BACKGROUND AND PURPOSE Therapeutic exercise improves balance and walking ability in individuals after stroke. The extent to which motor planning improves with therapeutic exercise is unknown. This case series examined how outpatient physical therapy affects motor planning and motor performance for stepping. CASE DESCRIPTION Individuals poststroke performed self-initiated stepping before (baseline), after (postintervention), and 1 month after (retention) intervention. Amplitude and duration of the movement-related cortical potential (MRCP) was measured using an electroencephalograph from the Cz electrode. Electromyography (EMG) of biceps femoris (BF) was collected. Additionally, clinical measures of motor impairment and function were evaluated at all 3 time points by a blinded assessor. INTERVENTION Two types of outpatient physical therapy were performed for 6 weeks: CONVENTIONAL (n = 3) and FAST (n = 4, Fast muscle Activation and Stepping Training). OUTCOMES All 7 participants reduced MRCP duration, irrespective of the type of physical therapy. The MRCP amplitude and BF EMG onset changes were more variable. Clinical outcomes improved or were maintained for all participants. The extent of motor impairment was associated with MRCP amplitude. DISCUSSION Changes in MRCP duration suggest that outpatient physical therapy may promote neuroplasticity of motor planning of stepping movements after stroke; however, a larger sample is needed to determine whether this finding is valid.This case series suggests motor planning for initiating stepping may improve after 6 weeks of outpatient physical therapy for persons with stroke.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A307).

中文翻译：

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中风后开始踏步的皮质规划的神经可塑性

背景和目的 治疗性运动可改善中风后个体的平衡能力和步行能力。运动计划在治疗性运动中的改善程度尚不清楚。本案例系列研究了门诊物理治疗如何影响运动计划和步进运动表现。案例描述 卒中后个体在（基线）干预前、干预后（干预后）和（保留）干预后 1 个月进行自我启动的踏步。使用来自 Cz 电极的脑电图仪测量运动相关皮层电位 (MRCP) 的幅度和持续时间。收集股二头肌 (BF) 的肌电图 (EMG)。此外，由盲法评估员在所有 3 个时间点评估运动损伤和功能的临床测量。干预 两种类型的门诊物理治疗进行了 6 周：常规（n = 3）和快速（n = 4，快速肌肉激活和步进训练）。结果 所有 7 名参与者都减少了 MRCP 持续时间，无论物理治疗的类型如何。MRCP 振幅和 BF EMG 起始变化更易变。所有参与者的临床结果都得到改善或保持。运动障碍的程度与 MRCP 振幅相关。讨论 MRCP 持续时间的变化表明门诊物理治疗可能会促进卒中后步进运动的运动规划的神经可塑性；然而，需要更大的样本来确定这一发现是否有效。该病例系列表明，中风患者在门诊物理治疗 6 周后，开始踏步的运动计划可能会有所改善。