IMU Data-Driven and PCA-Based Approach to Establish Quantifiable and Practically Applicable Measures for V2 Technique Elements in Cross-Country Skiing.

Quantifying movement coordination in cross-country (XC) skiing, specifically the technique with its elemental forms, is challenging. Particularly, this applies when trying to establish a bidirectional transfer between scientific theory and practical experts' knowledge as expressed, for example, in ski instruction curricula. The objective of this study was to translate 14 curricula-informed distinct elements of the V2 ski-skating technique (horizontal and vertical posture, lateral tilt, head position, upper body rotation, arm swing, shoulder abduction, elbow flexion, hand and leg distance, plantar flexion, ski set-down, leg push-off, and gliding phase) into plausible, valid and applicable measures to make the technique training process more quantifiable and scientifically grounded. Inertial measurement unit (IMU) data of 10 highly experienced XC skiers who demonstrated the technique elements by two extreme forms each (e.g., anterior versus posterior positioning for the horizontal posture) were recorded. Element-specific principal component analyses (PCAs)-driven by the variance produced by the technique extremes-resulted in movement components that express quantifiable measures of the underlying technique elements. Ten measures were found to be sensitive in distinguishing between the inputted extreme variations using statistical parametric mapping (SPM), whereas for four elements the SPM did not detect differences (lateral tilt, plantar flexion, ski set-down, and leg push-off). Applicability of the established technique measures was determined based on quantifying individual techniques through them. The study introduces a novel approach to quantitatively assess V2 ski-skating technique, which might help to enhance technique feedback and bridge the communication gap that often exists between practitioners and scientists.

Is it possible to voluntarily increase hamstring muscle activation during landing from a snow jump in alpine skiing? - a pilot study.

Activation of the hamstrings has been discussed as a measure for reducing strain on the ACL during jump landings in alpine skiing. The current study tested the hypothesis that hamstring and quadriceps activation can be voluntarily increased by the athlete. Specifically, two different instructions - to increase hamstring activation or to increase upper-leg co-contraction - were compared to normal landings. Eight members of the German national and junior national squad in freestyle skiing (age 19.6 ± 3.8 years; weight 66.1 ± 13.2 kg; height 172.2 ± 7.7 cm) performed 12 jump landings on a prepared run, 4 with no specific instruction, 4 with the instruction to generally activate the thigh muscles, and 4 with the instruction to specifically activate the hamstrings. Electromyographic (EMG) signals were recorded on the biceps femoris (BF), semitendinosus (ST), vastus lateralis (VL), rectus femoris (RF) and vastus medialis (VM). EMG activation levels were integrated over three landing phases and analysed with a repeated measures ANOVA. The instruction produced a significant main effect in ST (p = .026), VM (p = .032) and RF (p = .001). Contrary to previous research, the current study suggests that hamstring muscle activation levels can be voluntarily increased during jump landing, particularly in co-activation with its antagonists.

The Effect of Cognitive Resource Competition Due to Dual-Tasking on the Irregularity and Control of Postural Movement Components.

Postural control research suggests a non-linear, n-shaped relationship between dual-tasking and postural stability. Nevertheless, the extent of this relationship remains unclear. Since kinematic principal component analysis has offered novel approaches to study the control of movement components (PM) and n-shapes have been found in measures of sway irregularity, we hypothesized (H1) that the irregularity of PMs and their respective control, and the control tightness will display the n-shape. Furthermore, according to the minimal intervention principle (H2) different PMs should be affected differently. Finally, (H3) we expected stronger dual-tasking effects in the older population, due to limited cognitive resources. We measured the kinematics of forty-one healthy volunteers (23 aged 26 ± 3; 18 aged 59 ± 4) performing 80 s tandem stances in five conditions (single-task and auditory n-back task; n = 1-4), and computed sample entropies on PM time-series and two novel measures of control tightness. In the PM most critical for stability, the control tightness decreased steadily, and in contrast to H3, decreased further for the younger group. Nevertheless, we found n-shapes in most variables with differing magnitudes, supporting H1 and H2. These results suggest that the control tightness might deteriorate steadily with increased cognitive load in critical movements despite the otherwise eminent n-shaped relationship.

Changed Temporal Structure of Neuromuscular Control, Rather Than Changed Intersegment Coordination, Explains Altered Stabilographic Regularity after a Moderate Perturbation of the Postural Control System.

Sample entropy (SaEn) applied on center-of-pressure (COP) data provides a measure for the regularity of human postural control. Two mechanisms could contribute to altered COP regularity: first, an altered temporal structure (temporal regularity) of postural movements (H1); or second, altered coordination between segment movements (coordinative complexity; H2). The current study used rapid, voluntary head-shaking to perturb the postural control system, thus producing changes in COP regularity, to then assess the two hypotheses. Sixteen healthy participants (age 26.5 ± 3.5; seven females), whose postural movements were tracked via 39 reflective markers, performed trials in which they first stood quietly on a force plate for 30 s, then shook their head for 10 s, finally stood quietly for another 90 s. A principal component analysis (PCA) performed on the kinematic data extracted the main postural movement components. Temporal regularity was determined by calculating SaEn on the time series of these movement components. Coordinative complexity was determined by assessing the relative explained variance of the first five components. H1 was supported, but H2 was not. These results suggest that moderate perturbations of the postural control system produce altered temporal structures of the main postural movement components, but do not necessarily change the coordinative structure of intersegment movements.

Functional Mobility and Dynamic Postural Control Predict Overhead Handball Throwing Performance in Elite Female Team Handball Players.

The relationship between dynamic postural control, functional mobility and team handball throwing performance, velocity and accuracy, is largely unknown. The hand reach star excursion balance test (HSEBT) is a full kinetic chain assessment tool of these factors. Specifically, L135 and R135 (extension) reaches elicit joint movement combinations similar to the cocking and acceleration phase, while the L45 and R45 (flexion) reaches elicit joint movement combinations similar to the follow-through. The purpose of this study was to determine if specific HSEBT reach measures correlate with team handball throwing performance. Eleven elite female team handball players (21.7 ± 1.8 years; 71.3 ± 9.6 kg; 1.75 ± 0.07 m) executed selected HSEBT reaches before performing five valid step-up overhead throws (1x1m target) from which throwing velocity (motion capture) and accuracy (mean radial error) were quantified. Significant relationships between HSEBT measures and mean radial error, but not throwing velocity were established. Specifically, extension composite scores (L135+R135) for the dominant (150.7 ± 17.4cm) and non-dominant foot (148.1 ± 17.5 cm) were correlated with mean radial error (p < 0.05). Also, specific reaches on the dominant (L135: 87.4 ± 5.6 cm; R135: 63.4 ± 11.8 cm) and non-dominant (R135: 87.0 ± 6.1 cm) foot were correlated with throwing error (p < 0.05). The lack of significant findings to throwing velocity might be due to a ceiling effect of both L135 and R135 and of throwing velocity. We conclude that while there may be other reasons for handball players to train and test functional mobility and dynamic postural control as measured in the HSEBT, no beneficial effect on throwing performance should be expected in an elite group of handball players.

Effects of a cognitive dual task on variability and local dynamic stability in sustained repetitive arm movements using principal component analysis: a pilot study.

In many daily jobs, repetitive arm movements are performed for extended periods of time under continuous cognitive demands. Even highly monotonous tasks exhibit an inherent motor variability and subtle fluctuations in movement stability. Variability and stability are different aspects of system dynamics, whose magnitude may be further affected by a cognitive load. Thus, the aim of the study was to explore and compare the effects of a cognitive dual task on the variability and local dynamic stability in a repetitive bimanual task. Thirteen healthy volunteers performed the repetitive motor task with and without a concurrent cognitive task of counting aloud backwards in multiples of three. Upper-body 3D kinematics were collected and postural reconfigurations-the variability related to the volunteer's postural change-were determined through a principal component analysis-based procedure. Subsequently, the most salient component was selected for the analysis of (1) cycle-to-cycle spatial and temporal variability, and (2) local dynamic stability as reflected by the largest Lyapunov exponent. Finally, end-point variability was evaluated as a control measure. The dual cognitive task proved to increase the temporal variability and reduce the local dynamic stability, marginally decrease endpoint variability, and substantially lower the incidence of postural reconfigurations. Particularly, the latter effect is considered to be relevant for the prevention of work-related musculoskeletal disorders since reduced variability in sustained repetitive tasks might increase the risk of overuse injuries.

Technique analysis in elite athletes using principal component analysis.

The aim of this study was to advance current movement analysis methodology to enable a technique analysis in sports facilitating (1) concurrent comparison of the techniques between several athletes; (2) identification of potentially beneficial technique modifications and (3) a visual representation of the findings for feedback to the athletes. Six elite cross-country skiers, three world cup winners and three national elite, roller ski skated using the V2 technique on a treadmill while their movement patterns were recorded using 41 reflective markers. A principal component analysis performed on the marker positions resulted in multi-segmental "principal" movement components (PMs). A novel normalisation facilitated comparability of the PMs between athletes. Additionally, centre of mass (COM) trajectories were modelled. We found correlations between the athletes' performance levels (judged from race points) and specific features in the PMs and in the COM trajectories. Plausible links between COM trajectories and PMs were observed, suggesting that better performing skiers exhibited a different, possibly more efficient use of their body mass for propulsion. The analysis presented in the current study revealed specific technique features that appeared to relate to the skiers' performance levels. How changing these features would affect an individual athlete's technique was visualised with animated stick figures.

Human Postural Control: Assessment of Two Alternative Interpretations of Center of Pressure Sample Entropy through a Principal Component Factorization of Whole-Body Kinematics.

Sample entropy (SaEn), calculated for center of pressure (COP) trajectories, is often distinct for compromised postural control, e.g., in Parkinson, stroke, or concussion patients, but the interpretation of COP-SaEn remains subject to debate. The purpose of this paper is to test the hypotheses that COP-SaEn is related (Hypothesis 1; H1) to the complexity of the postural movement structures, i.e., to the utilization and coordination of the mechanical degrees of freedom; or (Hypothesis 2; H2) to the irregularity of the individual postural movement strategies, i.e., to the neuromuscular control of these movements. Twenty-one healthy volunteers (age 26.4 ± 2.4; 10 females), equipped with 27 reflective markers, stood on a force plate and performed 2-min quiet stances. Principal movement strategies (PMs) were obtained from a principal component analysis (PCA) of the kinematic data. Then SaEn was calculated for the COP and PM time-series. H1 was tested by correlating COP-SaEn to the relative contribution of the PMs to the subject specific overall movement and H2 by correlating COP-SaEn and PM-SaEn. Both hypotheses were supported. This suggests that in a healthy population the COP-SaEn is linked to the complexity of the coordinative structure of postural movements, as well as to the irregularity of the neuromuscular control of specific movement components.

Time scale dependence of the center of pressure entropy: What characteristics of the neuromuscular postural control system influence stabilographic entropic half-life?

The center of pressure (COP) movement in studies of postural control reveals a highly regular structure (low entropy) over short time periods and a highly irregular structure over large time scales (high entropy). Entropic half-life (EnHL) is a novel measure that quantifies the time over which short-term temporal correlations in a time series deteriorate to an uncorrelated, random structure. The current study suggested and tested three hypotheses about how characteristics of the neuromuscular postural control system may affect stabilometric EnHL: (H1) control system activity hypothesis: EnHL decreases with increased frequency of control system interventions adjusting COP motion; (H2) abundance of states hypothesis: EnHL decreases with increased number of mechanically equivalent states available to the postural system; and (H3) neurologic process hierarchy hypothesis: EnHL increases if postural control functions shift from the spinal level to the motor cortex. Thirty healthy participants performed quiet stance tests for 90 s in 18 different conditions: stance (bipedal, one-legged, and tandem); footwear (bare foot, regular sports shoe, and rocker sole shoes); and simultaneous cognitive task (two-back working memory task, no challenge). A four-way repeated-measures ANOVA revealed significant changes in EnHL for the different stance positions and for different movement directions (medio-lateral, anterior-posterior). These changes support H1 and H2. Significant differences were also found between rocker sole shoes and normal or barefoot standing, which supports H3. This study contributes to the understanding of how and why EnHL is a useful measure to monitor neuromuscular control of balance.

Efficacy of hinged and carbon fiber ankle-foot orthoses in children with unilateral spastic cerebral palsy and drop-foot gait pattern.

BACKGROUND: In children with unilateral spastic cerebral palsy (USCP), ankle-foot orthoses (AFOs) are widely used to correct common gait deviations such as a drop-foot pattern. Most studies on this topic have investigated specific time points while omitting other parts of the gait cycle. OBJECTIVES: This study investigated the separate effects of prefabricated carbon fiber AFOs and custom-made hinged AFOs compared with barefoot walking in children with USCP with a drop-foot gait pattern using statistical parametric mapping. STUDY DESIGN: Retrospective, cross-sectional, repeated measures study. METHODS: Twenty ambulatory children (9.9 ± 2.5 years) with USCP and a drop-foot gait pattern were included. Kinematics, kinetics, and spatiotemporal parameters assessed during 3-dimensional gait analysis were compared between barefoot and AFO walking. Statistical parametric mapping was used to compare joint angles and moment waveforms. Kinematics, kinetics and spatiotemporal parameters assessed during 3-dimensional gait analysis were compared between barefoot and AFO walking for each AFO type but not between the 2 AFO types. RESULTS: Compared with barefoot walking, there was a steeper sole angle at initial contact, corresponding to a heel strike pattern, and an increased ankle dorsiflexion in swing with the use of both AFOs. The ankle plantar flexion moment during loading response increased. Ankle power generation during pre-swing decreased in the carbon fiber AFO group when walking with AFOs. CONCLUSIONS: Both AFOs were beneficial for improving a drop-foot gait pattern in these small patient groups and can, therefore, be recommended to treat this gait deviation in patients with unilateral cerebral palsy. However, the reduction in ankle power generation during push-off and additional goals targeted by AFOs, such as correction of structural or flexible foot deformities, should be considered for prescription.

Is screening for motor skill deficits in Tyrolean preschool children warranted and feasible? A protocol for a two-stage cross-sectional study.

INTRODUCTION: Children with developmental coordination disorder (DCD) show deviations in motor development and motor skills in early childhood where the learning and execution of coordinated motor skills are below the level expected for their age. Early detection of DCD is critical to provide an opportunity for intervention and support, yet many cases remain undetected until school age. The study described aims to determine the warranty, feasibility and validity of a mobility screening in Tyrolean kindergartens and evaluate its potential benefit to enhance the motor development prospects of affected children. METHODS AND ANALYSIS: This research employs a two-stage cross-sectional approach with 6 months of follow-up assessments. The initial stage involves a playful mobility screening for all participating kindergarten children, followed by individual assessments for those displaying conspicuous motor skills. Motor skills will be evaluated using MobiScreen 4-6 and the Movement Assessment Battery for Children-2. Prior to the screening, informed consent is obtained from kindergarten bodies and authorities, parents and the children themselves. Parents are provided with information sheets and questionnaires to assess their attitudes and their child's eligibility. The study described aims to form a representative sample of kindergarten children, aged 4-6, in Tyrol. To target approximately 20-40 children with DCD for follow-up, the goal is to include 650 children, assuming an incidence of 3%-6%. For the follow-up, matching control groups will be formed and information about how identified motor deficits were addressed, including therapies or sports, will be gathered. Quantitative data will mainly be analysed descriptively, while feedback from kindergarten teachers regarding the practical implementation will be analysed using qualitative content analyses, according to Mayring. ETHICS AND DISSEMINATION: The study has been approved by the Research Committee for Scientific Ethical Questions (RCSEQ 3369/24). Findings will be disseminated through contributions, peer-reviewed journals, and conferences.

Corrigendum: In-contest body acceleration profiles for the judo male and female weight divisions.

[This corrects the article DOI: 10.3389/fspor.2024.1372314.].

In-contest body acceleration profiles for the judo male and female weight divisions.

Introduction: This study aimed to determine the body accelerations (BA) profile of the judo contest of the male and female weight divisions and to ascertain the involvement of the vertical, mediolateral and anteroposterior axes in it. Methods: Forty-eight male and forty-eight female national and international level athletes (some of them medalists in World, European and national championships) participated in a 5-min simulated contest (official fight time plus breaks) against an opponent of the same sex and weight division, wearing an accelerometer. Heart rate, blood lactate and ratings of perceived exertion were recorded to certify that the athletes performed the fullest. Results: The t2way test expressed differences in the athletes' BA (p = 0.001) and three profiles were identified: the light/middle weight male divisions, the light/middle weight female divisions and the heavy male and female ones. Athletes of all weight divisions performed their BA during the contest in all three directions (the one-sample Person's chi-square did not detect any significantly predominant one: p = 0.400, p = 0.631, p = 0.844, p = 0.749, p = 0.644 and p = 0.895, for male light, moderate and heavy, female light, moderate and heavyweight athletes, respectively). Monte Carlo method simulations suggested as the most likely scenarios those with BA involving all axes, with a slight preference of the anteroposterior and mediolateral ones. Discussion: These results suggest that the demands on judo athletes in a contest differ between weight classes and sexes.

Focus of Attention in Coach Instructions for Technique Training in Sports: A Scrutinized Review of Review Studies.

Literature reports superior performance when focusing one's attention during a movement on environmental effects of that movement (external focus, EF) compared to focusing on the moving body (internal focus, IF). Nevertheless, IF instructions still play an important role in the daily practice of coaches, trainers, and therapists. The current review compiles evidence for focus-of-attention concepts on movement form corrections and technique training. Reviews on the topic and selected additional papers addressing the effect of attentional focus on movement form or on kinetic, kinematic or muscle activity data were included. Both EF and IF instructions affect movement form. The reviews revealed that IF instructions seem to be better applicable to direct movement form changes than EF instructions. In contrast, EF instructions better facilitate optimization within the whole-body coordination, often resulting in better performance outcomes not directly linked to movement pattern changes. Several studies discuss focus-of-attention effects in the context of the optimal feedback control theory expanding on the constrained action hypothesis. In summary, EF and IF instructions both affect form and performance of movements, however, their relative efficacy is situation dependent. The often-purported superiority of EF over IF instructions cannot be generalized to all application contexts.

Walking Stability and Risk of Falls.

Walking stability is considered a necessary physical performance for preserving independence and preventing falls. The current study investigated the correlation between walking stability and two clinical markers for falling risk. Principal component analysis (PCA) was applied to extract the three-dimensional (3D) lower-limb kinematic data of 43 healthy older adults (69.8 ± 8.5 years, 36 females) into a set of principal movements (PMs), showing different movement components/synergies working together to accomplish the walking task goal. Then, the largest Lyapunov exponent (LyE) was applied to the first five PMs as a measure of stability, with the interpretation that the higher the LyE, the lower the stability of individual movement components. Next, the fall risk was determined using two functional motor tests-a Short Physical Performance Battery (SPPB) and a Gait Subscale of Performance-Oriented Mobility Assessment (POMA-G)-of which the higher the test score, the better the performance. The main results show that SPPB and POMA-G scores negatively correlate with the LyE seen in specific PMs (p ≤ 0.009), indicating that increasing walking instability increases the fall risk. The current findings suggest that inherent walking instability should be considered when assessing and training the lower limbs to reduce the risk of falling.

Bilateral Deficits in Dynamic Postural Stability in Females Persist Years after Unilateral ACL Injury and Are Modulated by the Match between Injury Side and Leg Dominance.

Previous research has documented brain plasticity after an anterior cruciate ligament (ACL) tear and suggests that these neural adaptations contribute to poorer motor control. Since both brain hemispheres show adaptations, we hypothesized that reduced dynamic stability occurs not only in the injured, but also the contralateral, uninjured leg. Further, given brain hemispheric specialization's impact on motor coordination, we hypothesized the need to consider the injury side. A total of 41 female athletes and 18 controls performed single-leg jump-landings. Dynamic postural stability was measured as time-to-stabilization (TTS). We found reduced medio-lateral dynamic stability for the ACL injured leg (p = 0.006) with a similar trend for the contralateral leg (p = 0.050) compared to the control group. However, when distinguishing between injuries to the dominant and non-dominant legs, we found increased medio-lateral TTS only if the injury had occurred on the dominant side where landings on injured (p = 0.006) and contralateral (p = 0.036) legs required increased TTS. Assessments of dynamic stability, e.g., in the context of return-to-sport, should consider the injury side and compare results not only between the injured and the contralateral leg, but also to uninjured controls. Future research should not pool data from the dominant-leg ACL with non-dominant-leg ACL injuries when assessing post-injury motor performance.

Ergonomic saddle design features influence lumbar spine motion and can reduce low back pain in mountain biking.

Low back pain is common in mountain biking due to the sustained flexion of the lumbar spine, particularly during fatiguing hill climbs. In this study, we investigated whether an ergonomic mountain bike saddle including a raised rear, a longitudinal dip, and a subtle lateral instability (the 'Active'-technology) can reduce acute low back pain at the end of a hill climb (>1 h) in a group of mountain bikers with a history of cycling-related low back pain (n = 28). In addition, we conducted a laboratory experiment to investigate the isolated effects of the 'Active'-technology on the cyclists' pelvis and spine motion as well as on the activity of surrounding muscles. The field test demonstrated a significant reduction in numerical low back pain ratings with the experimental saddle compared to the riders' own standard saddle (p = 0.001, strong effect). The laboratory-based data suggested that the 'Active'-technology does lead to potentially beneficial effects on pelvis-spine kinematics and muscle activity, which in combination with an optimised saddle geometry may explain the observed reduction in low back pain following mountain bike hill climbing.

Distinct coordination patterns integrate exploratory head movements with whole-body movement patterns during walking.

Visual guidance of gait is an important skill for everyday mobility. While this has often been studied using eye-tracking techniques, recent studies have shown that visual exploration involves more than just the eye; head movement and potentially the whole body is involved for successful visual exploration. This study aimed to assess coordinative patterns associated with head movement and it was hypothesized that these patterns would span across the body, rather than being localized. Twenty-one (after exclusions) healthy young adult volunteers followed a treadmill walking protocol designed to elicit different types of head movements (no stimuli compared to stimuli requiring horizontal, vertical, and mixed gaze shifts). Principal Component Analysis was used to establish whole-body correlated patterns of marker movement (Principal Movements; PMs) related to the activity of the head. In total 37 higher order PMs were found to be associated with head movement, two of these showed significant differences between trials associated with strong head rotations in the horizontal and sagittal plane. Both of these were associated with a whole-body pattern of activity. An analysis of the higher order components revealed that exploratory head movements are associated with distinct movement patterns, which span across the body. This shows that visual exploration can produce whole-body movement patterns that have a potentially destabilizing influence. These findings shed new light on established results in visual search research and hold relevance for fall and injury prevention.

Mountain Hiking: Prolonged Eccentric Muscle Contraction during Simulated Downhill Walking Perturbs Sensorimotor Control Loops Needed for Safe Dynamic Foot-Ground Interactions.

Safe mountain hiking requires precise control of dynamic foot-ground interactions. In addition to vision and vestibular afferents, limb proprioception, sensorimotor control loops, and reflex responses are used to adapt to the specific nature of the ground contact. Diminished leg dexterity and balance during downhill walking is usually attributed to fatigue. We investigated the supplementary hypothesis that the eccentric contractions inherent to downhill walking can also disrupt muscle proprioception, as well as the sensorimotor control loops and reflex responses that depend on it. In this study, we measured leg dexterity (LD), anterior-posterior (AP) and medio-lateral (ML) bipedal balance, and maximal voluntary leg extension strength in young and healthy participants before and after 30 min of simulated downhill walking at a natural pace on a treadmill at a 20° decline. Post-pre comparisons of LD (p < 0.001) and AP balance (p = 0.001) revealed significant reductions in dynamic foot-ground interactions after eccentric exercise without an accompanying reduction in leg extension strength. We conclude that eccentric contractions during downhill walking can disrupt the control of dynamic foot-ground interactions independently of fatigue. We speculate that mountaineering safety could be improved by increasing conscious attention to compensate for unadjusted proprioception weighting, especially in the descent.

Do Bernstein's Stages of Learning Apply after Stroke? A Scoping Review on the Development of Whole-Body Coordination after Cerebrovascular Accidents.

Stroke is one of the leading causes of disability around the world, presenting unique challenges in motor development during the rehabilitation process. Based on studies in movement and sports science, thorough knowledge has accumulated on the development of movement skills. Through the works of Nikolai Bernstein, it has been established that when learning new skills, people tend to first simplify coordination by 'freezing' their degrees of freedom, after which they start building efficiency by 'releasing' specific degrees of freedom. If a similar pattern of development can be established post-stroke, it would imply that lessons learned in sports skill acquisition can also be implemented to optimize stroke rehabilitation. The current scoping review aims to assess whether the Bernsteinian freezing-to-releasing stages of learning also apply to developing whole-body movement skills after stroke. To this end, we systematically screened the existing literature for studies involving a longitudinal measure of whole-body coordination after a stroke. Only five articles met the criteria for inclusion, indicating a gap in research on this topic. Based on the observations within these articles, we could neither confirm nor reject whether the freezing-to-releasing process can apply after a stroke. We could, however, hypothesize a detailed description of the freezing-to-releasing process, which can be assessed in future works.