE CORTICOMOTOR DRIVE TO THE LOWER EXTREMITY:
RELATIONSHIP TO FUNCTIONAL RECOVERY AND RESPONSES TO
FUNCTIONAL ELECTRICAL STIMULATION
Jacqueline Palmer, Ph.D.
University of Delaware
Newark, DE
ABSTRACT: Despite current standard rehabilitation efforts, walking deficits that contribute to limitations in activity
and participation in individuals with chronic stroke persist. Previous research has identified key biomechanical factors that
limit post-stroke walking speed and, when improved through rehabilitation, enhance functional ambulation. However the
neurophysiologic mechanisms underlying highly variable post-stroke biomechanical strategies are unknown. There is
recent evidence that corticomotor input to the paretic arm and hand of individuals post-stroke is related to functional
performance, can be changed through motor learning, and can predict functional outcomes in response to
intervention. The strength of corticomotor input to muscles of the paretic and nonparetic leg following stroke has been
less thoroughly researched, but may provide valuable insight into neurophysiologic mechanisms underlying post-stroke
walking recovery. Additionally, positive changes in corticomotor input to the lower extremity could translate to improved
functional ambulation. The overall purpose of this project is to explain neurophysiologic mechanisms underlying lower
extremity clinical function (aim 1) and biomechanical outcomes (aim 2) following stroke, and to investigate corticomotor
responses and the ability to predict the effect of a rehabilitation session utilizing functional electrical stimulation (FES)
with gait training on changes biomechanical measures (aim 3). Results of this work will enhance our current
understanding of the neurophysiologic processes underlying motor recovery of the lower extremity following stroke and
is a first step towards providing guidance for future rehabilitation efforts focusing on individual patient deficits and
maximizing functional recovery of ambulation through appropriate targeted interventions.
___________________________________________________________________________
Jacqueline Palmer is a physical therapist and neuroscientist with a strong clinical background using laboratory research to
apply to clinical settings in neurologic rehabilitation. She received her Doctor of Physical Therapy (DPT) degree in 2013
and is currently working towards completion of her PhD in Biomechanics and Movement Science at the University of
Delaware (UD), Newark, DE. Her research focuses on the investigation of neurophysiologic and biomechanical factors
underlying motor control and recovery of walking, primarily in individuals post-stroke. Early in her career she has published
5 peer-reviewed articles in journals that include Journal of Neurophysiology and Neurorehabilitation and Neural
Repair and received 6 professional awards including a Professional Student Research Award from the APTA's Neurology
Section and a PODs Level II scholarship from the Foundation of Physical Therapy. In addition to her research, Jacqueline
also instructs the Electrotherapy laboratory course in UD's DPT program and serves as a part-time treating physical
therapist and clinical instructor in UD's Neurologic and Older Adults clinic. Her long-term professional goals are enhance
the understanding of motor control and recovery in a way that provides clinicians with tools and guidelines that will help
individualize patient treatment and maximize the effectiveness of rehabilitation in neurologic patient populations.