335 Ischemic conditioning improves dynamic balance during treadmill walking in chronic stroke survivors

Abstract

OBJECTIVES/GOALS: Evaluate the use of IC to improve stroke survivors’ capacity for reactive stepping and adapt their gait cycles in response to a difficult walking environment. We hypothesize that IC will improve stroke survivors’ protective stepping response via improvements in muscle activation and motor learning METHODS/STUDY POPULATION: Stroke survivors have an impaired capacity for protective stepping. Decreased paretic muscle activation results in increased reaction time and reduced force generation. Ischemic conditioning (IC) is a vascular stimulus which improves motor performance in chronic stroke. It is performed by delivering transient, intermittent bouts of ischemia to a limb. It has been demonstrated that IC increases muscle activation post-stroke. 9 chronic stroke survivors completed 3 testing sessions and 7 intervention sessions. Participants walked on an instrumented treadmill and were perturbed unilaterally every step at the waist via a cable pulley system. Kinetic and kinematic data were collected. Step width was measured as the difference in position of the heel markers at the instant of heel strike in the frontal plane. RESULTS/ANTICIPATED RESULTS: After one and seven sessions of IC, controls did not alter their responses from baseline testing, but stroke survivors increased their step width by an average of 15% and 23% respectively. DISCUSSION/SIGNIFICANCE: Ischemic conditioning may be a useful intervention to improve stroke survivors’ ability to adapt their paretic foot placement in response to lateral perturbations during gait. Interventions which optimize muscle activation and neural adaptation could significantly improve balance post-stroke.